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General Rheumatology

ACR: New Data Highlights Urgent Need to Address Arthritis Burden New findings from national U.S. surveys reveal the profound impact of arthritis on millions of adults, especially those facing social and economic challenges. These data will be featured in an upcoming issue of https://t.co/3LlNQ3tx90
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Role of the Nurse in the Care and Management of Rheumatic Diseases - EULAR Review In 2023, a EULAR subcommittee evaluated the roles of nurses and Advanced Practice Nurses (APNs) in arthritis care per EULAR guidelines. Initially proposed in 2012 and revised in 2018, the scope of https://t.co/w1IOQxcACR
Dr. John Cush @RheumNow( View Tweet )
Five Fractures You Don’t Want to Miss 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. https://t.co/zyCRdUkMua
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Lilly announced phase 3 RCT TRIUMPH-4, where Retatrutide, a new GIP, GLP-1 & glucagon recpt agonist, was given to obese (BMI >35), knee osteoarthritis pts *without diabetes*. Wt loss at 68 wks was 28.7% with reduced WOMAC pain scores of -4.5 points (75.8%) https://t.co/73yIyvwRtL
Dr. John Cush @RheumNow( View Tweet )

Three Things to Know About Hiring, Onboarding, and Training APPs

As the utilization of APPs (nurse practitioners and physician assistants) in rheumatology becomes more prevalent, here are three things to consider if you are thinking about adding an APP to your practice.

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Lyme disease is endemic in Massachusetts. EHR study shows Lyme dz incidence declined from 211 per 100 000 patients in 2012 to 86 per 100 000 in 2024 (P< .001), but this decr. was driven by 1 large practice group implemented a new initiative to reduce Lyme Dx & Rx in pts w/ https://t.co/lMCUA9o4Uc
Dr. John Cush @RheumNow( View Tweet )

Tricks of the Trade – Clinic Advice from APPs

J. Cush and many APPs

December 2025 is focused on advanced practice providers, their impact, education and priorities.  In seeking and soliciting the help and advice of leaders in the rheumatology APP world, I have been impressed by APP pride, dedication and passion for what they do.

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Recent study shows that betw 2018-2023 # of Concierge medicine practices in the USA has increased 78.4% (3,935 to 7,021); mostly in Texas (402), California (387), Florida (352), Georgia (139).” Notably a signif growth of corporate owned practices, increased from 9.2% to https://t.co/nVRPfnwjZv
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Wolters Kluwer surveyed 203 PAs: - 62% wish for more clinical experience prior to - Most adopted AI, majority need more AI training - 45% prefer title of “physician associate” https://t.co/96Hkh21wSr https://t.co/j7Xep47qMN
Dr. John Cush @RheumNow( View Tweet )

Hidden in Plain Sight: IBD

As a PA with six years of experience in rheumatology and a background in gastroenterology, today I'm discussing the clinical overlap between inflammatory arthritis—particularly psoriatic arthritis and spondyloarthropathies—and inflammatory bowel disease.

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French ESTIVAL study - DB, sham trial of auricular vagal N stimulation in 148 Erosive hand OA (eHOA) pts w/ erosion + synovitis by US. @12wks, no signif difference in VAS pain (–16·0 vs –6 sham; p=0·22) w/ no safety issues. Was this a failed study or encouraging outcome? https://t.co/KI86H9izYS
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76 PsA pts asked 32 questions submitted to Chat-GPT4 & 12 specialists. Answers were scored (accuracy, completeness). Both equally accurate, ChatGPT scored lower in completeness. Other pts reviewed answers; they preferred ChatGPT 49% vs clinician 34%. ChatGPT was more readable.

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Evaluation of Rheumatic Complaints https://t.co/cdizOgFqYf https://t.co/sqbrY2oGcH
Dr. John Cush @RheumNow( View Tweet )

ACR: New Data Highlights Urgent Need to Address Arthritis Burden

New findings from national U.S. surveys reveal the profound impact of arthritis on millions of adults, especially those facing social and economic challenges. These data will be featured in an upcoming issue of Arthritis Care & Research, an official journal of the American College of

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Role of the Nurse in the Care and Management of Rheumatic Diseases - EULAR Review

In 2023, a EULAR subcommittee set out to assess the roles of nurses and Advanced Practice Nurses (APN) in the care of arthritis as outlined in published EULAR guidelines. The scope of APN practices was first proposed in 2012 and revised in 2018. EULAR updated its recommendations for the role

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Tarsal Tunnel Syndrome - review and quiz. A compressive neuropathy of the posterior tibial nerve within the tarsal tunnel. 80% caused by lipoma, ganglion, varicosity, trauma, tenosynovitis, rheumatoid arthritis, diabetes, etc https://t.co/zCyeVIJEuy https://t.co/f4jA13FDvN
Dr. John Cush @RheumNow( View Tweet )

Five Fractures You Don’t Want to Miss

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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I Can't Believe it's Not Seronegative Rheumatoid Arthritis?! In rheumatology, we're no stranger to uncertainty. In any diagnosis of seronegative rheumatoid arthritis, it's always our invitation to reconsider the diagnosis. https://t.co/JaLfRha6dq https://t.co/WwT5Q8B5Ad
Dr. John Cush @RheumNow( View Tweet )
APP QD Clinic: Difficult AxSpA Philip Mease, MD and Christy Vath, PA-C, Seattle discuss a difficult to treat axial spondyloarthritis (axSpA) case. This APP QD clinic is presented as part of RheumNow's "Mission: APP Partners in Care" campaign during the month of December. https://t.co/VY0O26l7XC
Dr. John Cush @RheumNow( View Tweet )
Dr, Tuhina Neogi writes its time for a new understanding of OA; its not just wear n tear. Based on preclinical and clinical evidence, OA is a systemic, whole-body disease and that this should change future research and treatment of #OA. https://t.co/gn9xt6CafP https://t.co/2iSKiyiCX4
Dr. John Cush @RheumNow( View Tweet )
GESPIC - German SpA study of 252 SpA (139 nr- axSpA, 113 r-axSpA), followed w/ serial Xrays and mSASS Scores over 2 yrs. 80% were on NSAIDs. Higher NSAID intake, particularly COX2i, on slowing radiographic progression in axSpA https://t.co/sKgCGaJFVr https://t.co/jMQTAnsCmG
Dr. John Cush @RheumNow( View Tweet )
JAMA reports that by end of 2025, half (52-56%) of USA nonfederal acute care hospitals will use generative AI and predictive AI. Teaching hospitals and EPIC EHR are early adopters, while For-profit and government hospitals were less likely to currently adopt AI. https://t.co/iJib0YjnW3
Dr. John Cush @RheumNow( View Tweet )
Medical Cannabis for Pain Management Recent research and publications have underscored the use, efficacy, safety and limitations to the use of cannabis for arthritis and pain patients. https://t.co/kxTDqbzpgg https://t.co/fBumEAgISU
Dr. John Cush @RheumNow( View Tweet )

Reefer Madness (12.12.2025)

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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