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Imaging and Early Detection in Psoriatic Arthritis
At EULAR 2025, there have been new developments in imaging in PsA.
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In 581 PsA pts (EuroSpA), MRI showed axial SpA features in 31%: BME (69%), erosions (68%), fat lesions (58%). MRI-axPsA pts: younger (41y vs 46y), male (70%), HLA-B27+ (55%), ↑CRP (13 vs 7 mg/L). Radiographs identified sacroiliitis in 29%. MRI adds key detection. POS0297 https://t.co/nAw0BDAH22
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Are we missing axial/SIJ lesions in PsA or are we misdiagnosing AxSPA + PSO pts for PsA?
5 register studies including 580+ pts w/ PsA/AxSPA+PSO
1/3 PsA routine care patients had SIJ MRI = SPA
29% Rx SII r-mNY criteria+
of which 38% MRI lesions AxSPA
@RheumNow #EULAR2025 https://t.co/DJljlm7T9m
Aurelie Najm AurelieRheumo ( View Tweet)
‼️Diagnosis of axSpA is clinical
-MRI is a tool but still has a lot of limitations.
-Improve reports by directly communicating with radiology and be specific on pt clinical info.
-Unified algorithms are needed to apply AI in dx of SIJ inflammation on MRI.
#EULAR2025 @RheumNow https://t.co/9GR6FsgIcL
Links:
Adela Castro AdelaCastro222 ( View Tweet)
🔍MRI lesions in early axSpA vs non axSpA with chronic back pain:
-Data from SPACE cohort
-n 318 (214 axSpA vs 108 non-axSpA).
-Baseline imaging (CR and MRI) and at 2y f/u
-Minimal progression on CR in both early axSpA and non-axSpA CBP.
-On MRI, significant increase in the https://t.co/m5YOAiFUz1
Links:
Adela Castro AdelaCastro222 ( View Tweet)
What's the difference between PIPsA & NIPsA?
(Persistent Inflammatory confirmed by IMAGING
vs. Non inflammatory PsA)
🔹️Cross-sectional study
🔹️517 pts under b/tsDMARDs
🔹️10.3% D2T
🔹️57% PIPsA / 43% NIPsA
👇 Distinct phenotypes 👇
OP0176
#EULAR2025
@rheumnow https://t.co/YGHpbeE6ws
Nelly ZIADE 🍀 Nellziade ( View Tweet)
A machine learning (ML) model using electronic medical record (EMR) data from 396,000 Mayo Clinic primary care patients identified undiagnosed psoriatic arthritis (PsA) with area under the curve (AUC) 79.6%. Key predictors: psoriasis, joint pain, tenosynovitis, https://t.co/VsYevnJEjK
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
📊 SIJ findings in PsA (n=581):
🧠 31% = MRI-confirmed axSpA
🦴 Only 29% met r-mNY criteria
MRI-axPsA group: younger, more male, HLA-B27+
Clinical + radiographic definitely underperform vs MRI
#POS0297 @RheumNow #EULAR2025
Jiha Lee JihaRheum ( View Tweet)
#Psoriatic_Arthritis
#Preclinical #Early
❓️ Does joint swelling occur in the same anatomical locations affected in the subclinical phase?
🅰️ Yes, in 68%
🅰️ Especially if positive ultrasound
#EULAR2025
@RheumNow
OP0179 by Ivan Giivannini et al. https://t.co/rKfreQyJeG
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Rheumatoid vasculitis: what to look for and how to find it
#EULAR2025 @AshimaMakol @RheumNow https://t.co/ZCUXgOr1dH
David Liew drdavidliew ( View Tweet)
LDCT to assess disease progression in early axSpA:
-Data from SPACE cohort 67 pts (>50% male,>80% hLAB27+)
- LDCT at baseline and 2 years apart.
-Overall 22% pt with net disease progression.
-Spine progression most frequent on thoracic spine.
-Good reliability in assessing https://t.co/M2jkDusD41
Links:
Adela Castro AdelaCastro222 ( View Tweet)
Do the sites of clinical onset of PsA (i.e., swelling) correspond to those that, at the time of enrollment in the study, showed evidence of joint tenderness and/or ultrasound-detected alterations compatible with inflammation? Of 28 incident PsA cases, 68% had prior subclinical https://t.co/rAZJU6Va5x
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Are we all going to be replaced by robots?
Not just yet
ARTHUR trial: the robotic ultrasonographer
vs. human
While the concept is promising, and ICC with humans were low to moderate, the robot is overestimating grey scale scores in MCPs of both HC and RA pts
#EULAR2025 https://t.co/mTtbknu0lO
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Multimodal data using clinical histological and serological predictors in renal function in #sle nephritis. Using the AMP SLE data.
Low baseline eGFR and histological damage predicted worsening renal function but not NIH activity index
#POS0173 #EULAR2025 @RheumNow @andreafa https://t.co/Eh8dZXHRVX
Links:
Bella Mehta bella_mehta ( View Tweet)
Ultrasound for ILD detection in RA 🫁
Sens 88.6
Spe 92.8
NPV 91.4
PPV 90.7
While if abnormal or high suspicion, HRCT should be the reference, I see this as an interesting tool in clinics for quick screening
POS0180 #EULAR2025 @RheumNow https://t.co/pUy0ki7Y6S
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#HOT topic
Lung 🫁 #ultrasound for #RA #ILD
#LUS B lines vs HRCT
Single site 🇫🇷 study
V sensitive & specific
🤔needs standardization & comparison in other groups
Abst#POS-180
#EULAR2025 @RheumNow @eular_org https://t.co/PwGE4rgk40
Janet Pope Janetbirdope ( View Tweet)
Does having a synovitis in a specific joint predicts Rx damage in that same joint?
Yes
Can US synovitis predict Rx progression better than clinical synovitis at the joint level?
Not really
At 1 year, only US synovitis is, both B-mode and Doppler ass w/ Rx prog, in particular https://t.co/Wu6dDqIUYn
Aurelie Najm AurelieRheumo ( View Tweet)
Tenosynovitis of 5th compartment independently associated w/ D2T RA in a cohort of 90+ pts compared to established RA
Erosions, Tenosynovitis and Synovitis non associated with D2T phenotype
It’d be interesting to see if this could predict D2T evolution in early RA pts
POS0185 https://t.co/faruOr3HhJ
Aurelie Najm AurelieRheumo ( View Tweet)
OP0176: Among D2T PsA pts, 43% lacked inflammation on imaging—despite symptoms.
Clinical + US split them into PIPsA vs NIPsA, helping distinguish who needs escalation vs who doesn’t.
A step toward smarter care in D2T PsA.
@RheumNow #EULAR2025 https://t.co/E9igwvDPPN
Jiha Lee JihaRheum ( View Tweet)
FAPI-PET/CT - detecting synovial and enthesial fibroblast activation- predicts the development of #psoriatic_arthritis in patients with psoriasis and arthralgia
✨️ A promising tool for early diagnosis of PsA
Giulia Corte et al.
OP#0174
#EULAR2025
@RheumNow https://t.co/QVmoECIhBI
Nelly ZIADE 🍀 Nellziade ( View Tweet)
