RT @PanktiMehta24@twitter.com

#Reviewcourse #ACR22

🔥 spondyloarthritis

👉The spectrum of nR SpA, R SpA and bamboo spine 🚫 linear

#MedTwitter #MedEd #rheumatology @ACRheum@twitter.com #ACRambassador

🐦🔗: https://twitter.com/PanktiMehta24/status/1591698849009369089

RT @PanktiMehta24@twitter.com

#Reviewcourse #ACR22

🔥 #Osteoarthritis

✏️Some take home messages!

🔸 Pain 🚫 proportional to radiographic damage
🔸 Pain sensitivity is an issue
🔸 Imaging NOT needed to make a diagnosis or for routine follow up
🔸Imaging for atypical presentations✅

@ACRheum@twitter.com

🐦🔗: https://twitter.com/PanktiMehta24/status/1591704958810091520

#ACR22 #ICYMI
#CRC for those at the #ReviewCourse

https://twitter.com/Ertugrul_cagri/status/1591093608870207493

RT @Ertugrul_cagri@twitter.com

Causes for low diagnostic and gene discovery rates
🎗️

#ACR22
#ACRAmbassador https://t.co/ux7C1FcbX8

🐦🔗: https://twitter.com/Ertugrul_cagri/status/1591093608870207493

#ACR22 #ReviewCourse

basics of DXA and osteoporosis

https://twitter.com/vksandhumd/status/1591091690391375873

RT @vksandhumd@twitter.com

modified...
👉🏾DEXA shd be done in
- F w E def
- XR w fx of spine or OSP
- steroids > 3mo and >5mg/d
- primary HyperPTH
- f/u Rx every 23 mo unless on steroids - sooner

👉🏾T score -2.5 or less with fracture = sev OSP
#reviewcourse #osteoporosis #bonehealth
#ACR22 #ACRambassador

🐦🔗: https://twitter.com/vksandhumd/status/1591091690391375873

#ACR22 #ICYMI

More on the NYU experience on how to choose treatments for PsA

https://twitter.com/vksandhumd/status/1591087523862044673

RT @vksandhumd@twitter.com

NYU experience with PsA
- MTX for peripheral disease, then adjust based on skin disease (APR/TNF/IL17/IL23)
- Axial dz per skin disease (mild = TNF/IL17; mod-severe = IFX / IL17/IL23)

#reviewcourse
#ACR22 #ACRambassador

🐦🔗: https://twitter.com/vksandhumd/status/1591087523862044673

#ACR22 #ICYMI
True whirlwind #spondyloarthritis overview from Dr Scher

https://twitter.com/Nellziade/status/1591088636438597632

RT @Nellziade@twitter.com

Great overview on #spondyloarthritis and #psoriaticarthritis by Jose Scher

#ACR22 @ACRheum@twitter.com #ACRambassador
#RheumTwitter #MedTwitter
#Reviewcourse https://t.co/d8YQQaUecm

🐦🔗: https://twitter.com/Nellziade/status/1591088636438597632

#ACR22 #ICYMI

How to perform some of these #Sjogrens diagnostic tests?

https://twitter.com/vksandhumd/status/1591072251129974784

RT @vksandhumd@twitter.com

Unstim salivary flow
Dixie cups + drool x 5 min + scale
1mg = 1mL saliva
<0.5mL - abnml

Schirmer's test location: medial 2/3 and lateral 1/3 meeting point.
<10 - abnml

Focus score = # of foci (50Lyc) per 4sqmm

#ACR22 #ReviewCourse

🐦🔗: https://twitter.com/vksandhumd/status/1591072251129974784

#ACR22 #ICYMI
Accompaniment to the #Sjogrens talk in the #ReviewCourse

https://twitter.com/CreakyJoints/status/1591075827974049792

RT @CreakyJoints@twitter.com

Lots of talk this morning at #ACR22 about #sjogrens. Key takeaway ▶️ while dry eye and parched mouth may be common symptoms, there's more you should pay attention to. Check out this resource for more info on those symptoms:

https://creakyjoints.org/symptoms/sjogrens-syndrome-symptoms/

🐦🔗: https://twitter.com/CreakyJoints/status/1591075827974049792

#ACR22 #ICYMI

#ReviewCourse #Sjogrens talk had a lot of emphasis on the DDX

https://twitter.com/RashmiDhitalMD/status/1591076450362433537

RT @RashmiDhitalMD@twitter.com

The many mimics of SjD #ACR22 https://t.co/7p6J6UKcQp

🐦🔗: https://twitter.com/RashmiDhitalMD/status/1591076450362433537

Waiting for him to say "VEXAS rhymes with Texas" as he did in a prior presentation

#ACR22 #ReviewCourse https://twitter.com/DrPedsRheum/status/1364621046947606529?s=20&t=LN8nbCFX4Kc_2RzyOEr6qA

"This is fact stranger than fiction!"

🔍odd vacuoles in the myeloid precursor cells in the bone marrow

After discussion with heme path, they found more patients (seen 8 yrs prior) with #VEXAS

#ACR22 #ReviewCourse

🧬"UBA1 is the mother of all ubiquitin genes"

🔍Curious part of the story: it's encoded on the X chromosome in a disease seen in older men

💡It's a sporadic mutation

#ACR22 #ReviewCourse

He's going to end with #VEXAS with the exclamation point

The story involves working backwards: genotype first, rather than collecting cases with similar phenotype

#ACR22 #ReviewCourse

Now the story of DADA2

protein: adenosine deaminase 2
➡️effects on vascular and myeloid development
➡️hence early onset strokes, livedo, vasculopathy

#ACR22 #ReviewCourse

"A triumph of molecular medicine": the effective use of IL-1b inhibition in cryopyrinopathies

An erstwhile mentor told me this was a "feel good NIH story"

#ACR22 #ReviewCourse

Cryopyrinopathies:

🧬NLRP3 mutation (protein, cryopyrin)

💉IL 1 inhibitors

#ACR22 #ReviewCourse

HIDS: a misnomer; 🧬MVK mutation (mevalonate kinase)

💉canakinumab

#ACR22 #Reviewcourse

TRAPS - perhaps best to learn it in contrast to FMF
⚡️longer episodes
⚡️not responsive to colchicine

🧬TNFRSF1A, coding for p55 TNF receptor
💉canakinumab (though steroids effective)

#ACR22 #ReviewCourse

FMF 101, all on one slide

🧬Mutation: MEFV which encodes the protein pyrin
(#ACRKnowledgeBowl stuff!)

💊colchicine or 💉canakinumab if intolerant/refractory

#ACR22 #ReviewCourse

RT @noellealicia242@twitter.com

Last speaker up! Diagnosis and Management of Autoinflammatory Syndromes by Dr. Kastner of NIH! #ACR22 #reviewcourse

🐦🔗: https://twitter.com/noellealicia242/status/1591147819003678720