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General Rheumatology

24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/hwkpeav4MQ
Dr. John Cush @RheumNow( View Tweet )
Steroids Corticosteroids remain a cornerstone of rheumatologic therapy — rapidly effective but chronically dangerous, as their power to suppress inflammation through inhibition of prostaglandins, lipoxygenase, pro-inflammatory cytokines, and proteases comes at the cost of a https://t.co/PKdnFi1XSr
Dr. John Cush @RheumNow( View Tweet )
Have a Rheumatology question or case for Jack Cush? Record it here, and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/yyGRvXx3lL https://t.co/MgPqpaFLOc
Dr. John Cush @RheumNow( View Tweet )

Influential Rheumatoid Factors (5.8.2026)

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

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Review of Toll-like Receptor Research A new review on TLRs systematically summarizes 40 years of discoveries in the TLR field, from the initial identification of Toll in Drosophila embryonic development to the current understanding of multilayered regulatory mechanisms that https://t.co/Rvy24nmuTj
Dr. John Cush @RheumNow( View Tweet )
Nurses - the calm through chaos Nurses are a unique breed. When they appear, it’s always a blessing. But who goes into nursing? What kind of person choose nursing over doctoring? https://t.co/smUWg06nVh https://t.co/swQYJ3NfZF
Dr. John Cush @RheumNow( View Tweet )
Supposedly there's a shortage of Infectious Dz specialists & Fellowship applic are down. Survey of 380 Int. Med residents (41 prgs) shows ID interest signif assoc w/ exposure to ID in Yr 1 & 2, outpt clinics, ID- research. https://t.co/AUkiIvsuaV https://t.co/pOqkBhy93U
Dr. John Cush @RheumNow( View Tweet )
A Patient’s Plea for a New Paradigm in Autoimmune Disease A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists? https://t.co/fJMwR864HW https://t.co/a6CJPpo4yq
Dr. John Cush @RheumNow( View Tweet )
American Nurses Assoc. response to Dept of Education’s Final Rule on Graduate Loans for nurses: "..profoundly dismayed by DoE exclusion of nursing from....“professional degree” programs... this ignores the voices of over 245,000 nurses and nurse advocates https://t.co/WEYdiO9x4n https://t.co/3wxOwDBHVg
Dr. John Cush @RheumNow( View Tweet )

A Review of Hydroxychloroquine Ocular Toxicity

While hydroxychloroquine (HCQ) is thought to be a very safe drug, its ocular risk profile is probably more serious than appreciated. A comprehensive review published in the Journal of Rheumatology discusses HCQ pharmacokinetics, mechanisms of retinal toxicity, risk stratification, and evidence-

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More Comorbidity in Difficult-to-Treat RA A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA). https://t.co/guMm6mqJGr https://t.co/xiykw5tBlJ
Dr. John Cush @RheumNow( View Tweet )
STEP Talk: Mitigating Surgical Risk with Dr. Susan Goodman Surgery is high stakes for rheum patients. Dr. Susan Goodman shares how to mitigate perioperative risk and optimize outcomes at #RheumNowLive 2026. Smart prep = better recovery. https://t.co/AM1N3SimiY #Rheumatology https://t.co/wk99ytXZKl
Dr. John Cush @RheumNow( View Tweet )
Global trends in systemic sclerosis (SSc) mortality. Betw 2001-23, in 74 countries, 85,291 SSc deaths (79% females). While SSc-Crude mortality increased from 1.97 (2001) to 2.34 (2023), the age-standardized mortality decreased from 1.58 to 1.29. declining in Americas & Europe. https://t.co/lvHbF5HLPY
Dr. John Cush @RheumNow( View Tweet )
24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/pAEqYJIKaw
Dr. John Cush @RheumNow( View Tweet )

A Patient’s Plea for a New Paradigm in Autoimmune Disease

A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists?

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Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis

Chronic inflammatory arthritis (CIA) is associated with elevated cardiovascular risk. While metabolic syndrome (MetS) is prevalent, how much it contributes to adverse clinical outcomes is unclear.

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By @RheumattDoc #Psoriasis and nail changes #PsA #PsoriaticArthritis #enthesitis #dactylitis https://t.co/rxH2zrGBwC
Dr Gurdeep S Dulay @gurdeep_dulay( View Tweet )

More Comorbidity in Difficult to Treat RA

A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).

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RCT 120 mod-severe hip OA (KL 2-4) pts Rx w/ THA +rehab or exercise. @12 mos. THA had signif. better pain, function & HRQoL vs exercise program alone (WOMAC total -30.9 vs -3.7). (38% of exercise/conservative grp needed THA) https://t.co/6vvRAr6isf https://t.co/VOYgS3PPwr
Dr. John Cush @RheumNow( View Tweet )
“Almost always, the creative dedicated minority has made the world better. “ -Martin Luther King, Jr.

Dr. John Cush @RheumNow( View Tweet )

Knee pain: JAMA review - 5% PCP visits knee pain - Knee OA ~654 million worldwide - Patellofemoral pain: <40 yrs & physically active; pain on squat - Meniscal tears in 12% adults (McMurray 61% sensitive; 84% specific; Joint line tender 83% sensitive; 83% specific) https://t.co/2fdpl464mb
Dr. John Cush @RheumNow( View Tweet )
Prospective study of 305 Consecutive newly diagnosed axSpA pts (55% male; Dx delay 6 yrs; 75% B27+). 56% w/ r-axSpA more male w/ hi CRP. nr-axSpA had more inflam LBP, +FHx SpA. SpA Dx made without sacroiliitis in 12%; only 2/38 later developed sacroiliitis https://t.co/xPlGwZ7Kjk https://t.co/2TBQALvxsG
Dr. John Cush @RheumNow( View Tweet )
Which autoimmune condition carries the highest relative risk for lymphoma? Test your knowledge in the latest RheumIQ quiz at https://t.co/TBlB4pmnKa https://t.co/sx8fpdHgHN
Dr. John Cush @RheumNow( View Tweet )
EULAR Recommendations for Physical Activity in Arthritis EULAR has published a 2025 update for physical activity recommendations for patients with osteoarthritis (OA) and rheumatoid arthritis (RA). https://t.co/RFECflCUgf https://t.co/Da7D6KpN6q
Dr. John Cush @RheumNow( View Tweet )

Great Lectures; Great Presentations

Dr. Jack Cush lectures on giving a great presentation; based on 40 years of lecturing in Rheumatology.

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