Imaging

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Toward Long-Term Prevention of Rheumatoid Arthritis: Are We Closer?

Jonathan Kay, MD

As earlier diagnosis and treatment of rheumatoid arthritis (RA) have resulted in greatly improved clinical outcomes, the focus of current research has now shifted to preventing the development of RA altogether. At EULAR 2025, several oral presentations explored this objective, highlighting data

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Nailfold Capillaroscopy correlated w/ cardiac ECHO in Systemic Sclerosis. NFC & ECHOs studied in 30 SSc pts. Systolic & diastolic dysfunction most common in late SSc NFC patterns. Cardiac dysfunction seen w/ low capillary density, avascular areas, cap neoangiogenesis https://t.co/M6uU6i5cW4
Dr. John Cush @RheumNow( View Tweet )
#EULAR2025 Abstr#POS0318 Single timepoint assessment may not show true picture of #SLE control. Data from BILAG-BR registry using machine learning showed 6 trajectories with clinical meaning: -Nonresponse with high activity: dsDNA-ve & RNP+ -Response-flare: active MSK @RheumNow https://t.co/VrI8e4ONtM

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Psoriatic Arthritis at Risk for Interstitial Lung Disease A TriNetX EHR study shows that psoriatic arthritis (PsA), but not Psoriasis (PsO), patients are at increased risk for interstitial lung disease (ILD). https://t.co/2zuxF1PY3Q. https://t.co/Icck4qE76X

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Dr. John Cush @RheumNow( View Tweet )
#CAR-T in active #scleroderma #diffuse open label @sclerodermaUM presented improvement in #nailfold #capillary patterns Suggesting #vascular recovery Hope is for lungs, skin and survival to improve but These are ▶️ Early days ?risk OP0338 #EULAR2025. @RheumNow @eular_org https://t.co/QhmO6gekXk

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Janet Pope @Janetbirdope( View Tweet )
Genicular artery embolisation is like so many interventions in MSK medicine: early promise with smaller RCT & observational data, but the later, more robust data doesn’t show the same benefit. If you do meta-analyses of all these data, you mix good with bad #EULAR2025 @RheumNow https://t.co/K1tN9KX8rq

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David Liew @drdavidliew( View Tweet )
EULAR Classification criteria for hemachromatosis, presented by Prof. Kiely shows clinical pearls in diagnosis - Hook osteophytes @MCP 2/3, & Iron Fist sign w/ elevation of MCPs 2&3. #EULAR2025 https://t.co/S8iA0C4pwG
Dr. John Cush @RheumNow( View Tweet )
In clinical practice, not all US enthesitis findings are SpA-specific. Enthesophytes/calcifications common in healthy pts. Inflammatory lesions (PD signal, erosions) at Achilles, distal patella & greater trochanter better distinguish PsA/axSpA. Target key sites to improve US https://t.co/jO61QjKfQp

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
In 581 PsA pts (EuroSpA), MRI showed axial SpA features in 31%: BME (69%), erosions (68%), fat lesions (58%). MRI-axPsA pts: younger (41y vs 46y), male (70%), HLA-B27+ (55%), ↑CRP (13 vs 7 mg/L). Radiographs identified sacroiliitis in 29%. MRI adds key detection. POS0297 https://t.co/nAw0BDAH22

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
mri-2813908_640.jpg

Imaging and Early Detection in Psoriatic Arthritis

Antoni Chan, MD, PhD

At EULAR 2025, there have been new developments in imaging in PsA. Two key poster presentations (POS0104 and 

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Are we missing axial/SIJ lesions in PsA or are we misdiagnosing AxSPA + PSO pts for PsA? 5 register studies including 580+ pts w/ PsA/AxSPA+PSO 1/3 PsA routine care patients had SIJ MRI = SPA 29% Rx SII r-mNY criteria+ of which 38% MRI lesions AxSPA @RheumNow #EULAR2025 https://t.co/DJljlm7T9m

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Aurelie Najm @AurelieRheumo( View Tweet )
‼️Diagnosis of axSpA is clinical -MRI is a tool but still has a lot of limitations. -Improve reports by directly communicating with radiology and be specific on pt clinical info. -Unified algorithms are needed to apply AI in dx of SIJ inflammation on MRI. #EULAR2025 @RheumNow https://t.co/9GR6FsgIcL

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Adela Castro @AdelaCastro222( View Tweet )
🔍MRI lesions in early axSpA vs non axSpA with chronic back pain: -Data from SPACE cohort -n 318 (214 axSpA vs 108 non-axSpA). -Baseline imaging (CR and MRI) and at 2y f/u -Minimal progression on CR in both early axSpA and non-axSpA CBP. -On MRI, significant increase in the https://t.co/m5YOAiFUz1

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Adela Castro @AdelaCastro222( View Tweet )
What's the difference between PIPsA & NIPsA? (Persistent Inflammatory confirmed by IMAGING vs. Non inflammatory PsA) 🔹️Cross-sectional study 🔹️517 pts under b/tsDMARDs 🔹️10.3% D2T 🔹️57% PIPsA / 43% NIPsA 👇 Distinct phenotypes 👇 OP0176 #EULAR2025 @rheumnow https://t.co/YGHpbeE6ws

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
A machine learning (ML) model using electronic medical record (EMR) data from 396,000 Mayo Clinic primary care patients identified undiagnosed psoriatic arthritis (PsA) with area under the curve (AUC) 79.6%. Key predictors: psoriasis, joint pain, tenosynovitis, https://t.co/VsYevnJEjK

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
📊 SIJ findings in PsA (n=581): 🧠 31% = MRI-confirmed axSpA 🦴 Only 29% met r-mNY criteria MRI-axPsA group: younger, more male, HLA-B27+ Clinical + radiographic definitely underperform vs MRI #POS0297 @RheumNow #EULAR2025

Jiha Lee @JihaRheum( View Tweet )

#Psoriatic_Arthritis #Preclinical #Early ❓️ Does joint swelling occur in the same anatomical locations affected in the subclinical phase? 🅰️ Yes, in 68% 🅰️ Especially if positive ultrasound #EULAR2025 @RheumNow OP0179 by Ivan Giivannini et al. https://t.co/rKfreQyJeG

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
Rheumatoid vasculitis: what to look for and how to find it #EULAR2025 @AshimaMakol @RheumNow https://t.co/ZCUXgOr1dH

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David Liew @drdavidliew( View Tweet )
LDCT to assess disease progression in early axSpA: -Data from SPACE cohort 67 pts (>50% male,>80% hLAB27+) - LDCT at baseline and 2 years apart. -Overall 22% pt with net disease progression. -Spine progression most frequent on thoracic spine. -Good reliability in assessing https://t.co/M2jkDusD41

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Adela Castro @AdelaCastro222( View Tweet )
Do the sites of clinical onset of PsA (i.e., swelling) correspond to those that, at the time of enrollment in the study, showed evidence of joint tenderness and/or ultrasound-detected alterations compatible with inflammation? Of 28 incident PsA cases, 68% had prior subclinical https://t.co/rAZJU6Va5x

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Are we all going to be replaced by robots? Not just yet ARTHUR trial: the robotic ultrasonographer vs. human While the concept is promising, and ICC with humans were low to moderate, the robot is overestimating grey scale scores in MCPs of both HC and RA pts #EULAR2025 https://t.co/mTtbknu0lO

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Aurelie Najm @AurelieRheumo( View Tweet )
Multimodal data using clinical histological and serological predictors in renal function in #sle nephritis. Using the AMP SLE data. Low baseline eGFR and histological damage predicted worsening renal function but not NIH activity index #POS0173 #EULAR2025 @RheumNow @andreafa https://t.co/Eh8dZXHRVX

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Bella Mehta @bella_mehta( View Tweet )
Ultrasound for ILD detection in RA 🫁 Sens 88.6 Spe 92.8 NPV 91.4 PPV 90.7 While if abnormal or high suspicion, HRCT should be the reference, I see this as an interesting tool in clinics for quick screening POS0180 #EULAR2025 @RheumNow https://t.co/pUy0ki7Y6S

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Aurelie Najm @AurelieRheumo( View Tweet )
#HOT topic Lung 🫁 #ultrasound for #RA #ILD #LUS B lines vs HRCT Single site 🇫🇷 study V sensitive & specific 🤔needs standardization & comparison in other groups Abst#POS-180 #EULAR2025 @RheumNow @eular_org https://t.co/PwGE4rgk40

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Janet Pope @Janetbirdope( View Tweet )
Does having a synovitis in a specific joint predicts Rx damage in that same joint? Yes Can US synovitis predict Rx progression better than clinical synovitis at the joint level? Not really At 1 year, only US synovitis is, both B-mode and Doppler ass w/ Rx prog, in particular https://t.co/Wu6dDqIUYn

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Aurelie Najm @AurelieRheumo( View Tweet )

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