Chronic Pain in Spondyloarthritis: Differentiating Active Disease From Fibromyalgia

In this episode, we examine Behcet’s Disease—a rare, multisystem inflammatory disorder that continues to challenge traditional frameworks of autoimmunity and vasculitis. Dr. Johannes Nowatzky joins us to discuss the disease’s hallmark features, including recurrent mucocutaneous ulcers and ocular involvement, as well as its geographic distribution and genetic associations. We explore the diagnostic difficulties posed by its heterogeneous presentation and symptom overlap with other conditions, and the rationale behind individualized, often multidisciplinary treatment strategies. This conversation offers valuable insights into a condition that remains as enigmatic as it is clinically significant. 

In this episode, we deliver a critical update on the rapidly evolving legislative landscape impacting rheumatology. We explore the intense policy battles shaping the future of the field, including steep Medicare reimbursement cuts threatening the survival of many practices. We also examine the ongoing challenges posed by pharmacy benefit managers (PBMs) and the growing uncertainty around research funding. Joining us is a special guest, Lennie Shewmaker McDaniel, JD, who brings a firsthand perspective from Capitol Hill, shedding light on what it truly takes to advocate for our patients and the profession in today’s complex policy environment. 

In this episode, we examine the evaluation of pain in patients with chronic inflammatory arthritis, with particular attention to spondyloarthritis and its clinical overlap with fibromyalgia. We explore why some patients continue to report persistent pain despite well-controlled inflammation, and the importance of distinguishing between active inflammatory disease and centralized pain syndromes such as fibromyalgia. Join us as we unpack the diagnostic nuances that can significantly impact patient care. 

This episode explores the evolving role of GLP-1 agonists in rheumatology, highlighting their potential to influence weight, inflammation, and overall disease activity. Our guest expert unpacks how adipose tissue contributes to systemic inflammation and why managing body weight is crucial in the treatment of rheumatic diseases. We delve into the underlying science, real-world clinical applications, and the exciting future of incorporating GLP-1 therapies into comprehensive rheumatologic care—offering fresh insight into a therapeutic class with game-changing potential. 

In this episode, we dive into the evolving role of AI in rheumatology—exploring how it's already reshaping workflows, enhancing diagnostic accuracy, optimizing treatment selection, and helping us monitor patients remotely. We tackle big questions around bias, control over critical data and whether we're truly ready to let AI serve as our assistants—or even gatekeepers. From addressing workforce shortages to revolutionizing medical research and education, we examine both the promise and the pitfalls of this powerful technology, and why caution must guide its integration into our clinical decisions.

In this episode, we dive into the complexities of IgG4-Related Disease (IgG4-RD), a mysterious and multi-organ condition that continues to challenge both patients and physicians. Back in January 2024, Dr. John Stone introduced us to the emerging landscape of treatments for IgG4-RD, and today, Dr. Matthew Baker joins us to provide an exciting update. With new therapies on the horizon, we explore the role of B and T cell pathogenesis, the limitations of traditional steroid treatments, and the off-label use of rituximab. We also take a closer look at the promising results from the “Mitigate Trial,” which offers hope for future strategies in managing this enigmatic disease. Join us as we discuss the evolving treatment landscape and what lies ahead for those affected by IgG4-RD. 

In this episode, we dive into a fascinating and often overlooked aspect of rheumatology: complications from diabetes that can mimic rheumatic diseases. Dr. Schiopu kicks off the discussion by shedding light on Diabetic Myonecrosis, a painful muscle condition that can be easily mistaken for other rheumatic disorders. We then explore Scleroderma, a skin-thickening muscle disorder that resembles systemic sclerosis (SSC) but has distinct underlying mechanisms. Dr. Schiopu shares invaluable insights on how to approach complex rheumatology consults in the hospital, emphasizing the importance of thoughtful diagnostic reasoning. She also discusses why sometimes the best approach in medicine is to avoid unnecessary tests and treatments, prioritizing patient care and accuracy in diagnosis. 

In this episode, we dive into the cutting-edge advancements presented by Dr. Christopher T. Ritchlin at Convergence 2024, where he shed light on the promising research set to transform the field of rheumatology. Join us as we break down key insights from one of the field’s leading experts, exploring the future of precision medicine, the role of TRBV9 cells in axSpA, the impact of sex differences on PsA, and the potential of urinary biomarkers in Lupus Nephritis. Tune in for a fascinating discussion on what’s next in rheumatology. 

In this episode, we explore a potential paradigm shift in the treatment of Rheumatoid Arthritis. For years, pharmacologic interventions have been the cornerstone of management, but now a groundbreaking approach is emerging. John Tesser, principal investigator in a pioneering study, discusses the use of an implantable device that stimulates the vagus nerve. By tapping into the body’s nervous system to reduce inflammation, this novel approach offers a promising alternative to traditional drug treatments. Tune in to learn how this innovative technology could reshape the future of Rheumatoid Arthritis care. 

In this episode, we explore the unique challenges and considerations in treating older adults, focusing on the need for a different approach to care due to polypharmacy and multimorbidity. We delve into the complexities of managing these patients, emphasizing the importance of understanding frailty—how to assess, prevent, and address it. The discussion also covers late-onset rheumatoid arthritis, its distinction from rheumatoid arthritis, and why it often goes underdiagnosed and undertreated. We introduce the 5 M’s framework; a geriatric care model that helps clinicians focus on what truly matters to older adults. Additionally, we address the role of palliative care in rheumatology, highlighting its importance beyond end-of-life care, and provide guidance on shared decision-making with older adults and their families to ensure patient-centered outcomes.