Stephen Slade, MD

Rheumatologist via @CUAnschutz, @VirginiaMason, @IowaMed, @DrakeUniversity. Process improver. Lawful/Neutral Good. Wordplay: the pun is mightier than the sword.

[Stephen Slade, MD @DrStephenSlade]

@sargsyanz @tatialiketasha “I just want to make sure the computer matches reality!”

[Stephen Slade, MD @DrStephenSlade]

@AaronGoodman33 As a subspecialist assessing multisystem diseases, I use “Consider” to comment on concepts outside my field or general internal medicine outside the reason I was consulted. Good specialty medicine requires good general medicine, and we can all pitch in

[Stephen Slade, MD @DrStephenSlade]

30% of recurrent rhabdomyolysis associated with RYR1 mutations (ryanodine receptor 1) - check gene panel instead of muscle biopsy for diagnosis #RheumBoards

[Stephen Slade, MD @DrStephenSlade]

Ryanodine is a…

[Stephen Slade, MD @DrStephenSlade]

@BharatKumarMD @philseo @ACRheum Doing great and excited to be back in Iowa, with Iowa Arthritis and Osteoporosis Center in Des Moines! Best of luck in your newest venture 🍀

[Stephen Slade, MD @DrStephenSlade]

Thanks to @philseo for his service in the role, and congrats to @BharatKumarMD—upcoming physician editor for @ACRheum The Rheumatologist publication 👏

[Stephen Slade, MD @DrStephenSlade]

@AaronGoodman33 Look for mimics too, like AL amyloidosis or even ANCA-associated vasculitis—but give steroids in the meantime!

[Stephen Slade, MD @DrStephenSlade]

@MKIttlesonMD In Epic, using braces {} will highlight enclosed text and be F2-searchable, like ***, which I find nice for phrases that are not uniformly applicable

[Stephen Slade, MD @DrStephenSlade]

@jbcarmody Intriguing use! Exclusively for bureaucratic compliance, don’t trainees just need to binarily report whether they experienced duty hour violations? Simpler than comprehensively logging, though still a resident burden

[Stephen Slade, MD @DrStephenSlade]

@dpfeifleMD @MayoMN_IMRES @IUPCCM Congrats, Dan, and very best of luck!! 👨‍⚕️ 👨‍🎓 ➡️ 🫁

[Andrew Sanchez @ASanchez_PS]

✨ Approach to Infiltrative Diseases! ✨

This framework was inspired by @Gurpreet2015's recent Clinical Problem Solving Grand Rounds for @UCSFDOM. Many teaching points on this DDx also passed down by the @CPSolvers.

First, what are the Infiltrative Diseases?

[Stephen Slade, MD @DrStephenSlade]

A shame @DGlaucomflecken didn’t visit us in the #rheumatology division while speaking at @CUMedicalSchool commencement. Maybe it’s because we’re a hoax?

[Stephen Slade, MD @DrStephenSlade]

@AshleyGWinter That being said, if the question is more about safety, rather than efficacy, it’s a generally good and well tolerated med. Avoid in diverticulITIS and monitor lipids. Will “artificially” normalize CRP (cannot use as biomarker). Wishing her well!

[Stephen Slade, MD @DrStephenSlade]

@AshleyGWinter TCZ great in GCA…but PMR-SPARE trial very preliminary and underwhelming. My take: *consider* TCZ if unable to taper steroids <10mg but not 1st-line. Start with pred 15-20mg, unless GCA features. Interested to hear from others and PMR-SPARE acolytes

[Stephen Slade, MD @DrStephenSlade]

@olsonplanner At the risk of irony, can the answer be “no?”

[Stephen Slade, MD @DrStephenSlade]

@AdamRodmanMD Did this ever appear with a public link?

[Stephen Slade, MD @DrStephenSlade]

Against Arguments Continued:
• Prognosis: decades of AS data to predict and counsel
• ⬇️Treatment response in nr-axSpA ➡️ implications for Pharma research 🔬💊
• Regressive lumping (e.g. PAN ➡️ DAD2, RPC ➡️ VEXAS)

[Stephen Slade, MD @DrStephenSlade]

#GreatDebate 🧵 on whether axSpA should replace and combine radiographic (ankylosing spondylitis). Arguments below, at #SPARTAN22

[Stephen Slade, MD @DrStephenSlade]

Against Arguments:
• Different phenotypes: ⬆️female, ⬇️uveitis, ⬇️CRP in nr-axSpA
• Genetics: ⬇️ similarity
• Progression: only 19-27% progression to AS at means 5-11yr f/u
• Subgroup preservation: splitter > lumper. nr-axSpA diagnosis may be misdiagnosis