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Episode 44 Low Back Pain  

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Vision of Tomorrow by Alex Grohl

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 43 Rheumatoid Arthritis 

Question 1: Pathogenesis and Risk Factors

A 45-year-old woman with a family history of rheumatoid arthritis (RA) presents with fatigue and intermittent joint stiffness. Laboratory testing reveals the presence of anti-citrullinated protein antibodies (ACPAs) and rheumatoid factor (RF), but no clinical synovitis is observed. Which of the following best describes the current understanding of the pathogenesis of RA in this patient?

C. Autoantibodies may originate in mucosal tissues and spread systemically

Question 2: Imaging and Early Detection

A 38-year-old man with anti-CCP positivity and musculoskeletal symptoms undergoes ultrasound imaging, which reveals subclinical synovitis. According to recent studies, what is the clinical significance of this finding?

B. Subclinical synovitis is a strong predictor of imminent inflammatory arthritis

Question 3: Pharmacologic Prevention of RA

A clinical trial evaluates the use of abatacept in patients with undifferentiated arthritis and positive anti-CCP antibodies. Participants receive weekly subcutaneous injections of 125 mg abatacept for six months. What was the primary outcome of this intervention according to the ADJUST trial?

B. Abatacept reduced RA development and structural damage

Paper for Next Week: 

Abdulsalam M. Aleid, et al. Dry needling for mechanical neck pain: A systematic review and meta-analysis of randomized controlled trials, Surgical Neurology International, 2025, 16 (44)

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