22. The Impact of Diet on Rheumatic Conditions

In this episode, we explore malignant atrophic papulosis—also known as Degos disease—an extraordinarily rare microvascular disorder so uncommon that most clinicians will never see a single case. For decades, medical literature labeled it "uniformly fatal." Our guest, Dr. Lee Shapiro, encountered this reality when he began treating a rapidly deteriorating 16-year-old boy with no clear treatment path. Driven by urgency, he reached out to experts across the country, slowly piecing together clues that ultimately led to the first successful treatment of systemic Degos disease. Today, Dr. Shapiro is a leading advocate for patients, connecting a global community, promoting early recognition, and working tirelessly to expand access to life-saving therapies.    Learn more at The Degos Disease Foundation 

Once the prescription is written, pharmacists like Katherine McCarthy step in—often becoming the steady guide patients rely on throughout their health journey. Specializing in the care of people with rheumatic diseases, Katherine tackles insurance barriers, supports patients through biosimilar transitions, and helps demystify complex medication regimens. Her work underscores just how pivotal pharmacists are in driving better outcomes in rheumatology. 

This episode explores the evolving intersection of rheumatology and cognitive science, beginning with what initially drew researchers to investigate cognitive symptoms in patients with rheumatoid arthritis (RA). We discuss the prevalence and nature of patient-reported cognitive concerns, how these subjective complaints compare with objective neurocognitive testing, and what current studies reveal underlying inflammatory and neurobiological mechanisms. The conversation examines the cognitive effects of commonly used RA therapies, as well as modifiable contributors—including physical activity, sleep apnea, diet, and stress—that clinicians should assess in routine practice. We also consider when formal neuropsychological evaluation is warranted, how to counsel patients seeking to prevent cognitive decline, and the most pressing unanswered questions that remain in the field. 

In this episode, we explore what happens when clinicians look beyond the prescription pad and begin listening more deeply to what their patients have lost. This isn't a conversation about rejecting medications but about expanding the tools we use to foster healing. We discuss the concept of disenfranchised grief—the often-unspoken losses that accompany chronic illness—the intricate links between depression and inflammation, and the transformative power of helping patients heal in ways that no pill alone can achieve.  This episode was sponsored by Pfizer

In this episode, we shine a light on Calcium Pyrophosphate Deposition Disease (CPPD)—a condition that has been hiding in plain sight for decades. Despite being common, painful, and prevalent in clinics everywhere, CPPD has long been misdiagnosed, undertreated, and under-researched. Our guest has been working to change that by uncovering the genetic and molecular underpinnings of the disease and exploring new ways to improve patient outcomes. We discuss what's new and what's next for CPPD, why it may be the most common inflammatory arthritis after age 60, how it overlaps with rheumatoid arthritis and osteoarthritis, and what emerging studies of biologics are revealing about its biology and untapped therapeutic potential.  This episode was sponsored by Pfizer

In this episode, we explore RheumCode, a groundbreaking new initiative from the American College of Rheumatology (ACR) designed to build a common digital language for rheumatology. RheumCode aims to ensure that data means the same thing wherever it lives—whether in an EHR, a clinic, or a registry—enabling systems to seamlessly communicate and make better use of the medical information already being documented. We discussed how RheumCode began, the collaboration behind its development, and its potential to transform the way clinicians practice; researchers study disease, and patients experience their care.  This episode was sponsored by Pfizer  

Welcome to ACR Convergence 2025 in Chicago! Here, Dr. Hausmann delivers a quick update on what our podcasts will cover while the meeting is in session. Don't forget to tune in to ACR on Air and ACR Journals on Air each morning, starting this Saturday, to catch up on the latest in Rheumatology

In this week's episode, we dive into the ins and outs of the rheumatology musculoskeletal ultrasound certification process—what it takes to log 150 scans, meet CME requirements, and ultimately sit for the exam. We're joined by Dr. Liudmila Kastsianok, who shares her insights on how ultrasound is reshaping clinical practice, from enhancing diagnostic accuracy to opening new avenues in research. We also explore how incorporating ultrasound into routine care can deepen the physician-patient relationship and improve communication. Finally, Dr. Kastsianok offers her perspective on where the field is headed and why ultrasound is becoming an essential skill for the next generation of rheumatologists. 

In this episode, we preview ACR Convergence 2025 in Chicago this October with Dr. Greg Gardner, Chair of the Annual Meeting Planning Committee (AMPC). We'll explore key topics like emerging therapies, AI in rheumatology, and highlights such as the Practice Innovation Summit, Ultrasound Course, and Fellows In Training (FiT) Program. Dr. Gardner also discusses highlights such as, CAR T-cell therapies, new non-renal lupus guidelines, a Live Journals Club focused on Big Data and why this year's meeting is earlier on the calendar. Tune in for a sneak peek at what's to come! 

In recognition of Rheumatic Disease Awareness Month this September, this episode explores the critical yet often underutilized role of exercise in the management of rheumatic diseases. We examine how structured movement—ranging from step counts to resistance training—can significantly alter the trajectory of pain, function, and overall disease progression. Our discussion offers practical strategies for helping patients integrate physical activity into their daily routines, with a focus on starting gradually and maintaining consistency. We also address the heightened cardiovascular risks associated with rheumatoid arthritis and how targeted exercise interventions can mitigate these risks. Finally, we delve into fall prevention tactics and the use of technology and interdisciplinary care teams to set achievable, patient-centered goals that physical therapists can effectively support.