Imaging

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How New Medications are Reframing Imaging Abnormalities in axSpA

Brian Jaros, MD

Bimekizumab (BKZ), a monoclonal antibody that selectively targets both IL-17A and IL-17F, was evaluated in the BE MOBILE 1 (non-radiographic axSpA) and BE MOBILE 2 (radiographic axSpA) trials and found to yield significant

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Did you know? 🤔 Capillaroscopy is performed on the nailfold because it is the area where the capillaries are fully visualized compared to the skin where capillary tips are only seen. This capillaroscopy session with Dr. Cutolo is so high yield I'd say! 🤓 @RheumNow #ACR24 https://t.co/8AN7RXUDrM

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sheila @RHEUMarampa( View Tweet )
Gender

Gender Differences in SpA

Sheila Reyes, MD

One of the hot topics during the meeting was gender differences in SpA. Three abstracts presented addressed issues related to these differences particularly in the aspects of treatment response and disease activity.

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In order to have a #DMOAD in knee #osteoarthritis ➡️ early detection may be v important Study of early pt Symptoms was done 2/3 had pain 1/2 #joint Swelling Need biomarkers & sensitive imaging in early #OA as symptoms are NOT uniform #ACR24 @RheumNow @ACRheum abst2111 https://t.co/K94m9rOjtP

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Janet Pope @Janetbirdope( View Tweet )
Risk stratification of GCA pts: who might lose vision? Cranial MRI with vessel wall enhancement used to calculate additive score... # of vessels affected Higher scores a/w ocular GCA > non-ocular GCA > no GCA and decreased w/ tx @RheumNow #ACRbest #ACR24 https://t.co/knDVrl84Qs

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Brian Jaros, MD @Dr_Brian_MD( View Tweet )
#Artificial #Intelligence can detect #osteoporosis On #CXR To detect #thoracic #vertebral #fractures > 100000 #chest #radiographs - test and validation cohorts found + results on ROC Helpful -sometimes vertebral changes are Not read on CXRs #ACR24 @RheumNow @ACRheum #2116 https://t.co/NxEaH0AKJv

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Janet Pope @Janetbirdope( View Tweet )
Yang et al. Cranial vessel wall MRI in GCA. Quantitated with PEG score. PEG score ocular GCA>non-ocular GCA>non-GCA. Decreases with treatment. @RheumNow #ACR24 Abstr#2650 https://t.co/e26urOpb7V https://t.co/eekQbzmKYm

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Richard Conway @RichardPAConway( View Tweet )
A#2651 Vasculitis w VEXAS 81 men, median age 67 - 27% had evid of vasculitis, variable size vessel 22% SVV- 17/18 cutaneous, one peritubular capillaritis on renal bx 2.5% MVV (2 cutan), LVV (2 carotid thickening, 1 had +TA bx), ANCA+ @RheumNow #ACR24 https://t.co/puablIBLCP

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Eric Dein @ericdeinmd( View Tweet )
A#2648 PET for GCA Delayed imaging at 180 min improve dx performance for pts on GCs Optimal PET w/in 3 days of GC, most patients unable to do w/in that window Delay has sensitivity 92% even on prednisone - may be good tool for pts unable to get early PET/CT #ACR24 @RheumNow https://t.co/kxpNfRqkGN

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Eric Dein @ericdeinmd( View Tweet )
A#2649 Relapsing Polychondritis Latent Class Analysis to define clinical phenotypes of heterogeneous dx Type 1- ear, nose, subglottic stenosis 2- tracheo/bronchomalacia 3- absence tracheomalacia Decision tree to classify pts in subgroups #ACR24 @RheumNow https://t.co/xpZedPVl7f

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Eric Dein @ericdeinmd( View Tweet )
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

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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

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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

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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

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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

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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

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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

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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

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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

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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 )

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