Fermín Gonzalez

[Wataru Hayashi / 林 航 @DraWataru]

Cytokine storm | Nature Reviews Disease Primers

(https://t.co/uD0amDEWZU)

[Santiago Oquendo MD @rksanti]

💧GOTA🦶
🔹 Artritis inflamatoria por depósito de cristales de urato monosódico cuando AU >6.8 mg/dL.
🔹 Fisiopatología: hiperuricemia (infraexcreción renal, base genética) → activación inmune → crisis dolorosa, tofos y erosiones.
🔹 Dx: cristales UMS en líquido sinovial (gold standard); AU puede ser normal en la crisis. US (doble contorno) y DECT ayudan.
🔹 Tx: crisis: AINEs, colchicina o corticoides. Crónico: bajar AU <6 mg/dL (alopurinol 1ª línea; febuxostat). Profilaxis al iniciar ULT.
🔹 Novedad: iSGLT2 ↓ urato y ↓ crisis/hospitalizaciones; énfasis en treat-to-target y titulación lenta.
📚 FitzGerald JD. Gout. Ann Intern Med (In the Clinic). 2025. doi:10.7326/ANNALS-24-03951
✅️Descarga aquí el pdf completo y Únete:https://t.co/alf9aGqxny

[Alí Sebastian Meza @AliSMV7]

🔺Cytokine storm (Nature 2026)

https://t.co/xk6CsoBH7x

[JAMA @JAMA_current]

The most common chronic liver disease worldwide, metabolic dysfunction–associated steatotic liver disease (MASLD) affects approximately 30% to 40% of the general adult population.

This Review summarizes the diagnosis, treatment, and prognosis of MASLD. https://t.co/cnge8XGwQ6

[ERM @Owner_X429]

Management of Chronic Kidney Disease in People with Diabetes
Reflections from the latest ADA 2026 Standards of Care Guide.

[Mario Pompermayer MD, RhMSUS @pompermarioMD]

It’s an honor to promote free education in Musculoskeletal Ultrasound (#MSUS) and Rheumatology.

We are happy to share the MSUS Database: over 1,000 images and videos of sonoanatomy and pathology, accessible with a single click from anywhere in the world 🌍 🌎 , even where there’s no textbook, mentor, or ultrasound machine, so students, residents, and practicing physicians can learn and compare cases in real time.

In the MSUS Database you will find:

1️⃣Shoulder Anatomy and Pathology
2️⃣Elbow Anatomy and Pathology
3️⃣Hand Anatomy and Pathology
4️⃣Hip Anatomy and Pathology
5️⃣Knee Anatomy and Pathology
6️⃣Foot Anatomy and Pathology
7️⃣Spine
8️⃣Soft Tissue
9️⃣Nerves
🔟Muscle
1️⃣1️⃣Interventional
1️⃣2️⃣Hyaluronic Acid
1️⃣3️⃣PRP
1️⃣4️⃣Doppler
1️⃣5️⃣Elastography
1️⃣6️⃣Trauma
1️⃣7️⃣Rheumatoid Arthritis
1️⃣8️⃣CPPD
1️⃣9️⃣And more…

📸 🎥 We’re expanding this library every week to its improvement! 🤝🌍

Special thanks to Giorgio Tamborrini of UZR Ultrasound Center (@rheumatology) for conceiving and leading this project and inviting me to contribute. It’s also a privilege to collaborate with MSUS experts such as:
🔹Dr. Jörg Dünkel of @SportklinikBern
🔹Dr. Alberto Schek @aschek3582

🔗 Explore & share: https://t.co/QYhHBlw5dz

❗️To find specific images or videos, go to the Photostream and use the 🔎 (magnifying glass) icon just below 👇 the “secondary menu”, or explore each album individually in its dedicated folder 📂

#MSUSDatabase #GlobalUltrasound #POCUS #FreeEducation #Rheumatology #MSUS #OpenEducation #FOAMed #USguidedInjections #PRP #SportsMed

[Aravind Palraj @Rheumat_Aravind]

🔍 ANA Positive - What Next? (2025 Approach)
ANA is a screening tool, not a diagnosis.
A simple, practical algorithm to avoid over-calling autoimmune disease:

1️⃣ Check clinical context
2️⃣ Look at titer & pattern
3️⃣ Order reflex antibodies
4️⃣ Correlate with symptoms - never by ANA alone
5️⃣ Classify into 3 outcomes

Infographic by Dr. Aravind Palraj
#Rheumatology #MedTwitter @DrAkhilX @IhabFathiSulima #MedicalEducation #FOAMed #SLE

[NefroClass @NefroClassMx]

Dapagliflozina 10 mg/día induce una glucosuria promedio de 78 ± 8 g/día (≈300 kcal), en pacientes con DM2 y FG normal

Equivale a 60 min/día de caminata rápida.
Pérdida de peso: 2.5 ± 0.6 kg a 24 semanas, principalmente grasa visceral.

DOI:10.1172/JCI72227

👇🏽

[Dr.Mukesh , MD , DM @dr_immuno29]

🚨 Deep Dive into IgG4-Related Disease (IgG4-RD) from Nature Reviews Rheumatology!

•🌟 What is IgG4-RD? A sneaky fibro-inflammatory disorder hitting multiple organs with slow-growing, pseudo-tumoural lesions—think hidden troublemakers!
•⚠️ Diagnosis Challenge: No gold-standard criteria! Needs a detective-like approach—blend clinical signs, radiology, and serology to ditch mimics like histiocytoses, vasculitis, and lymphoproliferative disorders.
•🎯 Subphenotypes: Spot the variety—Mikulicz (swollen glands), head-neck limited, pancreato-hepato-biliary (jaundice alert!), retroperitoneal/aortic—each with unique patient profiles, symptoms, and IgG4 levels!
•💊 Treatment: Glucocorticoids lead the charge, but B cell-depleting champs (rituximab, inebilizumab) and cytokine-targeting drugs are stealing the spotlight—most still in hot clinical trials!
•🔄 Chronic Nature: A relapsing rogue—demands vigilant, long-term follow-up to keep it in check!
•📊 Fun Fact: Hits men harder (2:1-3:1 ratio) with a vascular vibe—50% cases show large/medium artery involvement, even small vessels!
•🕵️ History Bite: Born in 2001 with autoimmune pancreatitis link—evolved into a systemic puzzle by 2003, tying sclerosing pancreatitis, Riedel thyroiditis, and more!
•🩺 Symptoms Spotlight: Jaundice, proptosis, abdominal pain, or cranial neuropathies—depends on the organ hit, making it a diagnostic rollercoaster!
•🔬 Histology Clue: Fibrosis + chronic inflammation = IgG4-RD signature—seen on FDG-PET-CT for activity tracking!
•🌐 Research Edge: Ongoing trials push boundaries with monoclonal antibodies—stay tuned for breakthroughs!
#IgG4RD #Rheumatology #AutoimmuneDisease #MedicalResearch #HealthInnovation #RareDisease #ClinicalTrials

https://t.co/bgqYTrDeZn

[Alberto Giraldo @alb_giraldo]

Relationship of sarcoidosis with other immune-mediated diseases
◦ #Sarcoidosis patients are more likely to have a history of #immune-mediated diseases (IMD) and have an increased risk of IMD after sarcoidosis diagnosis.
◦ There is a wide diversity of IMDs across several organ systems which have been observed to co-occur with sarcoidosis, including #autoimmune #rheumatic diseases such as ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, systemic sclerosis, Sjögren's disease, systemic lupus erythematosus, vasculitis, antiphospholipid syndrome, and inflammatory myopathies.
◦ Compared to other IMDs, it is unique for sarcoidosis that the male to female ratio is approximately 1 to 1, and that males tend to receive their diagnosis at a younger age than females.
◦ Sarcoidosis risk is increased in first degree relatives of patients with IMD, indicating some genetic overlap.

📸 Associations between sarcoidosis and immune-mediated diseases grouped by organ system.

*Arkema EV, Rossides M, Cozier YC. Sarcoidosis and its relation to other immune-mediated diseases: Epidemiological insights. J Autoimmun. 2024;149:103127.
🔗https://t.co/ZnaCMG2PdV

[Medicina Interna HCSBA @MHcsba]

Journal American Heart Association 2025: Endocarditis con hemocultivos negativos
DOI:10.1161/JAHA.124.040218
#MedEd #MedX #MedTwitter

[Aravind Palraj @Rheumat_Aravind]

Treatment of resistant proliferative lupus nephritis:

From Comprehensive Clinical Nephrology 7th Edition
@IhabFathiSulima @DrAkhilX @DurgaPrasannaM1 @JasmineNephro @thisis_drgsp #MedTwitter

[Jasmine Sethi @JasmineNephro]

✌️Cirrhosis and Ascites

By @TinaPhamHang

[Santiago Oquendo MD @rksanti]

🚨🧠🩸Manejo del ictus isquémico agudo en el servicio de urgencias: optimización del cerebro-2025✅
📚DOI:10.1186/s12245-024-00780-5
⚡️PDF👇https://t.co/i3gGexLm56

[Dr. John Cush @RheumNow]

Full read review of Hydryoxychloroquine -its pharmacology, MOA (eg, blocking TLR 7 &amp; 9), Dz specific efficacy and adverse effects https://t.co/WVErW1RrCj

[Juan David @Urrikinumab]

Algorithm for the treatment of acute and chronic forms of calcium pyrophosphate deposition disease:
Source: Lancet Rheumatol 2024; 6: e791–804

[ClinRheumatol @ClinRheumatol]

Take a look at the February issue of Clinical Rheumatology!
Explore the newest articles and updates
👉https://t.co/1i8KRDNdK7

[SEMERGEN | Médicos de AP @SEMERGENap]

📗Documentos de Consulta Rápida. 👉Nº10. Manejo de las Anemias en Atención Primaria
https://t.co/1ySSKnw8HX
#arritmias #AtenciónPrimaria

[Soc.Esp.Reumatología @SEReumatologia]

💯 ¡Ya está disponible el #webinar: La sexualidad en enfermedades reumáticas: claves y retos a afrontar!

Si no pudiste verlo o, simplemente, quieres volver a consultarlo, ya puedes acceder a él. https://t.co/pa9k7br9Bq

✔️ Encontrarás claves y consejos para mejorar este aspecto de la vida de las personas con enfermedades reumáticas.

[Prof Dimitrios P Bogdanos @DBogdanos]

The new issue of Mediterranean Journal of Rheumatology with 17 new informative articles has been published. Worthy to read and explore! https://t.co/DadLuHyBHQ . Submit your paper today! No fees, open access, papers in Pubmed! An excellent tool for researchers!