Chikungunya Club Meeting (7.24.2026)
Dr. Jack Cush reviews the news, journal reports from the past week on RheumNow.com.
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"Gout, unlike any other disease, kills more rich men than poor, more wise men than simple." — Thomas Sydenham
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Pragmatism in Gout: How therapeutic choices can have multiple benefits
William James famously wrote in Pragmatism, “There can be no difference anywhere that doesn’t make a difference elsewhere.” Gout treatment offers a striking medical example of that idea. https://t.co/DG29pro6XE
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The Hidden Cost of Gout
For many people, gout is viewed as an episodic disease: a painful flare, a short course of treatment, and then life returns to normal. However, as rheumatologists, we know that recurrent attacks can lead to joint damage and tophi if left untreated. https://t.co/RWTp5KKkyw
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Fibromyalgia: Diagnosis and Management
https://t.co/L9nA1TlJKx https://t.co/G4bkxTsXCt
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Swimming Reduces Diability from Low Back Pain
EurekAlert!
Swimming is commonly recommended for patients with chronic low back pain. Yet, there is little trial data investigating swimming. An Australian study has shown for the first time that a program of swimming can be clinically effective in reducing disability from chronic low back pain
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QD Clinic: Gout: Is it the Journey or the Destination?
Dr. Arthur Kavanaugh discusses a gout patient whose frequent flares improved after lifestyle changes, despite medication not being enough on its own.
https://t.co/frf4O87L0I https://t.co/cjtiYY9Ayt
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Gout patients are at greater risk for dementia, sleep apnea, septic arthritis and erectile dysfunction.
For more gout content, follow our Gout: More than Flares campaign at https://t.co/lQoiFjubZJ, https://t.co/p4WQ1GCB68
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Fibromyalgia: Diagnosis and Management
Fibromyalgia (FM) affects 4–6% of the U.S. population, with nearly a 2 fold female predominance. Nociplastic pain underlies the pathophysiology of FM. CNS hypersensitization to both painful and non-painful stimuli occurs with little or no tissue pathology. Framing FM as a disorder of CNS
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Why Do Gout Flares Start at Night?
The striking propensity for gout flares to initiate at night has been recognized for centuries. More recent epidemiological research supports this observation, indicating that the risk of a gout flare is more than twice as high in the early https://t.co/FbCUmXEl2y
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Psoriatic Arthritis: EULAR 2026 Recap
Years of IL-17 vs. IL-23 debate in PsA finally got tested head-to-head: bimekizumab outperformed risankizumab on joint outcomes in the BE BOLD trial, while a GLP-1 combination study suggests weight and metabolic status are active drivers of PsA — not just comorbidities. This recap also digs into
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Genicular artery embolization for knee OA does not work in a 12-mos randomized sham-controlled trial of 58 pts. Pain scores improved equally in both groups https://t.co/7wwmzpTaNL https://t.co/8MsRXqKDo2
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ACP Position Paper on Dietary Supplements
More than half of U.S. adults use dietary supplements, yet only a quarter use supplements recommended by a healthcare professional, and current law lets supplements reach the market with no premarket safety evaluation, unlike drugs or food additives. The paper notes that under DSHEA, dietary
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Do we need Better Strategies to Prevent Osteoporotic Fractures?
In a recent JAMA Viewpoints article, Dr. Susan Ott addresses several controversies in preventing osteoporosis (OP) related fractures.
https://t.co/YpmyZGCsjz https://t.co/NUkJVcxBjc
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New research shows synovial lining enriched in macrophages expressing SPP1 (encoding osteopontin) in proximity to fibroblasts and fibrin deposits. SPP1+ macrophages degrade fibrin & promote fibroblast proliferation that deposit collagen & does the damage, joint remodeling. A new https://t.co/yFxwAYFPPb
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Updated Algorithm for the Management of Restless Legs Syndrome
Diagnose: chronic vs intermittent RLS (no need for polysomnography)
Test Iron levels (& Rx if)
Consider: remove exacerbators; walking/massage/heat; carbidopa/ levodopa; pramipexole or ropinirole; low potency opioids; https://t.co/XdzIipw1X8
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QD Clinic: Cellulitis Paradoxes
Dr. Richard Conway, Dublin, discusses a case of cellulitis and gout. Presented as part of RheumNow's "Gout: More than Flares" campaign during the month of July 2026.
https://t.co/ZeYyISJrrE https://t.co/2Ih4QRa7FK
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QD CLINIC: Senior Year Gout
Daric Mueller, PA-C, discusses a case of difficult-to-treat gout in an individual first diagnosed at age 18 who is now in his early 30s. This QD Clinic is presented as part of RheumNow's "Gout: More than Flares" campaign.
https://t.co/9GNk8ZqwyS https://t.co/hAFz6zPcay
Dr. John Cush @RheumNow( View Tweet )
Weight loss helps gout, but extreme weight loss (bariatric surgery, ketogenic diets) may trigger gouty attacks. (Not seen with GLP-1 agonist weight loss)
For more gout content, follow our Gout: More than Flares campaign at https://t.co/xnBVBN5IXZ, https://t.co/LGEENexSZ6
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The Power of Self-Management with Chronic Low Back Pain
Almost everyone will deal with back pain at some point in their lives. Most recover quickly — but for about 20% of people, acute pain becomes a chronic condition that interferes with daily life and keeps them out of the https://t.co/urZPsVwCV8
Dr. John Cush @RheumNow( View Tweet )
The Power of Self-Management with Chronic Low Back Pain
EurekAlert!
Almost everyone will deal with back pain at some point in their lives. Most recover quickly — but for about 20% of people, acute pain becomes a chronic condition that interferes with daily life and keeps them out of the workforce
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RheumIQ: True or False: In the NORD-STAR trial, failure to achieve early remission in RA was associated with a significantly increased risk of fibromyalgic RA at 48 weeks. Find out if you got it right at https://t.co/z8mLbcgE5D. https://t.co/vkusOYHcQj
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RT @rheumarampa
"There’s more work to do” as Dr. Floris van Gaalen summarizes the challenges in peripheral SpA
-pSpA has limited lab value testing like imaging, clinical diagnosis
- few clinical trials to support tx guidelines
- SPARTACUS trial: GOL vs. MTX in early pSpA
Dr. John Cush @RheumNow( View Tweet )
RT @aurelierheumo Failure to achieve early remission RA asso w/ non-inflammatory pain
NORD-STAR 526 early RA pts)
no remission at 24 wks increased risk of 48wk
• unacceptable pain (OR ~6)
• refractory pain (OR ~6)
• fibromyalgic RA (OR ~16)
Signal strongest w/ very early
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Which is NOT a key feature of inflammatory back pain: relief with activity; morning stiffness; age under 40 years; unilateral pain? Test your knowledge in this week's RheumIQ quiz at https://t.co/z8mLbcgE5D. https://t.co/tOdPfEBJa4
Dr. John Cush @RheumNow( View Tweet )
Recent Blogs
Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice.
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I have been investigating the mechanisms of antinuclear antibody (ANA) expression in SLE since 1978. In this pursuit, I have followed the advice of my first division chief, Dr. Ralph Snyderman, a great academician. Ralph told me to identify a research focus and make it mine. I think I have done reasonably well in my mission so you can imagine my surprise (and excitement) when, for the Lupus 2025 meeting in Toronto, I was asked to conduct a Meet the Professor session on the Type 1 & 2 model for SLE.
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