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Periprosthetic Fractures: The New Osteoporotic Fragility Epidemic
Posted By: 
Richard S. Pope, PA-C, MPAS
September 07, 2021
Periprosthetic fracture, defined as a post-operative fracture around or near a prosthesis, has become increasingly common. This was shown in a study published in BMJ in 2020. The study period took place over 3.5 years, from April 2015 to December 2018, and used the International Classification of Diseases 10th (ICD-10) Revision code M96.6 (fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate) to identify these fractures in England's national dat... Continue Reading
Filed under: Orthopedics, Rheumatology
Prime Time for Osteoanabolic Therapy
Posted By: Richard S. Pope, PA-C, MPAS
September 03, 2021
We now have fracture risk reduction evidence from 2 separate trials comparing oral bisphosphonates with osteoanabolic medications. These well controlled phas... Continue Reading
Filed under: Orthopedics, Rheumatology
Advanced Practice Clinicians in Rheumatology, Part 1
Posted By: 
Jennifer Simpson, DNP
August 27, 2021
I have been practicing as an NP in rheumatology for 7 years and I love it. I got lucky, really: A recruiter reached out to a fellow student who was not inter... Continue Reading
Filed under: NPs & PAs, Practice Management/Career, Rheumatology
Two Low-tech, High-value Methods for Reducing Knee Pain in Your Patients With Arthritis
Posted By: Richard S. Pope, PA-C, MPAS
May 28, 2021
Osteoarthritis (OA) of the knee is one of the most common musculoskeletal conditions treated in this country. According to NIH statistics, in 2005 there were... Continue Reading
Filed under: Orthopedics, Rheumatology
Understanding Raynaud’s Phenomenon
Posted By: Richard S. Pope, PA-C, MPAS
February 12, 2021
Color changes in patients' fingertips during cold weather can be confusing. It is important to distinguish Raynaud's phenomenon, as it can be associated with... Continue Reading
Filed under: Cardiometabolic, Rheumatology
Not so FAST! Febuxostat vs Allopurinol Showing Equal Safety – Results of the FAST Trial in Europe
Posted By: Richard S. Pope, PA-C, MPAS
February 09, 2021
Optimal management of gout requires urate-lowering therapy; two commonly prescribed therapies for this are febuxostat and allopurinol. However, since 2018, t... Continue Reading
Filed under: Cardiometabolic, Rheumatology
Can Leading a Healthy Lifestyle Change the Likelihood of Developing Systemic Lupus Erythematosus?
Posted By: Richard S. Pope, PA-C, MPAS
December 31, 2020
An abstract presented at this year's American College of Rheumatology (ACR) conference asked whether the likelihood of being diagnosed with systemic lupus er... Continue Reading
Filed under: Preventive Medicine, Rheumatology
Gastric Bypass or Joint Replacement: Which Is the Better Option for Osteoarthritis of the Knee?
Posted By: Richard S. Pope, PA-C, MPAS
December 28, 2020
In November 2020, the American College of Rheumatology (ACR) hosted a virtual poster presentation. Abstract 1651, "Knee OA outcomes in patients with severe o... Continue Reading
Filed under: Orthopedics, Rheumatology
ACR Recommendations for Adult Patients With Rheumatoid Arthritis in the Context of COVID-19
Posted By: Richard S. Pope, PA-C, MPAS
October 09, 2020
Since COVID-19 will continue to be with us for some time, patients on disease modifying antirheumatic drugs (DMARDs) may discontinue therapy on their own due... Continue Reading
Filed under: Infectious Diseases, Rheumatology
Synovial Biopsy in Rheumatoid Arthritis: The Next Big Thing?
Posted By: Richard S. Pope, PA-C, MPAS
October 06, 2020
Synovial fluid aspirates, biomarkers in blood, serologic testing, radiography, and ultrasonography have all been used to assist in the diagnosis and manageme... Continue Reading
Filed under: Rheumatology
Uses of Anti-CCP in Early Rheumatoid Arthritis
Posted By: Richard S. Pope, PA-C, MPAS
July 07, 2020
A young woman presents for evaluation of joint pain in both wrists and hands and swelling of one knee. Her history and physical exam suggest rheumatoid arthr... Continue Reading
Filed under: Rheumatology
2020 ACR Gout Guidelines for Allopurinol Have Changed!
Posted By: Richard S. Pope, PA-C, MPAS
July 02, 2020
Gout is the most common type of inflammatory arthritis in both men and women in the United States. Allopurinol is commonly used to manage hyperuricemia in it... Continue Reading
Filed under: Rheumatology
Do Traumatic Fractures Relate to Osteoporosis? Is a Paradigm Shift Coming?
Posted By: Richard S. Pope, PA-C, MPAS
May 01, 2020
A new study by Leslie and colleagues evaluating high and low trauma fractures may change our thought process regarding how traumatic fractures pertain to ris... Continue Reading
Filed under: Orthopedics, Rheumatology
Raynaud’s Phenomenon: A Common Sense Approach to Diagnosis and Management
Posted By: Richard S. Pope, PA-C, MPAS
December 27, 2019
Raynaud's phenomenon (RP) is all too common in New England during the colder months of the year. In October, we often see patients return who ha... Continue Reading
Filed under: Miscellaneous, Rheumatology
Hydroxychloroquine Monitoring: A Common Drug Seen in Primary Care
Posted By: Richard S. Pope, PA-C, MPAS
October 25, 2019
Hydroxychloroquine (Plaquenil) has been a staple for treatment of rheumatoid arthritis, systemic lupus erythematosis (SLE), and discoid lupus for many decade... Continue Reading
Filed under: Rheumatology
Medical Marijuana, Fibromyalgia, and PTSD
Posted By: Richard S. Pope, PA-C, MPAS
August 23, 2019
Have you made up your mind about the use of medical marijuana in your practice? I haven't yet, but writing this posting has improved my knowledge of its use.... Continue Reading
Filed under: Rheumatology
Lyme Arthritis—From High Index of Suspicion to Diagnosis and Treatment
Posted By: Richard S. Pope, PA-C, MPAS
August 20, 2019
An effusion of the knee(s) is the most common manifestation of Lyme arthritis, a late stage of infection with Borrelia burgdorferi, the tick involve... Continue Reading
Filed under: Infectious Diseases, Rheumatology
How Do Drug Pricing Systems Work? If There Is More Competition, Shouldn’t the List Price Go Down?
Posted By: Richard S. Pope, PA-C, MPAS
June 22, 2019
Have you ever noticed how much more expensive drug prices become every year? I think we have all noticed this increase, so this week I decided to look in to... Continue Reading
Filed under: Health Policy and Trends, Rheumatology
What is the Best Treatment for Painful Osteoporotic Compression Fractures of the Spine?
Posted By: Richard S. Pope, PA-C, MPAS
April 19, 2019
Pop quiz: What is the best method of treatment for osteoporotic compression fractures of the spine? Nonsurgical treatment (NST) Balloon kyphop... Continue Reading
Filed under: Rheumatology
A View of Rheumatology From 31 Years And 30,000 Feet
Posted By: Richard S. Pope, PA-C, MPAS
April 16, 2019
The last 31 years of my PA career has been in the subspecialty of rheumatology. As I reflect on the changes in the field, I have become aware of the incredib... Continue Reading
Filed under: Rheumatology
Expanding JAK Inhibitor Market for RA on the Horizon in 2019: “Which One Is the Best?”
Posted By: Richard S. Pope, PA-C, MPAS
March 22, 2019
Rheumatoid arthritis (RA) treatments continue to improve outcomes in the latest clinical trials. At the 2018 American College of Rheumatology (ACR) meeting t... Continue Reading
Filed under: Rheumatology
CARES Study Prompts FDA Boxed Warning on Febuxostat
Posted By: Richard S. Pope, PA-C, MPAS
March 19, 2019
On February 21, 2019, the US Food and Drug Administration (FDA) issued a boxed warning on febuxostat. This was a result of the CARES study published in the Continue Reading
Filed under: Rheumatology
How Do You Make a Diagnosis of Gout Without Seeing MSU Crystals Under a Microscope?
Posted By: Richard S. Pope, PA-C, MPAS
February 22, 2019
Primary care/urgent care/emergency rooms are all settings where acute monoarthritis is seen. The differential diagnosis includes acute crystal arthritis (gou... Continue Reading
Filed under: Rheumatology
Is Long-term Survival Associated With the Use of Nitrogen-containing Bisphosphonates?
Posted By: Richard S. Pope, PA-C, MPAS
February 20, 2019
In the January issue of Osteoporosis International, there was an article entitled, “Mortality Risk Reduction Differs According to Bisphosphonate C... Continue Reading
Filed under: Rheumatology