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Imaging

SI AS SpA ACR

TNF inhibitors and radiographic progression in axSpA

A remaining challenge for clinicians is the ability to delay, if not completely stop, structural progression in patients with axSpA, whether they are diagnosed with radiographic (r-axSpa) or non-radiographic (nr-axSpA) disease.

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heel enthesitis spur calcaneal

Predicting RA, and Treatment of Subclinical Arthritis

Identifying patients that will develop RA in situations of seropositivity without overt clinical arthritis or identifying patients with undifferentiated oligo/polyarthritis that will develop RA remains a challenge in the field of rheumatology. 

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great Thieves market another dx to consider for ? inflammatory arthritis swelling/stiffness post cold exposure Microgeodic Disease-digital swelling/pain likely from bone infarction 2/2 to cold induced vasospasm characteristic x ray/MRI findings on poster #ACR21 #meded https://t.co/eq0aOlcB7I
Adam J Brown @AdamJBrownMD( View Tweet )
Nov 08, 2021
Echos in PsA, RA: 🔹Diastolic dysfxn: 52% of PsA and RA (!), controls 5% 🔹Mitral regurge PsA 84%, Ra 53%, controls 10% 🔹Mild pulmonary valve regurge higher in PsA (Diastolic dysfxn has been seen in prior RA studies)https://t.co/QCKR5itfYj#ACR21 Abst1308 @RheumNow

Pedro Castillo @_Castillo_Pedro( View Tweet )

Nov 08, 2021
Calcium hyperproficiency is a rare complication of vitamin D deficiency, where excess calcium from bone resorption forms complex structures resembling primary teeth. Neoformed teeth grow on different bones, such as this patient's hand, causing fractures and joint dysfunction. https://t.co/oGYCYkh1WD
Eduardo Valdés-Hevia 🦟 @Valdevia_Art( View Tweet )
Nov 08, 2021
#ACR21 @RheumNow Abst#0364 by Wetterslev et al. sought to identify axSpA characteristics of patients tapered off TNFI and showed clinical and radiographic improvement. 🔽52% were tapered off ⭐️The highest predictor of success is a low physician global VAS score
Nov 08, 2021
Completely new one for me, Dr Taniguchi presenting on using ear ultrasound to diagnose and monitor disease activity in relapsing polychondritis. Appears useful, I suspect in clinical practice more so for diagnosis. Abstr#0169 #ACR21 @RheumNow https://t.co/PLJtkYkP3A
Richard Conway @RichardPAConway( View Tweet )
Nov 08, 2021
DCVAS testing results in GCA. @davidliew @philipcrobinson are you guys essentially not imaging anyone in anyway? What's going on? #ACR21 @RheumNow https://t.co/IMr5ee2Iea
Richard Conway @RichardPAConway( View Tweet )
Nov 08, 2021
Dr Elliott presenting on US assessment of enthesitis with TNFi vs secukinumab. Surprisingly TNFi showed a more marked decrease in US enthesitis. Abstr#1356 #ACR21 @RheumNow https://t.co/XXgYMgkMyP
Richard Conway @RichardPAConway( View Tweet )
Nov 08, 2021
In one institution, 25% of Crohn's patients had abnormal SI findings on MRE/MRI. Majority without back pain, were female with intestinal complications. Abs#1306 #ACR21 @RheumNow https://t.co/z8Yvc98s67

Robert B Chao, MD @doctorRBC( View Tweet )

Nov 08, 2021
Ultrasound in CSA patients: Retro US cohort 110pts 28.2% w/ 💥Power Doppler synovitis. 36.8% at 6mo evolved to RA among which 100% PD+ vs 25% PD- PD + predicts evolution to clinical RA (OR 13.1; CI 1.07-161.04) Easier and less invasive than MRI! #Abstr1525 #ACR21 @RheumNow https://t.co/MkhWTvnv3L
Aurelie Najm @AurelieRheumo( View Tweet )
Nov 08, 2021
MRI Imaging in RA and SpA: Dr. Sheila Reyes (@RHEUMarampa ) Dr. Sheila Reyes discusses abstracts #0468 and #0469, presented at the #ACR21 annual meeting.https://t.co/KUoO88dEhQ https://t.co/10R4jC5p0y
Dr. John Cush @RheumNow( View Tweet )
Nov 07, 2021
SI AS SpA ACR

TNF inhibitors and radiographic progression in axSpA

A remaining challenge for clinicians is the ability to delay, if not completely stop, structural progression in patients with axSpA, whether they are diagnosed with radiographic (r-axSpa) or non-radiographic (nr-axSpA) disease.

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⭐️Imaging of the SIJ in psoriatic axSpA is similar to axSpA associated with iritis or colitis! Abst#0902 (https://t.co/f55Vfi1LSS) #ACR21 @RheumNow https://t.co/UCXrwPiyhh
Meral K. El Ramahi, MD @MeralElRamahiMD( View Tweet )
Nov 07, 2021
NORD-STAR Trial: outcomes in tx-naïve, early RA pts after 48w of csDMARDs+GC vs bDMARD (ABAtacept, CerToliZumab, or ToCiluZumab)+MTX ➡️ Superior CDAI remission rates w/ ABA+MTX & CZP+MTX but not TCZ+MTX vs csDMARD+GC ➡️Imaging progression low in all Abst#0825 #ACR21 @RheumNow https://t.co/QaFIF4WNEG
Meral K. El Ramahi, MD @MeralElRamahiMD( View Tweet )
Nov 07, 2021
@KatGilekMD @RichardPAConway @RheumNow @drhectorchinoy EMG/NCS can help uncover various neurological disorders including muscle dystrophies. Obviously it depends on center and expertise. Both MRI and EMG are useful and have different complementary utilities in Myositis. Many centers are not able to perform or interpret MRI reliably.

Rohit Aggarwal @docrota( View Tweet )

Nov 07, 2021
@NU_Rheum_MSK_US @RichardPAConway @drhectorchinoy @RheumNow Muscle ultrasound can be very useful but it is not ready for prime time currently to be used to do muscle biopsies. Perhaps in few years once we know how to target the muscle for biopsy.

Rohit Aggarwal @docrota( View Tweet )

Nov 07, 2021
Marc Hochberg lecture at #ACR21 - Bisphosphonates limited and inconclusive data in radiographic progression of OA, some ⬇️ in bone marrow lesions! @RheumNow https://t.co/ciMUINBLwm
Bella Mehta @bella_mehta( View Tweet )
Nov 07, 2021
SEC reduced SIJ bone marrow edema in active nr-axSpA pts. Majority of pts both in SEC and PBO arms showed no radiographic progression through 2 years. Abs 0921 #ACR21 #RheumNow @RheumNow https://t.co/yC2AZoacxF https://t.co/pjCL8HCanR
Dr. Rachel Tate @uptoTate( View Tweet )
Nov 07, 2021
#ultrasound led to a change in Dx or Tx 2/3 of the time in a Sports Med clinic! #ACR21 #ACRAmbassador #POCUS https://t.co/2CviSOQKiz
Arthur Mandelin, MD/PhD, RhMSUS, RMSK @NU_Rheum_MSK_US( View Tweet )
Nov 07, 2021
Physician global score only predictor of axSpA flares when tapering TNFi ⭐️Changes in imaging did not predict flare Abs#929 #ACR21 @RheumNow https://t.co/vVn6ARKJu0 https://t.co/FlVtlLmTfl
Robert B Chao, MD @doctorRBC( View Tweet )
Nov 07, 2021
Abst0898 #ACR21 @RheumNow MRI findings of Vertebral Corner Inflammation & Vertebral Corner Fat Deposition associated w/syndesmophyte formation 2 y later, ORs 1.87-2.58 for various VCI/VCFD patterns. Protection against syndesmophyte seen if both VCI and VCFD were absent (OR 0.35) https://t.co/t01nxdEwON
Olga Petryna @DrPetryna( View Tweet )
Nov 07, 2021
#ACR21 Abs#0825 Early RA -Rx-naive: 48 wk, csDMARD+GC vs. 3 bDMARD+MTX (CZP/ABA/TCZ) ⭐️Superiority for ABA+MTX and CZP+MTX vs. to csDMARD+GC, not in TCZ+MTX ⭐️ Radiographic progression low in all ▶️ Short study w very aggressive 1st line combo Rxhttps://t.co/TJPZkqmN8z @Rheumnow
Nov 07, 2021
Detecting inflammation in SIJ for axSpA is by MRI but Artificial intelligence convolutional network aids this: -In the Validation set: Trained CNN ▶️91.8% accuracy; Sens 88.9% Sp 93.5% - Holdout set: 81.5% accuracy; Sens 67%; Sp 84.5%. Abst# 0905 #ACR21 #ACRBest @RheumNow https://t.co/qmOxk9JQOC
swethaann23 @swethaann23( View Tweet )
Nov 07, 2021
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Identifying Gaps in axSpA: Lessons from European Map of Axial Spondyloarthritis (EMAS)

Nov 07, 2021

Despite the increasing scientific knowledge on axSpAs, a substantial gap still remains. Delay in diagnosis continues to pose a threat in the early identification of patients and those already on treatment may deal with additional issues such as work productivity or quality of life.

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