#Day5

Anti-CCP antibodies:
• More specific than RF
• Predict erosive disease
• Help risk-stratify

High anti-CCP? Be aggressive early.
#RheumPearls #RA

Hallo.
I’m here!
Have jumped on board to find something fun, fabulous, full of curious people and make connections.
Where is everyone?
Let’s rebuild hey.
And tell me all about it…
#medsky #rheumsky #healthpolicy
#rheumpearls

Did you know you can request amniotic bandages from you trauma/burn unit to help with healing digital ischemia from Raynauds? It's soothing and healing! #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

3 things to look for in your MRI in neurosarcoidosis patients: basal involvement, meningeal involvement, GAD enhancement. 🧠⭐️#rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

For our fibromyalgia patients, we need to remember to educate our patients that hurt doesn't mean harm, when we have sensitization. 📚⭐️💡#rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

What are the autonomic symptoms of Sjogrens? Cardiovascular (POTS) 🧡, gastrointestinal symptoms 🍴 (like gastroparesis), sudomotor 🌞(heat intolerance, hyperhidrosis, etc.), and genitourinary 🚽(frequency/hesitancy). #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

We need to optimize the dose of methotrexate, and consider subcutaneous MTX in our patients. SC MTX improves bio-availability and tolerability.💡⭐️📚#rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

TICORA – treat to target! Get a CDAI (or other objective measure) on your rheumatoid arthritis patients. 💡⭐️🩺 #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

IVIG can interfere with live vaccines. You should wait 8-11 months after IVIG before giving a live vaccine (CDC recommendation). 💡 #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

Consider vaccinating your immunocompromised patients with the pneumonia vaccines, shingles vaccine, and HPV vaccine to protect them. This is in line with CDC and ACR guidelines.💡📷 #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

How does CAR-T work? You will modify a T cell genetically, and the new modified T cells will attack the tumor cells causing apoptosis💡⭐️🩺#meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

Check out board prep material on . Let me know what you think!
#meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

You can have temporal arteritis caused by ANCA associated vasculitis. Serum ANCA levels can be negative 1/5 of the time, and patients have atypical symptoms like ENT SX, and non specific headaches.💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

In relapsing polychondritis, nasal chondritis is associated with upper and lower airway involvement, so it is good to get a CT of the chest. 💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

For patients who received cyclophosphamide, make sure to get annual urinalysis with cytology. 💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

IL-23 inhibitors are superior to TNF-alpha inhibitors for skin psoriasis.💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

In inclusion body myositis, patients often have asymmetric weakness and finger flexion is reduced.💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

If you’re worried about small fiber neuropathy, you should do a skin biopsy rather than an EMG. 💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

Don't place an arterial line in scleroderma patients in the ICU because its associated with high incidence of irreversible limb ischemia. 💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

Prior to treatment with anti-retrovirals, there were 3 different 'joint' manifestations of HIV including 1. HIV associated arthropathy 2. acute pain articular syndrome 3. spondyloarthopathies (eg PsA, ReA). 💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

Heerfordt syndrome is a pentad in sarcoidosis: fever 🌡️, parotid enlargement 👄, uveitis 👁️, arthritis 🦿, and facial nerve palsy 🙄.💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

ESR or erythrocytes sedimentation rate can be artificially elevated in obesity, increase age, or chronic kidney disease.💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

MPA is monophasic, GPA is biphasic, EGPA is triphasic. Each phase for each disease has different features, and the later phases tend to be more severe. Not all patients progress through all phases.💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

We had @jeffsparks give us a wonderful grand rounds at @HenryFordHealth with @HFRheumatology! Tid bit of the day: MUC5B is a genetic risk factor for RA/ILD. 💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

For SLE patients with high disease activity or positive anti-phospholipid labs, do not use oral hormonal contraceptives.💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

Approximately 10% of patients with Takaysu arteritis have coronary artery involvement ❤️‍🩹. Have you seen a case?💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

Rheumatological causes of neuropathy include SLE, RA, Sjogrens, sarcoidosis, PAN, ANCA vasculitis. Can you think of others?💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

Rheumatoid arthritis can affect the cricoarytenoid joint and can cause symptoms of dysphagia 🗣, hoarseness 🐎, pain 🔥, and stridor.💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls

There is risk of cardiac involvement in scleroderma - specifically ❤️ fibrosis which likely causes decreased exercise capacity even in “asymptomatic” patients.💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls #ACR22

Make sure to screen for malignancies. CT CAP, endoscopy (upper/lower), mammogram, pap smear, transvaginal ultrasound, testicular ultrasound, and possibly PET. 💡 ⭐️ 📚 #meded #rheumdoodles #rheumtwitter #MedTwitter #rheumpearls