Diagnosing Neuropsychiatric SLE (5.23.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com - including views on the vagus nerve, NPSLE and CAR-T mania.
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Lancet viewpoint on early imaging in axial SpA. Over-reliance on BM edema = incr in misDx. Newer tech (high-res sequences, quantitative MRI, radiomics, artificial intelligence) may improve Dx precision. Remember the SI is susceptible to mechanical stress https://t.co/E80GyQGIM0 https://t.co/csQrBPHAlM
Dr. John Cush @RheumNow( View Tweet )
An excellent presentation from Dr Pankti Mehta @PanktiMehta24
Re #Jaccoud’s
With
#IFN signature
if #erosive IA - often + CCP / RF
Vs
nonerosive often +RNP
@RheumNow #LUPUS2025 https://t.co/y6z4KbhCdy
Janet Pope @Janetbirdope( View Tweet )
The ANA pattern I hate
#DFS
Why
Dense fine speckled should R/O #SLE
But mimicking patterns that MAY Have #lupus
AC-2 pattern mimickers ex AC-4
Machine learning models to help
▶️improved accuracy
Fast saving hrs
#Artificial #intelligence
May Choi #LUPUS2025 @RheumNow https://t.co/9tk80ZOAWg
Janet Pope @Janetbirdope( View Tweet )
Subclinical #arthritis in #SLE
Do we look for it?
Should we care?
Certainly seems to exist on #MRI hands
More changes of course if tender joints
Not sure of clinical relevance
Optical imaging and POCUS was compared
#LUPUS2025 @RheumNow
ANCA Askanase presents
Janet Pope @Janetbirdope( View Tweet )
Assessing neuropsychiatric SLE by 3-T, 3D contrast-enhanced vessel wall imaging. 47 w/ NPSLE vs 42 without (just SLE) showed the NPSLE had 2 fold more 1ntracranial contrast-enhanced vessel wall imaging (CE-VWI) w/ AUC 0.78 for CE-VWLs, & sensitivity 60% , specificity 87%.
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Lupus in an empty house
The full house immunofluorescence pattern is the classic histopathologic finding of lupus and lupus nephritis. Glomerular deposits staining for IgG, IgA, IgM, C3 and C1q can help confirm a suspected diagnosis of systemic lupus erythematosus (SLE). This https://t.co/DQWwRJmdqM
Dr. John Cush @RheumNow( View Tweet )
Vitamin D Headlines (5.9.2025)
Dr. Jack Cush reviews the news, journal reports and lupus highlights from the past week on RheumNow.com. Triple positivity, the gut and CRPS, and hope for better outcomes with Vitamin D therapy.
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Pitfalls in sacroiliitis imaging: Bone marrow edema may also be seen in young-middle-aged postpartum women, & athletes & kids (ongoing bone growth) & w/ advancing age (DJD) https://t.co/bwS047wlmI https://t.co/pqI3xTYtCz
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Finish Birth Cohort followed since 1986, who were asymptomatic, found abnormal MRI knee findings, esp cartilage defects in the patellofemoral (56%) & tibiofemoral joints (25%) joints. Small/doubtful patellofemoral (52%) & tibiofemoral (17%) osteophytes seen. Most w/ High BMI. https://t.co/nQKREE4XfU
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Pitfalls in sacroiliitis imaging: Bone marrow edema may also be seen in young-middle-aged postpartum women, & athletes & kids (ongoing bone growth) & w/ advancing age (DJD) https://t.co/bwS047wlmI https://t.co/FvWlEcZ5JP
Dr. John Cush @RheumNow( View Tweet )
Rheumatologist Survey: What do you rely on to diagnose neuropsychiatric lupus (cerebritis)?
Dr. John Cush @RheumNow( View Tweet )
Keys to Mastery (5.2.2025)
Dr. Jack Cush reviews the news, articles and drug approvals from the past week on RheumNow.com. This podcast marks the beginning of our Lupus Campaign called "Lupus Unlocked: Keys to Mastery". This month's campaign on Lupus is sponsored by Aurinia.
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Osteoarthritis Initiative (OAI) longitudinal study analyzed 1075 #OA knees (1/pt) in 96 mo. MRI study to predict outcomes. Infrapatellar fat pad (IPFP volume & signal) predicted future knee replacement & long-term damage. IPFP correlated w/ cartil. volume & BM lesions; Not Sxs. https://t.co/Xsju7JdEVE
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RHEUMATOLOGIST Survey: What are your contraindications tor renal Bx?
Dr. John Cush @RheumNow( View Tweet )
RHEUMATOLOGIST Survey: What are your contraindications tor renal Bx?
Dr. John Cush @RheumNow( View Tweet )
Osteoarthritis Initiative (OAI) longitudinal study analyzed 1075 #OA knees (1/pt) in 96 mo. MRI study to predict outcomes. Infrapatellar fat pad (IPFP volume & signal) predicted future knee replacement & long-term damage. IPFP correlated w/ cartil. volume & BM lesions; Not https://t.co/VrLfiSGWGA
Dr. John Cush @RheumNow( View Tweet )
Simplistic overview of Lupus Nephritis - causes, risk factors, symptoms, diagnosis, and treatment of lupus nephritis. https://t.co/QkLXUQcSqo https://t.co/pGjCHmoelG
Dr. John Cush @RheumNow( View Tweet )
Hip replacement outcomes are not linked to OA severity, instead pts muscle quality before THA best predicts recovery after surgery. Imaging of 10 pts undergoing THA showed poor muscle quality predicted post-op performance/movement after surgery https://t.co/io0UXQl6n2 https://t.co/cFM7Fg10Zm
Dr. John Cush @RheumNow( View Tweet )
Hip replacement outcomes are not linked to OA severity, instead pts muscle quality before THA best predicts recovery after surgery. Imaging of 10 pts undergoing THA showed poor muscle quality predicted post-op performance/movement after surgery https://t.co/io0UXQl6n2 https://t.co/eI7u6BTPYx
Dr. John Cush @RheumNow( View Tweet )
Ultrasound lesions of dactylitis associ w/short-term development of PsA. Study of 64 PsO +arthralgia pts. IUS PD synovitis & B mode enthesitis predicted PsA Dx (p < .001) w/ an accuracy of 89.1 %, a sensitivity of 86.7 % and a specificity of 89.8 %. https://t.co/KoXMmoxXhP https://t.co/tj2NxKDkqh
Links:
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Distinguishing Septic and Gouty Arthritis
A single center, retrospective review of patients undergoing knee joint fluid aspirations for presumed crystalline arthritis (CA) showed that synovial WBC may provide a useful diagnostic marker for SA with an optimal threshold of 50,000 https://t.co/ye69mRooSh
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Genomics and Future Drug Targets for Osteoarthritis
A Nature article details the results of an osteoarthritis, genome-wide association study meta-analyses across up to 489,975 cases and 1,472,094 controls, establishing 962 independent associations, 513 of which have not been https://t.co/OYyePkAeAM
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Osteoarthritis Risky Business (4.18.2025)
Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com. Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.
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