General Rheumatology

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2025 Adult Rheumatology Fellowship Match is Strong (Again)

ACR

The American College of Rheumatology (ACR) announced today that 2025 Medicine and Pediatric Specialties Match results show rheumatology fellowship positions continuing to fill at high rates. The Match uses a computerized process to pair applicant and program preferences, determining where

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Betsy Kirchner

Metabolic Bone Pearls

Elizabeth Kirchner, DNP

Betsy Kirchner, DNP, shares practical tips for managing metabolic bone disease, including the importance of VFA imaging to catch asymptomatic vertebral fractures and utilizing fracture liaison services to close care gaps. She highlights key pearls like the doubled fracture risk in RA patients,

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The countdown is on! ⏱️ Drs. Jack Cush & Artie Kavanaugh are previewing what’s coming to RheumNow Live 2026 in Dallas (Feb 7–8) – and you don’t want FOMO on this one. ✅ Register now at https://t.co/4UQlqwujiR 🔥Early bird pricing ends December 15 – Get the inside scoop on https://t.co/K6kxX2oDtu

Links:

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/qlBUtt6zWr
Dr. John Cush @RheumNow( View Tweet )
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Medical Cannabis for Pain Management

Jack Cush, MD

Recent research and publications have underscored the use, efficacy, safety and limitations to the use of cannabis for arthritis and pain patients.

Chronic pain affects more than one in five American adults, yet practitioners are limited in treatment alternatives. Even if we exclude the

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Phase 1 trial of IL-6 targeting immunotherapy (PPV-06) in 24 pts w/ inflammatory knee osteoarthritis (KOA) demonstrates safety, Abs that neutralize IL-6, decreasing CRP values and improved clinical outcomes, determined by changes in KOOS scores https://t.co/urZupN62Kw https://t.co/sru1SnsOig

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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/HQWI14WSXg https://t.co/5bIWgqaETU

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Dr. John Cush @RheumNow( View Tweet )
INITIAL Goal is to not miss Red Flag Conditions (Fx, septic or crystal arthritis [all acute monarticular})! Then provide timely Dx & Rx by establishing acute vs chronic, inflam vs noninflam, & articular vs nonarticular.

Dr. John Cush @RheumNow( View Tweet )

OPD Spotter Identify it before the patient even sits Diagnosis ❓ https://t.co/xM90YEp9jZ

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DocXus @docxusofficial( View Tweet )
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I Can't Believe it's Not Seronegative Rheumatoid Arthritis?!

Daric A. Mueller, PA-C

In rheumatology, we're no stranger to uncertainty. In any diagnosis of seronegative rheumatoid arthritis, it's always our invitation to reconsider the diagnosis. 

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Low Dose Naltrexone for Fibromyalgia Pain - Use it or Lose it? Medscape recently reviewed off-label use of low dose naltrexone (LDN) in fibromyalgia (FM) and found it is deemed effective by some clinicians and patients, but 1) there is no FDA indication for LDN use in FM and 2) https://t.co/RgRRHU9ZRo
Dr. John Cush @RheumNow( View Tweet )
JAMA Case Challenge - Painful Hand Swelling With Finger Contractures 56-yoF w/ BL hand contractures, 15 mos BL hand pain/swelling/stiffness. No or partial relief w/ ibuprofen, 30 mg prednisone, MTX 10-20 mg/wk. All labs were normal. Whats the Dx? https://t.co/lZ0NHX5Y56 https://t.co/JC04E3JUxB

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Dr. John Cush @RheumNow( View Tweet )
Legislative Issues Affecting APPs Major interstate “compacts” allow for cross state licensing for physicians. However, compacts for Advanced Practice Registered Nurse (APRN) are fewer and currently on hold - thereby limiting healthcare manpower and patient care. https://t.co/cgzgGXIWka
Dr. John Cush @RheumNow( View Tweet )
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The Essential Role of Physician Assistants in Rheumatology

Daric A. Mueller, PA-C

Ready to bring a PA into your rheumatology practice? This blog post breaks down the key facts you need to know about PA training, scope of practice, and the recent changes to the profession's title.

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RheumNow Live 2026 Where the data meets the dialogue. Join leading rheumatologists, researchers, and innovators at RheumNow Live 2026 — the meeting redefining rheumatology education. ➡️https://t.co/zYYC2350tE https://t.co/I7YxpEcBG6

Links:

Dr. John Cush @RheumNow( View Tweet )
"Act as if what you do makes a difference. It does." – William James

Dr. John Cush @RheumNow( View Tweet )

Coccyx and Sacrococcygeal Joint Disorders Pain from coccygeal or sacrococcygeal disorders is rare, often presenting as a diagnostic challenge. Coccygeal pain is often mistaken for lumbosacral, pelvic, or gastrointestinal disorders. This review presents the epidemiology, https://t.co/zrGDwULms5
Dr. John Cush @RheumNow( View Tweet )
PROSPERO metanalysis of 22 studies & 2208 JIA associated uveitis (JIAU) showed severe visual impairment in 16.6% at ~18 yrs. Most frequent: Cataract (44.3%), followed by glaucoma, synechiae, band keratopathy and hypotony. Biologics were protective https://t.co/6OoupX64NE https://t.co/7bp0JtRken

Links:

Dr. John Cush @RheumNow( View Tweet )
High Cost of Cancelling Knee Replacement Surgery Thousands of NHS knee replacement operations are cancelled at short notice every year, many for avoidable reasons, according to a new study published December 1st. This costs the NHS millions of pounds and increases waiting times https://t.co/USWAPC0k6N
Dr. John Cush @RheumNow( View Tweet )
ICYMI: Inflammatory vs. Noninflammatory Pain https://t.co/3nJ2NZYTQY https://t.co/7FuSYzkX2G

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Dr. John Cush @RheumNow( View Tweet )
Hiring, Onboarding and Training APPs Watch our kickoff webinar for this month's Mission: APP — Partners in Care campaign. Our panel of rheumatologists and experienced advanced practice providers share insights into hiring, onboarding, training, compensation, and more. https://t.co/stgTQM9soW
Dr. John Cush @RheumNow( View Tweet )
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APPs in the News (12.5.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow.com, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salary concerns.

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RheumNow Live 2026 Where the data meets the dialogue. Join leading rheumatologists, researchers, and innovators at RheumNow Live 2026 — the meeting redefining rheumatology education. ➡️https://t.co/zYYC2350tE https://t.co/4Vz7swwqFJ

Links:

Dr. John Cush @RheumNow( View Tweet )
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Low Dose Naltrexone for Fibromyalgia Pain - Use it or Lose it?

Jack Cush, MD

Medscape recently reviewed off-label use of low dose naltrexone (LDN) in fibromyalgia (FM) and found it is deemed effective by some clinicians and patients, but 1) there is no FDA indication for LDN use in FM and 2) the data supporting its use is limited.

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Consensus Definitions on Difficult to Treat PsA A substantial number of patients with PsA, have difficult, persistent and hard-to-treat disease. A GRAPPA task force has developed a consensus terminology for two distinct states: Complex-to-manage PsA (C2M-PsA) https://t.co/po1psn9GNm
Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Advanced Practice Rheum

Evaluation of Rheumatic Complaints

Jack Cush, MD
Evaluation of MSK cover
Dr. Cush provides a systematic approach to evaluating musculoskeletal and rheumatic complaints in clinical practice. Read Post

The War Rheum

Kathryn H. Dao, M.D.
blue and yellow arms and hands
The effects on rheumatologists and their patients living in Ukraine largely have been unseen by the world. At ACR Convergence 2024, I met Dr. Marta Dzhus who practices at St. Michael's Clinical Hospital in Kyiv; she shared her story with me about the humanitarian crisis in rheumatologic care in Ukraine because of the ongoing war. Here is an excerpt of our conversation. Read Post
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