Discover and read the best of Twitter Threads about #rheumatoidarthritis

Most recents (20)

Thanks for playing the anatomy game everyone

Many mentioned the skin as 1 of their 5 organs

Some mentioned the gut (intestine/bowel)

There’s another organ that bridges the skin and gut, which nobody has mentioned …
The mouth! Image
Read 9 tweets
I'm 1 of 50 million Americans living with an immune system that mistakenly attacks/damages healthy tissue (rude). During #AutoimmuneAwarenessMonth we strive to promote better understanding of these complex chronic conditions. Follow me as I share my journey this month. Image
2) It takes an average of 4.5 years and 4 physicians for patients to recieve an autoimmune diagnosis:
-Many conditions mimic others
-Lab tests are not always definitive
-Symptoms flare and dissipate frequently
-Diseases often appear in clusters
3) This is me at 32, a month before I woke up 1 day + couldn't walk. Days later I couldn't bend my fingers. Bilateral pain/swelling + fam history of #rheumatoidarthritis prompted labs. Sky high CRP, ESR, rheumatoid factor sent me to a #rheumatologist.
#AutoimmuneAwarenessMonth Image
Read 47 tweets
The prevalence of #rheumatoidarthritis 🌍 ~1%

🙀 So ~14 million suffer from RA!

So we 👩‍⚕️ have to deal with special situations while managing this fairly common disease!

#MedTwitter #MedEd #rheumatology #RheumTwitter

@MedTweetorials @nihardesai7

Let's begin with one of the most beautiful miracles of life ☺️

#pregnancy in #rheumatoidarthritis

🤔Is it safe to conceive for a patient with RA? 🤰

👉Overall it is safe ☑️☑️☑️

👉But a mild risk of hypertensive disorders, IUGR and need for caesarian section +!

Read 9 tweets
💭When we think of #Rheumatoid #Arthritis , a mental image of this comes up 👇

But does it have to get to this🤔???

🙅NO! Definitely, NO! 🙅

#MedTwitter #MedEd #RheumTwitter #Rheumatology


(1/8) Image
🪜The first step is early diagnosis, do not wait until the deformities to form!

💬Think of RA when a patient presents with

🔸Morning stiffness>30 minutes


(2/8) ImageImage
🧪👨‍🔬A positive Rheumatoid factor is seen in ~70% of cases and anti-CCP in ~75% cases, so about 1/5th of the cases may be seronegative!!

So a good history and clinical examination is the king 👑

Read 8 tweets

Considered a cornerstone of Rheumatoid Arthritis treatment among other autoimmune conditions

FDA approved in 1988 for the treatment of #rheumatoidarthritis but DISCOVERED in the 1940s

⁉️ why the delay ⁉️

here is the (short)story 🧵

#meded #rheumtwitter
Dr Sidney Farber, pediatric pathologist, considered a founder of chemotherapy

recognized folic acid is important for DNA synthesis

🌟cancer needs more DNA synthesis

🌟Aminopterin developed to BLOCK folic acid and decrease cancer cell growth

🌟Used to treat childhood Leukemia
Methotrexate, a similar molecule was found to be better tolerated and easier to administer
Read 8 tweets
#LongCovid recovery story is long but short notes here:
#POTS confirmed with heart rate variability test & started on Ivabradine.
#MCAS treated based on clinical symptoms with Desloratadine, Famotadine, Montelukast-Cetrizine
#autoimmune assays done - #rheumatoidarthritis
Started on Methotrexate after all vaccinations. GI motility treated with Prucalopride.
Lung perfusion abnormalities but no cause detected (#microclots in blood) - treated with budesonide + tiatropium inhalers, ipratropium nebuliser & supplemental oxygen. #NEISvoid
Weekly IV infusions with Saline at home. Pulmonary rehabilitation. Eyes checked - connective tissue degeneration- tear film corrected with refresh tears & gel, special glasses & convergence exercises given.
Read 7 tweets
The Gut #Microbiome is implicated in the pathogenesis of inflammatory arthritides & other health conditions

Gut dysbiosis is a broad term relating to an 'imbalance' of gut microbiota associated with an unhealthy outcome

I find this an interesting topic with several unknowns

🧵 Image
"Gut inflammation is strongly associated with #Spondyloarthritis (SpA), as exemplified by the high prevalence of inflammatory bowel disease (IBD) and the even higher occurrence of subclinical gut inflammation in patients with #SpA."… Image
"Gut #Microbiome composition differs across regions and ethnicities, changes over time, and can be influenced by multiple factors, including, among others, diet, lifestyle, hormonal cycles, disease, comorbidity..."

'Gut microbiome in #Rheumatic diseases'… Image
Read 11 tweets
Differential diagnosis of RA-like arthritis based on the pattern of joint involvement is fascinating

Here is a 🧵 exploring this journey

#medtwitter #RheumTwitter @CPSolvers @rabihmgeha @DrCindyCooper @DxRxEdu @Sharminzi @sargsyanz @rav7ks @RosenelliEM @AnnKumfer @jackpenner
Various patterns of hand joint involvement

- PIP +DIP +1st CMC = OA
- MCP +PIP +Wrist = RA
- 2nd & 3rd MCP = Hemochromatosis
- Wrist +2nd MCP + 2nd PIP + all DIP= PsA
- Dactylitis/Sausage digits = PsA, Sickle cell anemia, Polyarticular gout, Sarcoidosis

#medtwitter @MithuRheum
Infections causing RA-like pattern

- Parvovirus B19
- HTLV-1
- Rubella
- HBV, VZV, Mumps (Large joints more common)
- Arboviruses: Chikungunya, Dengue
- Poncet's disease/ Tuberculous Rheumatism

Read 9 tweets
Do you know all of these nuances of #pleuraldisease? Why is an #empyema distinct from a complicated #parapneumoniceffusion? What is #contarinisyndrome #explosivepleuritis #chyliform #pseudochylous? Are all #chylothorax milky? #pccm #pulmcrit #pulmonary
#pleuraldisease is fascinating and nuanced. First step is #lightscriteria which give favor to finding #exudates which tend to be more urgent. You only need one criterion, which maximizes #sensitivity. Meaningless statement: "It's an exudate only by protein." One criterion=exudate
(Like on Tinder, the more criteria you require, the more you narrow your pool, compromising sensitivity for specificity.) Transudates I will skip over. Most common #exudate is #parapneumoniceffusion #PPE. If there is or is likely to be #pneumonia, it's PPE. Next task is to...
Read 26 tweets
Okay let's talk accommodations! I am grateful to have mine which include working from home during the pandemic and having a research assistant because my #RheumatoidArthritis has hit me fast and furious. But for me, they weren't easy to get... Mainly on the medical side 1/
I live in #Houston, Texas that has the WORLD'S largest medical center in the world. I was required to do a Functional Capacity Evaluation (FCE) because my initial rheum said he wasn't qualified to say what my impairments were... 2/
We had several appointments where I described to him the things I could and could not do. He wouldn't even prescribe me a rollator to get around even though I needed one. I couldn't ambulate well and was in excruciating pain if I attempted 0.1mi walks. 3/
Read 25 tweets
Delighted to share our latest work on defining the effects of the HLA on an intermediate phenotype: the T cell repertoire with @Kazu_Ishigaki… #genetics #type1diabetes #rheumatoidarthritis
HLA influence autoimmune risk. 2 non-exclusive hypotheses: i) the peripheral hypothesis, where HLA risk alleles increase binding to antigens ii) the central hypothesis, where HLA risk alleles influence thymic selection to select for antigen reactive T cell receptors (TCRs).
The CDR3 region of TCR recognizes antigens. CDR3 diversity in the repertoire gives the immune system its ability to respond to many antigens. If central hypothesis plays a role in HLA mediated risk, then the HLA alleles might influence CDR3 composition during thymic selection.
Read 7 tweets
A thread about our new paper…

A systematic review exploring the evidence reported to underpin exercise dose in clinical trials of rheumatoid arthritis…

#exercise #rheumatoidarthritis #clinicaltrials
@RheumJnl @thecsp
In the UK exercise is recommended by NICE alongside pharmaceutical interventions for the management of RA. Strengthening exercise is commonly used to counter the cachectic effects (muscle wasting) due to the disease. As with most things, dose is likely to matter 2/
Clinicians are encouraged to be evidence-based. RCTs are seen as one form of evidence that may be used to support clinical practice. However, have you ever wondered how researchers underpin the dose they prescribe in their trials? So did we, so we systematically looked... 3/
Read 24 tweets
Which of the following agents is not a TNF-alpha inhibitor?
TNF-alpha inhibitors were initially developed for sepsis and underwent studies in animal models. After successful results in patients with rheumatoid arthritis, these agents have been widely evaluated in other chronic inflammatory diseases.…
Read 18 tweets
In May my wonderful mother and amazing Oma to my son died. A long thread about, her, #mentalhealth #rheumatoidarthritis #cancer #NHS #carehomes #covid19 1/43 Marie Frosch stood at lake
I couldn’t have asked for a better mother, she embodied one of her favourite poems ‘Why god made friends’ 2/43 Image
And a former neighbour, about 50 years younger than her, captured her so beautifully when she wrote this 3/43 Image
Read 44 tweets
Patients with autoimmune diseases, such as #lupus and #RheumatoidArthritis, are having trouble filling their prescriptions since Trump touted their medicine as an experimental treatment for #Covid19. /thread…
“The hasty and inappropriate interpretation of the literature by public leaders has potential to do serious harm" write 2 rheumatology experts in the Annals of Internal Medicine.…
FL pharmacists report "nearly all of the new prescriptions for #hydroxychloroquine are being issued for the prescribing practitioners themselves or family members of the prescribing practitioners." Some drs are prescribing it to healthy people as a #Covid19 preventative.
Read 12 tweets
What's in a name?
Why @WHO's formal name for the new #coronavirus #disease matters:…

#COVID19 #Covid_19
1. Wash your hands often and/or use hand sanitizer more frequently.

2. Try not to touch your face... 🙈

3. Cough into your shirt or arm.

4. Stay home when you are sick.


Read 12 tweets
It's very good to see the first validation study @imaware_health. Congratulations to your team! This is important progress. I look forward to the followup studies described in the validation. In the meantime, I have some questions, which are numbered Q1-3 in this thread. 1/9
I am studying @MicrodropHealth / @imaware_health from multiple angles. I don't see investors or medical/scientific employees (rather than paid advisors) on the website. So I have a few Qs that arose as I started my review, and that I hope you are in a position to answer. 2/9
According to a PR release by the manufacturer of your kits, SQI Diagnostics @Best_Multiplex, the goal within a year is to begin testing 50k people annually for #celiac disease and 25k more for #rheumatoidarthritis… 3/9
Read 9 tweets
There has been a lot of talk in the last few days about #CMI & information provided by pharmacists & GPs when new medicines are provided.

@GregHuntMP @LeanneWells63 @CHFofAustralia @MetherellMark

@ShaneJacks @topherfreeman @PSA_National @gigmoses @elliott_rohan
One of the points raised is that written information is needed to support the person at a time when they are being inundated with new information

This is no doubt true - something I regularly call for - but it is also not a surrogate for the clinical role a pharmacist undertakes
I tweeted about a recent clinical discussion I had with a person in my pharmacy who had recently been diagnosed with #rheumatoidarthritis

You can see the summary here
Read 17 tweets
.@SarahbaxterSTM's argues that #fibromyalgia, #mecfs, #lupus, #depression, self-harming and #anorexia are caused by female ambition and fragility.

What's c. 1880 is new again.…
This is just so silly. In the 19th century, there was a panic in the medical profession (and among social commentators) about women becoming ill with neurological and "nervous" conditions because they were overworking their brains/nerves, which were naturally weaker than men's.
This “fact” was used to bolster the argument in favor of stopping women's formal education after age 16 and most certainly not letting them enroll in university.
Read 26 tweets

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