What is the "Direct Specialty Clinical Care Model" and is it a viable option for clinical rheumatologists in today's medical ecosphere? Dr. Diana Girnita, founder and CEO of Rheumatologists OnCall, joins us to speak on what motivated her to pioneer this clinical approach, how she empowers her patients by putting the cost of care directly in their hands, her thoughts on the financial viability of this model in the near future and how she manages the daily responsibilities facing every clinician, like: dealing with insurance companies, billing, managing referrals, telemedicine and more!

Join us as we explore what's new and exciting at ACR Convergence, the premier gathering for rheumatology science and innovation. Dr. Gregory Gardner, Chair of the Annual Meeting Planning Committee, shares a preview of this year's meeting, including emerging treatments like cellular therapy, hands-on workshops, and the science that could change clinical practice. We discuss the sessions you won't want to miss and offer tips for making the most of your time at the meeting, both inside and outside the conference room

When is Raynaud's phenomenon truly a disease? Dr. Robert Spiera joins us to discuss the key clinical clues, the value of patient photos and nail fold capillary findings, and how to approach a positive ANA without a defined connective tissue disease. We review treatment options from warming strategies and medication review to calcium channel blockers, PDE-5 inhibitors, prostaglandins, and digital sympathectomy and highlight the finding that demands urgent attention: a painful, persistently blanched digit. Most importantly, we discuss the balance between treating serious vascular disease and avoiding unnecessary medicalization of a common phenomenon.

Interstitial Lung Disease (ILD) is difficult to diagnose and treat. At first, the disease could look like a variety of other disorders, such as fibrosis or autoimmunity. Once a diagnosis is made, a decision on how aggressively to treat it can mean the difference between irreversible lung damage or overly impacting your patient's quality of life. We caught up with Dr. Robert Hallowell, a Pulmonary and Critical Care physician at the Massachusetts General Hospital and Director of the Interstitial Lung Disease Program at the Pulmonary Ambulatory Clinic. Dr. Hallowell tells us how he evaluates ILD

September is Rheumatic Disease Awareness Month (RDAM), and today we're sharing the story of Deborah Talbot, an occupational therapist from the Children's Hospital of Philadelphia and her daughter, Molly, who was diagnosed with Juvenile Idiopathic Arthritis (JIA) at the age of 12 years old. When an ankle injury turned out to be far more, Molly endured months of pain, swelling, repeated evaluations and the uncertainty of not understanding why she wasn't getting better. This is the story of how a family came together to fight through pain, discover a disease, find remission that would remain for years and start advocacy for those without the resources they were blessed with, emerging triumphant in the face of overwhelming adversity

Rheumatoid arthritis may begin years before the first swollen joint appears, with autoantibodies circulating long before a clinical diagnosis is made. In this episode, we explore what happens during this critical preclinical phase and whether RA can be prevented before it starts. Dr. Kevin Dean, director of the Autoimmune Disease Prevention Center at the University of Colorado Anschutz, joins us to discuss what a positive CCP antibody really means, where RA may originate, lessons from the STOP-RA trial, whether we should screen people at risk, and how clinicians should counsel patients who test positive for CCP antibodies.

The new clinical guidelines for juvenile and adult axial spondyloarthritis (axSpA), developed collaboratively by the American College of Rheumatology (ACR), the Spondylitis Association of America (SAA), and the Spondyloarthritis Research and Treatment Network (SPARTAN), mark an important evolution in the management of this complex disease. In this episode, Drs. Liron Caplan and Matthew Stoll discuss what's changed, why it matters, and how these recommendations can guide everyday clinical practice—from the first-ever juvenile axSpA guideline and the unified approach to radiographic and non-radiographic disease, to practical decisions around MRI use, first-line therapies, biologic selection, treatment failure, and physical activity.

2026 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Axial Spondyloarthritis in Adults and Children/Adolescents

In this episode, Dr. Randy Q. Cron discusses hyperinflammation and Macrophage Activation Syndrome (MAS), one of the most serious complications of Still's disease. Because MAS can mimic infection, sepsis, malignancy, or a disease flare, early recognition is critical—and treatment often must begin before every diagnostic criterion is met. We explore the clinical patterns and laboratory findings that matter most, how to interpret ferritin, and how to make timely decisions when multiple diagnoses may exist at once.