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Ivanova M, Zimba O, Dimitrov I, Angelov AK, Georgiev T. Axial Spondyloarthritis: an overview of the disease. Rheumatol Int 2024; 44:1607-1619. [PMID: 38689098 DOI: 10.1007/s00296-024-05601-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
Axial Spondyloarthritis (axSpA) is a chronic, inflammatory, immune-mediated rheumatic disease that comprises two subsets, non-radiographic and radiographic axSpA, and belongs to a heterogeneous group of spondyloarthritides (SpA). Over the years, the concept of SpA has evolved significantly, as reflected in the existing classification criteria. Considerable progress has been made in understanding the genetic and immunological basis of axSpA, in studying the processes of chronic inflammation and pathological new bone formation, which are pathognomonic for the disease. As a result, new medication therapies were developed, which bring more effective ways for disease control. This review presents a brief overview of the literature related to these aspects of disease after summarising the available information on the topic that we considered relevant. Specifically, it delves into recent research illuminating the primary pathological processes of enthesitis and associated osteitis in the context of inflammation in axSpA. The exploration extends to discussion of inflammatory pathways, with a particular focus on Th1/Th17-mediated immunity and molecular signaling pathways of syndesmophyte formation. Additionally, the review sheds light on the pivotal role of cytokine dysregulation, highlighting the significance of the IL-23/17 axis and TNF-α in this intricate network of immune responses which is decisive for therapeutic approaches in the disease.
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Affiliation(s)
- Mariana Ivanova
- Medical Faculty, Medical University-Sofia, Sofia, Bulgaria.
- Clinic of Rheumatology, University Hospital "St. Ivan Rilski", 13, Urvich St., Sofia, 1612, Bulgaria.
| | - Olena Zimba
- Department of Rheumatology, Immunology and Internal Medicine, University Hospital in Krakow, Kraków, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Ivan Dimitrov
- Clinic of Orthopedics and Traumatology, University Hospital "Prof. Dr. St. Kirkovich", Stara Zagora, Bulgaria
- Medical Faculty, Trakia University, Stara Zagora, Bulgaria
| | | | - Tsvetoslav Georgiev
- First Department of Internal Medicine, Faculty of Medicine, Medical University-Varna, Varna, Bulgaria
- Rheumatology Clinic, St. Marina University Hospital-Varna, Varna, Bulgaria
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Valgaeren B, Van Snick E, Claikens B. Tendinous Signal Alterations on MRI in the Asymptomatic Elbow: A Retrospective Cross-Sectional Study. J Belg Soc Radiol 2024; 108:69. [PMID: 39036521 PMCID: PMC11259101 DOI: 10.5334/jbsr.3651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 06/30/2024] [Indexed: 07/23/2024] Open
Abstract
Objectives It is clinically relevant to prevent overtreatment of tendinopathy diagnosed solely on imaging. Therefore, the prevalence of presumable asymptomatic signal changes in the common flexor origin, biceps insertion, brachialis insertion, and triceps insertion were assessed. Materials and methods Two hundred and five magnetic resonance imaging (MRI) exams of the elbow with coronal and axial fat-saturated fluid-sensitive sequences between January 1, 2018 and July 31, 2022 were retrospectively identified in our center.Two radiology residents reviewed the exams independently. The elbow tendons were given a score from 0 to 4. Score 0: no signal abnormality; score 1: increased T2-weighted signal around the tendon; score 2: increased T2-weighted signal compared to muscle within the tendon; score 3: partial tear; and score 4: complete tear. Results The common flexor tendon showed signal alterations in 8% of patients; nine patients had an increased signal around the tendon, and eight patients had an increased signal within the tendon. Three patients (1.5%) had an altered signal intensity in the biceps tendon. All triceps tendons showed a linear hyperintense signal, suggesting that it is physiological. There were no partial or complete tears. No signal abnormalities were noted in the brachialis tendon among all patients. Conclusion The prevalence of presumable asymptomatic signal alterations seen in the common flexor origin on MRI is not negligible; therefore, clinical correlation is advised to prevent overtreatment of tendinopathy in these cases. No partial or complete tears were seen.
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Affiliation(s)
- Bjorn Valgaeren
- Department of Radiology, KU Leuven, Herestraat 49, Leuven 3000, Belgium
| | - Elyn Van Snick
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussels Health Campus, Laarbeeklaan 101, Jette 1090, Belgium
| | - Bart Claikens
- Department of Radiology, General Hospital Ostend, Gouwelozestraat 100, Ostend 8400, Belgium
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Moazamian D, Athertya JS, Dwek S, Lombardi AF, Mohammadi HS, Sedaghat S, Jang H, Ma Y, Chung CB, Du J, Jerban S, Chang EY. Achilles tendon and enthesis assessment using ultrashort echo time magnetic resonance imaging (UTE-MRI) T1 and magnetization transfer (MT) modeling in psoriatic arthritis. NMR IN BIOMEDICINE 2024; 37:e5040. [PMID: 37740595 PMCID: PMC10754405 DOI: 10.1002/nbm.5040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 09/24/2023]
Abstract
The purpose of this study is to investigate the use of ultrashort echo time (UTE) magnetic resonance imaging (MRI) techniques (T1 and magnetization transfer [MT] modeling) for imaging of the Achilles tendons and entheses in patients with psoriatic arthritis (PsA) compared with asymptomatic volunteers. The heels of twenty-six PsA patients (age 59 ± 15 years, 41% female) and twenty-seven asymptomatic volunteers (age 33 ± 11 years, 47% female) were scanned in the sagittal plane with UTE-T1 and UTE-MT modeling sequences on a 3-T clinical scanner. UTE-T1 and macromolecular proton fraction (MMF; the main outcome of MT modeling) were calculated in the tensile portions of the Achilles tendon and at the enthesis (close to the calcaneus bone). Mann-Whitney-U tests were used to examine statistically significant differences between the two cohorts. UTE-T1 in the entheses was significantly higher for the PsA group compared with the asymptomatic group (967 ± 145 vs. 872 ± 133 ms, p < 0.01). UTE-T1 in the tendons was also significantly higher for the PsA group (950 ± 145 vs. 850 ± 138 ms, p < 0.01). MMF in the entheses was significantly lower in the PsA group compared with the asymptomatic group (15% ± 3% vs. 18% ± 3%, p < 0.01). MMF in the tendons was also significantly lower in the PsA group compared with the asymptomatic group (17% ± 4% vs. 20% ± 5%, p < 0.01). Percentage differences in MMF between the asymptomatic and PsA groups (-16.6% and -15.0% for the enthesis and tendon, respectively) were higher than the T1 differences (10.8% and 11.7% for the enthesis and tendon, respectively). The results suggest higher T1 and lower MMF in the Achilles tendons and entheses in PsA patients compared with the asymptomatic group. This study highlights the potential of UTE-T1 and UTE-MT modeling for quantitative evaluation of entheses and tendons in PsA patients.
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Affiliation(s)
- Dina Moazamian
- Department of Radiology, University of California, San Diego, CA
| | - Jiyo S Athertya
- Department of Radiology, University of California, San Diego, CA
| | - Sophia Dwek
- Department of Radiology, University of California, San Diego, CA
| | | | | | - Sam Sedaghat
- Department of Radiology, University of California, San Diego, CA
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, CA
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, CA
| | - Christine B. Chung
- Department of Radiology, University of California, San Diego, CA
- Radiology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA
- Radiology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, CA
- Radiology Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Orthopedic Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Eric Y. Chang
- Department of Radiology, University of California, San Diego, CA
- Radiology Service, VA San Diego Healthcare System, San Diego, CA, USA
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McGonagle D, David P, Macleod T, Watad A. Predominant ligament-centric soft-tissue involvement differentiates axial psoriatic arthritis from ankylosing spondylitis. Nat Rev Rheumatol 2023; 19:818-827. [PMID: 37919337 DOI: 10.1038/s41584-023-01038-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 11/04/2023]
Abstract
Since the original description of spondyloarthritis 50 years ago, results have demonstrated similarities and differences between ankylosing spondylitis (AS) and axial psoriatic arthritis (PsA). HLA-B27 gene carriage in axial inflammation is linked to peri-fibrocartilaginous sacroiliac joint osteitis, as well as to spinal peri-entheseal osteitis, which is often extensive and which provides a crucial anatomical and immunological differentiation between the AS and PsA phenotypes. Specifically, HLA-B27-related diffuse bone marrow oedema (histologically an osteitis) and bone marrow fatty corners detected via magnetic resonance imaging, as well as radiographic changes such as sacroiliitis, vertebral squaring, corner erosions and Romanus lesions, all indicate initial bone phenotypes in HLA-B27+ axial disease. However, in much of PsA with axial involvement, enthesitis primarily manifests in ligamentous soft tissue as 'ligamentitis', with characteristic lesions that include para-syndesmophytes and sacroiliac joint bony sparing. Like axial PsA, diffuse idiopathic skeletal hyperostosis phenotypes, which can be indistinguishable from PsA, exhibit a thoracic and cervical spinal ligamentous soft-tissue tropism, clinically manifesting as syndesmophytosis that is soft-tissue-centric, including paravertebral soft-tissue ossification and sacroiliac soft-ligamentous ossification instead of joint-cavity fusion. The enthesis bone and soft tissues have radically different immune cell and stromal compositions, which probably underpins differential responses to immunomodulatory therapy, especially IL-23 inhibition.
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Affiliation(s)
- Dennis McGonagle
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK.
| | - Paula David
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK
| | - Tom Macleod
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK
| | - Abdulla Watad
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK
- Department of Internal Medicine B & Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Østergaard M, Maksymowych WP. Advances in the Evaluation of Peripheral Enthesitis by Magnetic Resonance Imaging in Patients With Psoriatic Arthritis. J Rheumatol 2023; 50:18-22. [PMID: 37419626 DOI: 10.3899/jrheum.2023-0518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 07/09/2023]
Abstract
Enthesitis is a key disease manifestation in patients with psoriatic arthritis (PsA) that considerably contributes to pain, lower physical function, and reduced quality of life. Clinical assessment of enthesitis lacks sensitivity and specificity, and therefore better methods are urgently needed. Magnetic resonance imaging (MRI) allows detailed assessment of the components of enthesitis, and consensus-based validated MRI scoring systems exist. These include the Outcome Measures in Rheumatology (OMERACT) Heel Enthesitis MRI Scoring System (HEMRIS) method, which assesses the entheses of the heel region in a detailed manner, and the OMERACT MRI Whole-Body Score for Inflammation in Peripheral Joints and Entheses (MRI-WIPE) method, which provides an overall assessment of the inflammatory burden in the peripheral entheses and joints in the entire body using whole-body MRI. At an MRI workshop at the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2022 meeting in Brooklyn, the MRI appearances of peripheral enthesitis were described, as were the scoring methods. The utility of MRI for improved assessment of enthesitis was demonstrated with examples of patient cases. Clinical trials in PsA that evaluate enthesitis by MRI as a key endpoint should include the presence of MRI enthesitis as an inclusion criterion, and apply validated MRI outcomes to assess the effect of therapeutics on enthesitis are recommended.
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Affiliation(s)
- Mikkel Østergaard
- M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, and Department of Clinical Medicine, Faculty for Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;
| | - Walter P Maksymowych
- W.P. Maksymowych, MD, MB ChB, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Aydın F, Özçakar ZB, Avar Aydın PÖ, Mekik Akar E, Çakar N. Exertional leg pain represents a severe disease phenotype in childhood familial Mediterranean fever. Postgrad Med 2023; 135:588-592. [PMID: 37309906 DOI: 10.1080/00325481.2023.2224649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/09/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease. Recurrent fever, serositis, and arthritis are common findings of the disease. In addition, musculoskeletal complaints such as exertional leg pain can be overlooked, although they are common and affect patients' quality of life. The aim of this study was to evaluate the frequency of exertional leg pain in pediatric FMF patients and to analyze the association of this finding with other characteristics of FMF. METHODS The files of FMF patients were retrospectively evaluated. The clinical characteristics and disease severity of the patients with exertional leg pain were compared with the patients without exertional leg pain. International severity scoring system for FMF (ISSF) and Mor severity score were used for assessment. RESULTS The study included 541 FMF patients (287 females), 149 (27.5%) with exertional leg pain. The median colchicine dosage was significantly higher in patients with exertional leg pain (p = 0.02), arthritis (p = 0.001) and arthralgia (p˂0.001) were encountered more frequently in the attacks of these patients. The median disease severity scores calculated by both Mor severity scale and ISSF were significantly higher in patients with exertional leg pain compared to those without (p˂0.001). In the group of patients with exertional leg pain, the M694V mutation, either in one allele or in two alleles, was found to be significantly more common (p = 0.006 and p˂0.001, respectively). CONCLUSIONS Exertional leg pain in pediatric FMF patients is the component of moderate-to-severe disease course, and this may be considerably associated with the presence of M694V mutation.
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Affiliation(s)
- Fatma Aydın
- Ankara University School of Medicine, Department of Pediatrics, Division of Pediatric Rheumatology, Ankara, Turkey
| | - Zeynep Birsin Özçakar
- Ankara University School of Medicine, Department of Pediatrics, Division of Pediatric Rheumatology and Nephrology, Ankara, Turkey
| | - Pınar Özge Avar Aydın
- Ankara University School of Medicine, Department of Pediatrics, Division of Pediatric Rheumatology, Ankara, Turkey
| | - Ece Mekik Akar
- Ankara University School of Medicine, Department of Pediatrics, Ankara, Turkey
| | - Nilgün Çakar
- Ankara University School of Medicine, Department of Pediatrics, Division of Pediatric Rheumatology, Ankara, Turkey
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Li B, Guo Z, Qu J, Zhan Y, Shen Z, Lei X. The value of different involvement patterns of the knee "synovio-entheseal complex" in the differential diagnosis of spondyloarthritis, rheumatoid arthritis, and osteoarthritis: an MRI-based study. Eur Radiol 2023; 33:3178-3187. [PMID: 36892646 DOI: 10.1007/s00330-023-09485-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/25/2022] [Accepted: 01/25/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVES To explore the different involvement patterns of the knee "synovio-entheseal complex (SEC)" on MRI in patients with spondyloarthritis (SPA), rheumatoid arthritis (RA), and osteoarthritis (OA). METHODS This study retrospectively included 120 patients (male:female, 55:65) with a mean age of 39.20 years diagnosed with SPA (n = 40), RA (n = 40), and OA (n = 40) at the First Central Hospital of Tianjin between January 2020 and May 2022. Six knee entheses were assessed by two musculoskeletal radiologists according to the SEC definition. Bone marrow lesions associated with entheses include bone marrow edema (BME) and bone erosion (BE), which were classified as entheseal or peri-entheseal based on their relationship to the entheses. Three groups (OA, RA, and SPA) were established to characterize the location of enthesitis and the different SEC involvement patterns. Inter-group and intra-group differences were analyzed using the ANOVA or chi-square tests, and the inter-class correlation coefficient (ICC) test was used to determine inter-reader agreement. RESULTS The study contained a total of 720 entheses. The SEC-based analysis revealed different involvement patterns in three groups. The OA group had the most abnormal signals in tendons/ligaments (p = 0.002). The RA group had considerably greater synovitis (p = 0.002). The majority of peri-entheseal BE was identified in the OA and RA groups (p = 0.003). Furthermore, entheseal BME in the SPA group was significantly different from those in the other two groups (p < 0.001). CONCLUSIONS SEC involvement patterns differed in SPA, RA, and OA, which is important for differential diagnosis. SEC should be used as a whole evaluation method in clinical practice. KEY POINTS • The "synovio-entheseal complex (SEC)" explained differences and characteristic alterations in the knee joint in patients with spondyloarthritis (SPA), rheumatoid arthritis (RA), and osteoarthritis (OA). • The various SEC involvement patterns are crucial for differentiating SPA, RA, and OA. • When "knee pain" is the only symptom, a detailed identification of characteristic alterations in the knee joint of SPA patients may help timely treatment and delay the structural damage.
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Affiliation(s)
- Boya Li
- First Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Zikang Guo
- First Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Jin Qu
- Department of Radiology, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, Tianjin, China
| | - Ying Zhan
- Department of Radiology, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, Tianjin, China
| | - Zhiwei Shen
- Clinical Science, Philips Healthcare, Beijing, China
| | - Xinwei Lei
- Department of Radiology, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, Tianjin, China. .,Department of radiology, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, NO. 24 Fukang Road, Nankai District, Tianjin, 300192, China.
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The role of ultrasound in screening subclinical psoriatic arthritis in patients with moderate to severe psoriasis. Eur Radiol 2023; 33:3943-3953. [PMID: 36853346 DOI: 10.1007/s00330-023-09493-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/29/2022] [Accepted: 02/02/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVE To identify patients in the subclinical psoriatic arthritis (Sub-PsA) phase by ultrasound (US) and provide a solution to screen them. METHODS A total of 490 participants with moderate-to-severe psoriasis were evaluated. Among them, 384 participants without arthritis symptoms were enrolled into the silent psoriasis group and 106 participants with arthritis symptoms, called prodromal/active PsA phase, were enrolled into the clinical PsA group. Another 80 non-psoriasis participants were enrolled into the control group. Each participant received clinical assessments and US examinations of 60 joints, 38 tendons, and 40 entheses. We compared the incidences of synovio-enthesitis, synovitis, tenosynovitis, erosion, and dactylitis detected on US among the three groups. Subsequently, on the basis of significant US findings, we distinguished Sub-PsA from psoriasis alone (PsO) in the silent psoriasis group and analyzed the clinical characteristics, mainly including basic clinical characteristics, body surface area (BSA), and Psoriasis Area and Severity Index (PASI) score. RESULTS Only synovio-enthesitis significantly differed between the control group and the silent psoriasis group (1.3% vs. 16.1%, p < 0.001). The knee was the most commonly involved site of synovio-enthesitis (79.0%). Taking synovio-enthesitis as the standard, 16.1% of silent psoriasis participants and 12.7% of all psoriasis participants were in the Sub-PsA phase. Furthermore, there were no differences in BSA and PASI among the three phases of PsO, Sub-PsA, and prodromal/active PsA. CONCLUSIONS Since the psoriasis patients in Sub-PsA phase was as high as 12.7% in all patients with moderate-to-severe psoriasis, US-detected synovio-enthesitis was recommended routinely for screening them regardless of arthritis symptoms, especially in the lower limbs. KEY POINTS • Synovio-enthesitis on ultrasound was significantly associated with subclinical psoriatic arthritis, especially in the lower limbs. • Routine ultrasound evaluation could help screen psoriasis patients in the subclinical psoriatic arthritis phase, which was as high as 12.7% in all psoriasis patients.
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Morbée L, Vereecke E, Laloo F, Chen M, Herregods N, Jans LBO. Common incidental findings on sacroiliac joint MRI: Added value of MRI-based synthetic CT. Eur J Radiol 2023; 158:110651. [PMID: 36535080 DOI: 10.1016/j.ejrad.2022.110651] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 12/01/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To determine the prevalence of incidental findings on sacroiliac joint MRI and to determine the added value of MRI-based synthetic CT in the detection and evaluation of these incidental findings. METHOD In this retrospective study 210 patients clinically suspected of spondyloarthritis who underwent MRI of the sacroiliac joint with synthetic CT sequence were included. The images were reviewed by two radiologists in consensus for the prevalence of sacroiliitis, incidental findings, and the ability of synthetic CT and the conventional MRI to detect and diagnose these findings. RESULTS In 44.7% of patients sacroiliitis was present. In 89.0% of patients MRI showed at least one incidental finding other than sacroiliitis. Degeneration of the sacroiliac joint was the most prevalent finding (140 patients, 66.6%). The most frequent incidental findings outside the sacroiliac joint were facet joint degeneration (29.0%), disc degeneration (25.2%), enostosis (19.5%) and lumbosacral transitional vertebrae (14.3%). A total of 788 lesions was recorded and synthetic CT was found to be problem solving or necessary for diagnosis in 543 (68.9%) of these lesions. 42.1% of lesions were not visible on conventional MRI (T1 TSE and STIR), most often degenerative osteophytes in the sacroiliac joint or lower lumbar spine. CONCLUSION Incidental findings are seen more frequently on sacroiliac joint MRI than sacroiliitis, which is relevant as some will have clinical significance or require treatment. Nearly half of these incidental lesions were only visible on synthetic CT, which additionally has been shown to be problem solving for diagnosis in many other cases.
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Affiliation(s)
- Lieve Morbée
- Department of Radiology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| | - Elke Vereecke
- Department of Radiology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Frederiek Laloo
- Department of Radiology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Min Chen
- Department of Radiology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Nele Herregods
- Department of Radiology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Lennart B O Jans
- Department of Radiology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
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Li J, Zhu Y, Guo G. Enthesitis-related arthritis: the clinical characteristics and factors related to MRI remission of sacroiliitis. BMC Musculoskelet Disord 2022; 23:1054. [DOI: 10.1186/s12891-022-06028-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/25/2022] [Indexed: 12/04/2022] Open
Abstract
Abstract
Background
To describe the clinical characteristics and explore the factors related to the MRI remission of sacroiliitis in patients with enthesitis-related arthritis (ERA).
Methods
Patients with ERA from 2018–2022 in our medical center were retrospectively reviewed, which identified according to Pediatric Rheumatology International Trials Organization (PRINTO) criteria. Demographics, clinical characteristics, examinations, and treatments were described. Univariate and multivariate logistic regression models were used to analyze the factors related to MRI remission of sacroiliitis in ERA.
Results
This retrospective study included 160 ERA patients (51.9% male) with a mean onset age of 9.2 ± 3.0 years. There were 144 cases (81.9%) with peripheral arthritis, and the hip, knee, and ankle joints were the most commonly involved joints. Enthesitis occurred in 48 cases (30.0%), and sacroiliitis occurred in 142 cases (88.5%) at diagnosis. Human leukocyte antigen (HLA)-B27 was positive in 33 cases (17.1%), and acute uveitis occurred in 3 cases (1.9%). The majority of patients (93.7%) were treated with disease-modifying anti-rheumatic drugs (DMARDs), and 60% with biologics. Among 62 patients with MRI-defined sacroiliitis, 27 (43.5%) cases showed improvement in the sacroiliac joint lesion after treatment. Multivariate logistic regression analysis showed that duration from onset to diagnosis of less than 3 months (OR = 3.609, 95% CI: 1.068–12.192) and active joints of more than 4 (OR = 4.916, 95% CI: 1.006–24.037) were independent factors.
Conclusion
We highlighted differences in ERA clinical characteristics. Patients with a shorter diagnosis time and more joint involvement improved more significantly in sacroiliac joint lesions after treatment.
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Wu X, Liu D, Li Y, Xie Y, Tu L, Zhang Y, Zhang X, Fang L, Luo X, Lin Z, Liao Z, Rong L, Ren J, Zhou Y, Yang N, Xu J, Zhang H, Xu B, Wu Z, Zhan F, Li Z, Xiao W, Liu S, Zhou Y, Ye S, Lv Q, Zhang L, Zhao D, He S, Zhao L, Wu L, Lin H, Zhu Y, Guo D, Yang Z, Liu B, Yang K, Gu J. A clinical practice guideline for the screening and assessment of enthesitis in patients with spondyloarthritis. Front Immunol 2022; 13:978504. [PMID: 36172360 PMCID: PMC9510351 DOI: 10.3389/fimmu.2022.978504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The aim of this review is to provide guidance on the selection of approaches to the screening and assessment of enthesitis in patients with spondyloarthritis (SpA). Methods Twenty-four questions regarding the approaches to the screening and assessment of enthesitis and the implementation details were devised, followed by a systemic literature review. The Grading of Recommendations Assessment, Development, and Evaluation methodology was employed in the development of this guideline, with modifications to evaluate non-interventional approaches under comprehensive consideration of costs, accessibility, and evidence strength. A consensus from the voting panel was required for the inclusion of the final recommendations and the strength of each recommendation. Results Seventeen recommendations (including five strong recommendations) were included in this guideline. The voting panel expressed unequivocal support for the necessity of screening and assessment of enthesitis in patients with SpA. It was agreed unanimously that symptom evaluation and physical examination should serve as the initial steps to the recognition of enthesitis, whereas Maastricht Ankylosing Spondylitis Enthesitis Score is a reliable tool in both clinical trials and daily medical practice. Ultrasound examination is another reliable tool, with power Doppler ultrasound as an informative addition. Notwithstanding its high resolution, MRI is limited by the costs and relatively low accessibility, whereas radiographs had low sensitivity and therefore should be rendered obsolete in the assessment of enthesitis. PET/CT was strongly opposed in the detection of enthesitis. Conclusion This guideline provides clinicians with information regarding the screening and assessment of enthesitis in patients with SpA. However, this guideline does not intend on dictating choices, and the ultimate decisions should be made in light of the actual circumstances of the facilities.
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Affiliation(s)
- Xinyu Wu
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Dong Liu
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yanfei Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Ya Xie
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Liudan Tu
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yanli Zhang
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xi Zhang
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Linkai Fang
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiqing Luo
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhiming Lin
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zetao Liao
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Limin Rong
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jie Ren
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuqi Zhou
- Department of Pulmonary and Critical Care Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou>, China
| | - Niansheng Yang
- Department of Rheumatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian Xu
- Department of Internal Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hua Zhang
- Department of Rheumatology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Baijie Xu
- Department of Rheumatology, Jieyang People's Hospital, Jieyang, China
| | - Zhenbiao Wu
- Department of Rheumatology, Tangdu Hospital of Air Force Military Medical University, Xian, China
| | - Feng Zhan
- Department of Rheumatology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Zhenbin Li
- Department of Rheumatology, Bethune International Peace Hospital, People's Liberation Army, Shijiazhuang, China
| | - Weiguo Xiao
- Department of Rheumatology, The First Hospital of China Medical University, Shenyang, China
| | - Shengyun Liu
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yi Zhou
- Department of Rheumatology and Immunology, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shanhui Ye
- Department of Rheumatology and Immunology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qing Lv
- Department of Rheumatology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Lijun Zhang
- Department of Rheumatology, Shenzhen Hospital, The University of Hong Kong, Shenzhen, China
| | - Dongbao Zhao
- Department of Rheumatology and Immunology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Shanzhi He
- Department of Rheumatology, Zhongshan People's Hospital, Zhongshan, China
| | - Like Zhao
- Department of Rheumatology and Immunology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Lijun Wu
- Department of Rheumatology and Immunology, The People's Hospital of the Xinjiang Uygur Autonomous Region, Urumqi, China
| | - He Lin
- Department of Rheumatology, Fujian Provincial Hospital, Fuzhou, China
| | - Yunxiao Zhu
- Department of Medical Ultrasonics, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Donggeng Guo
- Department of Rheumatology and Immunology, Ningxia Clinical Institute of Bone and Joint Research, The Affiliated People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, China
| | - Zehong Yang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Budian Liu
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Jieruo Gu
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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12
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Guo Z, Li B, Zhang Y, Kong C, Liu Y, Qu J, Zhan Y, Shen Z, Lei X. Peripheral enthesitis assessed by whole-body MRI in axial spondyloarthritis: Distribution and diagnostic value. Front Immunol 2022; 13:976800. [PMID: 36081521 PMCID: PMC9446460 DOI: 10.3389/fimmu.2022.976800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/04/2022] [Indexed: 11/20/2022] Open
Abstract
Objective To determine the distribution and diagnostic value of peripheral enthesitis detected by whole-body MRI (WBMRI) in axial spondyloarthritis (axSpA) diagnosis, and to determine the value of the peripheral enthesitis score in axSpA assessment. Methods Sixty axSpA patients [mean age of 33.2 (24.8–40.6) years] and 50 controls with chronic low back pain (LBP) [mean age of 34.7 (28.3–41.1) years] were enrolled. The gold standard was physician’s comprehensive diagnosis based on current classification criteria and physical examination. All subjects underwent WBMRI, and 47 peripheral entheses were assessed for each patient with scores of 0–188. Results WBMRI identified 155 enthesitis sites in 78.3% (n = 47) patients with axSpA. Meanwhile, 23 enthesitis sites were identified in 32% (n = 16) controls. The pelvis had the maximum number of enthesitis sites (52, 33.5%) in axSpA patients. Pelvic and anterior chest wall enthesitis had the highest sensitivity (51.67%) and specificity (100%) in axSpA diagnosis, respectively. There were different manifestations of enthesitis subtypes between axSpA patients and the control group. Osteitis was more present than soft-tissue inflammation in axSpA patients. The AUC for the number of enthesitis sites was 0.819 (95% CI 0.739–0.899), and that for the enthesitis score was 0.833 (95% CI 0.755–0.910), indicating statistically significant differences (P = 0.025). Based on the Youden index and clinical need, three enthesitis sites (sensitivity of 53.33, specificity of 98, and Youden index of 0.51) and enthesitis score (sensitivity of 58.33, specificity of 98, and Youden index of 0.56) may have the greatest value for axSpA diagnosis. Conclusion The distribution of peripheral enthesitis can be adequately assessed by whole-body MRI, which could help diagnose axial spondyloarthritis. The enthesitis score may provide a more accurate assessment and diagnostic tool in axSpA compared with enthesitis site counting.
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Affiliation(s)
- Zikang Guo
- First Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Boya Li
- First Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Yimeng Zhang
- First Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Chunyu Kong
- Department of Rheumatology, Tianjin First Central Hospital, Tianjin, China
| | - Yang Liu
- Department of Radiology, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, Tianjin, China
| | - Jin Qu
- Department of Radiology, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, Tianjin, China
| | - Ying Zhan
- Department of Radiology, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, Tianjin, China
| | - Zhiwei Shen
- Clinical Science, Philips Healthcare, Beijing, China
| | - Xinwei Lei
- Department of Radiology, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, Tianjin, China
- *Correspondence: Xinwei Lei,
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13
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Pacini G, Cerinic MM. The Contribution of Imaging Beyond Clinical Diagnosis, the Ochronosis and Synovio-entheseal Complex Examples. RHEUMATOLOGY AND IMMUNOLOGY RESEARCH 2022; 3:51-53. [PMID: 36465319 PMCID: PMC9524816 DOI: 10.2478/rir-2022-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/24/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Giovanni Pacini
- Department of Experimental and Clinical Medicine University of Florence and Division of Rheumatology AOUC, Firenze, Italy
| | - Marco Matucci Cerinic
- Department of Experimental and Clinical Medicine University of Florence and Division of Rheumatology AOUC, Firenze, Italy
- Unit of Immunology, Rheumatology, Allergy and Rare diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy
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14
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Hioki T, Komine M, Ohtsuki M. Diagnosis and Intervention in Early Psoriatic Arthritis. J Clin Med 2022; 11:jcm11072051. [PMID: 35407659 PMCID: PMC8999837 DOI: 10.3390/jcm11072051] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/19/2022] [Accepted: 03/29/2022] [Indexed: 02/05/2023] Open
Abstract
Psoriatic arthritis (PsA) is a chronic inflammatory disorder that affects approximately 20–30% of patients with psoriasis. PsA causes deformities and joint damage, impairing quality of life and causing long-term functional disability. Several recent studies demonstrated that early diagnosis and intervention for PsA prevents permanent invalidity. However, the clinical features of PsA vary and are shared with other differential diseases, such as reactive arthritis, osteoarthritis, and ankylosing spondylitis. The common and overlapping features among these diseases complicate the accurate early diagnosis and intervention of PsA. Therefore, this review focuses on the current knowledge of the diagnosis of early PsA and discusses the meaning of early intervention for early PsA.
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Affiliation(s)
- Tomoyuki Hioki
- Department of Dermatology, Central Japan International Medical Center, Minokamo 505-8510, Japan
- Department of Dermatology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 329-0498, Japan;
- Correspondence: (T.H.); (M.K.)
| | - Mayumi Komine
- Department of Dermatology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 329-0498, Japan;
- Correspondence: (T.H.); (M.K.)
| | - Mamitaro Ohtsuki
- Department of Dermatology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 329-0498, Japan;
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15
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Osteo-Proliferative Lesions of the Phalanges on Radiography: Associations with Sex, Age, and Osteoarthritis. Diagnostics (Basel) 2022; 12:diagnostics12030618. [PMID: 35328171 PMCID: PMC8947450 DOI: 10.3390/diagnostics12030618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/10/2022] [Accepted: 02/28/2022] [Indexed: 02/01/2023] Open
Abstract
Objectives: The effects of aging such as osteophyte formation, acral shape changes, cortical tunneling, and bone porosity as well as enthesophytes can be studied in the X-rays of hands. However, during the interpretation of radiographs of the hands, misinterpretation and false-positive findings for psoriatic arthritis often occur because periosteal proliferations of the phalanges are overinterpreted and too little is known about enthesophytes of the phalanges in this area. Method: It included a total of 1153 patients (577 men, 576 women) who presented themselves to the emergency department and received a radiography of their right hand to exclude fractures. The Osseographic Scoring System was used in a modified form to record osteophytes and enthesophytes. A linear regression model for periosteal lesions was computed with age, sex, osteophytes, and global diagnosis as covariables. The inter-reader agreement was assessed using ICC (two-way mixed model) on the sum scores of osteophytes and periosteal lesions. Results: Overall, men exhibited more periosteal lesions, demonstrated by a higher mean sum score of 4.14 vs. 3.21 in women (p = 0.008). In both sexes, the second and third proximal phalanx were most frequently affected by periosteal lesions, but the frequencies were significantly higher in men. The female sex was negatively associated with an extent of periosteal lesions with a standardized beta of −0.082 (p = 0.003), while age and osteophytes were positively associated with betas of 0.347 (p < 0.001) and 0.156 (p < 0.001), respectively. The distribution of osteophytes per location did not differ between men and women (p > 0.05). The inter-reader agreement was excellent for periosteal lesions with ICC of 0.982 (95%CI 0.973−0.989, p < 0.001). Conclusions: Special care should be taken not to confuse normal periosteal changes in aging with periosteal apposition in psoriatic arthritis.
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16
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Balint PV, Poddubnyy D. Controversies in rheumatology: Imaging of enthesitis in spondyloarthritis - does it mean anything for treatment decisions? Rheumatology (Oxford) 2022; 61:3547-3551. [PMID: 35212727 DOI: 10.1093/rheumatology/keac116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Enthesitis is considered a hallmark manifestation of spondyloarthritis including axial spondyloarthritis and psoriatic arthritis. Detection of enthesitis might be challenging in both diagnostic and classification processes. In this debate, we discuss the controversy on the role of imaging in the detection of enthesitis including the relevance for treatment decisions in spondyloarthritis.
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Affiliation(s)
- Peter V Balint
- National Institute of Rheumatology and Physiotherapy/National Musculoskeletal Institute, 3rd Rheumatology Department, 25-29 Frankel St, Budapest, 1023 Hungary
| | - Denis Poddubnyy
- Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charité - Universitätsmedizin Berlin, Berlin, Germany
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17
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Herregods N, Maksymowych WP, Jans L, Otobo TM, Sudoł-Szopińska I, Meyers AB, Van Rossum M, Kirkhus E, Panwar J, Appenzeller S, Weiss P, Tse S, Doria AS, Lambert R, Jaremko JL. Atlas of MRI findings of sacroiliitis in pediatric sacroiliac joints to accompany the updated preliminary OMERACT pediatric JAMRIS (Juvenile Idiopathic Arthritis MRI Score) scoring system: Part I: Active lesions. Semin Arthritis Rheum 2021; 51:1089-1098. [PMID: 34311986 DOI: 10.1016/j.semarthrit.2021.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/15/2021] [Accepted: 07/05/2021] [Indexed: 01/19/2023]
Abstract
Magnetic resonance imaging (MRI) is an increasingly important tool for identifying involvement of the sacroiliac joints (SIJ) in juvenile idiopathic arthritis (JIA). The key feature for diagnosing active sacroiliitis is bone marrow edema (BME), but other features of active arthritis such as joint space inflammation, inflammation in an erosion cavity, capsulitis and enthesitis can be seen as well. Structural changes may also be seen. Systematic MRI assessment of inflammation and structural damage may aid in monitoring the disease course, choice of therapeutics and evaluating treatment response. In this pictorial essay, we illustrate normal MRI findings and growth-related changes of the SIJ in the pediatric population, as well as the different MRI features of SIJ inflammation. This atlas demonstrates fundamental MRI disease features of active inflammation in a format that can serve as a reference for assessing SIJ arthritis according to the updated preliminary JAMRIS (Juvenile Idiopathic Arthritis MRI Score) scoring system proposed by the MRI in JIA working group of Outcome Measures in Rheumatology and Clinical Trials (OMERACT). The atlas is intended to be read in conjunction with its companion Part 2, Structural Lesions.
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Affiliation(s)
- N Herregods
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium.
| | | | - Lbo Jans
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - T M Otobo
- Institute of Medical Sciences, Faculty of Medicine, University of Toronto, and Department of Diagnostic Imaging, The Hospital for Sick Children and Department of Translational Medicine, SickKids Research Institute, Peter Gilgan Center for Research and Learning, University of Toronto, Toronto, Canada
| | - I Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - A B Meyers
- Department of Radiology, Cincinnati Children's Hospital, Cincinnati, OH, United States
| | - Maj Van Rossum
- Amsterdam Rheumatology and Immunology Center, Reade, and Emma Children's Hospital Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - E Kirkhus
- Department of Radiology, Oslo University Hospital, Oslo, Norway
| | - J Panwar
- Department of Radiology, Christian Medical College, Vellore, India
| | - S Appenzeller
- Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - P Weiss
- University of Pennsylvania Perelman School of Medicine, Division of Rheumatology, Children's Hospital of Philadelphia and Department of Pediatrics, University of Pennsylvania, Philadelphia, USA
| | - Sml Tse
- Division of Rheumatology, The Hospital for Sick Children, Toronto, Canada
| | - A S Doria
- Department of Medical Imaging, University of Toronto, Toronto and Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Rgw Lambert
- Canada Department of Radiology and Diagnostic Imaging, University of Alberta and WC Mackenzie Health Sciences Center, Edmonton, Alberta, Canada
| | - J L Jaremko
- Canada Department of Radiology and Diagnostic Imaging, University of Alberta and WC Mackenzie Health Sciences Center, Edmonton, Alberta, Canada
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Gottlieb AB, Bakewell C, Merola JF. Musculoskeletal Imaging for Dermatologists: Techniques in the Diagnosis and Management of Psoriatic Arthritis. Dermatol Ther (Heidelb) 2021; 11:1199-1216. [PMID: 34145558 PMCID: PMC8322349 DOI: 10.1007/s13555-021-00565-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Indexed: 01/18/2023] Open
Abstract
Psoriatic arthritis is an inflammatory condition affecting up to 30% of patients with psoriasis. Patients may experience irreversible joint damage if not treated early, and diagnostic delays of even 6 months are associated with radiographic progression and impaired function. Therefore, early detection and intervention are of critical importance in patients with psoriatic arthritis. Given that psoriasis often precedes symptoms of psoriatic arthritis, dermatologists are uniquely positioned to identify patients with psoriatic arthritis early in their disease course, before permanent damage has occurred. Several screening tools have been developed to help dermatologists identify patients who may have psoriatic arthritis, but these tools may not capture patients with subclinical disease or quantify the type and severity of the underlying tissue insult, which is often the presenting sign of psoriatic arthritis. In these cases, a combination of clinical assessment and musculoskeletal imaging (e.g., ultrasound) is required. This review summarizes three common musculoskeletal imaging techniques used in the diagnosis and management of patients with psoriatic arthritis: conventional radiography, ultrasound, and magnetic resonance imaging. Further understanding of musculoskeletal imaging will assist dermatologists in making treatment decisions and allow them to have a more active role in the detection of psoriatic arthritis.
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Affiliation(s)
| | | | - Joseph F Merola
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Psoriatic Dactylitis: Current Perspectives and New Insights in Ultrasonography and Magnetic Resonance Imaging. J Clin Med 2021; 10:jcm10122604. [PMID: 34204773 PMCID: PMC8231617 DOI: 10.3390/jcm10122604] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/06/2021] [Accepted: 06/09/2021] [Indexed: 01/08/2023] Open
Abstract
Dactylitis, one of the most typical features of psoriatic arthritis (PsA), is the diffuse swelling of the digits and is determined by the involvement of different anatomic structures, including: the subcutaneous fibrous tissue “accessory pulley” system; flexor tendons, with their related structures; the articular synovium; the small enthesis of the hands. Dactylitis is currently considered both a marker of disease activity and severe prognosis and its importance in PsA is emphasized by the inclusion in the classification criteria of PsA. This review focuses on the role of imaging in the management of PsA patients with dactylitis in clinical practice and in a research setting. Furthermore, imaging could be a valuable tool to assist in unravelling some of the underlying mechanisms of the onset and chronicization of dactylitis in PsA patients.
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20
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Nissen MJ, Möller B, Ciurea A, Mueller RB, Zueger P, Schulz M, Ganz F, Scherer A, Papagiannoulis E, Hügle T. Site-specific resolution of enthesitis in patients with axial spondyloarthritis treated with tumor necrosis factor inhibitors. Arthritis Res Ther 2021; 23:165. [PMID: 34107999 PMCID: PMC8188725 DOI: 10.1186/s13075-021-02534-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/19/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Enthesitis is a hallmark of spondyloarthritis (SpA) with a substantial impact on quality of life. Reports of treatment effectiveness across individual enthesitis sites in real-world patients with axial SpA (axSpA) are limited. We investigated the evolution of enthesitis following tumor necrosis factor inhibitor (TNFi) initiation in axSpA patients, both cumulatively and at specific axial and peripheral sites. METHODS AxSpA patients in the Swiss Clinical Quality Management Registry were included if they initiated a TNFi, had an available Maastricht Ankylosing Spondylitis Enthesitis Score, modified to include the plantar fascia (mMASES, 0-15), at start of treatment and after 6 and/or 12 months and ≥12 months follow-up. Logistic regression models were utilized to analyze explanatory variables for enthesitis resolution. RESULTS Overall, 1668 TNFi treatment courses (TCs) were included, of which 1117 (67%) had active enthesitis at baseline. Reduction in mMASES at the 6- and 12-month timepoints was experienced in 72% and 70% of TCs, respectively. Enthesitis resolution at 6/12 months occurred in 37.9%/43.0% of all TNFi TCs and 40.7%/50.9% of first TNFi TCs. At 6 months, a significant reduction in the frequency of enthesitis was observed at all sites, except for the Achilles tendon and plantar fascia among first TNFi TCs, while at 12 months, reduction was significant at all sites in both TC groups. Enthesitis resolved in 60.3-77% across anatomical sites, while new incident enthesitis occurred in 4.0-13.5% of all TNFi TCs at 12 months. Both baseline and new-incident enthesitis occurred most frequently at the posterior superior iliac spine and the fifth lumbar spinous process. Younger age and lower mMASES at baseline were predictors of complete enthesitis resolution, while female sex and second- or later-line TNFi treatment were associated with persistence of enthesitis at 12 months. CONCLUSION In real-world axSpA patients treated with a TNFi, enthesitis improved in the majority of patients across all anatomical sites. Significant improvement at the Achilles and plantar fascia entheses was observed only at 12 months. Complete and site-specific enthesitis resolution occurred in ≥40% and ≥60% of TCs evaluated at 12 months, with a low incidence of new site-specific enthesitis. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Michael J Nissen
- Department of Rheumatology, Geneva University Hospital, 26 Avenue Beau-Séjour, 1211, Geneva 14, Switzerland.
| | - Burkhard Möller
- Department of Rheumatology, University Hospital of Bern, Bern, Switzerland
| | - Adrian Ciurea
- Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Ruediger B Mueller
- Division of Rheumatology and Immunology, Department of Internal Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | | | | | | | - Almut Scherer
- Swiss Clinical Quality Management in Rheumatic Diseases Foundation, Zurich, Switzerland
| | | | - Thomas Hügle
- Department of Rheumatology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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21
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Bollow M. [Typical arthritis of the hands : Psoriatic arthritis]. Radiologe 2021; 61:448-457. [PMID: 33783565 DOI: 10.1007/s00117-021-00841-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Psoriatic arthritis (PsA) is considered the prototype of peripheral spondyloarthritides (SpA) and is associated as skin-bone disease (SkiBo) with typical skin changes and with typical arthritides of the joints, especially of the hands and feet. OBJECTIVE Systematic review of imaging manual findings patterns in PsA with its typical enthesitic arthritides in context with clinical findings. MATERIALS AND METHODS A review based on the current literature on the subject from a radiological and rheumatological point of view is provided. RESULTS In PsA, inflammatory manifestations in the hands and feet are the most frequently affected regions of the body. Image morphological variability between early and late stages is evident. The projection radiographic characteristic of PsA is the simultaneous coexistence of osteodestructive-rarefactive changes with typical osteoproliferative-proliferative changes, which are part of the Classification of Psoriatic Arthritis (CASPAR) criteria. With the help of magnetic resonance imaging (MRI), the image-morphological spondyloarthritis inflammatory patterns of enthesitis, dactylitis and osteitis can be detected in the hands even in the early stages. CONCLUSIONS The basic knowledge of the image morphological changes of this complex autoimmunological skin-bone disease will be imparted in order to gain the necessary confidence in the systematic diagnostic evaluation of hand arthritis patterns typical for PsA in images both at the initial diagnosis and over the course of the disease and in the classification of early and late stages, which serve as a guide for rheumatologists regarding "step-up" treatments.
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Affiliation(s)
- Matthias Bollow
- Ruhr-Universität Bochum, Bochum, Deutschland. .,Klinik für diagnostische und interventionelle Radiologie, Augusta-Kranken-Anstalt Bochum, Bergstraße 26, 44791, Bochum, Deutschland.
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22
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Szaro P, Nilsson-Helander K, Carmont M. MRI of the Achilles tendon-A comprehensive pictorial review. Part one. Eur J Radiol Open 2021; 8:100342. [PMID: 33850971 PMCID: PMC8039565 DOI: 10.1016/j.ejro.2021.100342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 12/28/2022] Open
Abstract
Presence of normal septation between subtendons may mimic an intrasubstance tear. MRI is superior to ultrasound in detection of partial tears. Ultrasound is as useful as MRI in detection of tendinopathy and full-thickness tears. Kager's fat pad is involved in infection more than in postoperative changes. The Achilles tendon xanthoma has a higher signal on T1- and T2-weighted sequences.
The normal Achilles tendon is composed of twisted subtendons separated by thin high signal septae, which are a potential pitfall on MRI because they mimic a tendon tear. Tendinopathy and full thickness tears may be assessed effectively both on MRI and ultrasound. MRI is superior to ultrasound in detection of partial tears and for postoperative assessment. The use of fat suppression sequences allows the ability to detect focal lesions. Sagittal and coronal sections are useful for assessing the distance between stumps of a ruptured tendon. Sequences with contrast are indicated in postoperative investigations and suspicion of infection, arthritis or tumor. MRI may reveal inflammatory changes with minor symptoms long before the clinical manifestations of seronegative spondyloarthropathy. The most common non-traumatic focal lesion of the Achilles tendon is Achilles tendon xanthoma, which is manifested by intermediate or slightly higher signal on T1- and T2-weighted images compared to that in the normal Achilles tendon. Other tumors of the Achilles tendon are very rare, whereas the involvement of the tendon from tumor in adjacent structures is more frequent. The novel MRI sequences may help to detect disorders of the Achilles tendon more specifically before clinical manifestation. Regeneration or remodeling of the Achilles tendon can be non‐invasively detected and monitored in diffusion tensor imaging. Assessment of healing is possible using T2-mapping while evaluating the tendon vascularization in intravoxel incoherent motion MRI.
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Affiliation(s)
- Pawel Szaro
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Musculoskeletal Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland
| | - Katarina Nilsson-Helander
- Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Michael Carmont
- Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,The Department of Orthopaedic Surgery, Princess Royal Hospital, Shrewsbury & Telford Hospital NHS Trust, Shropshire, UK
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23
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Imaging in the Assessment of Musculoskeletal Manifestations Associated with Inflammatory Bowel Disease. GASTROENTEROLOGY INSIGHTS 2021. [DOI: 10.3390/gastroent12010010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Extraintestinal manifestations are the cause of morbidity and affect the quality of life of patients with inflammatory bowel diseases (IBDs). Musculoskeletal manifestations, in particular, spondyloarthritis and osteoporosis, are the most frequent extraintestinal manifestation of IBDs. The diagnosis and management of the musculoskeletal manifestation of IBDs relies on imaging. Conventional radiography, magnetic resonance imaging, computed tomography, and ultrasound can help to detect pathological signs of spondyloarthritis, both peripheral and with axial involvement. Dual-energy X-ray absorptiometry is the gold standard for identifying the presence of osteoporosis, whereas conventional radiology and computed tomography can reveal occult vertebral fractures. The aim of this narrative review is to describe the imaging of musculoskeletal manifestations of IBDs.
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24
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Osseous Pathology on Wrist Magnetic Resonance Imaging. Top Magn Reson Imaging 2021; 29:245-261. [PMID: 33021576 DOI: 10.1097/rmr.0000000000000257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Advanced imaging of the osseous structures of the wrist by magnetic resonance imaging (MRI) yields powerful information regarding marrow composition and overall bone structure. Various forms of pathology, both benign and malignant, have unique marrow signal abnormalities that can be easily detected by MRI given its high sensitivity to radiographically occult processes. In particular, osseous pathology can be seen in the setting of traumatic, degenerative, congenital, infectious, and neoplastic conditions. The acuity or chronicity of these conditions can often be determined by imaging to aid in appropriate therapy. A thorough understanding of the breadth of pathology and corresponding MRI appearances can allow the interpreting radiologist to formulate a concise and accurate assessment of an examination.
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25
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Martinis F, Tinazzi I, Bertolini E, Citriniti G, Variola A, Geccherle A, Marchetta A, McGonagle D, Macchioni P. Clinical and sonographic discrimination between fibromyalgia and spondyloarthopathy in inflammatory bowel disease with musculoskeletal pain. Rheumatology (Oxford) 2021; 59:2857-2863. [PMID: 32068873 DOI: 10.1093/rheumatology/keaa036] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/13/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Joint pain is common in subjects with IBD and is linked to several factors including SpA, drug therapy, concomitant OA or FM. The primary aim of this study was to estimate the prevalence of primary FM and concomitant FM and SpA in a cohort of patients with IBD utilizing clinical and US assessment. METHODS A total of 301 consecutive cases with IBD attending two IBD Units were assessed by a rheumatologist for Assessment of SpondyloArthritis International Society criteria fulfilment for SpA or the 2010 ACR criteria for FM. Some 158 cases also had US entheseal examination on large insertions in the upper and lower limbs. RESULTS Thirty-seven IBD patients (12%) met the ACR criteria for primary FM with 9% presenting with primary FM and 3.3% presenting with concomitant FM and SpA. Meeting FM criteria was not related to smoking, sedentary job, BMI or the presence of psoriasis. FM patients presented higher Leeds Enthesitis Index, BASDAI and BASFI scores than SpA patients. At US examination, patients who satisfied the Assessment of SpondyloArthritis International Society criteria for SpA had significantly higher mean enthesis or patient power Doppler positive as compared with the IBD and FM group (P < 0.001). CONCLUSION We found that FM occurred in 12% of SpA patients and in this setting SpA disease activity indices performed poorly. US examination in a large patient subgroup showed a promising discriminating capacity between FM and SpA in IBD patients.
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Affiliation(s)
- Federica Martinis
- Rheumatology Unit, Department of Medicine, University of Verona, Verona
| | - Ilaria Tinazzi
- Rheumatology Unit, IRCCS Sacro Cuore Don Calabria, Negrar
| | - Elena Bertolini
- Gastroenterological Unit, Ospedale S. Maria Nuova, Reggio Emilia
| | - Giorgia Citriniti
- Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena
| | | | | | | | - Dennis McGonagle
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust & The University of Leeds, Leeds, UK
| | - Pierluigi Macchioni
- Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena.,Rheumatology Department, Ospedale S. Maria Nuova, Reggio Emilia, Italy
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26
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Kaeley GS. Enthesitis in psoriatic arthritis (Part 2): imaging. Rheumatology (Oxford) 2021; 59:i15-i20. [PMID: 32159789 PMCID: PMC7065457 DOI: 10.1093/rheumatology/keaa040] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/02/2020] [Indexed: 01/30/2023] Open
Abstract
Enthesitis is a hallmark finding in PsA and may predate the onset of synovitis. Clinical examination of enthesitis provides no structural information, relies on eliciting tenderness at entheseal sites and may not be sensitive or specific. Soft tissue imaging techniques such as musculoskeletal ultrasound and MRI can depict ultrastructural and inflammatory changes. Although these imaging techniques are complimentary, ultrasound can image superficial entheses with high fidelity and examine vascularity with the use of Doppler but cannot image subchondral bone. MRI depicts bone and can visualize bone marrow edema as well as soft tissue edema. However, due to short relaxation times, entheseal structures are not easily differentiated. There has been increasing recognition of biomechanical confounding, especially since the majority of the entheses examined are in the lower extremity. Imaging entheseal indices are being developed to minimize the effect of body weight and activity. In the following article, contemporary concepts of entheses in relation to imaging will be reviewed as well as important confounders in assessing entheseal alterations. The role and limitations of imaging techniques will be discussed.
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Affiliation(s)
- Gurjit S Kaeley
- Division of Rheumatology and Clinical Immunology, University of Florida College of Medicine, Jacksonville, FL, USA
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27
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Girolimetto N, Zabotti A, Tinazzi I, Possemato N, Costa L, Batticciotto A, Canzoni M, Citriniti G, Lucia OD, Figus F, Idolazzi L, McConnel R, Peluso R, Sakellariou G, Tullio A, Salvarani C, Scarpa R, Iagnocco A, Caso F, Macchioni P. Sensitivity to change and clinical correlations of the novel DACtylitis glObal Sonographic (DACTOS) score in psoriatic arthritis. Rheumatology (Oxford) 2020; 60:4103-4111. [PMID: 33369655 DOI: 10.1093/rheumatology/keaa885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/25/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The aim of the study is to assess the performance of the DACTOS (DACtylitis glObal Sonographic) score in a PsA dactylitis clinical setting. In particular, we evaluated the ability of DACTOS to identify the affected fingers, its sensitivity to change after treatment, the correlations between DACTOS and clinical parameters, and the capacity of the score to identify the treatment responders. METHODS Forty-six consecutive patients with symptomatic PsA hand dactylitis were enrolled. A total of seventy-three dactylitic digits were evaluated clinically and sonographically before and after treatment in this observational and prospective study. Clinical assessment included the Leeds Dactylitis Index-basic (LDI-b) score and visual analogue scales for pain (VAS-p) and functional impairment (VAS-FI). Sonographic lesions were investigated using high-frequency ultrasound with grey scale and power Doppler features according to the DACTOS score. Correlations between the DACTOS score and the clinical parameters were assessed at baseline, 1 month (T1) and 3 months (T3). RESULTS We observed significant improvements in all of the assessed clinical parameters and the DACTOS scores after dactylitis treatment. There was a statistically significant correlation between the variation of all clinical parameters (VAS-p, VAS-FI and LDI-b) and the DACTOS score at T1 and T3 evaluations. We found statistically significant differences in the DACTOS score between clinical responder and non-responder groups (P < 0.001) and between clinical remission and non-remission groups (P < 0.001). CONCLUSION The DACTOS score performs well in real-life clinical settings in terms of sensitivity to change and correlations with clinical features in PsA dactylitis.
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Affiliation(s)
- Nicolò Girolimetto
- Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia.,Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples
| | - Alen Zabotti
- Department of Medical and Biological Science, Rheumatology Clinic, University of Udine
| | - Ilaria Tinazzi
- IRCSS Ospedale Sacro Cuore Don Calabria, Unit of Rheumatology, Negrar, Verona
| | - Niccolò Possemato
- Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples
| | - Alberto Batticciotto
- Department of Internal Medicine, Rheumatology Unit, ASST-Settelaghi 'Ospedale di Circolo-Fondazione Macchi', Varese
| | | | - Giorgia Citriniti
- Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia
| | - Orazio De Lucia
- Department of Rheumatology and Medical Sciences, UOC of Clinical Rheumatology, ASST Centro Traumatologico Ortopedico G. Pini-CTO, Milan
| | - Fabiana Figus
- Academic Rheumatology Centre, Dipartimento di Scienze Cliniche e Biologiche, Università degli Studi di Torino, MFRU, Turin
| | - Luca Idolazzi
- Rheumatology Unit, University of Verona, Ospedale Civile Maggiore, Verona
| | - Rebecca McConnel
- Department of Surgical Sciences, Università degli Studi di Torino, Turin
| | - Rosario Peluso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples
| | - Garifallia Sakellariou
- Division of Rheumatology, University of Pavia, Istituti Clinici Scientifici Maugeri, Pavia
| | - Annarita Tullio
- Institute of Hygiene and Clinical Epidemiology, University Hospital of Udine, Udine, Italy
| | - Carlo Salvarani
- Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples
| | - Annamaria Iagnocco
- Academic Rheumatology Centre, Dipartimento di Scienze Cliniche e Biologiche, Università degli Studi di Torino, MFRU, Turin
| | - Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples
| | - Pierluigi Macchioni
- Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia
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Ziegeler K, Eshed I, Diekhoff T, Hermann KG. Imaging of Joints and Bones in Autoinflammation. J Clin Med 2020; 9:E4074. [PMID: 33348664 PMCID: PMC7766736 DOI: 10.3390/jcm9124074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 12/19/2022] Open
Abstract
Autoinflammatory disorders are commonly characterized by seemingly unprovoked systemic inflammation mainly driven by cells and cytokines of the innate immune system. In many disorders on this spectrum, joint and bone involvement may be observed and imaging of these manifestations can provide essential diagnostic information. This review aimed to provide a comprehensive overview of the imaging characteristics for major diseases and disease groups on the autoinflammatory spectrum, including familial Mediterranean fever (FMF), Behçet disease (BD), crystal deposition diseases (including gout), adult-onset Still's disease (AoSD), and syndromatic synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO)/chronic recurrent multifocal osteomyelitis (CRMO). Herein, we discuss common and distinguishing imaging characteristics, phenotypical overlaps with related diseases, and promising fields of future research.
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Affiliation(s)
- Katharina Ziegeler
- Department of Radiology, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.D.); (K.G.H.)
| | - Iris Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, Tel Giborim Affiliated with the Sackler School of Medicine, Tel Aviv University, 52621 Tel Aviv, Israel;
| | - Torsten Diekhoff
- Department of Radiology, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.D.); (K.G.H.)
| | - Kay Geert Hermann
- Department of Radiology, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.D.); (K.G.H.)
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Mascarenhas S. A Narrative Review of the Classification and Use of Diagnostic Ultrasound for Conditions of the Achilles Tendon. Diagnostics (Basel) 2020; 10:E944. [PMID: 33202763 PMCID: PMC7696236 DOI: 10.3390/diagnostics10110944] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 12/23/2022] Open
Abstract
Enthesitis is a cardinal feature of spondyloarthropathies. The Achilles insertion on the calcaneus is a commonly evaluated enthesis located at the hindfoot, generally resulting in hindfoot pain and possible tendon enlargement. For decades, diagnosis of enthesitis was based upon patient history of hindfoot or posterior ankle pain and clinical examination revealing tenderness and/or enlargement at the site of the tendon insertion. However, not all hindfoot or posterior ankle symptoms are related to enthesitis. Advanced imaging, including magnetic resonance imaging (MRI) and ultrasound (US), has allowed for more precise evaluation of hindfoot and posterior ankle conditions. Use of US in diagnosis has helped confirm some of these cases but also identified other conditions that may have otherwise been misclassified without use of advanced imaging diagnostics. Conditions that may result in hindfoot and posterior ankle symptoms related to the Achilles tendon include enthesitis (which can include retrocalcaneal bursitis and insertional tendonopathy), midportion tendonopathy, paratenonopathy, superficial calcaneal bursitis, calcaneal ossification (Haglund deformity), and calcific tendonopathy. With regard to classification of these conditions, much of the existing literature uses confusing nomenclature to describe conditions in this region of the body. Some terminology may imply inflammation when in fact there may be none. A more uniform approach to classifying these conditions based off anatomic location, symptoms, clinical findings, and histopathology is needed. There has been much debate regarding appropriate use of tendonitis when there is no true inflammation, calling instead for use of the terms tendinosis or tendonopathy. To date, there has not been clear examination of a similar overuse of the term enthesitis in conditions where there is no underlying inflammation, thus raising the need for more comprehensive taxonomy.
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Affiliation(s)
- Sheryl Mascarenhas
- Department of Internal Medicine, Division of Rheumatology, The Ohio State University Wexner Medical Center, 543 Taylor Ave, Columbus, OH 43203, USA
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30
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Aydin SZ, Mathew AJ, Koppikar S, Eder L, Østergaard M. Imaging in the diagnosis and management of peripheral psoriatic arthritis. Best Pract Res Clin Rheumatol 2020; 34:101594. [PMID: 33032929 DOI: 10.1016/j.berh.2020.101594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Psoriatic arthritis is a heterogenous disease affecting peripheral and axial joints, tendons, ligaments, and their insertions, in addition to the skin and the nails. The complexity of the involved structures has puzzled clinicians trying to understand the underlying pathology that leads to symptoms in order to choose the appropriate medications with different modes of actions. Imaging, mainly ultrasound and magnetic resonance imaging, allows of accurate detection of inflammatory changes in the musculoskeletal structures, which helps to avoid false positive and negative assessments. The linking of different anatomical structures' involvement using imaging also provides insights into the pathogenesis of psoriatic arthritis. In this review, ultrasound and magnetic resonance imaging will be discussed in depth with regard to their use in the field of peripheral psoriatic arthritis, with a focus on the literature from the last 4 years and recent advances.
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Affiliation(s)
- Sibel Zehra Aydin
- University of Ottawa Faculty of Medicine, Rheumatology, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada.
| | - Ashish J Mathew
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Immunology & Rheumatology, Christian Medical College, Vellore, India; Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada; Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, ON, Canada.
| | - Sahil Koppikar
- Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
| | - Lihi Eder
- Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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31
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Evaluation Effects of Laser Therapy and Extracorporeal Shock Wave Therapy with Clinical Parameters and Magnetic Resonance Imaging for Treatment of Plantar Fasciitis in Patients with Spondyloarthritis: A Randomized Controlled Trial. Int J Rheumatol 2020; 2020:4386361. [PMID: 32908536 PMCID: PMC7474377 DOI: 10.1155/2020/4386361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/14/2020] [Accepted: 05/05/2020] [Indexed: 12/03/2022] Open
Abstract
Objective Low-level laser therapy (LLLT) and extracorporeal shock wave therapy (ESWT) is applied in the conservative treatment of inflammatory plantar fasciitis, which is also a characteristic feature of spondyloarthritis (SpA) (Gill, 1997 and Roxas, 2005). We determined and compared the effectiveness of LLLT and ESWT using magnetic resonance imaging (MRI). Methods This study is a prospective, randomized, comparative, single-blind clinical study. Voluntarily followed 40 patients with the diagnosis of SpA and having pain at the heels at least for 6 months. Patients were divided randomly into two treatment groups. One group undertook 14 sessions of infrared Ga-Al-As LLLT, and the other group undertook 3 sessions ESWT. Feet functions of the patients were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) and Roles and Maudsley Scoring; VAS was evaluated for foot pain and function. In clinical assessment, disease activity was carried out by applying the BASDAI, the functional assessment was evaluated through the BASFI, and the patient quality of life was evaluated through the ASQoL; enthesitis was scored according to MASES assessment, performed before and at 1 month after treatment. The thickness of the plantar fascia was measured with MRI before and 1 month after treatment. Results Compared with the pretherapy, progress in the feet function by AOFAS and Roles-Maudsley scoring and decrease in VAS levels were statistically significant in both groups (p < 0.001). Only the VAS exercise score was superior to LLLT (p < 0.05). The thickness of the plantar fascia had decreased significantly on MRI in all two groups. Conclusion The treatment of plantar fasciitis with LLLT and ESWT was more successful in pain improvement and functional outcomes with the dose, frequency, and duration used in our study.
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Affiliation(s)
| | - Natalie Faith
- Florida Medical Clinic, Rheumatology, Zephyrhills, Florida, USA
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33
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Mathew AJ, Østergaard M. Magnetic Resonance Imaging of Enthesitis in Spondyloarthritis, Including Psoriatic Arthritis-Status and Recent Advances. Front Med (Lausanne) 2020; 7:296. [PMID: 32695789 PMCID: PMC7338655 DOI: 10.3389/fmed.2020.00296] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/26/2020] [Indexed: 12/16/2022] Open
Abstract
Enthesitis, inflammation at the attachment sites of tendons, ligaments, fascia, and joint capsules to bones plays a critical role in the pathogenesis of spondyloarthritis (SpA), including psoriatic arthritis (PsA). Magnetic resonance imaging (MRI) has aided in a better understanding of pathophysiology, early diagnosis, prognostication, therapeutic outcomes, and follow up of enthesitis. The concept of enthesitis as a focal insertional pathology has transformed over the past decade, with the help of MRI, to a more widespread entity involving both bone and surrounding soft tissues. The utility of MRI in the differential diagnosis of suspected enthesitis has recently been explored. With the emergence of the treat-to-target concept, and a domain-based approach in the management of SpA, objective and sensitive monitoring of response to targeted therapy becomes prudent. Properties like high sensitivity, ability to image intra-osseous pathology along with surrounding structures exemplify the utility of MRI technology. Considering the lack of a comprehensive, validated MRI score the Outcome Measures in Rheumatology (OMERACT) MRI in Arthritis Working Group, informed by a systematic literature review, developed the first international, consensus-based MRI-scoring system, combined with MRI definitions of pathologies for enthesitis in patients with spondyloarthritis (SpA) and PsA. An atlas with representative images of each grade of the scoring system was subsequently developed by the group to aid readers interested in using the heel enthesitis MRI scoring system (HEMRIS). The HEMRIS can find utility in clinical trials targeting enthesitis as the primary outcome. MRI also finds value for global assessment of the total burden of enthesitis. The concept of whole-body MRI (WBMRI), enabling visualization of entheses throughout the body using a single image is relatively new. The MRI whole-body score for inflammation in peripheral joints and entheses (MRI-WIPE) is a promising scoring system, which is undergoing further testing in clinical trials and longitudinal cohorts evaluating global measures of inflammation at entheses. This review discusses the role of MRI in diagnosis and monitoring of enthesitis in SpA and PsA, along with recent advances in the field, based on published literature.
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Affiliation(s)
- Ashish J Mathew
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India.,Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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34
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Carron P, De Craemer AS, Van den Bosch F. Peripheral spondyloarthritis: a neglected entity-state of the art. RMD Open 2020; 6:e001136. [PMID: 32385142 PMCID: PMC7299516 DOI: 10.1136/rmdopen-2019-001136] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 02/06/2023] Open
Abstract
Peripheral spondyloarthritis (pSpA) refers to a number of seemingly different spondyloarthritis subsets in which psoriatic arthritis (PsA) is the most common, and symptoms of arthritis, enthesitis or dactylitis predominate the clinical presentation. Although formal classification criteria for pSpA have been introduced in 2011, only a minority of epidemiological and clinical studies addressed this clinical entity as a separate disease. Moreover, research on outcome measures and treatment modalities in pSpA has been mainly focused on PsA. Subsequently, all biological treatments are off-label in patients with non-psoriatic pSpA. Its neglected status has important implications for clinical practice since the emerging group of early-diagnosed non-psoriatic pSpA patients remains poorly characterised and lacks specific treatment recommendations. This review summarises what is currently known regarding pSpA in terms of epidemiology, clinical presentation, diagnosis and therapeutic approach.
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Affiliation(s)
- Philippe Carron
- Rheumatology, University Hospital Ghent, Ghent, Belgium
- VIB Center for Inflammation Research, Ghent, Belgium
| | - Ann-Sophie De Craemer
- Rheumatology, University Hospital Ghent, Ghent, Belgium
- VIB Center for Inflammation Research, Ghent, Belgium
| | - Filip Van den Bosch
- Rheumatology, University Hospital Ghent, Ghent, Belgium
- VIB Center for Inflammation Research, Ghent, Belgium
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Navallas M, Inarejos Clemente EJ, Iglesias E, Rebollo-Polo M, Antón J, Navarro OM. Connective Tissue Disorders in Childhood: Are They All the Same? Radiographics 2020; 39:229-250. [PMID: 30620697 DOI: 10.1148/rg.2019180078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Systemic connective tissue disorders are characterized by the presence of autoantibodies and multiorgan system involvement. Juvenile systemic lupus erythematosus with or without associated antiphospholipid syndrome; juvenile dermatomyositis; sclerodermiform syndromes, including systemic and localized sclerodermas and eosinophilic fasciitis; mixed connective tissue disease; and Sjögren syndrome are the disorders that affect children most frequently. Diagnosis is difficult, because the clinical presentation of patients is diverse, from mild to severe disease. In addition, all organs may be affected. However, a variety of imaging techniques are now available to investigate rheumatic disease in children. These imaging modalities offer the potential for earlier diagnosis and improved assessment of therapeutic response. This article reviews the main connective tissue disorders that affect children, highlighting their key imaging features on images acquired with different diagnostic imaging modalities and correlating these features with clinical and pathologic findings, when available. ©RSNA, 2019.
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Affiliation(s)
- María Navallas
- From the Departments of Radiology (M.N., E.J.I.C., M.R.P.) and Rheumatology (E.I., J.A.), Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Spain; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (M.N., O.M.N.); and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (M.N., O.M.N.)
| | - Emilio J Inarejos Clemente
- From the Departments of Radiology (M.N., E.J.I.C., M.R.P.) and Rheumatology (E.I., J.A.), Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Spain; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (M.N., O.M.N.); and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (M.N., O.M.N.)
| | - Estíbaliz Iglesias
- From the Departments of Radiology (M.N., E.J.I.C., M.R.P.) and Rheumatology (E.I., J.A.), Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Spain; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (M.N., O.M.N.); and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (M.N., O.M.N.)
| | - Mónica Rebollo-Polo
- From the Departments of Radiology (M.N., E.J.I.C., M.R.P.) and Rheumatology (E.I., J.A.), Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Spain; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (M.N., O.M.N.); and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (M.N., O.M.N.)
| | - Jordi Antón
- From the Departments of Radiology (M.N., E.J.I.C., M.R.P.) and Rheumatology (E.I., J.A.), Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Spain; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (M.N., O.M.N.); and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (M.N., O.M.N.)
| | - Oscar M Navarro
- From the Departments of Radiology (M.N., E.J.I.C., M.R.P.) and Rheumatology (E.I., J.A.), Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Spain; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (M.N., O.M.N.); and Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (M.N., O.M.N.)
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Schiettecatte E, Jaremko J, Sudoł-Szopińska I, Znajdek M, Mandegaran R, Swami V, Jans L, Herregods N. Common incidental findings on sacroiliac joint MRI in children clinically suspected of juvenile spondyloarthritis. Eur J Radiol Open 2020; 7:100225. [PMID: 32154331 PMCID: PMC7058907 DOI: 10.1016/j.ejro.2020.100225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/18/2020] [Accepted: 02/22/2020] [Indexed: 02/07/2023] Open
Abstract
What to look for on MRI of the sacroiliac (SI) joint. Incidental findings are common on MRI of the sacroiliac (SI) joint in children. There is more to see than sacroiliitis on MRI of the sacroiliac (SI) joint. Degeneration, inflammation, tumor and normal variants can be seen on MRI of SI joint.
Purpose To determine the prevalence of incidental findings on sacroiliac (SI) joint MRI in children clinically suspected of Juvenile Spondyloarthritis (JSpA). Methods In this retrospective multi-center study of 540 children clinically suspected of JSpA who underwent MRI of SI joints from February 2012 to May 2018, the prevalence of sacroiliitis and other incidental findings was recorded. Results In 106/540 (20 %) children MRI features of sacroiliitis were present. In 228 (42 %) patients MRI showed at least one incidental finding other than sacroiliitis. A total of 271 abnormal findings were reported. The most frequent incidental findings were at lumbosacral spine (158 patients, 29 %) and hip (43 patients, 8 %). The most common incidental finding was axial degenerative changes, seen in 94 patients (17 %). Other less frequent pathologies were: simple (bone) cyst in 15 (2,8 %) patients; enthesitis/tendinitis in 16 (3 %) patients; non-specific focal bone marrow edema (BME) away from SI joints in 10 (1,9 %) patients; ovarian cysts in 7 (1,3 %) patients; BME in the course of chronic recurrent multifocal osteomyelitis (CRMO) in 4 (0,7 %) patients; muscle pathology in 4 (0,7%) patients; benign tumors in 3 (0,6 %) patients; (old) fractures in 3 (0,6 %) patients; bony apophyseal avulsion in 2 (0,4 %) patients and malignant tumors in 2 (0,4 %) patients. Conclusion Incidental findings are common on MRI of the SI joints in children clinically suspected of JSpA, particularly at the lumbar spine and hips. They are seen even more frequently than sacroiliitis and can be relevant, as some will have clinical significance or require treatment.
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Key Words
- AVN, avascular necrosis
- BME, bone marrow edema
- CRMO, chronic recurrent multifocal osteomyelitis
- FOV, field of view
- Gd, gadolinium DTPA
- HLA-B27, human leukocyte antigen B27
- IV, intravenous
- Inflammation
- JSpA, juvenile spondyloarthritis
- Juvenile spondyloarthritis
- MRI, magnetic resonance imaging
- Magnetic resonance imaging (MRI)
- SI, sacroiliac
- ST, slice thickness
- STIR, short tau inversion recovery
- Sacroiliac joint
- Sacroiliitis
- TE, echo time
- TR, repetition time
- TSE, turbo spin echo
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Affiliation(s)
- E. Schiettecatte
- Department of Radiology and Medical Imaging, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Gent, Belgium
- Corresponding author.
| | - J.L. Jaremko
- Department of Radiology, University of Alberta Hospital, 8440-112 Street, Edmonton, T6G 2B7, Alberta, Canada
| | - I. Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - M. Znajdek
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - R. Mandegaran
- Department of Radiology, University of Alberta Hospital, 8440-112 Street, Edmonton, T6G 2B7, Alberta, Canada
| | - V. Swami
- Department of Radiology, University of Alberta Hospital, 8440-112 Street, Edmonton, T6G 2B7, Alberta, Canada
| | - L. Jans
- Department of Radiology and Medical Imaging, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Gent, Belgium
| | - N. Herregods
- Department of Radiology and Medical Imaging, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Gent, Belgium
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Active inflammatory changes around the pubic symphysis in patients with axial spondyloarthritis: Magnetic resonance imaging characteristics and association with clinical factors. Eur J Radiol 2020; 124:108802. [DOI: 10.1016/j.ejrad.2019.108802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/20/2019] [Accepted: 12/18/2019] [Indexed: 01/12/2023]
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Mathew AJ, Krabbe S, Eshed I, Lambert RG, Laredo JD, Maksymowych WP, Gandjbakhch F, Emad Y, Stoenoiu MS, Foltz V, Bird P, Carron P, Paschke J, Conaghan PG, Pedersen SJ, Glinatsi D, Østergaard M. Atlas of the OMERACT Heel Enthesitis MRI Scoring System (HEMRIS). RMD Open 2020; 6:rmdopen-2019-001150. [PMID: 32568094 PMCID: PMC7046972 DOI: 10.1136/rmdopen-2019-001150] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/30/2019] [Accepted: 01/05/2020] [Indexed: 01/28/2023] Open
Abstract
Objective Assessment of enthesitis, a key feature in spondyloarthritis (SpA) and psoriatic arthritis (PsA), using objective and sensitive methods is pivotal in clinical trials. MRI allows detection of both soft tissue and intra-osseous changes of enthesitis. This article presents an atlas for the Outcome Measures in Rheumatology (OMERACT) Heel Enthesitis Magnetic Resonance ImagingMRI Scoring System (HEMRIS). Methods Following a preliminary selection of potential examples of each grade, as per HEMRIS definitions, the images along with detailed definitions and reader rules were discussed at web-based, interactive meetings between the members of the OMERACT MRI in Arthritis Working Group. Results Reference images of each grade of the MRI features to be assessed using HEMRIS, along with reader rules and recommended MRI sequences are depicted. Conclusion The presented reference images can be used to guide scoring Achilles tendon and plantar fascia (plantar aponeurosis) enthesitis according to the OMERACT HEMRIS in clinical trials and cohorts in which MRI enthesitis is used as an outcome.
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Affiliation(s)
- Ashish J Mathew
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Glostrup, Denmark .,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - Simon Krabbe
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Iris Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Robert Gw Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.,Medical Imaging Consultants, Edmonton, Alberta, Canada
| | - Jean-Denis Laredo
- Service de Radiologie, Hôpital Lariboisiére, APHP & Université Paris-Diderot, Paris, France
| | - Walter P Maksymowych
- CaRE (Canadian Research Education) Arthritis, Edmonton, Alberta, Canada.,Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Frederique Gandjbakhch
- Department of Rheumatology, CHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.,Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Yasser Emad
- Rheumatology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Maria Simona Stoenoiu
- Rheumatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.,Institut de Recherche Experimentale et Clinique, Universite Catholique de Louvain La Faculte de Medecine, Brussels, Belgium
| | - Violaine Foltz
- Department of Rheumatology, CHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.,Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Paul Bird
- Division of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Joel Paschke
- CaRE (Canadian Research Education) Arthritis, Edmonton, Alberta, Canada
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,Leeds Teaching Hospitals NHS Trust, NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Glostrup, Denmark
| | - Daniel Glinatsi
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Glostrup, Denmark.,Rheumatology, Skaraborg Hospital Skövde, Skovde, Sweden
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Pseudoerosions of Hands and Feet in Rheumatoid Arthritis: Anatomic Concepts and Redefinition. J Clin Med 2019; 8:jcm8122174. [PMID: 31835340 PMCID: PMC6947149 DOI: 10.3390/jcm8122174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/18/2019] [Accepted: 12/02/2019] [Indexed: 01/05/2023] Open
Abstract
Rheumatoid arthritis is a chronic inflammatory disease characterized by the development of osseous and cartilaginous damage. The correct differentiation between a true erosion and other entities—then often called “pseudoerosions”—is essential to avoid misdiagnosing rheumatoid arthritis and to correctly interpret the progress of the disease. The aims of this systematic review were as follows: to create a definition and delineation of the term “pseudoerosion”, to point out morphological pitfalls in the interpretation of images, and to report on difficulties arising from choosing different imaging modalities. A systematic review on bone erosions in rheumatoid arthritis was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following search terms were applied in PubMed and Scopus: “rheumatoid arthritis”, “bone erosion”, “ultrasonography”, “radiography”, “computed tomography” and “magnetic resonance imaging”. Appropriate exclusion criteria were defined. The systematic review registration number is 138826. The search resulted ultimately in a final number of 25 papers. All indications for morphological pitfalls and difficulties utilizing imaging modalities were recorded and summarized. A pseudoerosion is more than just a negative definition of an erosion; it can be anatomic (e.g., a normal osseous concavity) or artefact-related (i.e., an artificial interruption of the calcified zones). It can be classified according to their configuration, shape, content, and can be described specifically with an anatomical term. “Calcified zone” is a term to describe the deep components of the subchondral, subligamentous and subtendinous bone, and may be applied for all non-cancellous borders of a bone, thus representing a third type of the bone matrix beside the cortical and the trabecular bone.
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Bakewell C, Aydin SZ, Ranganath VK, Eder L, Kaeley GS. Imaging Techniques: Options for the Diagnosis and Monitoring of Treatment of Enthesitis in Psoriatic Arthritis. J Rheumatol 2019; 47:973-982. [PMID: 31676700 DOI: 10.3899/jrheum.190512] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2019] [Indexed: 02/08/2023]
Abstract
Psoriatic arthritis (PsA) affects up to 30% of patients with psoriasis and may include musculoskeletal manifestations such as enthesitis. Enthesitis is associated with joint damage, and early detection and treatment are essential to management of the disease. Traditionally assessed by clinical examination and conventional radiography, entheseal inflammation can now be more accurately assessed earlier in the disease using techniques such as ultrasound, magnetic resonance imaging, computed tomography, and molecular imaging. However, there is little consensus on the optimum definition for diagnosing enthesitis in PsA or on the ideal scoring system for measuring response to treatment. This review aims to summarize the benefits and limitations of different imaging modalities in the assessment of enthesitis. It also proposes that adoption of standardized definitions and validation of scoring systems and imaging techniques in clinical trials will allow the efficacy of new treatment options to be assessed more accurately.
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Affiliation(s)
- Catherine Bakewell
- From the Intermountain Healthcare Medical Group, Salt Lake City, Utah, USA; University of Ottawa, Ottawa, Ontario, Canada; University of California, Los Angeles (UCLA), California, USA; Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; University of Florida College of Medicine, Jacksonville, Florida, USA. .,C. Bakewell has received consultancy fees from and/or served on speakers bureaus for AbbVie and Novartis Pharmaceuticals Corp. S.Z. Aydin has received honoraria from Novartis. V.K. Ranganath has served on the Data and Safety Monitoring Board for Amgen and has received grants for investigator-initiated studies from Mallinckrodt. L. Eder has received research or educational grants and/or consultancy fees from Novartis. G.S. Kaeley has received consultancy fees from Novartis. .,C. Bakewell, MD, Rheumatologist, Intermountain Healthcare Medical Group Salt Lake Clinic; S.Z. Aydin, MD, Associate Professor in Rheumatology, University of Ottawa, Ottawa Hospital Research Institute; V.K. Ranganath, MD, MS, Health Sciences Associate Clinical Professor, Division of Rheumatology, David Geffen School of Medicine at UCLA; L. Eder, MD, PhD, Assistant Professor of Medicine, Women's College Research Institute, Women's College Hospital, University of Toronto; G.S. Kaeley, MBBS, MRCP, RhMSUS, Professor, Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Florida College of Medicine.
| | - Sibel Zehra Aydin
- From the Intermountain Healthcare Medical Group, Salt Lake City, Utah, USA; University of Ottawa, Ottawa, Ontario, Canada; University of California, Los Angeles (UCLA), California, USA; Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; University of Florida College of Medicine, Jacksonville, Florida, USA.,C. Bakewell has received consultancy fees from and/or served on speakers bureaus for AbbVie and Novartis Pharmaceuticals Corp. S.Z. Aydin has received honoraria from Novartis. V.K. Ranganath has served on the Data and Safety Monitoring Board for Amgen and has received grants for investigator-initiated studies from Mallinckrodt. L. Eder has received research or educational grants and/or consultancy fees from Novartis. G.S. Kaeley has received consultancy fees from Novartis.,C. Bakewell, MD, Rheumatologist, Intermountain Healthcare Medical Group Salt Lake Clinic; S.Z. Aydin, MD, Associate Professor in Rheumatology, University of Ottawa, Ottawa Hospital Research Institute; V.K. Ranganath, MD, MS, Health Sciences Associate Clinical Professor, Division of Rheumatology, David Geffen School of Medicine at UCLA; L. Eder, MD, PhD, Assistant Professor of Medicine, Women's College Research Institute, Women's College Hospital, University of Toronto; G.S. Kaeley, MBBS, MRCP, RhMSUS, Professor, Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Florida College of Medicine
| | - Veena K Ranganath
- From the Intermountain Healthcare Medical Group, Salt Lake City, Utah, USA; University of Ottawa, Ottawa, Ontario, Canada; University of California, Los Angeles (UCLA), California, USA; Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; University of Florida College of Medicine, Jacksonville, Florida, USA.,C. Bakewell has received consultancy fees from and/or served on speakers bureaus for AbbVie and Novartis Pharmaceuticals Corp. S.Z. Aydin has received honoraria from Novartis. V.K. Ranganath has served on the Data and Safety Monitoring Board for Amgen and has received grants for investigator-initiated studies from Mallinckrodt. L. Eder has received research or educational grants and/or consultancy fees from Novartis. G.S. Kaeley has received consultancy fees from Novartis.,C. Bakewell, MD, Rheumatologist, Intermountain Healthcare Medical Group Salt Lake Clinic; S.Z. Aydin, MD, Associate Professor in Rheumatology, University of Ottawa, Ottawa Hospital Research Institute; V.K. Ranganath, MD, MS, Health Sciences Associate Clinical Professor, Division of Rheumatology, David Geffen School of Medicine at UCLA; L. Eder, MD, PhD, Assistant Professor of Medicine, Women's College Research Institute, Women's College Hospital, University of Toronto; G.S. Kaeley, MBBS, MRCP, RhMSUS, Professor, Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Florida College of Medicine
| | - Lihi Eder
- From the Intermountain Healthcare Medical Group, Salt Lake City, Utah, USA; University of Ottawa, Ottawa, Ontario, Canada; University of California, Los Angeles (UCLA), California, USA; Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; University of Florida College of Medicine, Jacksonville, Florida, USA.,C. Bakewell has received consultancy fees from and/or served on speakers bureaus for AbbVie and Novartis Pharmaceuticals Corp. S.Z. Aydin has received honoraria from Novartis. V.K. Ranganath has served on the Data and Safety Monitoring Board for Amgen and has received grants for investigator-initiated studies from Mallinckrodt. L. Eder has received research or educational grants and/or consultancy fees from Novartis. G.S. Kaeley has received consultancy fees from Novartis.,C. Bakewell, MD, Rheumatologist, Intermountain Healthcare Medical Group Salt Lake Clinic; S.Z. Aydin, MD, Associate Professor in Rheumatology, University of Ottawa, Ottawa Hospital Research Institute; V.K. Ranganath, MD, MS, Health Sciences Associate Clinical Professor, Division of Rheumatology, David Geffen School of Medicine at UCLA; L. Eder, MD, PhD, Assistant Professor of Medicine, Women's College Research Institute, Women's College Hospital, University of Toronto; G.S. Kaeley, MBBS, MRCP, RhMSUS, Professor, Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Florida College of Medicine
| | - Gurjit S Kaeley
- From the Intermountain Healthcare Medical Group, Salt Lake City, Utah, USA; University of Ottawa, Ottawa, Ontario, Canada; University of California, Los Angeles (UCLA), California, USA; Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; University of Florida College of Medicine, Jacksonville, Florida, USA.,C. Bakewell has received consultancy fees from and/or served on speakers bureaus for AbbVie and Novartis Pharmaceuticals Corp. S.Z. Aydin has received honoraria from Novartis. V.K. Ranganath has served on the Data and Safety Monitoring Board for Amgen and has received grants for investigator-initiated studies from Mallinckrodt. L. Eder has received research or educational grants and/or consultancy fees from Novartis. G.S. Kaeley has received consultancy fees from Novartis.,C. Bakewell, MD, Rheumatologist, Intermountain Healthcare Medical Group Salt Lake Clinic; S.Z. Aydin, MD, Associate Professor in Rheumatology, University of Ottawa, Ottawa Hospital Research Institute; V.K. Ranganath, MD, MS, Health Sciences Associate Clinical Professor, Division of Rheumatology, David Geffen School of Medicine at UCLA; L. Eder, MD, PhD, Assistant Professor of Medicine, Women's College Research Institute, Women's College Hospital, University of Toronto; G.S. Kaeley, MBBS, MRCP, RhMSUS, Professor, Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Florida College of Medicine
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Gupta S, Nischal N, Sharma L, Gupta R, Singh JP. Spondyloarthropathy - Is sacroiliac joint imaging sufficient? A study of 431 patients. Indian J Radiol Imaging 2019; 29:372-377. [PMID: 31949338 PMCID: PMC6958885 DOI: 10.4103/ijri.ijri_212_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/20/2019] [Accepted: 10/08/2019] [Indexed: 11/04/2022] Open
Abstract
Abstract
Background: Sacroiliac (SI) joint involvement (sacroiliitis) is considered as major criteria for diagnosing Spondyloarthropathy (SpA), although involvement of spine and hip can also occur. The aim of our study was to assess the utility of including sagittal short-tau inversion recovery (STIR) sequence of dorsolumbar spine and coronal STIR/proton density (PD) fat saturated sequence through both hips, to routine SI joint magnetic resonance (MR) imaging protocol, in patients clinically suspected to have SpA. Material and Methods: A retrospective observational study was conducted between February 2013 and February 2018 on clinically suspected SpA patients referred to our department for imaging. The images obtained using this new SI joint protocol were evaluated for findings suggesting SpA diagnosis as per the Assessment of SpondyloArthritis international Society criteria. Other differentials for similar symptoms were also looked for. Results: Of the 431 patients (313 M and 118 F), 255 had features confirming the diagnosis of SpA and 176 had no radiological manifestations of SpA (56 were normal and 120 had other findings to suggest clinical symptoms; e.g., degenerative SpA, Pott’s spine, skeletal metastases, early AVN of hip, cysticercus, iliofemoral impingement). 19/255 patients had normal SI joints but other findings to suggest diagnosis of SpA, e.g. romanus lesions, costovertebritis/costotransversitis, pubic symphysitis, inflammatory hip arthropathy, enthesitis, iliofemoral/trochanteric bursitis. 33/61 patients with chronic sacroiliitis had disease activity in spine or hip. Conclusion: Inclusion of sections through dorsolumbar spine and both hips to routine SI joint protocol, helped in identifying: (a) early disease in 19 patients, who had normal SI joints and may have otherwise been missed with routine only SI joint imaging, (b) additional findings in SpA-related sacroiliitis, (c) disease activity in chronic sacroiliitis, and (d) other causes of low back pain and thus helped in further patient management.
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Affiliation(s)
- Saurabh Gupta
- Department of Radiology, Dayanand Medical College and Hospital, Ludhiana, Punjab
| | - Neha Nischal
- Departments of Radiology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Lucky Sharma
- Departments of Rheumatology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Rajiva Gupta
- Departments of Rheumatology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Jatinder Pal Singh
- Departments of Radiology, Medanta-The Medicity, Gurugram, Haryana, India
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Abstract
The triggers and pathogenesis of axial spondyloarthritis (axSpA) are not yet completely understood. However, therapeutic agents targeting tumor necrosis factor-α and interleukin-17 inflammatory pathways have proven successful in suppressing many of the clinical symptoms and signs of axSpA, giving us an indication of which pathways are responsible for initiating and maintaining the inflammation. The mechanisms that eventuate in syndesmophytes and ankyloses are less clear. This review addresses these two critical pathways of inflammation, discussing their nature and these factors that may activate or enhance the pathways in patients with axSpA. In addition, genetic and other markers important to the inflammatory pathways implicated in axSpA are explored, and prognostic biomarkers are discussed. Treatment options available for the management of axSpA and their associated targets are highlighted.
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Affiliation(s)
- Daniel E Furst
- Department of Medicine, Division of Rheumatology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - James S Louie
- Department of Medicine, Division of Rheumatology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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43
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Macchioni P, Salvarani C, Possemato N, Gutierrez M, Grassi W, Gasparini S, Perricone C, Perrotta FM, Grembiale RD, Bruno C, Tripolino C, Govoni M, Ciancio G, Farina I, Ramonda R, Frallonardo P, Desiati F, Scarpa R, Costa L, Zabotti A, De Vita S, D’Attino RM, Gualberti G, Merolla R, di Luzio Paparatti U, Aldigeri R, Marchesoni A. Ultrasonographic and Clinical Assessment of Peripheral Enthesitis in Patients with Psoriatic Arthritis, Psoriasis, and Fibromyalgia Syndrome: The ULISSE Study. J Rheumatol 2019; 46:904-911. [DOI: 10.3899/jrheum.171411] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2018] [Indexed: 01/21/2023]
Abstract
Objective.The purpose of the ULISSE study was to evaluate the prevalence of clinical and ultrasonographic (US) entheseal involvement in patients with psoriatic arthritis (PsA), psoriasis, and fibromyalgia syndrome (FMS).Methods.In this cross-sectional multicenter study, patients with PsA and psoriasis (not taking systemic therapy) and FMS underwent a clinical evaluation of the entheses, and a B-mode and power Doppler examination of 6 pairs of entheses.Results.The study analyzed 140 patients with PsA, 51 with psoriasis, and 51 with FMS. Clinical and US examinations were performed in 1960 and 1680 entheses in the PsA group, and 714 and 612 entheses both in the psoriasis group and in the FMS group. In both per-patient and per-enthesis evaluation, the frequency of entheseal tenderness was higher in patients with FMS (92% of the patients and 46% of the entheses, compared with 66%/23% in the PsA group and 59%/18% in the psoriasis group). With US examination, signs of entheseal involvement were more frequent in both the per-patient and per-enthesis evaluation in PsA and psoriasis (about 90% of patients in both the PsA and psoriasis groups and 75% of patients in the FMS group had at least 1 site affected, and 54%, 41%, and 27% of the pairs of entheses in, respectively, PsA, psoriasis, and FMS patients showed at least 1 enthesis involved).Conclusion.The ULISSE study indicated that enthesitis is a common feature in patients with PsA, those with psoriasis, and in those with FMS if only clinical examination is used. US entheseal assessment showed findings more consistent with the 3 disorders.
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Sarbu MI, Sarbu N. Musculoskeletal Clinical and Imaging Manifestations in Inflammatory Bowel Diseases. Open Med (Wars) 2019; 14:75-84. [PMID: 30847394 PMCID: PMC6401387 DOI: 10.1515/med-2019-0011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 12/05/2018] [Indexed: 02/07/2023] Open
Abstract
Rheumatic musculoskeletal manifestations are increasingly recognized as a major cause of morbidity and impaired quality of life in patients with inflammatory bowel diseases (IBDs). IBDs are associated with a variety of musculoskeletal pathologies, from peripheral arthritis to axial involvement, and from localized or regional pathologies to diffuse metabolic disorders. Recent advances, especially in imaging techniques, allow a better understanding of these pathologies, and assist their recognition even in the preclinical phase. This review aims to describe the musculoskeletal clinical and imaging manifestations in IBD with special emphasis on the current concepts and the updated radiological work-up.
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Affiliation(s)
- Mihaela Ionela Sarbu
- Department of Radiology and Magnetic Resonance Imaging, Erasme Hospital, University of Brussels (ULB), Brussels, Belgium
| | - Nicolae Sarbu
- Department of Radiology and Magnetic Resonance Imaging, Erasme Hospital, University of Brussels (ULB), Route de Lennik 808-B-1070 Brussels, Belgium
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Krabbe S, Eshed I, Gandjbakhch F, Pedersen SJ, Bird P, Mathew AJ, Lambert RG, Maksymowych WP, Glinatsi D, Stoenoiu MS, Poggenborg R, Jans L, Jaremko JL, Herregods N, Foltz V, Conaghan PG, Althoff CE, Paschke J, Peterfy C, Hermann KGA, Østergaard M. Development and Validation of an OMERACT MRI Whole-Body Score for Inflammation in Peripheral Joints and Entheses in Inflammatory Arthritis (MRI-WIPE). J Rheumatol 2019; 46:1215-1221. [PMID: 30770508 DOI: 10.3899/jrheum.181084] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To develop a whole-body magnetic resonance imaging (MRI) scoring system for peripheral arthritis and enthesitis. METHODS After consensus on definitions/locations of MRI pathologies, 4 multireader exercises were performed. Eighty-three joints were scored 0-3 separately for synovitis and osteitis, and 33 entheses 0-3 separately for soft tissue inflammation and osteitis. RESULTS In the last exercise, reliability was moderate-good for musculoskeletal radiologists and rheumatologists with previously demonstrated good scoring proficiency. Median pairwise single-measure/average-measure ICC were 0.67/0.80 for status scores and 0.69/0.82 for change scores; κ ranged 0.35-0.77. CONCLUSION Whole-body MRI scoring of peripheral arthritis and enthesitis is reliable, which encourages further testing and refinement in clinical trials.
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Affiliation(s)
- Simon Krabbe
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA. .,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen.
| | - Iris Eshed
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Frédérique Gandjbakhch
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Susanne J Pedersen
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Paul Bird
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Ashish J Mathew
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Robert G Lambert
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Walter P Maksymowych
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Daniel Glinatsi
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Maria S Stoenoiu
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - René Poggenborg
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Lennart Jans
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Jacob L Jaremko
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Nele Herregods
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Violaine Foltz
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Philip G Conaghan
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Christian E Althoff
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Joel Paschke
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Charles Peterfy
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Kay-Geert A Hermann
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
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Mathew AJ, Krabbe S, Eshed I, Gandjbakhch F, Bird P, Pedersen SJ, Stoenoiu MS, Foltz V, Glinatsi D, Lambert RG, Hermann KGA, Maksymowych WP, Haugen IK, Jaremko JL, Poggenborg RP, Paschke J, Laredo JD, Carron P, Conaghan PG, Østergaard M. The OMERACT MRI in Enthesitis Initiative: Definitions of Key Pathologies, Suggested MRI Sequences, and a Novel Heel Enthesitis Scoring System. J Rheumatol 2019; 46:1232-1238. [PMID: 30709961 DOI: 10.3899/jrheum.181093] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To develop and validate an enthesitis magnetic resonance imaging (MRI) scoring system for spondyloarthritis/psoriatic arthritis, using the heel as model. METHODS Consensus definitions of key pathologies and 3 heel enthesitis multireader scoring exercises were done, separated by discussion, training, and calibration. RESULTS Definitions for bone and soft tissue pathologies were agreed. In the final exercise, median pairwise single-measures intraclass correlation coefficients (ICC; patient-level) for entheseal inflammation status/change scores were 0.83/0.82 for all readers. For radiologists and selected rheumatologists, ICC were 0.91/0.84 and quadratic-weighted κ (lesion-level) 0.57-0.91/0.45-0.81. CONCLUSION The proposed definitions and Heel Enthesitis Scoring System (HEMRIS) are reliable among trained readers and promising for clinical trials.
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Affiliation(s)
- Ashish J Mathew
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Simon Krabbe
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Iris Eshed
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Frédérique Gandjbakhch
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Paul Bird
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Susanne J Pedersen
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Maria S Stoenoiu
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Violaine Foltz
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Daniel Glinatsi
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Robert G Lambert
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Kay Geert A Hermann
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Walter P Maksymowych
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Ida K Haugen
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Jacob L Jaremko
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - René P Poggenborg
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Joel Paschke
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Jean-Denis Laredo
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Philippe Carron
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Philip G Conaghan
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Mikkel Østergaard
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK. .,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen.
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Mathew AJ, Krabbe S, Kirubakaran R, Barr AJ, Conaghan PG, Bird P, Østergaard M. Utility of Magnetic Resonance Imaging in Diagnosis and Monitoring Enthesitis in Patients with Spondyloarthritis: An OMERACT Systematic Literature Review. J Rheumatol 2019; 46:1207-1214. [DOI: 10.3899/jrheum.181083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 12/16/2022]
Abstract
Objective.A systematic literature review was performed to document published magnetic resonance imaging (MRI) lesion definitions and scoring systems for enthesitis in spondyloarthritis (SpA).Methods.PubMed, Embase, and Cochrane Library databases were searched for original publications involving adult patients with SpA undergoing MRI of axial/peripheral joints. Selected articles were assessed for quality using a standardized assessment tool and metric indices.Results.Considering the heterogeneous design, quality, and outcome measures of studies, statistical data pooling was considered inappropriate. A qualitative narrative of results was undertaken based on study designs.Conclusion.Lack of a comprehensive, validated score warrants additional research to develop an MRI enthesitis scoring system. PROSPERO registration number: CRD42018090537.
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Symptomatic psoriatic dactylitis is associated with ultrasound determined extra-synovial inflammatory features and shorter disease duration. Clin Rheumatol 2018; 38:903-911. [PMID: 30569440 DOI: 10.1007/s10067-018-4400-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/03/2018] [Accepted: 12/09/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To explore the link between ultrasonographic features of dactylitis in psoriatic arthritis (PsA) and symptoms, digital tenderness and duration of dactylitis. METHODS Forty-eight cases of PsA dactylitis were investigated using high frequency ultrasound (US) both in grey scale (GS) and Power Doppler (PD), evaluating the presence and the degree of flexor tenosynovitis, peri-tendinous oedema, subcutaneous PD, extensor tendon involvement, GS synovitis and intra-articular PD signal (PDS) of the involved digits. Patients were compared according to the presence of local pain and digital tenderness, the duration of dactylitis and the concomitant treatment. RESULTS The presence of pain/tenderness was positively associated with US GS flexor tenosynovitis of grade > 2 (p < 0.001), PD-flexor tenosynovitis (p < 0.001), peri-tendinous oedema (p < 0.001) and subcutaneous PDS (p < 0.001); moreover, it was negatively associated with GS synovitis (p < 0.001) and intra-articular PD (p < 0.001). The same positive and negative association with US findings were found comparing patients with duration of dactylitis shorter or longer than the median (24 weeks) (p < 0.001 for all comparisons). CONCLUSIONS Pain and digital tenderness are linked to dactylitis duration and earlier lesions are associated with extra synovial inflammatory changes. These findings suggest a hitherto unappreciated extra synovial basis for symptoms in PsA dactylitis.
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Watad A, Bridgewood C, Russell T, Marzo-Ortega H, Cuthbert R, McGonagle D. The Early Phases of Ankylosing Spondylitis: Emerging Insights From Clinical and Basic Science. Front Immunol 2018; 9:2668. [PMID: 30505307 PMCID: PMC6250731 DOI: 10.3389/fimmu.2018.02668] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 10/29/2018] [Indexed: 12/12/2022] Open
Abstract
In our paper, we discuss how the early phases of ankylosing spondylitis (AS) are linked to peri-firbocartilagenous osteitis in the sacroiliac joint and entheseal bone related anchoring sites. This skeletal proclivity is linked to an abnormal immunological response to skeletal biomechanical stress and associated microdamage. A key event in the early stages of AS appears to be the association with subclinical Crohn's-like colitis with this gut inflammation being pivotal to the osteitis reaction. Whether this osteitis is consequent to non-specific intestinal innate immune activation or adaptive immune responses against specific microbiotal or self-antigens is unknown. Recurrent iritis is an HLA-B27 associated feature that may predate AS and pursues a course independent of joint involvement, and points toward the pivotal role of organ specific immunology over generalized systemic immune responses in disease expression. Human genetics and animal model studies strongly incriminate the IL23/17 axis and TNF-α in disease pathogenesis. Preliminary work shows a strong convergence of innate immune cells including type 3 innate lymphoid-cells (ILC3) and γδ T-cells in skin, gut, entheseal, and eye inflammation. Despite the HLA-B27 association, the role of adaptive immunity, especially CD8+ T-cells mediated responses remains unproven and alternative theories have been proposed. The emerging non-dependence of axial inflammation on IL-23 but dependence on IL-17A is an unexpected new twist that awaits full explanation. In this mini-review, we discuss the key events in the early stages of human AS from clinical and basic science aspects, which could be crucial for attempted disease prevention studies in at risk subjects.
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Affiliation(s)
- Abdulla Watad
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, United Kingdom
- Department of Medicine “B”, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Charlie Bridgewood
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, United Kingdom
| | - Tobias Russell
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, United Kingdom
| | - Helena Marzo-Ortega
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, United Kingdom
| | - Richard Cuthbert
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, United Kingdom
| | - Dennis McGonagle
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, United Kingdom
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Whole Body MRI: Non-oncological Musculoskeletal Applications. CURRENT RADIOLOGY REPORTS 2018. [DOI: 10.1007/s40134-018-0298-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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