APPs in the News (12.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salary concerns.
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ICYMI: MSK Evaluation
https://t.co/QuHWcv6zAc https://t.co/0n5A1EtL9c
Dr. John Cush @RheumNow( View Tweet )
Simple, low-cost strategy to Dx/Prognose GCA using CBC components NLR & PLR. 119 GCA vs 131 non-GCA pts - All CBC biomarkers signif assoc w/ ESR & CRP, but ESR/CRP did not predict mortality over time; YET mortality signif predicted by PLR, NLR, MLR (P value < 0.044) https://t.co/96Q7jDAiWt
Dr. John Cush @RheumNow( View Tweet )
I agree that multiple assessments are needed to Dx NP-SLE; but my order of preference (for Dx yield) is: A) Hx c/w cerebritis; B) imaging to r/o other causes; C) CSF IgG index w/ Q albumin
Dr. John Cush @RheumNow( View Tweet )
Coccyx and Sacrococcygeal Joint Disorders
Pain from coccygeal or sacrococcygeal disorders is rare, often presenting as a diagnostic challenge. Coccygeal pain is often mistaken for lumbosacral, pelvic, or gastrointestinal disorders. This review presents the epidemiology, anatomy, biomechanics, presentations, diagnostic evaluation,
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CorEvitas observational registry of 3,696 w/ psoriatic arthritis (no hx of CV eents), followed for mean 3.7 yrs, showed that Dactylitis and enthesitis did not predict future CV events. But Dactylitis and enthesitis and Synovitis were all significantly interrelated. Cureus 17(11): https://t.co/kPgGKliUUs
Dr. John Cush @RheumNow( View Tweet )
APEX Study: Inhibition of structural damage progression with Guselkumab in Psoriatic Arthritis
Guselkumab, a human IL-23 inhibitor, was evaluated in patients with active psoriatic arthritis (PsA) and shown to have both clinical and radiographic benefits at weeks 24 and 48.
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Seeking Musculoskeletal Care
A report entitled The Burden of Musculoskeletal Diseases in the United States (BMUS) report was published by the US Bone and Joint Decade (USBJD) with input from rheumatology, orthopedic surgery, physical medicine and rehabilitation regarding musculoskeletal care.
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Deep Learning Model Accurately Detects Ankylosing Spondylitis on MRI
AI continues to move from research labs into rheumatology clinics, promising to reshape how inflammatory diseases are diagnosed and monitored. AS, in particular, poses a diagnostic challenge—its early imaging https://t.co/TH2YIiPPEq
Dr. John Cush @RheumNow( View Tweet )
More on Methotrexate and ILD Risk
To assess the progression of the interstitial lung disease related to Methotrexate (MTX) exposure, and to evaluate the lung involvement in RA non-ILD patients with MTX exposure, a systematic review was performed to assess whether RA patients receiving methotrexate (MTX) are at greater
Diagnostic Delays in PsA: A Radiographic Perspective
Dr. Brian Jaros reports on abstract 1713 (Diagnostic Delay in Psoriatic Arthritis and its Impact on Radiological Outcomes: A Systematic Review and Meta-analysis of 23,894 Patients), presented at #ACR25. https://t.co/iLllm7DcCF
Dr. John Cush @RheumNow( View Tweet )
Bone Density in Ankylosing Spondylitis
At #ACR25, a retrospective study from China tackled this challenge using quantitative computed tomography (QCT), a more precise imaging modality that measures true volumetric bone density unaffected by cortical ossifications. https://t.co/1Z5cshkqjt
Dr. John Cush @RheumNow( View Tweet )
PET Uptake in Large Vessel GCA – Does tocilizumab help?
Giant cell arteritis (GCA) is the most common form of adult vasculitis in the United States and can be subdivided into those with cranial only symptoms, those with large vessel vasculiti/PMR, and those with mixed features. Non-invasive imaging is key in detecting large vessel
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Taking a closer look: B-Cell depletion beyond the blood
Following the landmark case series by the Erlangen group, multiple cellular therapies have entered the race—each with unique targets, constructs, and mechanisms. Yet, a fundamental question remains: How deep is the B-cell depletion? In clinical practice, peripheral blood counts often serve as
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Deep Learning Model Accurately Detects Ankylosing Spondylitis on MRI
AI continues to move from research labs into rheumatology clinics, promising to reshape how inflammatory diseases are diagnosed and monitored. Ankylosing spondylitis, in particular, poses a diagnostic challenge—its early imaging findings are subtle, and radiographic changes may take years to
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Not only lovely work @TheLancetRheum from @jeffsparks and friends, but they have some AI imaging work up tomorrow from the same SAIL-RA cohort, showing the spectrum of impact in all RA patients, using radiomics.
Check it out #ACR25 ABST1751 @RheumNow
https://t.co/TlmHOOpNNp https://t.co/P62RXI8ePQ
Links:
David Liew @drdavidliew( View Tweet )
Catching AxSpA Early: Closing the Diagnostic Gap
Dr. Akhil Sood reports on abstract 2635 and abstract 2636 presented at #ACR25.
https://t.co/TmJQKQUu9E https://t.co/6dWf8DY2W3
Dr. John Cush @RheumNow( View Tweet )
Psoriatic Arthritis Imaging
Dr. Arthur Kavanaugh talks about imaging in psoriatic arthritis at #ACR25
https://t.co/l6MKTgEJXu https://t.co/sKhoQWCPli
Dr. John Cush @RheumNow( View Tweet )
From Fitbit to first diagnosis: AI is rewriting the RA playbook
Two studies presented at this year’s #ACR25 meeting highlight just how close we may be to a future where algorithms flag disease before we can and monitor activity with minimal patient burden. https://t.co/8AwBZkyZIW
Dr. John Cush @RheumNow( View Tweet )
#Urinary #biomarkers #lupus #nephritis
#Tenascin C -suggests repair, fibrosis, progress of #LN
#IL16, #CD163, & more for LN activity
Sometime a biomarker may replace repeat #kidney #biopsies?
#AMP group #Accelerated #Medicines #Program
#ACR24 @ACRheum @RheumNow abst#851
Janet Pope @Janetbirdope( View Tweet )
#2686 Using HR-pQCT, researchers tracked bone changes in RA & PsA. Seropositive RA showed worst bone density & microstructure, worsening with disease activity. TNFi, RTX & BARI improved MCP bone density, highlighting the impact of inflammation and treatment. @RheumNow #ACR25
Mrinalini Dey @DrMiniDey( View Tweet )
#2702 @ClevelandClinic Vascular ultrasound (VUS) for suspected GCA showed excellent specificity (100%) but low sensitivity (21%) compared with 6m confirmed diagnosis.
Fair agreement with TAB (κ=0.64).
Findings highlight need for standardised VUS protocols in US. @RheumNow #ACR25 https://t.co/LRFpFBnWWz
Mrinalini Dey @DrMiniDey( View Tweet )
Lots of interest in MRI for GCA diagnosis... but what about monitoring?
Case series of 14 pts: MRI identified relapse prior to symptoms or inflammatory markers in 2 cases, including those on TCZ, which hides them
More available in US context, noninvasive, & more structures https://t.co/pnrI9SEpll
Mike Putman @EBRheum( View Tweet )
In early axSpA vs non-axSpA CBP, 2 year spinal x-ray progression was minimal in both groups. But on MRI, fat lesions increased significantly in axSpA (0.16 units/yr vs –0.02), with 15% having ≥3 lesions at 2 year vs 1% in non-axSpA. Fat lesions may signal early structural https://t.co/zvgU1Gt0po
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Observational study from VCRC AAV patinet, >70% had pulm involvement at some point
As expected, nodules favor GPA (63% vs 12% MPA) & DAH favors MPA (61% vs 31%)
More ILD in MPA (11% vs 1%) & more endobronchial in GPA (12% vs 2%)
Helpful pearls!
@RheumNow #ACR25 Abstr#0721 https://t.co/Iu5MdiTABR
Mike Putman @EBRheum( View Tweet )
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