#493: Joint Pain in Older Adults with Dr. Una Makris

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 28 July 2025

⏱️ 74 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Intro
Case 1 from Kashlak
General approach to joint pain in older adults
Diagnosing osteoarthritis
Management of osteoarthritis in older adults
- Non-pharmacological interventions
- Pharmacological interventions: topicals, orals, injectables
- When to refer for joint replacement
Case 2 from Kashlak
Diagnosis of Late onset rheumatoid arthritis (LORA)
- Differential Diagnosis and Distinguishing features
- Lab work/Imaging
- When to refer to rheumatology
Approach to managing LORA
- The 5Ms framework
- Initial treatment with glucocorticoids
- Ageism as a driver of undertreatment in older adults
- Treating to target
Key takeaways
Outro

Credits

Producers, Writers and Show Notes: Joseph (Lee) Young, MD, Leah Witt, MD, Rachel Miller, MD
Cover Art and Infographic: Leah Witt, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Dr. Una Makris

Disclosures

Dr. Makris reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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Transcript

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0:00.0	Hey, before we get to the show, I wanted to remind you to check out our Patreon at patreon.com slash curbsiders.
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0:11.7	and a whole bunch of other cool stuff at patreon.com slash curbsiders.
0:18.7	You know, Paul, I have some bad news.
0:22.3	I'm so sorry, Matt.
0:23.4	Tell me, tell me more.
0:25.1	Hackers brought down my online business, but I managed to keep the website address.
0:33.3	Is there more?
0:36.5	And you know what, Paul?
0:38.7	That's domain thing.
0:42.3	Jeez.
0:43.6	Oh, boy.
0:45.8	All right.
0:48.2	Matt.
0:50.1	I noticed my robotic vacuum cleaner,
0:53.3	it's just not cleaning as much as you used to.
0:55.0	It doesn't seem to be getting around the house nearly as well as it has in the past.
0:58.2	I'm a little afraid it has rhombo toid arthritis.
1:04.8	God, puns suck, Paul.
1:06.3	This show's bad.
1:07.9	Everything's bad.
1:10.7	The curbsiders podcast is for entertainment, education, and information purposes only, and the topics discussed should not be used solely to diagnose, treat, cure, or prevent any diseases or conditions. For the more of the views and statements expressed on this podcast are solely those of those and should not be interpreted to reflect official policy or position of any entity, aside from possibly cash like moral and affiliate outreach programs. If indeed, there are any. In fact, there are none. Pretty much we are responsible if you screw up. You should always do your own homework and let us know when we're...
	...

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