ACR on Air Podcast

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, Liron Caplan, MD, PhD, and Matthew Stoll, MD, PhD, MSCS, 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.

Matthew Stoll, MD, PhD, MSCS – Matthew Stoll, MD, PhD, MSCS, is a pediatric rheumatologist who earned his MD and PhD at Upstate Medical University (Syracuse, NY) in 2001, followed by completion of residency in pediatrics at the Long Island Jewish Medical Center in 2004 and fellowship in pediatric rheumatology at Boston Children’s Hospital in 2007. He has been at the University of Alabama at Birmingham since 2011. During his fellowship, Dr. Stoll developed an interest in the clinical epidemiology of spondyloarthritis, and he subsequently turned his attention to the links between spondyloarthritis and inflammatory bowel disease as well as the intestinal microbiota in children with spondyloarthritis. Dr. Stoll has been on the Board of Directors of the Spondyloarthritis Research and Treatment Network (SPARTAN) since 2019 and was Chair of the BoD from May 2024–2026.

Liron Caplan, MD, PhD – Liron Caplan, MD, PhD, is a rheumatologist, physician-scientist, and Associate Professor of Medicine in the Division of Rheumatology at the University of Colorado School of Medicine, where he also serves as Section Head of Rheumatology at the Rocky Mountain Regional VA Medical Center. He earned his MD from Baylor College of Medicine, completed his Internal Medicine residency at Emory University and Rheumatology fellowship at Washington University in St. Louis, and later received a PhD in Health Services Research from the University of Colorado.

His research focuses on improving care for patients with axial spondyloarthritis and other inflammatory rheumatic diseases through outcomes research, clinical guidelines, and health services research. Dr. Caplan has authored more than 110 peer-reviewed publications, including numerous first-author papers, has helped develop American College of Rheumatology treatment guidelines, and has received multiple honors for his contributions to research, clinical care, and medical education.

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In this episode, Randy Q. Cron, MD, PhD, 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.

Randy Q. Cron, MD, PhD – Randy Q. Cron, MD, PhD, is a basic, translational, and clinical scientist who studies macrophage activation syndrome. Professor Cron serves as the Arthritis Foundation, Alabama Chapter Endowed Chair and Division Director of Pediatric Rheumatology at UAB. He also developed and serves as the Program Director of the Pediatric Rheumatology Fellowship Program at UAB.

Dr. Cron also has a PhD in Immunology from the University of Chicago, and his laboratory's basic research focuses on functional genetics of cytokine storm syndromes. His clinical and translational research interests include childhood arthritis-related macrophage activation syndrome (MAS) and temporomandibular joint (TMJ) arthritis, for both of which he is known worldwide.

He has published over 290 PUBMED cited manuscripts and 40 textbook chapters, and he is co-editor of the first ever textbook devoted to cytokine storm syndromes.

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What if some patients who never quite fit their diagnosis actually have an underlying genetic disorder? In this episode, we explore Haploinsufficiency of A20 (HA20), a condition first described less than a decade ago that is already reshaping our understanding of autoinflammation, autoimmunity, and immune dysregulation. How many patients in our clinics have a genetic diagnosis we've never thought to consider? Join us as we discuss this emerging disease and its clinical implications with Daniella M. Schwartz, MD.

Daniella M. Schwartz, MD – Daniella M. Schwartz, MD, completed her BA in Biochemistry and French at Rice University (cum laude) followed by an MD at the Wake Forest University School of Medicine (Alpha Omega Alpha). She completed a residency in Internal Medicine at Virginia Commonwealth University, where she also served as a chief medical resident. After completing a clinical fellowship in rheumatology at the National Institutes of Health, NIAMS, she completed a postdoctoral fellowship in T cell epigenetics with Dr. John O'Shea and studied inborn errors of immunity under the mentorship of Dr. Joshua Milner, Dr. Daniel Kastner, and Dr. Pamela Guererrio. In 2022, Dr. Schwartz was recruited to the University of Pittsburgh, where she is currently an Assistant Professor in the Division of Rheumatology and Clinical Immunology. Her lab investigates mechanisms of immune dysregulation, with a focus on genetic and epigenetic regulation of immune cells and cytokines through the lens of inborn errors of immunity. She is the founding co-director of the Pittsburgh Immunogenetics Discovery Center (PIDC) and of the UPMC Autoinflammatory Center of Excellence. She has authored over 60 peer-reviewed publications in major journals and was awarded the NPF Robertson Fellowship (2018), the ASCI Young Physician Scientist Award (2020), and the ICIS Regeneron Young Investigator Award (2024).

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Could chronic inflammatory calcium pyrophosphate deposition disease (CPPD) be hiding in plain sight? In this episode, we explore why CPPD may be far more common than previously recognized, how it can masquerade as conditions such as refractory inflammatory arthritis, polymyalgia rheumatica, and erosive osteoarthritis, and why it is so often overlooked in clinical practice. We discuss the growing role of musculoskeletal ultrasound in diagnosis and disease management, the structural damage associated with chronic CPPD, and where the field may be headed as researchers pursue more effective treatment strategies.

Janeth Yinh, MD – Janeth Yinh, MD, is a recognized leader in musculoskeletal ultrasound within rheumatology. She previously served for a decade as Director of the Rheumatology Musculoskeletal Ultrasound Clinic at Tufts Medical Center, where she played a pivotal role in advancing ultrasound-based diagnostics and training. She now serves as Associate Director of the Musculoskeletal Ultrasound Program at Massachusetts General Hospital.

Dr. Yinh has been deeply committed to education and dissemination of ultrasound techniques in rheumatology, contributing to the training of clinicians and the broader adoption of imaging-guided care. She is a co-author of the Clinical Atlas of Musculoskeletal Ultrasound in Rheumatology, a key resource for practitioners in the field.

Her scholarly work includes significant contributions to the understanding of calcium pyrophosphate deposition disease (CPPD). Notably, she participated in the development of the 2023 ACR/EULAR classification criteria for CPPD and has authored multiple publications focused on imaging in this condition. Through her clinical, educational, and research efforts, Dr. Yinh continues to shape the evolving role of ultrasound in rheumatologic practice.

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The 2026 ACR Guidelines for Juvenile Idiopathic Arthritis (JIA) are here, and lead author Karen Brandt Onel, MD, joins us to unpack the key updates shaping pediatric rheumatology care. From a biologics-first approach in systemic JIA to more individualized treatment pathways for non-systemic disease, the new recommendations emphasize earlier intervention, faster treatment tailoring, and risk-based decision-making. Dr. Onel also discusses the guidelines’ broader focus on mental health, physical activity, rehabilitation, and the challenges of growing up with a chronic illness. More than an update to treatment algorithms, these guidelines reflect a fundamental shift in philosophy—one that puts the whole child, not just the diagnosis, at the center of care.

Karen Brandt Onel, MD – An expert in pediatric rheumatology, Karen Onel, MD, cares for children and teens with arthritis and other autoimmune disorders. In particular, she diagnoses and treats: lupus, juvenile arthritis, vasculitis, uveitis (an inflammatory disorder of the eye), chronic non-infectious osteomyelitis, dermatomyositis and the periodic fever syndromes. Her goal is to work with the patient and his/her family to create a long-term care plan that will lead to improved quality of life.

Dr. Onel's research focuses on gaining a greater understanding of the causes of rheumatic illnesses, as well as evaluating the safety and tolerability of new treatments. She is collaborating with other institutions to define evidence-based best treatment practices for children with JIA, SLE and recurrent non-infectious osteomyelitis.

Dr. Onel has authored numerous papers, reviews and book chapters on pediatric rheumatology. In addition, she serves as a reviewer for many scientific journals, is on the editorial board of Pediatric Rheumatology and is Associate Editor for Seminars in Arthritis and Rheumatism.

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