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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
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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
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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
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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
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Richard Conway RichardPAConway ( View Tweet)
