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Interstitial lung disease imaging for autoimmune diseases 自身免疫性疾病的间质性肺疾病影像学研究
IF 4.8 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-09-01 DOI: 10.1016/j.berh.2025.102065
John P. Lichtenberger , Sean Hagaman , Wesley Jong , Sydney Yee , Darwish Alabyad , Nadeem Kandalaft
Imaging plays a central role in the diagnosis and surveillance of patients with rheumatic diseases complicated by lung disease. This lung disease ranges from acute lung injury 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 computed tomography 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.
影像学在风湿病合并肺部疾病患者的诊断和监测中起着核心作用。这种肺部疾病的范围从急性肺损伤到慢性弥漫性肺部疾病,归因于他们潜在的自身免疫性疾病。无论是筛查肺部疾病还是评估风湿病患者的呼吸道症状,胸部x线摄影和计算机断层扫描仍然是最常见和最重要的诊断性影像学检查。MRI仍然是评估肺部疾病的一种不断发展的方式,但它是评估血管疾病或心脏和胸壁受累的重要测试。这项工作旨在说明诊断成像在间质性肺疾病和其他自身免疫性疾病的胸部表现中的作用。
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引用次数: 0
Update of imaging in the assessment of axial spondyloarthritis 轴型脊柱性关节炎影像学评估的最新进展。
IF 4.8 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-09-01 DOI: 10.1016/j.berh.2025.102064
Natalya Horbal , Krystel Aouad , Xenofon Baraliakos , Nelly Ziade , Walter P. Maksymowych
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.
本更新介绍了过去5年来轴性脊柱炎影像学的新进展。这些主要集中在增强的CT和mri技术上,这些技术可以更精确地评估骶髂关节的炎症和结构性病变。国际共识推荐4序列MRI用于骶髂关节的常规诊断评估,旨在描述炎症的位置和程度,以及结构损伤的侵蚀敏感序列。后者包括高分辨率薄层序列,强调软骨下骨与上覆盖软骨和关节间隙之间的界面,以及合成CT,这是一种基于深度学习的技术,可将某些MRI序列转换为类似CT的图像。基于x线平片、CT和MRI数据集的深度学习算法在识别骶髂炎和骶髂关节和脊柱图像上观察到的单个病变方面越来越准确。
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引用次数: 0
Practical utilization of sonography for the assessment of muscle diseases in rheumatology 超声在风湿病中评估肌肉疾病的实际应用。
IF 4.8 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-09-01 DOI: 10.1016/j.berh.2025.102055
Takeshi Yoshida, Jemima Albayda
Muscular manifestations are common complaints encountered in daily rheumatology practice. Magnetic resonance imaging and electromyography are employed to evaluate muscular manifestations associated with myositis 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. 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 inflammatory cell infiltrates observed in histopathological analysis. Additionally, it can evaluate non-inflammatory muscular conditions, such as muscular dystrophy, sarcopenia, and certain neurologic disorders 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.
肌肉表现是风湿病学日常诊疗中常见的主诉。磁共振成像和肌电图可用于评估与肌炎和其他风湿病相关的肌肉表现,但两者都有局限性,妨碍了其普遍适用性。另一方面,超声波作为一种护理点工具,已被越来越多地使用。越来越多的数据表明,它是一种安全、灵敏的肌炎筛查工具。超声图像的变化在急性和慢性肌炎之间有所不同,回声强度已被证明与肌力以及组织病理学分析中观察到的炎性细胞浸润数量相关。此外,它还能评估非炎症性肌肉状况,如肌肉萎缩症、肌肉疏松症和某些类似肌炎的神经系统疾病。尽管肌肉超声具有很大的潜力,但由于医生缺乏经验,以及肌肉评估标准化和优化方面的挑战,其在临床实践中的应用仍然有限。本综述提供了有关肌肉超声的最新知识,它是评估肌炎和其他风湿性疾病的一种实用成像模式。它讨论了有助于将其应用于临床实践的设置、技术和不同的评估方法。
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引用次数: 0
Clinical utility of ultrasound and MRI in rheumatoid arthritis: An expert review 超声和MRI在类风湿关节炎中的临床应用:专家综述。
IF 4.8 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-09-01 DOI: 10.1016/j.berh.2025.102072
David A. Kellner , Nicolette T. Morris , Stephanie M. Lee , Joshua F. Baker , Philip Chu , Veena K. Ranganath , Gurjit S. Kaeley , Howard H. Yang
Musculoskeletal ultrasound (MSUS) and magnetic resonance imaging (MRI) are advanced imaging techniques that are increasingly important in the diagnosis and management of rheumatoid arthritis (RA) and have significantly enhanced the rheumatologist's ability to assess RA disease activity 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.
肌肉骨骼超声(MSUS)和磁共振成像(MRI)是先进的成像技术,在类风湿性关节炎(RA)的诊断和治疗中越来越重要,并显著提高了风湿病学家评估RA疾病活动和进展的能力。这篇综述是对我们之前发表的关于当代影像学在RA中的作用的5年更新,强调了MSUS和MRI在临床实践中的持续重要性及其不断扩大的应用。这篇综述探讨了MSUS在诊断RA、区分RA与模仿者、评分系统和质量控制措施、疾病监测的新型纵向方法以及可能从MSUS中获益最多的患者群体中的作用。它还探讨了MRI在诊断临床前和早期RA、疾病活动监测、研究和临床试验以及利用人工智能开发替代评分方法中的作用。最后,总结了MRI在RA诊断和治疗中的作用,并提出了将MSUS与MRI结合到临床实践中的关键提示。
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引用次数: 0
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 超声和磁共振成像在评估系统性红斑狼疮肌肉骨骼受累中的作用:最近进展和见解的回顾。
IF 4.8 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-09-01 DOI: 10.1016/j.berh.2025.102042
Andrea Di Matteo , Patricia Corzo , Emilio Filippucci
Systemic lupus erythematosus (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 soft tissue involvement in both symptomatic and asymptomatic patients. Ultrasound is highly sensitive in detecting synovitis, tenosynovitis, 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 bone marrow oedema, subtle erosions, and inflammatory changes.
Recent studies demonstrate that subclinical synovitis 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 arthropathy subtypes, challenging traditional classifications. Imaging has also revealed the presence of entheseal and muscle involvement, expanding the understanding of SLE-related MSK pathology.
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.
系统性红斑狼疮(SLE)是一种以多种表现为特征的自身免疫性疾病,肌肉骨骼(MSK)受累是最普遍和使人衰弱的疾病之一。超声和磁共振成像(MRI)等先进成像技术越来越多地挑战了SLE关节炎是轻度和主要非糜烂性的传统观念。这些模式在有症状和无症状的患者中都显示了亚临床炎症改变、结构损伤和关节周围软组织受累。超声在检测滑膜炎、腱鞘炎和腱鞘异常方面非常敏感,在没有临床关节炎的患者中也是如此,这为亚临床疾病活动提供了见解,否则这些疾病将无法诊断。MRI虽然由于成本和可及性不太常用,但仍然是检测骨髓水肿、细微侵蚀和炎症变化的金标准。最近的研究表明,通过影像学识别的亚临床滑膜炎和腱鞘炎可能先于一些患者的临床症状,强调了这些发现的潜在预后价值。骨侵蚀,曾经被认为是罕见的SLE,现在观察到各种关节病亚型,挑战传统的分类。影像学也显示了骨骺和肌肉受累的存在,扩大了对sle相关MSK病理的理解。这篇综述强调了超声和MRI在SLE中MSK累及的诊断、监测和管理中的变革性作用。将影像学结果纳入常规实践和更新的分类标准可能有助于早期干预和个性化治疗。虽然用于检测SLE中肌肉骨骼受累的成像技术取得了重大进展,但在标准化方案以及将发现与疾病活动和结果相关联方面仍然存在挑战。需要进一步的研究来解决这些挑战,并进一步探讨影像学结果的预后意义。
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引用次数: 0
Integrating handheld ultrasound in rheumatology: A review of benefits and drawbacks 集成手持式超声在风湿病学:优点和缺点的回顾。
IF 4.8 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-09-01 DOI: 10.1016/j.berh.2025.102085
Ricardo Sabido-Sauri , Lihi Eder , Paul Emery , Sibel Zehra Aydin
Musculoskeletal ultrasound is a key tool in rheumatology 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.
肌肉骨骼超声是风湿病学诊断和治疗炎性关节炎的关键工具。传统的超声系统虽然有效,但可能笨重且昂贵,限制了它们在许多临床环境中的使用。手持式超声(hus)设备便携、价格合理、用户友好,已成为一种有前途的替代方案。这篇综述探讨了HHUS在风湿病学中的作用,特别是评估了它对诊断准确性、易用性和筛查炎性关节炎的效用的影响。该评估还解决了关键挑战,如图像质量、存储和数据安全,以及集成人工智能以提高设备性能的潜力。我们比较了HHUS设备与基于小车的超声设备,讨论了它们的优点和局限性,并研究了广泛采用的潜力。我们的研究结果表明,HHUS设备可以有效地支持肌肉骨骼评估,并在资源有限的环境中提供显着的好处。然而,适当的培训、标准化的协议和持续的技术进步对于优化其在临床实践中的应用至关重要。
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引用次数: 0
Imaging for inflammatory neuropathies 炎性神经病变的影像学检查。
IF 4.8 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-09-01 DOI: 10.1016/j.berh.2025.102066
Federico Zaottini , Federico Pistoia , Riccardo Picasso , Marta Macciò , Giovanni Marcenaro , Marina Grandis , Luana Benedetti , Carlo Martinoli
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.
炎症性神经病包括由炎症介导的周围神经及其血管神经损伤联合起来的异质组。虽然分类、诊断和管理主要基于临床特征、电诊断和实验室检查,但影像学检查起着重要的辅助作用。超声和核磁共振成像是周围神经成像的两种方式。这两种技术在临床应用、提供的信息和诊断性能方面有所不同。本综述旨在为炎性神经病变患者何时以及如何使用超声或MRI提供指导,突出其各自的优势和缺陷,以及如何结合这些成像方式以增强其在这些罕见疾病的诊断和治疗管理中的有用性。
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引用次数: 0
Imaging in the diagnosis and management of peripheral psoriatic arthritis: Update and recent advances 周围性银屑病关节炎的影像学诊断和治疗:最新进展。
IF 4.8 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-09-01 DOI: 10.1016/j.berh.2025.102061
Ashish J. Mathew , Alan L. Zhou , Mikkel Østergaard , Sahil Koppikar
Psoriatic arthritis is an immune-mediated inflammatory disease characterized by inflammatory and structural changes in multiple clinical domains, including peripheral and axial arthritis, enthesitis, and dactylitis. Early diagnosis and initiation of targeted therapies in patients with PsA lead to a better quality of life. Conventional radiography continues to be the most frequently used imaging modality in routine care, given its easy accessibility and low cost. Advanced imaging techniques, such as ultrasound and magnetic resonance imaging, with their ability to assess both inflammatory and structural pathologies simultaneously, have facilitated a better understanding of disease pathogenesis, early diagnosis leading to early initiation of therapy, sensitive outcome measurement in clinical trials, and close monitoring of the disease process, enabling practical switching of therapies. Novel imaging techniques still seeking broad applicability have demonstrated encouraging results but require further testing before clinical use. This review focuses on the progress in imaging techniques for peripheral psoriatic disease.
银屑病关节炎是一种免疫介导的炎症性疾病,其特征是在多个临床领域发生炎症和结构变化,包括外周和轴性关节炎、鼻炎和指突炎。PsA患者的早期诊断和开始靶向治疗可提高生活质量。传统放射照相仍然是常规护理中最常用的成像方式,因为它容易获得和低成本。先进的成像技术,如超声和磁共振成像,能够同时评估炎症和结构病理,促进了对疾病发病机制的更好理解,早期诊断导致早期开始治疗,临床试验中敏感的结果测量,以及对疾病过程的密切监测,使治疗的实际转换成为可能。新的成像技术仍在寻求广泛的适用性,已经显示出令人鼓舞的结果,但在临床应用前需要进一步的测试。本文就周围性银屑病的影像学研究进展作一综述。
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引用次数: 0
Corrigendum to “Arthritis related to parasitic infections” [Best Practice Res Clinic Rheumatol 39 (2025) 102062] “与寄生虫感染有关的关节炎”的勘误表[最佳实践Res诊所风湿病39(2025)102062]。
IF 4.8 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-09-01 DOI: 10.1016/j.berh.2025.102086
Shaheed Ahmed , Jasmin Raja
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引用次数: 0
Update in imaging for large vessel vasculitis 大血管炎的最新成像技术。
IF 4.8 2区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-09-01 DOI: 10.1016/j.berh.2025.102060
Berit D. Nielsen , Luca Seitz , Wolfgang A. Schmidt
Diagnostic imaging is recommended to confirm suspected giant cell arteritis (GCA) or Takayasu arteritis (TAK), and may, in the follow-up of these patients, be used to assess vascular damage. Ultrasound, magnetic resonance imaging (MRI) and 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) can all visualise inflammation in vascular regions affected. Ultrasound and MRI are recommended first line diagnostic test in GCA and TAK, respectively, but local expertise, availability and potential differential diagnoses are important prerequisites for the choice of imaging modality. Ultrasound, MR- and CT-angiography may also be used to assess morphologic changes. Further research is necessary on the role of imaging for monitoring disease activity and guide treatment decisions. Advantages and limitations apply to all modalities separately. This review will discuss the pros and cons, the application and pitfalls of each of these imaging modalities in the diagnosis and management of GCA and TAK.
诊断性影像学推荐用于确认疑似巨细胞动脉炎(GCA)或高须动脉炎(TAK),并可在这些患者的随访中用于评估血管损伤。超声、磁共振成像(MRI)和18f -氟脱氧葡萄糖(18F-FDG)正电子发射断层扫描(PET)/计算机断层扫描(CT)都可以显示受影响血管区域的炎症。超声和MRI分别被推荐为GCA和TAK的一线诊断检查,但当地专业知识、可用性和潜在的鉴别诊断是选择成像方式的重要先决条件。超声,磁共振和ct血管造影也可用于评估形态变化。有必要进一步研究影像学在监测疾病活动和指导治疗决策方面的作用。优点和局限性分别适用于所有模式。本文将讨论这些成像方式在GCA和TAK的诊断和治疗中的优缺点、应用和缺陷。
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引用次数: 0
期刊
Best Practice & Research in Clinical Rheumatology
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