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New Advances in Ultrasound Diagnostics for Psoriatic Arthritis
ACR Press Release
Two pivotal studies led by an international team of rheumatology experts will be presented at ACR Convergence 2025, showcasing major strides in the ultrasound-based diagnosis of enthesitis in psoriatic arthritis (PsA).
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In a retrospective study of TAK patients, ~about 1/3 developed new lesions on imaging over time
Most lesions:
- stenotic
- L carotid
- Abdominal aorta
- SMA
50% of the 1/3 = 2 or more lesions
Serial imaging is crucial!
@RheumNow #ACR25 Abst 1631
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
The first father-daughter session at ACR?
Brilliant session in diagnostic thinking and mimics in rheumatology from @LCalabreseDO and @CCalabreseDO, teasing apart heuristics, biases, and examples straddling the ID-Rheum divide. Well worth catching on the replay #ACR25 @RheumNow https://t.co/16FEqVyDGg
Links:
David Liew drdavidliew ( View Tweet)
Functional MRI studies have been out there for a while, but mechanisms and significance underlying fMRI findings are unclear
fMRI study in 38 active PsA pts w/ significant fatigue
Altered functional connectivity between posterior insula to cerebellum & superior frontal gyrus https://t.co/3s9CJUg2uN
Aurelie Najm AurelieRheumo ( View Tweet)
Dr. Gensler gave a fantastic talk on SpA mimics
☝️Not all IBP is axSpA - interpret in the appropriate context + imaging
WOF other mimics
🔸 Sacral insufficiency fractures
🔸 Infections
🔸DISH
#ACR25 @RheumNow https://t.co/7TIqyp5rYe
Links:
sheila RHEUMarampa ( View Tweet)
Primary CNS vasculitis: what else causes vessel wall enhancement on dedicated brain MRI?
From Dr. Hajj-Ali https://t.co/v5ZtyezX3x
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
12 year follow up radiographic data in axial SpA - ASAS definition of early stage does not significantly influence long term radiographic outcomes. Abt#1432 #ACR25 @RheumNow https://t.co/fFP2CW6X0B
Bella Mehta bella_mehta ( View Tweet)
Screening for ILD in RA patients:
CXR and PFTs by themselves are close to a waste of time.
When it comes to screening (high-risk) RA patients, it’s HRCT (or lung USS) or nothing really.
(in keeping with EULAR, ACR guidelines)
#ACR25 ABST1335 @RheumNow https://t.co/XBDxLwYsAT
David Liew drdavidliew ( View Tweet)
This poster is absolutely bonkers & I LOVE it
Huge table. Frequency of everything over time
Really interesting to see which activity persists / how much damage is accumulated
Every trial should be obligated to share this (esp SLE!)
#ACR25 @RheumNow #ACRBest Abst#1608 https://t.co/blRrvwi3qP
Mike Putman EBRheum ( View Tweet)
Loarce et al. Poor performance of CXR and PFT in diagnosing RA-ILD (compared to HRCT). Message is, if you think they have RA-ILD, you need to do CT. @RheumNow #ACR25 Abstr#1335 https://t.co/eeSTf72mvM
Richard Conway RichardPAConway ( View Tweet)
Kharouf et al. Effect of handedness on radiographic damage in PsA. Left-handedness associated increased peripheral damage, especially in left hand. Hypothesis that having to use tools designed for right-handedness increases mechanical stress @RheumNow #ACR25 Abstr#1415 https://t.co/gfGQkrYyc8
Richard Conway RichardPAConway ( View Tweet)
Really useful observational study, 305 pts with TAK
Out of 205 pts w/subsequent imaging, 72 (35%) w/NEW lesions in previously-unaffected territory
Majority of lesions stenotic. Emphasizes importance of regular monitoring
#ACR25 @RheumNow Abstr#1631 https://t.co/zoWjH0lEym
Links:
Mike Putman EBRheum ( View Tweet)
Abstract 1431: Radiographic sacroiliitis in #PsA: insights from an Indian cohort
- Cervical and lumbosacral spine syndesmophytes were common
- Levels C5, C6, and L4 vertebrae frequently involved including syndesmophyte damage w/ non-marginal bridging
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Picture this 👉radiographic joint damage tied to worse physical function in #PsA:
🔹 ↑ mSS → ↑ HAQ (β=0.003 [0.002–0.004])
🔹 ↑ mSS → ↓ SF-36 PF (β=−0.10 [−0.15 to −0.05])
🔹 ↑ # of damaged joints → worse physical function
@RheumNow #ACR25 Abstract 1425
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Abstrat 1414 Compared to #PsO, early #PsA showed:
🔹 ↑ Dactylitis (66%), Enthesitis (78%), CRP/ESR
🔹 Longer morning stiffness & ↑TJC/SJC
🔹 MRI/US: frequent tenosynovitis & bone changes
🔹 Predictive model combining these features showed Sens 89%, Spec 84%
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
@RheumNow on virtual learning:
It’s integrated in clinical care, research and #MedEd
How to manage info overload?
- schedule, make use of tools
- use AI to curate, analyze & focus
#ACR25 @rheumarhyme https://t.co/ogCezlnxUP
Links:
sheila RHEUMarampa ( View Tweet)
In the #ACR25 Great AI debate, @RADoctor shows automated ultrasound scanning - one legitimately promising application ready very soon.
I’ve written about this work (ARTHUR/DIANA) for @RheumNow last year - check it out:
https://t.co/Zq4ywEjspi https://t.co/3RYCVunE3a
Links:
David Liew drdavidliew ( View Tweet)
The CLASSIC study (n=1015, 27 countries) validated revised ASAS-SPARTAN axSpA criteria. Final model achieved 79.5% sensitivity & 90.4% specificity vs global diagnosis. MRI SIJ (active + structural) was strongest predictor. HLA-B27, CRP, IBD, uveitis also included. Abstract#0854 https://t.co/GjSHE2ihVI
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#0854 @Official_ASAS & @SPARTAN_Updates revised #axSpA criteria meet targets: Sn 79.5% / Sp 90.4%.
Imaging is central (SIJ MRI + structural lesions) with focused clinical items: HLA-B27, IBP, uveitis, IBD, heel enthesitis, psoriasis, ↑CRP
@RheumNow #ACR25 https://t.co/i2d12y9HcD
Mrinalini Dey DrMiniDey ( View Tweet)
The severity of skin psoriasis increases the risk of psoriatic arthritis. Scher J @RheumNow #ACR25 https://t.co/EI0ACWACHy
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
