Imaging

Is Giant cell arteritis over diagnosed or over-referred? Caution IF the patient is: 1) under age 50yrs; 2) has Hx of chronic HA or migraine; 3) has normal ESR/CRP. Why not consider screen w/ Giant Cell Arteritis Probability Score (needing 9.5/32 points) https://t.co/qnCWgzjYJ4 https://t.co/LT6atm0m8f

Links:

Dr. John Cush @RheumNow( View Tweet )
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3 Months of Romosozumab in Postmenopausal Osteoporosis

Jack Cush, MD

A report in The Lancet Diabetes & Endocrinology suggested that 3 months of romosozumab (ROMO) followed by denosumab is as effective at increasing hip bone mineral density (BMD) as the standard 12-month course.

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Paradoxical Reactions, Target Selection & the Future of Imaging in Psoriatic Care At RheumNow Live, Dr. Joseph Merola presented a compelling discussion on paradoxical immune reactions in psoriatic disease. He began with a case of a 60-year-old woman with mild psoriasis who, https://t.co/AVIOO42vfP
Dr. John Cush @RheumNow( View Tweet )
The vasculitis session at #RNL26 was a fantastic update on inflamed blood vessels, large and small, by two experts in the field. https://t.co/KuVei8jiFu https://t.co/47cI4WSSkU

Links:

Dr. John Cush @RheumNow( View Tweet )
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Diagnosing and Managing GCA and Takayasu’s Arteritis

Adela Castro, MD

Giant-cell arteritis and Takayasu’s arteritis are both large-vessel vasculitides, but each brings its own diagnostic and management challenges. Many of the difficulties overlap because they are rare, heterogeneous, and lack perfect diagnostic tests or specific biomarkers.

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Ortho v Rheum

Referrals - Orthopedics or Rheumatology?

Jack Cush, MD

“Orthopedics or rheumatology, who should I see?" A question, often asked with urgency, posed by those who genuinely don’t know who to see for a musculoskeletal (MSK) complaint.  Inquiring patients, family, or other physicians may be one forum for such a request. Another occurs in the

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Paradoxical Reactions, Target Selection & the Future of Imaging in Psoriatic Care

Audrey Gibson, PA-C

From paradoxical psoriasis to IL-23 vs IL-17 to imaging in PsA, speakers in RheumNow Live's "Decisions in Psoriatic Arthritis" pod delivered valuable, clinically relevant education.

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Screening study of lung US (LUS) vs HRCT in 73 RA pts (DAS28 3.47) Chest HRCT identified ILD in 29%. LUS identified ILD in 22% of patients. LUS sensitivity was 59%; specificity 94%. ROC. This study demonstrates the good diagnostic performance of LUS in RA- ILD detection https://t.co/E8avnbvUiw
Dr. John Cush @RheumNow( View Tweet )
Rotator cuff abnormalities are nearly universal after age 40, & incr w/ age; routine imaging should not guide Dz or Tx of atraumatic shoulder pain. Study of 602 having MRI (58yrs) RC abnormalities in 98.7%;; 25% tendinopathy, 62% Partial & 11% Full thickness tears https://t.co/Jw9rMUQBLs
Dr. John Cush @RheumNow( View Tweet )
The vasculitis session at #RNL26 was a fantastic update on inflamed blood vessels, large and small, by two experts in the field. https://t.co/KuVei8jiFu https://t.co/PR4h2qniEL

Links:

Dr. John Cush @RheumNow( View Tweet )
RT @gibson_rheumPAC Arthur Kavanaugh’s RheumNow 2026: Why Do Plain X-Rays in Psoriatic Arthritis? Thought-provoking session on the role of plain radiographs in psoriatic arthritis—not as relics of the past, but as tools that still inform prognosis, function, and long-term

Dr. John Cush @RheumNow( View Tweet )

RT @richardPAConway AUC of various published screening strategies for RA-ILD. We often say 0.80 is an acceptable cut off but ideally would like a bit better #RNL26 https://t.co/L19uJ7ETwc
Dr. John Cush @RheumNow( View Tweet )
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Maui Potpourri (2.13.2026)

Jack Cush, MD

Dr. Jack Cush reviews the hot item takeaways from last week's RheumNow.Live 2026.

  1. Diet & Obesity Management in Rheumatology - Uzma Haque, MD
  2. Mitigating risk for Rheum patients undergoing orthopedic surgery - Susan Goodman, MD
  3. Paradoxical skin reactions – Joseph
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Canada's 2025 Top 10 Funded Rheumatology Projects

Arthritis Society

Arthritis Society Canada (ASC) is Canada’s largest charitable funder of cutting-edge arthritis research, investing more than $240 million in research projects since its founding, and over $7 million invested in 2024-2025. Below are the investigators and projects that were funded in 2025.

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NEJM - Baker’s Cyst A 63-year-old woman with psoriatic arthritis presented with a 9-month history of pain in the left knee. A nontender, palpable mass was present in the left popliteal fossa, which had a “speech bubble” shape on ultrasonography. https://t.co/7wBnkDoUaX https://t.co/m0AhRnDc4c

Links:

Dr. John Cush @RheumNow( View Tweet )
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Consensus on Managing Vertebral Fractures in Advanced CKD

EurekAlert!

A coalition of leading international experts have released the first comprehensive Consensus Statement on the Management of Vertebral Fractures in Chronic Kidney Disease (CKD) Stages G4–G5D. The statement highlights a neglected yet devastating complication of advanced

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Emergencies, Independence & Hemorrhage (1.23.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and reports from the past two weeks on RheumNow.Com

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EULAR Classification criteria for hemachromatosis, presented by Prof. Kiely shows clinical pearls in diagnosis - Hook osteophytes @MCP 2/3, & Iron Fist sign w/ elevation of MCPs 2&3. #EULAR2025 https://t.co/ICSDysexOR
Dr. John Cush @RheumNow( View Tweet )
FDA,approved,stamp,blue

Nerandomilast FDA Approved for Progressive Pulmonary Fibrosis

Jack Cush, MD

The FDA has approved nerandomilast (Jascayd), a PDE4b inhibitor, to treat adults with progressive pulmonary fibrosis (PPF). Nerandomilast was approved to treat idiopathic pulmonary fibrosis (IFP) in October 2025.  

PPF is a a life-threatening, progressive lung condition, leading to

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🦴 Genant-Modified Sharp Scoring System 🧮 A radiographic scoring system used to quantify joint damage in Rheumatoid Arthritis (RA), especially in clinical trials and long-term follow-up. 🔍 What does it assess? X-rays of hands and feet for: •Erosions •Joint Space Narrowing https://t.co/r5bvzFliBP

Links:

Ravi Kumar @RheumattDoc( View Tweet )

5 fractures

5 Fractures You Don’t Want to Miss

Jordan Lyons, MS, PA-C

In orthopedic practice, missing the wrong fracture can significantly alter a patient’s outcome. Certain injuries may appear subtle on initial imaging yet carry serious consequences if not promptly recognized and managed. Below are five fractures that warrant a high index of suspicion due to

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Reefer Madness (12.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow.com.  B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.

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ICYMI: MSK Evaluation https://t.co/QuHWcv6zAc https://t.co/0n5A1EtL9c

Links:

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 )

Therapeutic Updates

Diagnosis of PMR

RheumNow
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Nine perspectives now available: Red Flags in the Diagnosis of PMR; Epidemiology of PMR; Role of the PCP in Diagnosis and Care; Importance of Diagnostic Imaging; ESR/CRP in PMR; PMR Must Rule Outs; Which PMR Patients Should Rheumatologists See?; Is There Hidden GCA?; and PMR Mimics.
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Recent Blogs

rheumthought

CNS Lupus (NPSLE)

Jack Cush, MD
Cush RhTh CNS
29 yr. old woman with SLE and transverse myelitis. Is this NPSLE; how to diagnose?
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rheumthought

Universal Imaging for GCA in PMR? Not So Fast

Michael Putman, MD, MSCI
Putman PMR RheumThought
For decades we've been screening GCA with a patient history and exam. Doing so with imaging would be a sharp departure from the current standard of care. And you may be asking yourself, well, yeah, but what could it hurt? Don't you want to catch GCA early?  Let me tell you the problems with this. 
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Unpopular opinion: spinach can be bad for you

Lara El Khoury, MD
pro con unsure opinion thumbs debate
PMR might be one of the most rewarding diagnoses to make in real practice: the patient comes to you in severe debilitating pain, and you prescribe steroids, giving them their lives back! As much as this impressive response makes your intervention appear almost magical, there is the often-forgotten story about the implications of such a diagnosis and treatment on patients' daily lives. 
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