Best Practice & Research in Clinical Rheumatology最新文献

{"title":"Imaging rheumatology: Emerging tools and expanding applications","authors":"Pamela Diaz P.D., MD, MSc , Gurjit S. Kaeley G.S.K., MBBS, MRCP, RhMSUS","doi":"10.1016/j.berh.2025.102088","DOIUrl":"10.1016/j.berh.2025.102088","url":null,"abstract":"","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102088"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New developments in ultrasound and MRI imaging of pediatric rheumatic diseases","authors":"Johannes Roth ,&nbsp;Clara Malattia","doi":"10.1016/j.berh.2025.102069","DOIUrl":"10.1016/j.berh.2025.102069","url":null,"abstract":"<div><div><span><span>The evidence base for ultrasound and MRI imaging in </span>pediatric<span><span> rheumatic diseases continues to grow, enabling the routine clinical use of the two techniques that complement each other. </span>Ultrasound imaging<span><span> has a superior spatial resolution, the ability to assess several joints at the same time without sedation and provides very detailed assessments of important structures like the entheses. MRI has advantages in the assessment of osteochondral damage and certain anatomic regions like the </span>temporomandibular joint (TMJ) and the </span></span></span>axial skeleton<span><span>. Significant progress in the standardization of image acquisition and quantification of findings allows the utilisation of both techniques as an outcome measure. This will improve the standard of care in pediatric rheumatic diseases where objective measurements of </span>disease activity are urgently needed. Finally, the integration of artificial intelligence (AI) represents a groundbreaking development in the field and potential applications will be discussed.</span></div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102069"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in imaging techniques for Sjogren's disease","authors":"Baptiste Quéré ,&nbsp;Sandrine Jousse-Joulin","doi":"10.1016/j.berh.2025.102087","DOIUrl":"10.1016/j.berh.2025.102087","url":null,"abstract":"<div><div>Imaging of salivary glands (SG), particularly Salivary Glands Ultrasonography (SGUS) is increasingly used in patients with suspected Sjogren's disease (SD). SGUS is the first-line imaging modality. Numerous studies have highlighted this non-invasive, non-irradiating, and low-cost imaging modality. The OMERACT group has established a classification of SG structural damage based on B-mode findings, ranging from grade 0 (normal) to 3 (severe structural damage). SGUS abnormalities (≥ grade 2) have been reported in approximately 63 % of patients with SD. More recently, Hocevar et al. described a Doppler-based classification assessing SG parenchymal vascularization, graded from 0 (normal) to 3 (Doppler signals occupying the entire glandular surface) and could be used as a marker of disease activity and as a biomarker of response to therapy. Moreover, SGUS can be useful for looking for complications such as lymphoma. New ultrasound techniques are currently being developed, including elastography for assessing tissue stiffness, analysis of microvascularization using contrast-enhanced ultrasound with microbubbles, and analysis of minor salivary glands using the ultra-high frequency probe. The combination of several US modalities enhances both sensitivity and specificity of the technique, allowing for the development of a comprehensive multimodal imaging approach. Other imaging techniques can be performed for SD, such as MRI of the parotid glands, allowing analysis of the glandular parenchyma (“salt and pepper” appearance), and certain sequences (DWI-MR) should be performed when lymphoma or other tumors are suspected. 18-FDG PET-CT may be useful to detect systemic manifestations or complications in SD and new PET tracers are currently being developed.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102087"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interstitial lung disease imaging for autoimmune diseases","authors":"John P. Lichtenberger ,&nbsp;Sean Hagaman ,&nbsp;Wesley Jong ,&nbsp;Sydney Yee ,&nbsp;Darwish Alabyad ,&nbsp;Nadeem Kandalaft","doi":"10.1016/j.berh.2025.102065","DOIUrl":"10.1016/j.berh.2025.102065","url":null,"abstract":"<div><div><span><span>Imaging plays a central role in the diagnosis and surveillance of patients with rheumatic diseases complicated by </span>lung disease. This lung disease ranges from </span>acute lung injury<span><span> to chronic, diffuse lung disease attributed to their underlying autoimmune condition. Whether screening for lung disease or evaluating respiratory symptoms in patients with rheumatic diseases, chest radiography and </span>computed tomography<span> remain the most common and important diagnostic imaging tests. MRI remains an evolving modality for the evaluation of lung disease, but it is an important test in evaluating vascular disease or involvement of the heart and chest wall. This work aims to illustrate the role of diagnostic imaging in interstitial lung disease and other thoracic manifestations of autoimmune disease.</span></span></div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102065"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update of imaging in the assessment of axial spondyloarthritis","authors":"Natalya Horbal ,&nbsp;Krystel Aouad ,&nbsp;Xenofon Baraliakos ,&nbsp;Nelly Ziade ,&nbsp;Walter P. Maksymowych","doi":"10.1016/j.berh.2025.102064","DOIUrl":"10.1016/j.berh.2025.102064","url":null,"abstract":"<div><div>This update addresses new developments in imaging of axial spondyloarthritis from the past 5 years. These have focused mostly on enhanced CT and MRI-based technologies that bring greater precision to the assessment of both inflammatory and structural lesions in the sacroiliac joint. An international consensus has recommended a 4-sequence MRI for routine diagnostic evaluation of the sacroiliac joint aimed at depicting the location and extent of inflammation as well as an erosion-sensitive sequence for structural damage. The latter include high resolution thin slice sequences that accentuate the interface between subchondral bone and the overlying cartilage and joint space as well as synthetic CT, a deep learning-based technique that transforms certain MRI sequences into images resembling CT. Algorithms based on deep learning derived from plain radiographic, CT, and MRI datasets are increasingly more accurate at identifying sacroiliitis and individual lesions observed on images of the sacroiliac joints and spine.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102064"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical utilization of sonography for the assessment of muscle diseases in rheumatology","authors":"Takeshi Yoshida,&nbsp;Jemima Albayda","doi":"10.1016/j.berh.2025.102055","DOIUrl":"10.1016/j.berh.2025.102055","url":null,"abstract":"<div><div><span><span>Muscular manifestations are common complaints encountered in daily rheumatology practice. </span>Magnetic resonance imaging<span> and electromyography<span> are employed to evaluate muscular manifestations associated with myositis<span> and other rheumatologic diseases, but both have limitations that hinder their universal applicability. Ultrasound, on the other hand, has been increasingly used given its utility as a point-of-care tool. There is increasing data that show it is a safe and sensitive tool for screening for myositis<span>. Changes in ultrasound images differ between acute and chronic myositis, and echo intensity has been shown to correlate with muscle strength as well as the number of </span></span></span></span></span>inflammatory cell<span><span><span> infiltrates observed in histopathological analysis. Additionally, it can evaluate non-inflammatory muscular conditions, such as muscular dystrophy, </span>sarcopenia, and certain </span>neurologic disorders<span> that mimic myositis. Despite its potential, its use in clinical practice remains limited due to a lack of physician experience and challenges associated with standardizing and optimizing muscle assessment. This review provides updated knowledge on muscle ultrasound as a practical imaging modality for the evaluation of myositis and other rheumatologic diseases. It discusses settings, techniques, and different assessment methods that will aid in its deployment in clinical practice.</span></span></div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102055"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of ultrasound and magnetic resonance imaging in the assessment of musculoskeletal involvement in systemic lupus erythematosus: A review of recent advances and insights","authors":"Andrea Di Matteo ,&nbsp;Patricia Corzo ,&nbsp;Emilio Filippucci","doi":"10.1016/j.berh.2025.102042","DOIUrl":"10.1016/j.berh.2025.102042","url":null,"abstract":"<div><div><span><span>Systemic lupus erythematosus<span> (SLE) is an autoimmune disease characterized by diverse manifestations, with musculoskeletal (MSK) involvement being one of the most prevalent and debilitating. Traditional perceptions of SLE arthritis as mild and primarily non-erosive are increasingly challenged by advanced imaging techniques, such as ultrasound and magnetic resonance imaging (MRI). These modalities have revealed subclinical inflammatory changes, structural damage, and peri-articular </span></span>soft tissue involvement in both symptomatic and asymptomatic patients. Ultrasound is highly sensitive in detecting </span>synovitis<span><span>, tenosynovitis<span>, and entheseal abnormalities, also in patients without clinical arthritis, offering insights into subclinical disease activity that would otherwise remain undiagnosed. MRI, while less commonly used due to cost and accessibility, remains the gold standard for detecting </span></span>bone marrow oedema, subtle erosions, and inflammatory changes.</span></div><div><span>Recent studies demonstrate that subclinical synovitis<span> and tenosynovitis, identified through imaging, may precede clinical symptoms in some patients, emphasizing the potential prognostic value of these findings. Bone erosions, once thought rare in SLE, are now observed across various </span></span>arthropathy subtypes, challenging traditional classifications. Imaging has also revealed the presence of entheseal and muscle involvement, expanding the understanding of SLE-related MSK pathology.</div><div>This review highlights the transformative role of ultrasound and MRI in diagnosing, monitoring, and managing MSK involvement in SLE. Incorporating imaging findings into routine practice and updated classification criteria may enable early intervention and personalized treatment. While significant advancements have been made in imaging technologies for detecting musculoskeletal involvement in SLE, challenges remain in standardizing protocols and correlating findings with disease activity and outcomes. Further research is needed to address these challenges and further explore the prognostic significance of imaging findings.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102042"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging for inflammatory neuropathies","authors":"Federico Zaottini ,&nbsp;Federico Pistoia ,&nbsp;Riccardo Picasso ,&nbsp;Marta Macciò ,&nbsp;Giovanni Marcenaro ,&nbsp;Marina Grandis ,&nbsp;Luana Benedetti ,&nbsp;Carlo Martinoli","doi":"10.1016/j.berh.2025.102066","DOIUrl":"10.1016/j.berh.2025.102066","url":null,"abstract":"<div><div>Inflammatory neuropathies comprise a heterogeneous group of conditions united by inflammation-mediated damage to peripheral nerves and their vasa nervorum. Although classification, diagnosis and management are largely based on clinical features, electrodiagnostic and laboratory examinations, imaging studies play an important supporting role. Ultrasound and MRI are the two modalities used for imaging peripheral nerves. The two techniques differ in the clinical context of application, the information provided and the diagnostic performance. This narrative review aims to provide guidance on when and how to use ultrasound or MRI in patients with inflammatory neuropathies, highlighting their respective strengths and pitfalls, and how to combine these imaging modalities to enhance their usefulness in the diagnostic-therapeutic management of these far from rare conditions.</div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102066"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility of ultrasound and MRI in rheumatoid arthritis: An expert review","authors":"David A. Kellner ,&nbsp;Nicolette T. Morris ,&nbsp;Stephanie M. Lee ,&nbsp;Joshua F. Baker ,&nbsp;Philip Chu ,&nbsp;Veena K. Ranganath ,&nbsp;Gurjit S. Kaeley ,&nbsp;Howard H. Yang","doi":"10.1016/j.berh.2025.102072","DOIUrl":"10.1016/j.berh.2025.102072","url":null,"abstract":"<div><div><span>Musculoskeletal ultrasound (MSUS) and magnetic resonance imaging (MRI) are advanced imaging techniques that are increasingly important in the diagnosis and management of </span>rheumatoid arthritis<span> (RA) and have significantly enhanced the rheumatologist's ability to assess RA disease activity<span> and progression. This review serves as a five-year update to our previous publication on the contemporary role of imaging in RA, emphasizing the continued importance of MSUS and MRI in clinical practice and their expanding utility. The review examines the role of MSUS in diagnosing RA, differentiating RA from mimickers, scoring systems and quality control measures, novel longitudinal approaches to disease monitoring, and patient populations that may benefit most from MSUS. It also examines the role of MRI in diagnosing pre-clinical and early RA, disease activity monitoring, research and clinical trials, and development of alternative scoring approaches utilizing artificial intelligence. Finally, the role of MRI in RA diagnosis and management is summarized, and selected practice points offer key tips for integrating MSUS and MRI into clinical practice.</span></span></div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102072"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating handheld ultrasound in rheumatology: A review of benefits and drawbacks","authors":"Ricardo Sabido-Sauri ,&nbsp;Lihi Eder ,&nbsp;Paul Emery ,&nbsp;Sibel Zehra Aydin","doi":"10.1016/j.berh.2025.102085","DOIUrl":"10.1016/j.berh.2025.102085","url":null,"abstract":"<div><div>Musculoskeletal ultrasound is a key tool in rheumatology<span> for diagnosing and managing inflammatory arthritis. Traditional ultrasound systems, while effective, can be cumbersome and costly, limiting their use in many clinical settings. Handheld ultrasound (HHUS) devices, which are portable, affordable, and user-friendly, have emerged as a promising alternative. This review explores the role of HHUS in rheumatology, specifically evaluating its impact on diagnostic accuracy, ease of use, and utility in screening for inflammatory arthritis. The review also addresses key challenges, such as image quality, storage and data security, and the potential for integrating artificial intelligence to improve device performance. We compare HHUS devices to cart-based ultrasound machines, discuss their advantages and limitations, and examine the potential for widespread adoption. Our findings suggest that HHUS devices can effectively support musculoskeletal assessments and offer significant benefits in resource-limited settings. However, proper training, standardized protocols, and continued technological advancements are essential for optimizing their use in clinical practice.</span></div></div>","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":"39 3","pages":"Article 102085"},"PeriodicalIF":4.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}