Dr Brittany Panico

02/26/2026

I saw a patient recently who I have been treating for arthritis. I’ve done the blood work, X-rays, and prescribed medications but she wasn’t feeling better.

Her hands still hurt to grip and squeeze. She felt that her knuckles were getting larger and was self-conscious about the way her hands looked.

We had a visit and discussed changing medications or doing further testing. I ordered a dual energy CT scan of her hand, hoping this would help us understand why her hands still hurt so much. Her uric acid level was not high. But I did not know why she was not feeling better.

Her CT scan showed gout (uric acid) in her joints and tendons. She had inflammation that I did not see on her blood work or test results. But we saw it clearly on her scan.

We talked about starting gout medication and monitoring her symptoms. Next, we will take away some of her arthritis medication if she is feeling better. Instead of guessing what medication was going to do for her, I knew what she needed because her scan showed me the gout in her hand.

If you have joint pain that is not getting better with your medication, or if you know you have gout and you are not feeling better, please speak up! Rheumatologists are trained to treat gout and can help with this type of joint pain.

Not all states offer dual energy CT scan, so you will need to ask your healthcare practitioner or doctor if this test can be done for you. If you live in Arizona, we can do this test for you!

Please do not give up looking for answers. We want you to feel better. We want to find the right diagnosis and treatment for you!

01/28/2026

My kids just had their 100th day of school celebration and it got me thinking about what 100 days looks like when you have an autoimmune diagnosis or gout.

💡 Have you made progress with your treatment or do you still feel like something is missing?

💡 Are you able to do an activity you weren’t able to do 3 months ago?

💡 Have you changed insurances and maybe you’re being told you need to change medications?

💡 Do you feel like you’re in a slump and can’t figure out how to come out of it?

If any of these thoughts bring up questions for you, your rheumatology clinician can, and should be, helping you sort through your options. If you feel great, that is exactly what we want for you and please celebrate your progress!!

If you are a clinician and are not sure how to help your patients navigate better success and feel stuck yourself, follow along because I’ll be offering tips for you too!

It’s never too late to start down a new path, learn a new skill, or get better at what you are already doing!

01/14/2026

This year I am focusing on organization and creating systems that work for me rather than slow me down.

As I make it through my reading list, I’m trying to slow down and pay attention to some of the references the authors talk about. Not just to reference their ideas, but to learn how to extrapolate leadership themes into medicine and healthcare.

Brené Brown’s book Strong Ground is one of those books I will be talking about for awhile even after I finish it. I have a few hours left on audible and there are so many💡 moments that I can’t list them all.

One of her references is to an article by Coach Dawn Staley from 2015 that still carries just as much relevance now as it did then.

The idea that we just keep trying to do the next best thing. And we keep at it. That may actually be the fundamentals in your field of work. It may be the boring things that don’t seem to make a difference. And it may mean repeating yourself over and over 10 times until your message sinks in.
Coach Staley states:

“I live by two mottos:
A disciplined person can do anything.

Dare to do what you don’t want to get what you do want.”

We can all take away something either personally or professionally from these ideas.

Discipline to not let things pile up. Dare to show up even when your voice feels small.

Who’s with me to remain disciplined with your goals longer than the first month of the year?

Who’s with me to dare to do something to stand out this year?

Enjoy the article, it may inspire you to change something about your leadership approach or mindset!

This isn’t just about the four years they spend with me. This is bigger than being their coach.

12/05/2025

I’m planning out content to highlight the effects of gout.
How we diagnose gout, treat it, and ultimately help people understand that gout is not “just a swollen toe”. And yes, women get gout too. I have many patients who are married and both have gout 🤯

My gouty green skeleton shows where uric acid can deposit and land in our bodies. Look at all that green!! ❇️❇️

If you have questions about gout, drop them here. I’ll be sure to post an answer!