Imaging

@RheumNow article further exploring the roe of lung ultrasound for RA-ILD screening as shown through 3 #EULAR2026 abstracts https://t.co/smN8hg51nj

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Jiha Lee @JihaRheum( View Tweet )

🏠 Take Home Messages from the early #axSpA session 🔺 Earlier diagnosis is possible and better 🔺 Early axSpA is not synonymous to mild 🔺 Longitudinally, early axSpA is heterogeneous 🔺 MRI has transformed the field ❗️Beware of pitfalls #EULAR2026 @RheumNow https://t.co/IhGQSxssyd

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
EULAR.Docs.APP

Day 4 EULAR Report

Jack Cush, MD

The last day in London was exciting as both the Late-Breaking abstracts and new EULAR guidelines were presented. Guidelines presented addressed several significant unmet need areas including PMR, GCA, Takayasu’s arteritis, Vaccinations in Rheumatic patients, Imaging in spondyloarthritis and

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Thoracic U/S for #RA-ILD screening? Multicenter study (n=272, Argentina/Denmark/Belgium): 86% sensitivity and 94% NPV. Accessible, no radiation, integrates into clinic flow. Time to build TUS into routine RA-ILD pathways? @RheumNow #EULAR2026 POS1265 https://t.co/FGH5iUstxa

Links:

Jiha Lee @JihaRheum( View Tweet )
ILD.colors

RA-ILD in the Age of Treat-to-Target: Put the Probe on the Chest

Jiha Lee, MD

At EULAR 2026, speakers of the session “Catching Your Breath: Unravelling RA Associated Interstitial Lung Disease (ILD)” noted RA-ILD is one of the few outcomes not improving in the biologic era. Three abstracts reinforce that message and make the case for a practical, low-cost screening tool

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🏠 Take Home Messages from the early #axSpA session 🔺 Earlier diagnosis is possible and better 🔺 Early axSpA is not synonymous to mild 🔺 Longitudinally, early axSpA is heterogeneous 🔺 MRI has transformed the field ❗️Beware of pitfalls #EULAR2026 @RheumNow

Nelly ZIADE 🍀 @Nellziade( View Tweet )

#EULAR2026 Recommendations: Vasculitis -Confirm diagnosis with imaging and biopsy - Start GC early but with taper plan - For major flare again confirm dx and restart GC - Consider IL-6 or UPA - MTX may be option if biologics not available @RheumNow https://t.co/DqLZtW630y

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Jiha Lee @JihaRheum( View Tweet )
CT imaging in RA Body composition changes beyond BMI 489 RA vs 397 ctrl RA asso w/ -increased subcutaneous fat -increased intermuscular adipose tissue -poorer muscle quality Looks like it represent “hidden obesity” with more by fat redistribution and myosteatosis #OP0348

Aurelie Najm @AurelieRheumo( View Tweet )

And now does MRI do better than US at predicting RA progression in at risk pts? Short answer: No likely too sensitive! 130 anti-CCP+ symptomatic pts 36.9% progressed BL US positivity predicted progression HR 2.8 MRI showed prevalence of subclinical disease synovitis >80%

Aurelie Najm @AurelieRheumo( View Tweet )

Detecting subclinica tenosynovitis in pts at risk for RA: who does it better US or DixonMRI? 65 pts RA CSA, US detected only ~23% of cases identified by Dixon US misses most! But are they “real” tenosynovitis? MRI (5-min, no contrast) higher sens US higher spe Shall we do https://t.co/stsMRdj9eY

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Aurelie Najm @AurelieRheumo( View Tweet )
Lung US for RA-ILD screening Comparison with diagnostic scores 147 RA pts (68 ILD on HRCT) Asymptomatic cohort Sens 95.4% Spe 77.7% Risk scores alone performed poorly. Combining US + risk scores boosted sensitivity to 100% → promising low-cost screening tool alongside HRCT. https://t.co/7C4zClaxry

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Aurelie Najm @AurelieRheumo( View Tweet )
Can AI read 20 years of RA X-rays? And how much faster/better than us? 20 years ESPOIR cohort 7500+ joints RADAR algorithm 94–95% accuracy compared with expert readers 99% spe 93% sens #OP0344 #EULAR2026 @RheumNow https://t.co/8hFHCY4SaY

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Aurelie Najm @AurelieRheumo( View Tweet )
Can AI spot RA inflammation from a thermal hand scan? Cohort 100 RA pts AI model analysing thermal images detected US PD+ wrist inflammation AUC 0.87 Main features wrist temperature & heat-pattern With all due validation could this be the next mass screening tool for RA? https://t.co/2AzXj5yQJI

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Aurelie Najm @AurelieRheumo( View Tweet )
The axSpA classification has been revised with the 2025 ASAS SPARTAN criteria. 5 abstracts at #EULAR2026 Abstr OP0236, OP0100, OP0239, POS0190 and POS1341. The single most important change in the 2025 criteria: MRI is now the highest-weighted variable and what counts as a https://t.co/xg4R4xRH2D

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
SPARTAN-SSR: New quantitative criteria: BME in ≥3 consecutive slices OR any two of (BME, Erosion, Fat lesion each in ≥3 SIJ quadrants) or ankylosis in ≥3 halves achieves 88-96% sensitivity and 90-98% specificity across 3 cohorts. Precision #axSpA imaging. Abstr OP0100

Antoni Chan MD (Prof) @synovialjoints( View Tweet )

Which imaging test has the highest carbon footprint??? Think wisely before prescribing 🩻 #EULAR2026 @RheumNow https://t.co/36Ej8smWRd

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
#OP0350 UK Biobank analysis found widespread white matter microstructural abnormalities on diffusion MRI in RA, esp in fronto-subcortical & transcallosal pathways, despite no cortical volume/thickness differences on T1 MRI. #EULAR2026 @RheumNow

Mrinalini Dey @DrMiniDey( View Tweet )

Starting the “Imaging innovation in RA” session with #OP0343: Singapore investigators developed an AI-based thermography model to detect RA wrist inflammation using thermal hand images, achieving an AUC of 0.87 against ultrasound power doppler as reference. #EULAR2026 @RheumNow https://t.co/2v39E6VOWB

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Mrinalini Dey @DrMiniDey( View Tweet )
This study describes the SIJ differences in axSpA vs. non-axSpA pts with CBP axSpA: BME w/ widespread distribution & inflamm⬇️ over time non-axSpA: BME rare or limited only to ventral & middle superior sacrum Findings may improve MRI ID of axSpa AbsPOS0193 @RheumNow #EULAR2026 https://t.co/7eiHQOOIWs

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sheila @RHEUMarampa( View Tweet )
PET-derived parameters in #PsA correlated with DAPSA, CRP and patient pain. Angiogenesis imaging may be a complementary biomarker of overall disease burden Abstr#OP068 #EULAR2026 #Imaging

Antoni Chan MD (Prof) @synovialjoints( View Tweet )

One of the main changes in the 2025 update on the EULAR guidelines for imaging in SpA is that of MRI replacing CR as the initial imaging modality while CR & low dose CT of SIJs became alternative modalities in the absence of or if with CIs to MRI AbsPOS0682 @RheumNow #EULAR2026 https://t.co/bj2NWKnIGf

Links:

sheila @RHEUMarampa( View Tweet )
#OP0344 RADAR, AI-automated scoring of RA radiographic damage, was applied to 20yr ESPOIR imaging data. Strong performance vs expert readers, w binary classification accuracy up to 0.95 & ICC 0.86. Supports AI-assisted long-term structural assessment in RA. #EULAR2026 @RheumNow

Mrinalini Dey @DrMiniDey( View Tweet )

abstract

New JAK inhibitors in the axSpA treatment landscape

Mrinalini Dey, MD

At EULAR 2026, two large phase 3 studies highlight that the JAK story in axSpA is still evolving rapidly, with different selectivity profiles and expanding global development programs continuing to push the field forward.

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MRI.scan

MRI as a novel biomarker in lupus

Sheila Reyes, MD

The clinical abstract sessions on diagnostic tools in lupus showcased interesting studies, including the use of MRI as potential non-invasive biomarkers.

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🔍 Do posterior element lesions progress over 10 years in axSpA? Data from the DESIR inception cohort (n=320) says RARELY! But baseline PE inflammation raises facet ankylosis risk ~70-fold #POS0189 #EULAR2026 @RheumNow https://t.co/PdwlPGjKqK

Links:

Nelly ZIADE 🍀 @Nellziade( View Tweet )

Therapeutic Updates

Diagnosis of PMR

RheumNow
Yates Thumbnail
Nine perspectives now available: Red Flags in the Diagnosis of PMR; Epidemiology of PMR; Role of the PCP in Diagnosis and Care; Importance of Diagnostic Imaging; ESR/CRP in PMR; PMR Must Rule Outs; Which PMR Patients Should Rheumatologists See?; Is There Hidden GCA?; and PMR Mimics.
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Recent Blogs

rheumthought

CNS Lupus (NPSLE)

Jack Cush, MD
Cush RhTh CNS
29 yr. old woman with SLE and transverse myelitis. Is this NPSLE; how to diagnose?
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rheumthought

Universal Imaging for GCA in PMR? Not So Fast

Michael Putman, MD, MSCI
Putman PMR RheumThought
For decades we've been screening GCA with a patient history and exam. Doing so with imaging would be a sharp departure from the current standard of care. And you may be asking yourself, well, yeah, but what could it hurt? Don't you want to catch GCA early?  Let me tell you the problems with this. 
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Unpopular opinion: spinach can be bad for you

Lara El Khoury, MD
pro con unsure opinion thumbs debate
PMR might be one of the most rewarding diagnoses to make in real practice: the patient comes to you in severe debilitating pain, and you prescribe steroids, giving them their lives back! As much as this impressive response makes your intervention appear almost magical, there is the often-forgotten story about the implications of such a diagnosis and treatment on patients' daily lives. 
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Podcasts

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