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"Do not fear RPF." - John Stone
Retroperitoneal fibrosis certainly feels challenging at times, and radiologic features might stay even after functional improvement
but we've come a long way
(although, despite B cell depletion, there's plenty more to do)
#ACR24 16S26 @RheumNow https://t.co/2Y3buXrAFY
David Liew drdavidliew ( View Tweet)
Difficult to Manage Axial Spondyloarthritis
Studies show that patients with difficult-to-manage axSpA have a higher disease activity; however, the lack of a consensus definition led researchers and clinicians to utilize their own proposed definition, resulting in variability of the characteristics of non-responders.
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Improving the Value of Musculoskeletal Ultrasound in Rheumatology Care
Unlike traditional imaging techniques, MSUS can be easily used at the point-of-care and offers high-resolution images of joints, tendons, and soft tissues, facilitating the early detection of inflammation and structural damage. On Saturday, November 16th at the ACR Convergence 2024, Dr. Veena Ranganath, Dr. Gurjit Kaeley, and Dr. Catherine Bakewell will present the “Proposed ACR Guidance for Use of Musculoskeletal Ultrasound in Rheumatoid and Psoriatic Arthritis.” This is the first update in a decade since the 2012 ACR guidance on the reasonable use of MSUS in rheumatology clinical practice.
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171 SSc pts w/ hand Xrays and US found 20% w/ Joint involvement. Active Synovitis & tenosynovitis predicted by CRP>10mg/L (p = 0.013), fibrotic tenosynovitis on US (p = 0.005), anti-RNA polymerase III antibodies (p = 0.043) https://t.co/DZrM5aQpJ7 https://t.co/CkGP6H8J6x
Dr. John Cush RheumNow ( View Tweet)
Prof @WalterMaks et al reports the validation of data-driven quantitative MRI cutoffs for a +SIJ MRI perform highly in pts with established axSpA.
- Deep fat lesions & sclerosis: high specificity for #axSpA
@RheumNow #ACR24 abs821 https://t.co/sSAtTt1GGV
sheila RHEUMarampa ( View Tweet)
Not just the presence but higher levels of biomarkers predict RA-ILD progression.
#ACR24 @RheumNow ABST#0804 https://t.co/5jhBjXDUeY
Jiha Lee JihaRheum ( View Tweet)
Does alcohol consumption affect radiographic progression in axSpA?
Canadian cohort study over 6 years found greater radiographic progression among alcohol consumers.
Still a lot of confounding factors to fully establish an association.
Abst#0822 #ACR24
@RheumNow https://t.co/GG0rXq3kjC
Adela Castro AdelaCastro222 ( View Tweet)
The use of ultrasound in clinically suspect arthralgia can complement MRI early diagnosis of RA. Abstr#228 Gupta A @RheumNow #ACR24 https://t.co/rpVqZKeMXE
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
More evidence: persistence of imaging abnormalities is probably NOT an adequate metric of LVV tx failure
Boiardi et al - 87% TAK/LV-GCA pt w persistent dz on imaging despite clinical remission, TAK>GCA
PET avidity more persistent in GCA
@RheumNow #ACR24 Abstract 1617
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Dr. Catherine Bakewell @CatherineB27 shares the preliminary ACR guidelines on ultrasound imaging in psoriatic arthritis covering 4 domains, detailed PICOs covering the early phase, diagnosis, assessment covering the domains of PsA @RheumNow #ACR24 https://t.co/DoHE1rsSGf
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#0322🔬 Myocarditis in Myositis(IIM)
📊 26% new IIM pt had myocarditis (ESC,Lake Louise)
💥 Anti-Ku most common MSA
💥Myocarditis a/w ⬆️heart failure, arrhythmia (43 v 6%;p=0.02)
🎯 Myocarditis🟰poor outcomes
🎯Cardiac MRI🟰earlier detection
#ACR24 @RheumNow @JuliePaikMD https://t.co/yz0f2ozFVL
Caoilfhionn Connolly CaoilfhionnMD ( View Tweet)
171 SSc pts w/ hand Xrays and US found 20% w/ Joint involvement. Active Synovitis & tenosynovitis predicted by CRP>10mg/L (p = 0.013), fibrotic tenosynovitis on US (p = 0.005), anti-RNA polymerase III antibodies (p = 0.043) https://t.co/OIornA9sAA https://t.co/yXyX5k2yqD
Dr. John Cush RheumNow ( View Tweet)
Serial MRI study of SI & lumbar (LS) joints in 24 early axSpA (Sxs < 5.5yrs) over 3 yrs, showed:
- SIJ developed bone marrow edema, sclerosis & erosion.
- LS: fat lesions decreased & erosions increased.
- Facet joint inflammation (in t0) significantly influenced yr 3. LS bony… https://t.co/COlFAXVE1x https://t.co/4Xs9ngJN4w
Dr. John Cush RheumNow ( View Tweet)
Dr. Quotes (11.8.2024)
Dr. Jack Cush reviews the news and journal reports from this past week from RheumNow.com.
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Serial MRI study of SI & lumbar (LS) joints in 24 early axSpA (Sxs < 5.5yrs) over 3 yrs, showed:
- SIJ developed bone marrow edema, sclerosis & erosion.
- LS: fat lesions decreased & erosions increased.
- Facet joint inflammation (in t0) significantly influenced yr 3. LS bony… https://t.co/czBPVXYHYa https://t.co/6ByhsXONtf
Dr. John Cush RheumNow ( View Tweet)
Happy Diwali (11.1.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.
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Airway Dz in RA (w/o ILD dx) studied in 188 pts. Airways obst. in 21% by PFTs (assoc w/ older, male, smoking). CXR abnl in 61%, (55% bronchial thickening, 12% bronchiectasis), esp in RF+.
Quant CT scan measures correlated w/ respiratory symptoms https://t.co/In1sxLZQRm https://t.co/anmUNGuby8
Dr. John Cush RheumNow ( View Tweet)
Nailfold videocapillaroscopy (NVC) study of 65 Behcets pts found vascular abnl in 40-47% ( enlarged/tortuous capillaries, microhaemorrhages. Having ≥2 NVC abnormalities increase risk of Vascular events (VTE, superficial thrombophlebitis), but not ANA https://t.co/2Om0IIFVnG https://t.co/W7mbdPh9ee
Dr. John Cush RheumNow ( View Tweet)
Full read review on the detection & management of #ILD in Autoimmune Dz (AID).
- AID at risk for ILD should be screened with hi-res CT Scan
- ILD should be monitored closely w/ PFTs
- Multidisciplinary Rx includes immunosuppressives & antifibrotics https://t.co/X6Feor2wF5 https://t.co/Z2WBWL3q1W
Dr. John Cush RheumNow ( View Tweet)
#VEXAS can present as atypical &/or refractory #ANCA-associated #vasculitis
Consider possibility of VEXAS in cases of AAV
▶️Refractory to multiple treatment
▶️Atypical kidney biopsy
👉🏽https://t.co/1Vewb5n5vZ
via @RheumJnl https://t.co/FLov5xaQAA
Dr Ai Lyn Tan DrAiLynTan ( View Tweet)