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Yang et al. Cranial vessel wall MRI in GCA. Quantitated with PEG score. PEG score ocular GCA>non-ocular GCA>non-GCA. Decreases with treatment. @RheumNow #ACR24 Abstr#2650 https://t.co/e26urOpb7V https://t.co/eekQbzmKYm
Links:
Richard Conway RichardPAConway ( View Tweet)
A#2651
Vasculitis w VEXAS
81 men, median age 67 - 27% had evid of vasculitis, variable size vessel
22% SVV- 17/18 cutaneous, one peritubular capillaritis on renal bx
2.5% MVV (2 cutan), LVV (2 carotid thickening, 1 had +TA bx), ANCA+
@RheumNow #ACR24 https://t.co/puablIBLCP
Eric Dein ericdeinmd ( View Tweet)
A#2648
PET for GCA
Delayed imaging at 180 min improve dx performance for pts on GCs
Optimal PET w/in 3 days of GC, most patients unable to do w/in that window
Delay has sensitivity 92% even on prednisone - may be good tool for pts unable to get early PET/CT
#ACR24 @RheumNow https://t.co/kxpNfRqkGN
Links:
Eric Dein ericdeinmd ( View Tweet)
A#2649
Relapsing Polychondritis
Latent Class Analysis to define clinical phenotypes of heterogeneous dx
Type 1- ear, nose, subglottic stenosis
2- tracheo/bronchomalacia
3- absence tracheomalacia
Decision tree to classify pts in subgroups
#ACR24 @RheumNow https://t.co/xpZedPVl7f
Links:
Eric Dein ericdeinmd ( View Tweet)
A#2650
MRI can show extent of vessel wall inflamm to guide severity of GCA
Brain & orbital MRI performed
Assessed 7 arteries bilaterally -> CAMRIS-GCA MRI score (0-10)
33 GCA (17 ocular), 41 not GCA
CAMRIS-GCA ass w/ ocular GCA, higher severity. Improved w Rx
@RheumNow #ACR24 https://t.co/19XCuZJXqF
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Eric Dein ericdeinmd ( View Tweet)
A re-evaluation of lupus arthritis. Old dogma is RA is erosive and SLE non-erosive. With better imaging, lupus arthritis can be erosive. Vivianne Malstrom. @RheumNow #ACR24 https://t.co/JEqVPLGNfu
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Did you know?
#Lupus arthritis have clinical and US classifications.
On MRI, findings will show:
- periarticular hyperplastic tissue
- capsular swelling
- edematous tenosynovitis
@RheumNow #ACR24 @rheumarhyme @theactiverheum https://t.co/EoKh2Q3V9Z
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sheila RHEUMarampa ( View Tweet)
Disseminated acanthamoeba : pt with modular painful skin lesions on his palms and scalp— initially dx’d with a cutaneous vasculitis- he got worse with immunosuppression. Imaging and histology shown #ThievesMarket #ACR24 @RheumNow https://t.co/FjJ0Sk0Kxt
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TheDaoIndex KDAO2011 ( View Tweet)
Dr. CStone et al. assessed nailfold dermoscopy in distinguishing DM from SLE
Almost all DM pts had nailfold changes in at least 1 digit vs. SLE
& majority of DM pts had nailfold changes in all 10 digits
Dermoscopy is a simple alternative to capillaroscopy
@rheumNow #ACR24 ab2404 https://t.co/6tEXAlX7lt
sheila RHEUMarampa ( View Tweet)
Neuroimaging is done to support the diagnosis of CNS #lupus but only 75% reveal abnormal brain MRI.
📌 It is more useful in pts with local deficits than diffuse.
📌 poorly correlated with cognitive dysfunction & psych phenotypes.
@Rheumnow #ACR24 @rheumarhyme @theactiverheum https://t.co/HjNbVBaOHv
sheila RHEUMarampa ( View Tweet)
Cardiology is on!
Dr. Olin discusses Fibromuscular Dysplasia findings on imaging
Definite: string of beads and/or focal narrowing in right setting / location
Possible but nonspecific: dissection, ecstasia, aneurysm, and tortuously
@RheumNow #ACR24 https://t.co/Dr81KQfLSf
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
#2222
📊 New data on #RA-ILD:
🔴In early RA, ILD prevalence hits 21.4% after 10 years, with 8.2% cumulative incidence at 5 years (IR 14.9/1000 PY).
🔴ILD often precedes or coincides with RA onset.
🔴NSIP > UIP
🔴airway involvement less common than expected.
#acr24 @RheumNow
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
Cool study investigating differences in nailfold capillaroscopy, jives w/my clinical experience
Compared to SLE, pts with DM 🔼nailfold changes, 🔼 loop dilation, 🔼hemorrhages
#ACR24 @rheumnow Abstr#2404 https://t.co/8N7KNRZet8
Mike Putman EBRheum ( View Tweet)
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
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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)
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
Links:
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)
