Surgery

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Can EMR Treatment Suggestions Improve Decision Making?

EurekAlert!

In a new study involving 402 U.S.-based primary care physicians, researchers from Northwestern University and the University of Sydney identified a “sweet spot” in clinical decision-making. By presenting just the right number of treatment alternatives in the electronic health record (EHR) system

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Click on the link to see my take on implantable vagal nerve stimulation RCT in RA 🎥👇🏼 https://t.co/CZrFKouSqp @RheumNow #ACR25 #ABSTRACT1675

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Aurelie Najm @AurelieRheumo( View Tweet )

#0852 LEVI-04, a novel p75NTR-Fc fusion protein, significantly reduces MRI bone marrow lesions in knee #OA 🦵📉 Phase II RCT (n=518): dose-dependent BML reduction (p<0.001) + correlated improvement in pain & function. Promising structure-modifying OA therapy @RheumNow #ACR25 https://t.co/huA8OaFGSd

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Mrinalini Dey @DrMiniDey( View Tweet )
In this ph2 trial of LEVI-04 for knee #osteoarthritis, At wk 20, LEVI-04 ⬇️ bone marrow lesions (BML), greater ⬇️ in BML area even w/ higher KL grades Promising treatment. #ACR25 @RheumNow Abs0852 #ACRBest https://t.co/MrmLPlFiDs

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sheila @RHEUMarampa( View Tweet )
Meniscal tears - Systematic review of 46 studies - Incidence of 66 per 100,000 - Annual cost of 5 billion to US healthcare - Trend to preserve the meniscus, do less removal, more preservation - Biologic Rx (platelet-rich plasma & stem cell Rx) inconclusive results https://t.co/IPyRFad9GX
Dr. John Cush @RheumNow( View Tweet )
UK National Joint Registry study of 1.5 million TKR and THA (2010 to 2022); trends show median Length of hosp stay (LOS) decreased from 4.3d to 2.75 d for THR; & from 4.35d to 2.9d for TKR; & from 3.2d to 1.9d for UKR (unilat. knee replacement). Longer LOS with comorbidity, https://t.co/DNBZTPFRsl
Dr. John Cush @RheumNow( View Tweet )
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Big Fat FDA Pink Slip (9.19.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this week on RheumNow.com. Today we cover GLP-1 agonists, acupuncture, what JAKs won’t do & an FDA Pink Slip. 

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🆕 ILD (Part II): advanced insights 🫁 Multidisciplinary management 💊 Treatment strategies 📊 Prognosis & monitoring 🧑⚕️ What rheums should know next ⬇️ Download & learn more: https://t.co/dmhULfqiMj Created by @MithuRheum | For our Rheum to Breathe: ILD Campaign https://t.co/ivvDjxkCvt

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Dr. John Cush @RheumNow( View Tweet )
Hospital for Special Surgery (HSS) reports that ear acupuncture applied during hip replacement surgery reduces pain and lessens opioid use over the weeks to follow. https://t.co/lOrwb1DzW5 https://t.co/6rkHNTwaAl

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Dr. John Cush @RheumNow( View Tweet )
Tarsal Tunnel Syndrome: An Ultrasound Pictorial Review https://t.co/Qr4ehZo41p Tarsal tunnel syndrome (TTS) is an entrapment neuropathy caused by compression of the posterior tibial nerve or its branches as they pass beneath the flexor retinaculum at the medial ankle. Clinical https://t.co/FivPCl7EvU

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sergio serrano belmar @sserranobmsk( View Tweet )
PT in RA - Metanalysis of 17 RCTs, 1362 pts Rx w/ aerobic/resistance exercise, hydrotherapy, manual Rx, electrotherapy, multimodal Rx. 5 RCTs (n 307) signif reduced pain (SMD −0.347; interpreted as a small to medium effect favoring PT. https://t.co/UJGSGrgMV0 https://t.co/n4DzMSm9iJ

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Dr. John Cush @RheumNow( View Tweet )
Survival in #RA pts undergoing cervical spine surgery is not good! Retrospective study of 139 RA pts who underwent Cx surgery shows higher mortality risk if they are older, w low albumin levels, high-dose pred. and have subaxial subluxation. https://t.co/hKvgaas2gh https://t.co/ygtJjb4mVl

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Dr. John Cush @RheumNow( View Tweet )
Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the https://t.co/gjJOjZhSHU
Dr. John Cush @RheumNow( View Tweet )
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Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients

Jack Cush, MD

More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the

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Genicular nerve block (GNB) is effective intervention for Knee OA. Metanalysis of 6 RCTs & 420 KOA pts. GNB significantly reduced pain & improved function (p<0.003), w/ significant relief as early as 2wks and function by 12 weeks. https://t.co/wC2dPvVR7x https://t.co/HCFSXBfVGM

Links:

Dr. John Cush @RheumNow( View Tweet )
Genicular nerve block (GNB) is effective intervention for Knee OA. Metanalysis of 6 RCTs & 420 KOA pts. GNB significantly reduced pain & improved function (p<0.003), w/ significant relief as early as 2wks and function by 12 weeks. https://t.co/NMtiQPICpw https://t.co/gVJ0TyuY01

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Dr. John Cush @RheumNow( View Tweet )
@RheumNow So rheumatoid nodule treatment might target some of that pathophysiology. Rituximab, abatacept, or JAKi? And while surgery often isn’t great (plus they often grow back), definitely an option for some. Christopher Edwards #EULAR2025 @RheumNow https://t.co/sFWnQN8uC4

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David Liew @drdavidliew( View Tweet )
1 shot will do! #symptomatic #Knee #OA given #gene #therapy #intra-#articular Seemed to last up to 104 weeks! But no placebo small safety study but sustained #WOMAC responses Needs large #RCT but v interesting #EULAR2025 @RheumNow @eular_org Abst# POS0492 https://t.co/hqTqBorrbA

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Janet Pope @Janetbirdope( View Tweet )
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Rheumatology: Believe It or Not (4/25/2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?

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Bullhead Sign in #SAPHO Syndrome ▶️Synovitis, ▶️Acne ▶️Pustulosis ▶️Hyperostosis ▶️Osteitis 👉🏽https://t.co/ownI4Q543w via @MayoProceedings https://t.co/FXlTtmsDDX

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Dr Ai Lyn Tan @DrAiLynTan( View Tweet )
Shanghai hospital retrospective cohort study of 249 pts w/ post-Unilat TKA & lat knee pain. 144 Rx w/ IA steroids vs 105 Rx w/ PO meds. Infection rate w/in 6 mos post-TKA found no signif difference (2.1% vs 2.9%); Injx pts had signif better pain relief, QOL & knee function (KSS) https://t.co/ULVO6KU7pn
Dr. John Cush @RheumNow( View Tweet )
JAMA Staphylococcus aureus Review - s. aureus bacteremia leads to septic arthritis (7%), vertebral osteomyelitis (≈4%) - bacteremia (≥48 hs) has 39% 90-day mortality risk https://t.co/1UQoz7JDPU https://t.co/xTAkakv2he

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Dr. John Cush @RheumNow( View Tweet )
Consensus Against Interventional Injections for Chronic Spinal Pain BMJ has published a clinical practice guideline resulting from the work of an international, multidisciplinary panel addressing chronic spine pain (≥3 months duration) not associated with cancer or https://t.co/mCsz88JACh
Dr. John Cush @RheumNow( View Tweet )
Joint Implant Metals May Be Leaking Patients with metal-containing joint replacements had significantly higher concentrations of cobalt in their cerebrospinal fluid (CSF) relative to patients without arthroplasties, researchers reported. https://t.co/ubDhWqtTSL https://t.co/GjMnog8mcJ

Links:

Dr. John Cush @RheumNow( View Tweet )
Consensus Against Interventional Injections for Chronic Spinal Pain BMJ has published a clinical practice guideline resulting from the work of an international, multidisciplinary panel addressing chronic spine pain (≥3 months duration) not associated with cancer or https://t.co/PfXM210PsZ
Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

FEAR: A Perception of Fact In Spite of the Fiction

Kathryn H. Dao, M.D.
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How do you help your patients who are resistant to your medical recommendations when they are receiving biased information from friends, family, and the internet? I wanted to share with you two cases and my approach. Read Post
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