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Will be covering some TAK pearls and pitfalls from today’s session!
Renal dz stratified by location of vessel inflammation:
- TAK = proximal (off aorta)
- FMD = mid-section, beading
- PAN = distal arterial branches
@RheumNow #ACR24 https://t.co/zu6qJ6DXcF
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Imaging in TAK Diagnosis
@KQuinnRheum @RheumNow
⭐ Take homes ⭐
👉location of renal artery stenosis (RAS) key to making Dx with proximal RAS in TAK
👉FDG PET -focal uptake in TAK vs diffuse in GCA
👉MRI good surrogate for disease activity where PET unavailable
#ACR24 https://t.co/UWxTAZScIt
Patricia Harkins DrTrishHarkins ( View Tweet)
Lung ultrasound for ILD in SSc/IIM would be great, no radiation and by the bedside - but a lot of skill required to interpret in reality.
Maybe AI/computer vision can come to the rescue?
Some nice models @StanfordRheum - will be watching this space!
#ACR24 ABST1965 @RheumNow https://t.co/0uXBSVSE4c
David Liew drdavidliew ( View Tweet)
Systemic polyarteritis nodosa looks creepily/scarily beautiful on PET/CT. Look at that Christmas tree!
but sensitivity can be affected by pred, & isn't great even without (48%).
By itself, a good rule in test, but not a good rule out test.
#ACR24 ABST1962 @MayoClinic @RheumNow https://t.co/y28J6VKja4
David Liew drdavidliew ( View Tweet)
Fantastic interview from @RheumNow from #ACR24 of @DrTrishHarkins talking to @bososhea from @stjamesdublin @tcddublin @TrinityMed1 about carotid doppler ultrasound screening in AxSpA https://t.co/HN1nA5lNTj
Richard Conway RichardPAConway ( View Tweet)
Beyond the Needle: Redefining the Assessment of Lupus Nephritis
Lupus nephritis is one of the most silent and severe manifestations of SLE. When not captured early, patients are at high risk of progressing to end-stage renal disease, which would require dialysis or transplantation. Renal biopsy remains the gold standard for diagnosis and disease classification. However, the procedure is invasive and very painful. Non-invasive measures are critical for early detection and continuous monitoring.
Read Article
A#1690 fibroblast activation protein inhibitor (FAPI)-PET in SSc ILD
Introduces FAPI quantification algorithm
FAPI uptake predicts greater rate of FVC decline. Trend for DLCO, not statistically signif
FAPI volume & intensity both predict accel lung decline
#ACR24 @RheumNow https://t.co/YA2ptLDaMy
Eric Dein ericdeinmd ( View Tweet)
Abstract 1686: Urinary proteomics reveals potential markers (MMP-13, M-CSF receptor, CD163, ALCAM, FOLR2) and pathways (neutrophil degranulation, ECM, tissue remodeling) involved in lupus nephritis Class II.
@RheumNow #ACR24 https://t.co/kufd2zl9yc
Akhil Sood MD AkhilSoodMD ( View Tweet)
@kekuchinad A#1689 PFT ref equations -> inequities in SSc ILD Predict FVC uses age, ht, sex & race - higher % pred values -> underdx Race-specific v neutral equations: More black pts meet trial eligibility (69/57%), immunos (56/40), lung t, (14/9) @RheumNow #ACR24 #ACRBest https://t.co/40PFmdk3Xv
Eric Dein ericdeinmd ( View Tweet)
Is there a less invasive approach to evaluate lupus nephritis?
Abstract 1683 highlights the potential role of 68Ga-FAPI PET imaging in evaluating for lupus nephritis. FAPI uptake ↑ in pts with lupus nephritis vs HC. Correlated with IFN -α and IFN-γ pathways.
@RheumNow #ACR24
Akhil Sood MD AkhilSoodMD ( View Tweet)
Brenac et al. Orbital MRI to distinguish GCA AOIN/CRO from non-arteritic. @RheumNow #ACR24 Abstr#1641 https://t.co/qIwaX3qp02 https://t.co/5CIZ0aV98Z
Richard Conway RichardPAConway ( View Tweet)
Brenac et al. Orbital MRI to distinguish GCA AOIN/CRO from non-arteritic. @RheumNow #ACR24 Abstr#1641 https://t.co/qIwaX3qp02 https://t.co/5CIZ0aV98Z
Richard Conway RichardPAConway ( View Tweet)
Cowley et al. US pattern in Subclinical GCA in PMR vs GCA. Subclinical GCA has more isolated axillary artery involvement. Severity of US inflammation significantly higher in GCA than subclincal GCA @RheumNow #ACR24 Abstr#1629 https://t.co/6Iyx76YgkS https://t.co/DxzTEwE5J5
Richard Conway RichardPAConway ( View Tweet)
Cowley et al. US pattern in Subclinical GCA in PMR vs GCA. Subclinical GCA has more isolated axillary artery involvement. Severity of US inflammation significantly higher in GCA than subclincal GCA @RheumNow #ACR24 Abstr#1629 https://t.co/6Iyx76YgkS https://t.co/DxzTEwE5J5
Richard Conway RichardPAConway ( View Tweet)
New agent on the block: Bimekizumab IL-17A/F inhibitor
Promising clinical data in SpA - what about imaging findings?
Dramatic reductions in MRI activity at SI joints seen in BKZ pt, esp when compared to trajectory of PBO pt before cross-over
@RheumNow #ACR24 Abst #1757 https://t.co/ACLJx5XkyN
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Reason for consult: aortitis- evaluate for systemic causes
Abstract 1638: Kmetova et al highlight the promising clinical utility of calprotectin as a marker for clinically isolated aortitis
@RheumNow #ACR24 https://t.co/2qPaAqWswG
Akhil Sood MD AkhilSoodMD ( View Tweet)
The 3-4-5 rule for positive MRI in axSpA remains.
The MRI lesion cut-offs demonstrated high performance across different features of axSpA (PsO, AAU,IBD).
Deep fat and deep sclerosis high specificity for axSpA.
#Abst0821 #ACR24 @RheumNow https://t.co/4JM5MHrB8z
Adela Castro AdelaCastro222 ( View Tweet)
🫁RP-ILD a/w high morbidity and mortality
How to Predict RP-ILD Development?
➡️AutoAb: anti-MDA5, anti-ARS, anti-Ro52
➡️Biomarkers: CRP, LD, Ferritin, KL-6
➡️CT: Lower consolidation/GGO
#ACR24 @RheumNow https://t.co/OIrHfVTZcM
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
In the @ACRheum MSK Ultrasound Guidance:
In difficult-to-treat RA, MSUS can distinguish symptoms of active synovitis from other sources of pain.
(consensus: mod)
CURRENTLY do you often use ultrasound when RA gets difficult to treat, and synovitis isn't obvious? #ACR24 @RheumNow
David Liew drdavidliew ( View Tweet)
One situation I've seen MSK ultrasound have impact ++ in the real-world is showing patients their own RA disease activity.
Arthritis might be the invisible disease sometimes, but seeing it in full Doppler colour on screen means a lot to many.
#ACR24 MSK USS Guidance @RheumNow https://t.co/wd9s6FAfp4
David Liew drdavidliew ( View Tweet)