ERA, APPs, & Alpha GAL (3.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Listen in for 2 new case questions - Ask Cush Anything.
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Increasing Prevalence of Osteoporosis
Research published in Osteoporosis International studied NHANES data showed increasing trends in osteoporosis in the United States of America. The key findings showed statistically significant results.
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Axial Involvement in Psoriatic Arthritis
Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.
Is better earlier imaging needed for axial #PsA? to better visualize spinal ligamentous soft tissue Spinal entheseal soft tissue and contiguous ligamentous tissues are poorly visualized on MRI in early inflammatory back pain pts. https://t.co/4w4CamMT4I https://t.co/RQigMjMe9n
Dr. John Cush @RheumNow( View Tweet )
New insights into Moyamyoa a complex cerebrovascular disorder affecting children/young adults w/ carotid or CV vessel narrowing; leading to CVA, Sz, HA, TIA, Cognitive Sx. Genetic mutations add to succeptibility (RNF213, ACTA2, DIAPH1, HLA). DIfficult to Dx vs Atherosclerosis.… https://t.co/LqFcU0xO3J https://t.co/CileSRAZgU
Dr. John Cush @RheumNow( View Tweet )
Increased Mortality In Arthritis Patients with COPD
EurekAlert!
People with chronic obstructive pulmonary disease (COPD) and arthritis have a higher risk of death than people with arthritis who do not have COPD, according to a new study. The study is published in the January 2025 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD
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MMWR: Idiopathic Pulmonary Fibrosis Mortality in the United States
MMWR
Idiopathic pulmonary fibrosis (IPF), a progressive lung disease characterized by scarring and worsening lung function, has a poor prognosis. An estimated 21% of IPF deaths might be attributable to occupational exposures.
Opioid Deaths are Down (2.28.2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Opioid deaths are down, IL-33 levels are up and Weight loss is in the news again this week!
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ACPA+ linked to nodule progression. 208 #RA pts w/ Chest CT studied. Lung nodules seen in 1/3; 10% before RA Dx (10.4 mos before). Positive ACPA (not RF) was assoc w/ nodule progression (OR 3.69). csDMARDs & b/ts-DMARDs NO affect on nodule progression. https://t.co/GO1wLRIl9j https://t.co/pfFGbPv2DG
Dr. John Cush @RheumNow( View Tweet )
Seeing Beyond the Surface: Salivary Gland Ultrasound in IgG4 Related Disease
Presentation by Dr. Amy Trang at the Rheumatology Winter Clinical Symposia - Feb 2025.
https://t.co/DLXKCRz3fF https://t.co/lfobyjElFG
Dr. John Cush @RheumNow( View Tweet )
Dr Rhee @RennieRhee mimics of medium/large vessel vasculitis. Increase in cross-sectional imaging use has increased the number of these we get referred. Segmental arterial mediolysis also pops up a fair bit. @RheumNow #RNL2025 https://t.co/yozRGE9Ncl
Richard Conway @RichardPAConway( View Tweet )
Will AI put me out of a job?
The development of AI and other technologies brings new possibilities for optimizing diagnosis, management and has potential for improving outcomes in RA. At RheumNow Live 2025, Dr. Jeff Curtis, University of Alabama at Birmingham, presented a talk on, "AI applied to Rheumatoid Arthritis Care:
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Pregnancy is 🔥 inflammatory
Hard to interpret MRI of SI joints in setting of pregnancy
Ideally, don't score MRI during pregnancy or 1 year afterwards, would be affected by the pregnancy
If needed for clinical eval, focus on structural lesions like erosions
#RNL2025 @RheumNow
Eric Dein @ericdeinmd( View Tweet )
MDA5 + Pts with #ILD in #dermatomyositis can improve!
@RheumNow @ACRheum #RNL2025
Data from Christina Charles-Schoeman
#ClinicalPearl
Her pearls
👇
#DM is a #vascular #disease
#CK is not reliable in chronic DM
Neg Abs don’t r/o #myositis https://t.co/hxomz70aq5
Janet Pope @Janetbirdope( View Tweet )
OK this is ‘HOT’
App on phone for a
👇
#thermal #camera
Of hands 🙌
If #hot➡️ flare of #inflammatory #arthritis
And call for a #follow up apt
If not — then not a flare
#AI #artificial #intelligence
#rheumatoid #arthritis
@RheumNow #RNL25
Jeff Curtis AI in #rheum
Janet Pope @Janetbirdope( View Tweet )
Infectious Sacroiliitis
A large Chinese cohort study of patients with infectious sacroiliitis (SI) suggests that CT-guided biopsy of the sacroiliac joint is necessary to properly identify the infectious pathogen leading to SI.
https://t.co/GYI8iz0rOS https://t.co/3wQR47Wd4g
Dr. John Cush @RheumNow( View Tweet )
Participation is Up! (1.31.2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. We also have two call-in cases on "Ask Cush Anything".
Be sure to join in the fun at RNL 2025 next weekend - Gong Show Karaoke; what will you sing?
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Review of 39 imaging studies (12 MRI, 26 evaluated ultrasound) in pts w/ clinically suspect arthralgia showed variable results for imaging predicting progression from CSA to inflamm. arthritis (RA). US sensitivity/specificity = 37%/90%; MRI was 45%/84% https://t.co/uUl5i2t7ib https://t.co/ScnA7aN07N
Dr. John Cush @RheumNow( View Tweet )
Infectious Sacroiliitis
A large Chinese cohort study of patients with infectious sacroiliitis (SI) suggests that CT-guided biopsy of the sacroiliac joint is necessary to properly identify the infectious pathogen leading to SI.
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Palmar fasciitis & polyarthritis syndrome (PFPAS). JAMA case 50yoM w/ progressive hand swelling, stiffness, thickening, erythema, hepato-splenomegaly. Skin Bx dermal fibrous tissue. WBC 152k, LDH 889, lead to CML dx made by BM Fx (myeloid-erythroid ratio 21 w/ myeloblasts). +… https://t.co/xtHbzAioss https://t.co/RfMrfntFtb
Dr. John Cush @RheumNow( View Tweet )
Systematic review of 208 pts w/ IgG4–related disease & pachymeningitis - mean age 52 yrs; 2/3 male. HA & cranial nerve dysfunctions were most common Sxs. nearly half had systemic Dz. Abnl imaging of cavernous sinus and middle fossa. Incr. IgG4 in 65% w/ CSF pleocytosis in 52%… https://t.co/0TberfIXsH https://t.co/6k5QgGTnkw
Dr. John Cush @RheumNow( View Tweet )
🚨 Just 4 weeks until #RheumNowLive 2025! 🚨
📅 Feb 8-9 | Dallas, TX
Don’t miss 1.5 days of cutting-edge #rheumatology education, interactive sessions, and unmatched networking!
🧠 Expert insights:
🔹 EGPA care innovations (Dr. Wechsler)
🔹 Vasculitis imaging… https://t.co/ObHBj1dQoK https://t.co/UuDZxBhdLr
Dr. John Cush @RheumNow( View Tweet )
Alive in 2025 (1.10.2025)
Dr. Jack Cush brings in the new year with a review of the latest from RheumNow.com
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Full read JAMA ILD Review article. ILD= 33% idiopathic (IPF) + 15% hypersensitivity pneumonitis + 25% from CTD.
30% of ILD has cough
Chest CT 91% sensitive, 71% specific
5% decr in FVC/12 mos assoc w/ 2-fold incr in mortality
Rx options nintedanib or pirfenidone, TCZ, MMF, RTX… https://t.co/s5v3XD8QmC https://t.co/iP5yFWkQwb
Dr. John Cush @RheumNow( View Tweet )
A re-evaluation of lupus arthritis. Old dogma is RA is erosive and SLE non-erosive. With better imaging, lupus arthritis can be erosive. Vivianne Malstrom. @RheumNow #ACR24 https://t.co/dFRnmGMGls https://t.co/LNoCtmtVuI
Links:
Dr. John Cush @RheumNow( View Tweet )
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