Imaging

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

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Richard Conway @RichardPAConway( View Tweet )
AI

Will AI put me out of a job?

Adela Castro, MD

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

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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

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Dr. John Cush @RheumNow( View Tweet )
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Participation is Up! (1.31.2025)

Jack Cush, MD

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

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Dr. John Cush @RheumNow( View Tweet )
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Infectious Sacroiliitis

Jack Cush, MD

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 )
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Alive in 2025 (1.10.2025)

Jack Cush, MD

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

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Dr. John Cush @RheumNow( View Tweet )
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/FKZyNU1s06 https://t.co/w5q0hOesEH
Dr. John Cush @RheumNow( View Tweet )
171 SSc pts w/ hand Xrays and US found 20% w/ Joint involvement. Active Synovitis & tenosynovitis predicted by CRP>10mg/L (p = 0.013), fibrotic tenosynovitis on US (p = 0.005), anti-RNA polymerase III antibodies (p = 0.043) https://t.co/XYeMl6ag9c https://t.co/ycM573lUGT

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Dr. John Cush @RheumNow( View Tweet )
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Best of 2024: Mixed Long-term Effects of Calcium and Vitamin D in Postmenopausal Women

Jack Cush, MD

A follow-up analysis of a randomized clinical trial found that the use of calcium and vitamin D supplements among postmenopausal women was associated with decreased risk for cancer mortality, but increased risk for cardiovascular disease mortality. The analysis is published in Annals of

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Best of 2024: 13 Risk Factors for RA-associated Interstitial Lung Disease

Jack Cush, MD

Interstitial lung disease (ILD) is the most widespread and fatal pulmonary complication of rheumatoid arthritis (RA). A recent metanalysis shows the pooled prevalence of RA-ILD was approximately 18.7%.

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Sarcoidosis is biopsy supported not proven” -Dx is clinical with broad ddx. -Assess organ involvement in all pts. -Whole body PET can help assess disease activity (not in CNS disease) -MR brain with pituitary cuts helpful in CNS sarcoid. #ACR24 @ACRheum @RheumNow… https://t.co/Ka1cHtFOqj

Dr. John Cush @RheumNow( View Tweet )

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Best of 2024: Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease

Jack Cush, MD

A matched cohort study from the Veterans Health Administration shows that rheumatoid arthritis patients have a >50% increased risk of lung cancer, and a 3-fold higher risk of lung cancer in RA-interstitial lung disease (ILD).

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Bah Humbug Vitamin D (12.20.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

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Steroids do NOT hamper muscle Bx dx of ANCA vasculitis. Tokyo study of 126 pts w/ suspected vasculitis had Quad muscle Bx; 71 (+) w/ Dx of AAV. Bx yield in 56 and 15 pts w/ off or on steroids, respectively, was similar (59% vs 53%). https://t.co/Xpt01Wksd3 https://t.co/NSBclcEgwq

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Dr. John Cush @RheumNow( View Tweet )
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Tocilizumab Efficacy in Giant Cell Arteritis Phenotypes

Jack Cush, MD

A Spanish Collaborative Group study of Tocilizumab (TCZ) in Giant Cell Arteritis (GCA) demonstrated high efficacy regardless of the different vascular phenotypes treated. 

Multicentre study of 471 GCA patients treated with TCZ, assessed outcomes according to vascular

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kidneys

ICYMI: Beyond the Needle: Redefining the Assessment of Lupus Nephritis

Akhil Sood, MD

Lupus nephritis is one of the most silent and severe manifestations of SLE. When not captured early, patients are at high risk of progressing to end-stage renal disease, which would require dialysis or transplantation. Renal biopsy remains the gold standard for diagnosis and disease

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Recent Blogs

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.  Read Post

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.  Read Post
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