rheum: 1/ gout ACR criteria for diagnosis, anti-inflammatories NSAID,

rheum: 1/ gout ACR criteria for diagnosis, anti-inflammatories (NSAID, colchicine, steroid) indication, doses, monitoring, duration of therapy, ULT first line choices and monitoring 2/ osteoarthritis pain relief with NSAIDs, indication, doses, monitoring, duration of therapy, Xray findings (description) 3/ rheumatoid arthritis ACR classification criteria, DMARDS for long term management, indication, doses, monitoring, duration of therapy, evaluation for disease activity 4/ osteoporosis meds, indication, doses, monitoring, duration of therapy, DEXA (to check BMD) when? WHO classification criteria?

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#	Topic	Key Highlights
1. Gout	2015 ACR/EULAR criteria (score ≥8 or MSU crystals); NSAIDs (indomethacin/naproxen), colchicine (1.2 mg load + 0.6 mg x1h), steroids (pred 30 mg/day); ULT = allopurinol (1st), febuxostat (2nd); target urate <6 mg/dL; prophylaxis 3-6 months when starting ULT
2. OA	X-ray: joint space narrowing + osteophytes + subchondral sclerosis + cysts, NO erosions/osteopenia; NSAIDs: naproxen 500 mg BID, ibuprofen 400 mg QID, celecoxib 100-200 mg/day; topical preferred in elderly; monitor renal/GI/BP; shortest effective duration
3. RA	2010 ACR/EULAR criteria (score ≥6); domains: joints + serology + APR + duration; MTX anchor (7.5-25 mg/week + folic acid, CBC/LFTs q8-12 wk); add biologic/JAK inhibitor if MTX fails; screen TB before biologics; disease activity = DAS28, CDAI
4. Osteoporosis	WHO T-score: normal ≥-1.0, osteopenia -1.0 to -2.5, osteoporosis ≤-2.5; DEXA: women ≥65, men ≥70, or younger with risk factors; Tx 1st-line = bisphosphonates (alendronate 70 mg weekly, zoledronic acid 5 mg/year x 3-5 years); severe = teriparatide (20 mcg/day, max 2 years); denosumab 60 mg q6 months (do NOT stop abruptly)