[ACR22] Imaging

Author: Manouk de Hooge

Wittoek et al. (2207) investigated the structural sonographic features of joints and tendons (right shoulder, hip, knee, ankle, first metatarsophalangeal joint (MTP1), elbow, wrist and second metacarpophalangeal joint (MCP2) in 500 healthy children (age 0-18 yo; 305 females). Cartilage diminished markedly as children aged and cartilage of boys was significantly thicker compared to girls in most of the joints. In addition, cartilage also became thinner as children’s height and weight increased. Upon ageing, the diameter of tendons thickened.

In a large MRI study van Dijk et al. (2204) compared the frequency of interosseous tendon inflammation (ITI) of 667 subjects with clinically suspect arthralgia to the general population and investigated the relation of ITI with other locally inflamed tissues (synovitis/tenosynovitis/osteitis), symptoms and future arthritis development. They concluded that ITI is absent in the general population but occurs in clinically suspect arthralgia, where it precedes clinical arthritis. ITI is strongly related to tenosynovitis which evokes the question whether ITI represents true peritendonitis or juxta-articular synovial inflammation.

In a retrospective analysis of electronic medical records Lin et al. (1970) demonstrated distinct clinical and ultrasonography features of seronegative inflammatory arthritis. Authors conclude that seronegative inflammatory arthritis is likely underdiagnosed in individuals who complain of joint pain without gross synovitis on physical examination.

Mandl et al. (1261) presented a poster with the definitions of elementary lesions (bone erosions, cartilage change and malalignment) in the finger joints of RA patients. They developed a reliable semi-quantitative scoring systems for assessing these structural damage by ultrasound.

Stal et al. (2255) showed that vertebral corner inflammation only infrequently leads to syndesmophyte formation with visible vertebral corner fat deposition as intermediate component in 2 datasets of in total 217 r-axSpA patients.

In a study on an arteficial intellegence algorithm De Craemer et al. (1256) propose a fully automated machine learning pipeline for detection of bone marrow oedema on MRI of the sacroiliac joints that has major potential to assist clinicians in early diagnosis and reliable quantification of inflammatory lesions in patients with (suspected) spondyloarthritis.

Eder et al. (2206) showed in the DUET study substantial inter-rater agreement for assessing sonographic elementary lesions of enthesitis between central and local readers in 88 patients with psoriatic arthritis, 41 patients with solely psoriasis and 32 non-psoriatic controls. Interreader agreement was not influenced by patient characteristics with the exceptance of obesity, which may increase variability in imaging assessment.

About the Author