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Deep Learning Model Accurately Detects Ankylosing Spondylitis on MRI

Bella Mehta, MBBS, MS

AI continues to move from research labs into rheumatology clinics, promising to reshape how inflammatory diseases are diagnosed and monitored. Ankylosing spondylitis, in particular, poses a diagnostic challenge—its early imaging findings are subtle, and radiographic changes may take years to appear and require specific musculoskeletal radiology expertise. A new deep learning model offers a glimpse into how AI could bridge this diagnostic gap.

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Cush and Kavanaugh

ACR 2025 Rheumatology Round Up

Jack Cush, MD

Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.

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Bone Density in Ankylosing Spondylitis

Bella Mehta, MBBS, MS

Ankylosing spondylitis (AS) is a burden on the bones—both literally and diagnostically. The disease’s dual nature, marked by chronic inflammation and abnormal new bone formation, complicates the assessment of bone health.

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Tofacitinib in AxSpA in Developing Countries Dr. Antoni Chan reports on abstracts 0582 and abstract 0554 presented at #ACR25 https://t.co/4kTv90PhIC https://t.co/WRUBP0O21b

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Dr. John Cush RheumNow ( View Tweet)
Difficult to Manage axSpA Drs. Antoni Chan and Rodrigo Garcia Salinas discuss abstract 0584, "Difficult-to-Manage Axial Spondyloarthritis According to ASAS Criteria in Reuma-Check Cohort: Frequency, Predictive Factors, and Treatment Patterns", presented at #ACR25 https://t.co/84HZojI3FJ
Dr. John Cush RheumNow ( View Tweet)
Early Peripheral SpA: Is it okay to stop treatment sometimes? Dr. Richard Conway reports on abstract 0568 "Drug-Free Remission in Early Peripheral Spondyloarthritis: 10-year follow-up from the CRESPA-trial," presented at #ACR25 https://t.co/FtI2o90v9O https://t.co/jUAEDZhDW5

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Dr. John Cush RheumNow ( View Tweet)
Catching AxSpA Early: Closing the Diagnostic Gap Dr. Akhil Sood reports on abstract 2635 and abstract 2636 presented at #ACR25. https://t.co/TmJQKQUu9E https://t.co/6dWf8DY2W3

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Dr. John Cush RheumNow ( View Tweet)

#ACR25 Sheds Light on Disparities, Age-Related Trends, and Epidemiology in Autoimmune Rheumatic Diseases At #ACR25, new research explored critical disparities and epidemiologic trends shaping outcomes in autoimmune rheumatic diseases across diverse populations and age groups. https://t.co/CPob0ppjv3

Dr. John Cush RheumNow ( View Tweet)
💬 #ACR2025 Topic Panels — LIVE! Nov. 2 join RheumNow at 7 PM ET for a deep dives into the hottest topics in rheumatology: 👉 PsA Join Us Live on: X Live • Facebook Live • YouTube Live • LinkedIn Live • https://t.co/V10S4oVFsv Top experts. Real clinical insight. Don't miss https://t.co/A4pUjZG3Dr

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Dr. John Cush RheumNow ( View Tweet)
New Insights into Pregnancy Outcomes and Maternal-Fetal Health in Rheumatic Diseases At #ACR25, the ACR presented new research illuminating critical challenges and advances in pregnancy outcomes for women living with rheumatic diseases, including axial spondyloarthritis, https://t.co/nJjtTMHnD3
Dr. John Cush RheumNow ( View Tweet)
What happens if you have #axSpA & concomitant #FM? Pts with both have less TNFi retention, -residual pain may lead to d/c Rx. Need to determine if axSpA pt has #fibromyalgia as there may not be objective findings if no peripheral arthritis in axSpA. #ACR25 @RheumNow abst#534

Janet Pope Janetbirdope ( View Tweet)

In AxSpA, an 8-week personalized exercise program improved trunk strength (+14.1%), mobility (+14.9%), and cardiorespiratory fitness ( increased oxygen pulse, ventilatory efficiency, anaerobic threshold). BASDAI and chest expansion also improved. Supports tailored rehab based on https://t.co/jawosa2AJK

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
In early axSpA vs non-axSpA CBP, 2 year spinal x-ray progression was minimal in both groups. But on MRI, fat lesions increased significantly in axSpA (0.16 units/yr vs –0.02), with 15% having ≥3 lesions at 2 year vs 1% in non-axSpA. Fat lesions may signal early structural https://t.co/zvgU1Gt0po

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
New biomarkers in axSpA. In early axSpA (DESIR cohort), higher baseline Phospholipid transfer protein (PLTP) activity was linked to sacroiliac radiographic progression over 5 years. Lower zonulin and lipopolysaccharides (LPS) levels also associated with progression. Highlights https://t.co/1uBtR4QA97

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Clinical Year in Preview SpA: no difference in efficacy rotating vs switching bDMARD MoA for next steps @RheumNow #ACR25 #LB09 https://t.co/shCLgk7Yqz

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Jiha Lee JihaRheum ( View Tweet)
In a U.S. axSpA cohort (n=4,799), women had a 24% higher adjusted risk of TNFi discontinuation vs men especially under age 65. No sex differences seen for IL-17i or JAKi, though sample sizes were small. Highlights need for sex-informed treatment strategies. Abstract#2634 https://t.co/58Dw3nFCsf

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Use of AI in AxSpA imaging for diagnosis. ASembleNet, a hybrid deep learning model, achieved 99% accuracy on coronal and 98.1% on axial MRI for AS classification, outcomes higher than ResNet50, Xception, and InceptionV3. Validated on ASAS cases, with Grad-CAM interpretability and https://t.co/yU8shaIdP2

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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
What's the latest in PsA? https://t.co/I8ZgRQpVy6 Great review for whats new in PsA by @drpnash Looking forward for Large IL23-Axial study results. @RheumNow #ACR25

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Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)

Cohort study comparing 3yr safety outcomes of JAKi vs. TNFi in AS pts JAKi use: ⬆️incidence of HZ infxn but not significant; ⬆️all-cause mortality (HR 4.94) and GI bleed (p=0.04) Individualize tx. consider potential complications #ACR25 @RheumNow Abs2633 https://t.co/pjKAazQFwW

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sheila RHEUMarampa ( View Tweet)
Sex differences in 💊 d/c in axSpA from the RISE registry 🔅Females - ⬆️discontinuation risks for TNFi 🔅No sex differences seen in dc risks for IL17i and JAKis 🔅Young females discontinued faster than males Gender diff in SpA can guide tx decisions #ACR25 @RheumNow Abs2634 https://t.co/kcXfZrU4zI

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sheila RHEUMarampa ( View Tweet)
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