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Imaging

Best of 2024: Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease

A matched cohort study from the Veterans Health Administration shows that rheumatoid arthritis patients have a >50% increased risk of lung cancer, and a 3-fold higher risk of lung cancer in RA-interstitial lung disease (ILD).

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Bah Humbug Vitamin D (12.20.2024)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

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Steroids do NOT hamper muscle Bx dx of ANCA vasculitis. Tokyo study of 126 pts w/ suspected vasculitis had Quad muscle Bx; 71 (+) w/ Dx of AAV. Bx yield in 56 and 15 pts w/ off or on steroids, respectively, was similar (59% vs 53%). https://t.co/Xpt01Wksd3 https://t.co/NSBclcEgwq
Dr. John Cush @RheumNow( View Tweet )

Tocilizumab Efficacy in Giant Cell Arteritis Phenotypes

A Spanish Collaborative Group study of Tocilizumab (TCZ) in Giant Cell Arteritis (GCA) demonstrated high efficacy regardless of the different vascular phenotypes treated. 

Multicentre study of 471 GCA patients treated with TCZ, assessed outcomes according to vascular

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ICYMI: Beyond the Needle: Redefining the Assessment of Lupus Nephritis

Lupus nephritis is one of the most silent and severe manifestations of SLE. When not captured early, patients are at high risk of progressing to end-stage renal disease, which would require dialysis or transplantation. Renal biopsy remains the gold standard for diagnosis and disease

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JAMA FULL READ review and overview of Axial Spondyloarthritis by Drs. Deodhar & Bittar - Dx often delayed 6-8 yrs - Sensitivity/Specificity of: HLA-B27 (50%/90%), CRP (35%/91%), Xray sacroiliitis (66%/68%) or MRI (78%/88%). Great tables, figs, Xrays &Reference!… https://t.co/UbqVOr2iDx https://t.co/Ye5mYcbYX2
Dr. John Cush @RheumNow( View Tweet )
Will the Robots Save Ultrasound? Ultrasound has a lot going for it in rheumatoid arthritis and psoriatic arthritis. It is free of ionizing radiation, yet can deliver helpful insights to the bedside, educating our patients along the way. As we seek to prognosticate more and… https://t.co/2JL2be3RMj https://t.co/4oQy6gcQVS
Dr. John Cush @RheumNow( View Tweet )
JAMA Images in Dermatology - Palmar Fasciitis and Polyarthritis Syndrome -- 50yoM w/ 6 mo. hx of hand/finger swelling, stiffness, thickening, and erythema, impairing mobility. Also found to have hepato-/splenomegaly, WBC 151K, LDH 889; abnl BM Bx. Pt dx w/ palmar fasciitis & CML… https://t.co/1Z9Oz0sRa7 https://t.co/HRSJcv4lzZ
Dr. John Cush @RheumNow( View Tweet )

ICYMI: Improving the Value of Musculoskeletal Ultrasound in Rheumatology Care

Unlike traditional imaging techniques, MSUS can be easily used at the point-of-care and offers high-resolution images of joints, tendons, and soft tissues, facilitating the early detection of inflammation and structural damage. On Saturday, November 16th at the ACR Convergence 2024, Dr. Veena

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Will the Robots Save Ultrasound?

Despite all its benefits, ultrasound’s daily clinical use remains the domain of only a subset of interested rheumatologists. If the benefits are so clear, then why is it not universal? In the late-breaking oral abstracts at ACR Convergence, the final abstract presentation was from the Danish

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ACR24: Rheumatology Roundup

Join Drs. Jack Cush and Artie Kavanaugh as they review 15+ presentations and abstracts from the 2024 ACR Convergence meeting in Washington, DC.

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How New Medications are Reframing Imaging Abnormalities in axSpA Bimekizumab (BKZ), a monoclonal antibody targeting IL-17A and IL-17F, was evaluated in the BE MOBILE 1 and 2 trials for non-radiographic and radiographic axSpA, respectively. It showed significant clinical… https://t.co/wJYh5XCVfw https://t.co/qZ2MnGVXXG
Dr. John Cush @RheumNow( View Tweet )

What Lies Beneath: Understanding Nailfold Capillaroscopy

Capillaroscopy is a non-invasive imaging technique used for the in vivo assessment of the microcirculation. kin capillaries at the nailfold are evaluated because the fingers are involved in pathological processes such as Raynaud’s phenomenon. Several abstracts and sessions on nailfold

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Maximizing DMARDs to Strive for Steroid-Free Remission in RA

In 1950, three scientists were awarded the Nobel Prize for their groundbreaking discovery of steroids, heralded at the time as a "miracle cure" for rheumatoid arthritis (RA). However, just a year after their introduction, evidence began to surface regarding the harmful side effects

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A new score to quantify GCA inflammation? The treatment paradigm for Giant Cell Arteritis (GCA) has been a binary approach to the presence or absence of vasculitis. When GCA is present, we institute high doses of glucocorticoids for treatment of the inflammatory process. #ACR24… https://t.co/b5H7KOtZPC https://t.co/AvrwHcXI7r
Dr. John Cush @RheumNow( View Tweet )

How New Medications are Reframing Imaging Abnormalities in axSpA

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

Gender Differences in SpA

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
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
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
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
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
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
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
Eric Dein @ericdeinmd( View Tweet )
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