RPS 2310 - From inflammation to degeneration

Author Block: M. A. Korteweg, M. Wessels, B. Bartels, M. Gerritsen, W. Van der Heijden, C. Van der Laken; Amsterdam/NL
Purpose: Axial spondyloarthritis (axSpA) affects costovertebral joints (CVJs). Radiographs visualize CVJs poorly. Advancements in low-dose (ld)CT facilitate spine imaging with 2-7 fold lower effective dose (ED) than radiography (1.4mSv). This study describes structural CVJ changes in suspected axSpA patients.
Methods or Background: Between 1/8/24-30/11/24 consecutive suspected axSpA patients were included. Final clinical diagnosis (axSpA, diffuse idiopathic skeletal hyperostosis (DISH), rheumatoid arthritis (RA), osteoarthritis (OA)), was outcome variable. Two radiologists, blinded for diagnosis, evaluated ldCTs. 24 medial (M), 20 lateral (L) CVJs were scored per patient using Kellgren-Lawrence OA-classification; 0-4 (no pathology-complete ankyloses)- as no CVJ-scoring system is known.
Joints scored 3-4 were rated as significant pathology; and reported as 1 for final analyses. These were compared per level between axSpA and other diagnosis groups using Student's t-test for independent samples, assuming equal variance, with two-tailed distribution (p-value ≤0.05 = statistically significant). Erosions were assessed visually. Interobserver agreement and ED were determined.
Results or Findings: 77 patients (48 female, mean age 45y; range 19-74y) were included with clinical diagnosis: axSpA (n=26); DISH (n=6); RA (n=5), OA (n=40). Structural changes occur at different levels in all groups. Average number of significantly affected CVJs/patient in axSpA, DISH, RA, OA: 8.5; 12; 6; 8.5. Most prevalent is; axSpA at CVJ4L (p=0.05), DISH at CVJ10L (p=0.02).
Mean ED; 1.3 mSv (± SD 0.4). 1 patient had erosions (20 CVJs); diagnosed axSpA. Interobserver agreement; kappa 0.86 (95% CI 0.73-1.00).
Conclusion: LdCT detects structural CVJ changes at low ED. AxSpA structural abnormalities overlap in amount and number with; DISH, RA, OA. RA shows the least and DISH the most changes- mainly caudally. Erosions are scarce and only in axSpA. Potential differential features in structural imaging findings at affected sites warrant further investigation.
Limitations: No major limitations.
Funding for this study: No funding
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: The METC approved this study.

Author Block: S. Sedaghat¹, J. Park², E. Fu², M. Grözinger¹, H-U. Kauczor¹, H. Jang²; ¹Heidelberg/DE, ²Davis/US
Purpose: To evaluate a novel source-separated quantitative susceptibility mapping (QSM) technique integrated with ultrashort echo time (UTE) for accurate detection and quantification of hemosiderin in hemophilic arthropathy (HA), and to compare it with conventional QSM methods.
Methods or Background: This prospective, multicenter study included 10 MRI scans at 3T of knee and ankle joints (5 HA patients and 5 healthy controls). A validation phantom containing calcium carbonate (diamagnetic) and iron oxide (paramagnetic) was used. Three susceptibility mapping approaches were compared: (1) the novel multi-step source-separated UTE-QSM, (2) a non-source-separated UTE-QSM, and (3) a conventional non-UTE QSM. Susceptibility values were quantified in the phantom, and in vivo image quality was assessed by two musculoskeletal radiologists using a 5-point Likert scale.
Results or Findings: In the phantom, conventional QSM underestimated susceptibility (up to 0.236 ppm), whereas source-separated UTE-QSM yielded distinct diamagnetic (–0.704 to –0.410 ppm) and paramagnetic (0.484 to 0.857 ppm) values, strongly correlating with true concentrations (R = –0.99 / 0.95, p < 0.05). In vivo, visual Likert-scale ratings confirmed that source-separated UTE-QSM maps provided the highest image quality and diagnostic confidence. They consistently detected hemosiderin deposits in all HA patients, delineating both subtle focal accumulations and extensive joint involvement. These findings were underestimated on conventional QSM and only partially visible on non-source-separated UTE-QSM, particularly in regions with mixed tissue composition. Lesion conspicuity and boundary sharpness were superior on source-separated maps, facilitating reliable tissue differentiation. No false-positive paramagnetic signals were observed in healthy controls, underscoring the technique's specificity.
Conclusion: Source-separated UTE-QSM enables superior quantification and visualization of hemosiderin in hemophilic arthropathy compared with conventional approaches, supporting its potential as a valuable tool for diagnosis and longitudinal monitoring in HA.
Limitations: Small cohort and specialized post-processing requirements limit immediate clinical implementation.
Funding for this study: This research received funding from the National Institutes of Health (NIH) in the US and from the Deutsche Forschungsgemeinschaft (DFG) in Germany.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: University of California San Diego

Author Block: S. Mema, R-T. Hoffmann, R. Winzer, M. Miederer, I. Platzek; Dresden/DE
Purpose: The aim of the present study is to assess the agreement between contrast-enhanced whole-body MRI and FDG-PET in the detection of joint and entheses involvement in patients with polymyalgia rheumatica.
Methods or Background: The current retrospective study included 26 (15 women and 11 men, mean age 70.4 y, SD 8.1) with polymyalgia rheumatica who received a contrast-enhanced FDG-PET-MRI in the period between 2013 and 2023.
10 anatomical structures per patient (glenohumeral, acromioclavicular and hip joints, greater trochanters and ischial tuberosities) were evaluated independently by two nuclear medicine physicians and two radiologists. A total of 155 joints and 102 tendon insertions were evaluated.
A four-point Likert scale was used to rate the signs of inflammation (0 = no signs of inflammation ....up to 3 = pronounced signs of inflammation). Differing results were resolved in consensus.
Weighted kappa (k) was used to quantify the agreement between methods (MRI and FDG-PET) as well as the interrater agreement.
Results or Findings: Scores based on FDG-PET and MRI were identical for 90 anatomical sites and differed for 167 sites. The resulting weighted kappa was k = 0.45, indicating moderate agreement according to Landis and Koch´s criteria.
Conclusion: Whole-body MRI revealed bilateral symmetric synovitis and enthesitis in the majority of patients. The agreement between MRI and FDG-PET regarding the extent of inflammation of the synovium and entheses was moderate. A substantial number of joints and entheses identified as inflamed on FDG-PET were interpreted as normal on MRI. These findings suggest that whole-body MRI may underestimate inflammatory activity in PMR compared to FDG-PET.
Limitations: Limitations include the small patient cohort and the fact that many patients had already initiated treatment at the time of FDG-PET/MRI.
Funding for this study: Internal funds
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study was approved by the ethics committee of Dresden University of Technology (file number BO-EK-307082024)

Author Block: Q. Zhang, J. Liu, L. Ruifeng, Y. Chen, X. Chen, W. Lin, X. Xia, X. Liu, M. Li; Guangzhou/CN
Purpose: To develop and validate a deep convolutional neural network (CNN) that analyzes radiographic images and incorporates clinical risk factors (age and sex) to enhance the diagnostic accuracy of axial spondyloarthritis (axSpA) in patients with chronic lower back pain.
Methods or Background: Clinical and radiographic data were retrospectively collected from patients presenting with chronic lower back pain. A total of 34178 pelvic radiographs were included and split into a training cohort (n = 31015; 1891 axSpA, 29124 non-axSpA) and a validation cohort (n = 3164; 181 axSpA, 2983 non-axSpA). A deep CNN model was trained to detect radiographic features indicative of axSpA. Additionally, a combined model integrating clinical risk factors (age and sex) with imaging data (radio-clinical model) was developed. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy (ACC), sensitivity, and specificity. Calibration curves and decision curve analysis (DCA) were also performed to assess clinical utility.
Results or Findings: The CNN model achieved an AUC of 0.906, accuracy of 0.836, sensitivity of 0.836, and specificity of 0.837 in the training cohort. In the validation cohort, it reached an AUC of 0.928, accuracy of 0.855, sensitivity of 0.839, and specificity of 0.840. The radio-clinical model demonstrated improved diagnostic performance, with an AUC of 0.993 (95% CI: 0.989–0.995) in the training cohort and 0.941 (95% CI: 0.897–0.968) in the validation cohort. Calibration curves indicated good agreement between predicted and observed outcomes, and DCA confirmed the model's added value in clinical decision-making.
Conclusion: A deep CNN can accurately distinguish between axSpA and non-axSpA cases based on radiographs. The incorporation of clinical risk factors further enhances diagnostic performance, offering a promising tool for supporting early and accurate diagnosis of axSpA.
Limitations: None
Funding for this study: None
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: None

Author Block: D. Deppe, S. T. Ulas, M. Koka, F. N. Proft, V. Rios Rodriguez, M. Protopopov, J. Rademacher, D. Poddubnyy, T. Diekhoff; Berlin/DE
Purpose: In routine practice, patients with suspected axial Spondyloarthritis (axSpA) usually undergo sacroiliac joint radiography, followed by MRI if negative. However, X-rays (XR) are limited by low sensitivity and specificity. Computed tomography (CT) is gold standard for detecting structural lesions and can now be performed with ultra-low-dose (uld) techniques at radiation exposure comparable to or lower than XR. This study evaluates the diagnostic efficacy of XR-, MRI-, and uld-CT -based pathways in suspected axSpA.
Methods or Background: 231 patients with suspected axSpA were randomized into three arms:
1. Standard (XR first, followed by MRI if negative; followed by uld-CT if negative)
2. MRI-first (followed by uld-CT if MRI was negative)
3. CT-first (followed by MRI if CT was negative).
Positive imaging was defined by the unambiguous identification of active inflammatory (according to updated ASAS definition) or structural lesions (e.g. extensive erosions), rated in consensus reading by two radiologist specialists in musculoskeletal imaging.
Results or Findings: In the standard-imaging Arm (42 patients), XR was positive in 4/42 patients (9.52%). Subsequent MRI was positive in three patients (3/38; 7.89%) and negative in the other 35 patients. All 35 patients who underwent further subsequent CT had negative results. In the MRI-first arm (97 patients), MRI was positive in 21/97 (21.65%) patients. Subsequent CT in 76 patients showed no positive results (0/76). In the CT-first arm (92 patients), initial CT was positive in 23/92 (25 %). Subsequent MRI, performed in 69 patients, was positive in two patients (2.9%).
Conclusion: The standard imaging pathway demonstrated the lowest diagnostic efficacy compared to the MRI-first and CT-first approaches, raising the question of whether the current imaging pathway should be updated.
Limitations: This is an ongoing study and clinical final diagnosis as the gold standard is missing.
Funding for this study: No funding was provided for this study.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: The study was approved by the local ethics committee (EA1/145/22).

Author Block: A. Pooyan¹, E. Alipour², M. Nyflot², M. Chalian²; ¹Philadelphia, PA/US, ²Seattle, WA/US
Purpose: Knee osteoarthritis (OA) is a prevalent disabling disease. Total knee arthroplasty (TKA) treats end-stage OA. Early identification of patients at high risk for TKA may improve understanding of disease progression. This study aimed to find the features associated with TKA and compared the performance of clinical, radiomics, and combined models for predicting TKA in OA patients.
Methods or Background: We analyzed 507 knees from the OAI-ZIB dataset with manually segmented baseline MRIs. The outcome was TKA within 9 years in the segmented knee. Radiomics features (n=400) were extracted from femoral bone, femoral cartilage, tibial bone, and tibial cartilage using PyRadiomics. Clinical variables (n=13) included demographics, comorbidities, medication use, and baseline WOMAC scores. Univariate logistic regression with Benjamini-Hochberg correction identified significant features. Three model types: logistic regression, Least Absolute Shrinkage and Selection Operator (LASSO), and Extreme Gradient Boosting (XGBoost), were trained on three feature sets: radiomics only, clinical only, and combined. Performance was assessed by AUC-ROC, AUC-PR, and F1-score with 95% confidence intervals. Feature importance for XGBoost was evaluated using SHAP values.
Results or Findings: 45 radiomics features and three clinical variables (WOMAC pain, disability, stiffness) were significantly associated with TKA in univariate analysis. The combined XGBoost model performed best, achieving an AUC-ROC of 0.95 (95% CI: 0.92-0.97), AUC-PR of 0.72 (0.58-0.82), and F1 of 0.56 (0.46-0.64) in cross-validation, and an AUC-ROC of 0.72 (0.57-0.84), AUC-PR of 0.30 (0.16-0.47), and F1 of 0.48 (0.31-0.63) on the test set. Final model included 38 of 413 features, with femoral bone sphericity, WOMAC disability, and WOMAC pain as top predictors.
Conclusion: Combining radiomics with clinical features improves TKA prediction in OA, with XGBoost showing the strongest performance.
Limitations: Study was limited by using TKA as a surrogate outcome influenced by non-disease factors.
Funding for this study: No funding was received for this study.
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information:

Author Block: F. R. M. König, M. W. Raudner, G. Wollner, V. Juras, P. Szomolanyi, V. Vetchy, J. Leitner, V. Schmidbauer, S. Trattnig; Vienna/AT
Purpose: This study aimed to assess the impact of intralesional bony overgrowth (ILBO) after cartilage repair on the
integrity of opposing articulating cartilage (OpaC) using T2 mapping and to correlate these findings with clinical outcomes in a five year follow up.
Methods or Background: In this multicenter study, MRI examinations were conducted in 45 patients up to 5 years after cartilage repair (Microfracturing [MFX] and Matrix-induced Autologous Chondrocyte Implantation [MACI]). ILBO was classified into <50% and ≥50% of the transplant thickness. T2 values of the opposing articulating cartilage (OpAC) were measured at 3, 12, and 60 months post-surgery in patients with and without ILBO at 60 months, together with clinical assessments using the International Knee Documentation Committee (IKDC) and Knee injury and Osteoarthritis Outcome Score (KOOS).
Results or Findings: At 60 months post-surgery, 44.4% of patients had ILBO, associated with significantly higher OpAC T2 values (P = 0.004). A trend toward increased T2 values at 12 months was observed but was not statistically significant (P = 0.06). No significant differences in clinical outcomes were found between patients with or without ILBO, nor between those with higher or lower OpAC T2 values. Notably, even small ILBO (<50%) significantly elevated OpAC T2 ratios.
Conclusion: Even small ILBO (<50% or ≥50% of transplant thickness) significantly alters the biophysical MRI properties of OpAC, shown as higher T2 values after 60 months. Although these changes are not yet reflected in clinical scores, they may indicate early cartilage degeneration and could guide future monitoring strategies after cartilage repair.
Limitations: ILBO was categorized as <50% or ≥50% overgrowth. While useful, finer 25% intervals could clarify ossification effects on OpAC. Additionally, a 60-month follow-up may be too short to reveal long-term clinical implications.
Funding for this study: This study has received funding from FWF Der Wissenschaftsfonds (grant no. KLI917) and the Slovak Research and Development Agency (grant no. APVV-21-0299)
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Approval was obtained from the local ethics committees and federal authorities at
each participating site prior to patient enrollment. The study was conducted from May 2013 to June 2023 to compare the outcomes after MFX and MACI. This trial was registered under EudraCT number 2011-005798-22 and ClinicalTrials.gov identifier NCT01656902.

Author Block: Z. Huang, Y. Yin, S. Mo, F. Dong; Shenzhen/CN
Purpose: This study aimed to develop and validate a predictive model for assessing disease activity in patients with rheumatoid arthritis (RA) by integrating clinicopathological data, conventional ultrasound features, and photoacoustic imaging-derived SO₂ measurements. The goal was to improve diagnostic accuracy and provide comprehensive clinical insights.
Methods or Background: A total of 182 patients diagnosed with RA were enrolled and randomly divided into a training cohort (70%) and a testing cohort (30%). Univariate and multivariate logistic regression analyses were conducted to identify independent predictors. Three models were constructed: ModA (clinical parameters only), ModB (clinical and ultrasound features), and ModC (clinical, ultrasound, and photoacoustic SO₂ measurements). The diagnostic performance of each model was assessed and compared using receiver operating characteristic curve analysis and the DeLong test.
Results or Findings: Multivariate analysis identified disease duration, age, pain score, grayscale ultrasound score, power Doppler score, and joint SO₂ levels measured by photoacoustic imaging as significant predictors of RA disease activity. In the testing cohort, ModA achieved an AUC of 0.646 , ModB improved to 0.773, and ModC achieved the highest AUC of 0.801. These findings indicate that the integrated model combining clinical, ultrasound, and photoacoustic imaging features (ModC) provides superior predictive accuracy for RA disease activity.
Conclusion: Combining photoacoustic SO₂ measurements with conventional clinical and ultrasound features significantly enhances the accuracy of disease activity prediction in patients with RA. The proposed integrated model offers a comprehensive, reliable, and reproducible tool for clinical decision support and individualized disease monitoring.
Limitations: Although the sample size was adequate for preliminary validation, it may limit the generalizability of our findings. Furthermore, while photoacoustic imaging has shown considerable promise in experimental and early clinical settings, its widespread adoption in routine clinical practice remains limited.
Funding for this study: No
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study strictly adhered to the ethical standards set forth in the Declaration of Helsinki and received approval from the Medical Ethics Committee of Shenzhen People’s Hospital (Approval No.: SYL-202161-02). Written informed consent was obtained from all participants.

Author Block: M. Aslan, T. Pınarbaşılı, I. Erdem Toslak; Antalya/TR
Purpose: The aim of the study is to evaluate hamatolunate facet morphology and association with cartilage lesions using magnetic resonance imaging(MRI) in patients with wrist pain
Methods or Background: From January to December 2024 wrist MRI of patients with Type II lunate were retrospectively evaluated.Geometric characteristics of the hamate(tapered/round) and lunate facet(concave/straight) was decided.Maximum diameter of the facet of the lunate and hamate, the angle between the ulnar and radial margins of the hamate were measured from coronal images. Ulnar variance was evaluated from X-Rays. On MRI, triangularfibrocartilage complex lesions were noted and cartilage surface of the hamatolunate facet was subjectively graded as 0;normal, 1;partial thickness, 2; full thickness cartilage defect, 3; full thickness cartilage defects with signal changes in the subchondral bone.Data was statistically analyzed.
Results or Findings: We included 137 wrists of 127 patients. The mean coronal sizes of the lunate and hamate facet were 2.99(±0,92) and 3.55(±1.2) mm respectively. The mean angle between margins of the hamate was 43.8°(±9.3). %36.5 of the patients had positive, %36.5 had negative ulnar variance. 46.7% of patients had grade o, 20.4% had grade 1 , 21.9% had grade 2, 10.9 % had grade 3 cartilage lesions. There was not any correlation between the measurements or geometrical analysis of hamate,TFCC lesions or ulnar variance with the cartilage lesions.
Logistic regression analysis revealed a trend towards presence of cartilage lesions as the lunate transverse diameter decreases (p=0.083).There was a statistically significant correlation between age and grade 3 lesions (p=0.047)
Conclusion: In patients with type II lunate, age is an important contributor factor for grade 3 cartilage lesions, Patients with shorter lunate facet are more likely to have cartilage lesions.
Limitations: Small sample size and retrospective nature of the study are the limitations.
Funding for this study: No funding was received.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Antalya Training and Research Hospital Ethics Commitee 2025-80

Author Block: S. Lavalle¹, A. MONTANA², F. Aiello¹, G. Privitera², R. Foti², R. Foti², P. Romeo²; ¹Enna/IT, ²Catania/IT
Purpose: Whole-body MRI (wbMRI) is an advanced scan modality which provides high-contrast resolution images of the entire body and it's a valuable tool for diagnosing and monitoring systemic arthritides by virtue of its comprehensive coverage . We aim to investigate how quantification of DIXON fat fraction (FF) mapping and water fraction (WF) mapping on diagnostic accuracy and how it change in relaction to sex and age.
Methods or Background: In this prospective imaging study, we enrolled 67 patients with confirmed or suspected rheumatologic disease, with possible axial involvement, who underwent whole-body MRI. We assessed both sacroiliac joints at four sites. Differences in fat fraction and water fraction were observed and correlated. To obtain robust and accurate confidence intervals, we performed all analyses with the nonparametric Mann-Whitney and Kruscal-Wallis tests.
Results or Findings: There is a significant correlation between age and FF values, in particular as age increases, FF values ​​increase and older subjects present lower WF values. Sex does not determine significant differences in the mappings. Furthermore, patients with psoriatic arthritis have higher FF values ​​than other rheumatological patients (p value 0.008).
Conclusion: These preliminary data suggest that age and the presence of psoriatic arthritis are correlated with elevated FF values. Larger studies may help identify the optimal cutoff for predicting disease activity and progression.
Limitations: Small simple size, inter-reader agreement
Funding for this study: No funding
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information:

Author Block: A. Shah, M. H. Mir, N. A. Choh; Srinagar/IN
Purpose: The primary objective was to estimate the prevalence of ultrasound-detected synovitis in patients receiving ICIs(Immune checkpoint inhibitors ). Secondary objectives were to evaluate correlations between ultrasound findings and musculoskeletal symptoms, to assess associations with laboratory biomarkers, and to describe the joint distribution.
Methods or Background: In this prospective cohort, 120 patients starting ICI therapy were screened and 110 enrolled. All underwent clinical evaluation, laboratory testing(ESR, CRP, RF, anti-CCP, ANA), and standardized US of wrists, MCP(metacarpals), and knees three months after ICI initiation. Synovitis was defined as gray-scale (GS) ≥1 and/or power Doppler (PD) ≥1 using OMERACT scoring. Prevalence was estimated with 95% CIs(Confidence Intervals), and predictors were assessed using logistic regression.
Results or Findings: US-detected synovitis was present in 62/110 patients (56.4%, 95% CI 47.0–65.3%). PD activity was seen in 19%, and effusion in 71%. Wrists were most often affected (52%), followed by MCP joints (38%) and knees (24%). Prevalence did not differ by cancer type or ICI regimen. Synovitis was far more frequent in symptomatic patients (84%) than in asymptomatic patients (28%). Inflammatory markers and autoantibodies showed no significant association. On multivariable analysis, musculoskeletal symptoms were the only independent predictor (OR 3.1, 95% CI 1.4–7.8).
Conclusion: This study revealed a high prevalence of US detected synovitis in ICI-treated patients, including many without joint symptoms. Conventional biomarkers were unhelpful, highlighting US as a valuable tool for early detection and monitoring of musculoskeletal irAEs.
Limitations: This was a single-centre study with a modest sample size, restricting subgroup analyses by cancer type and ICI regimen. Patients were evaluated only at a three-month time point, so the prognostic significance of subclinical synovitis remains uncertain. Longitudinal follow-up is needed to establish whether subclinical synovitis predicts clinical progression or necessitates treatment modification.
Funding for this study: No funding was provided for this study
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: The ethics committee notification can be found under the number IEC/SKIMS Protocol # 91/2025

Author Block: R. B. Venkatasubramanian¹, R. Sivakumar¹, G. MURUGAN¹, L. Murali², V. Sai¹, R. Ramachandran¹, B. Dev¹, R. Rangasami¹, G. Ilangovan²; ¹Chennai/IN, ²Tirupattur/IN
Purpose: To compare&evaluate T2 Relaxometry, ADC /DWI and Diffusion Tensor Imaging in assessment of early-onset articular cartilage damage of knee in young adults.
Methods or Background: Certain routine sequences in MRI knee protocol like T2,GRE can help in assessing cartilage damage once macrostructural damage had already occured. However special sequences like T2 Relaxometry, ADC and DTI/FA are increasingly used in cases with high suspiscion of microstructural /impending cartilage damage, especially in athletes and trauma victims.
T2 relaxometry is sensitive to collagen integrity and water content.
ADC/diffusion weighted sequence can identify early stages of inflammation.
Diffusion Tensor Imaging sensitively depicts proteoglycan content and collagen structure in cartilage.
40 adults(18-30 years age) who presented for knee MRI for indications other than trauma/pain and without gross signal changes in T2/PDFS were chosen.
Additional primary sequences of T2 Relaxometry, ADC/DWI and DTI centered for cartilage and derivative sequences like T2*, R2*, AvDC and Fractional anisometry were obtained.
Qualitative&quantitative assessment of cartilage was done with these sequences to establish the more sensitive/specific sequence which can help to detect cartilage damage earlier than conventional sequences.
Results or Findings: T2 relaxometry showed qualitative signal changes in articular cartilage earlier than ADC&DTI, predominantly in tibiofemoral joint surface.
Healthy controls had mean T2 values 29.1 +/- 3.2 msec, while early-onset cartilage damage had 35.2+/- 3.3 [p<0.05] in affected areas.
ADC values in healthy controls were 1.81 +/- 0.44 x 10−3mm2/s compared to 1.21 +/- 0.89 x 10-3mm2/s.[p<0.05].FA values showed minimal difference even in cartilage damage identified in other 2 sequences.
Conclusion: T2 relaxometry is a sensitive sequence for cartilage microstructural damage.
T2 relaxometry and ADC mapping can be done routine in athletes and young adults for early detection of cartilage damage.
Limitations: Limited sample size can be increased.
Funding for this study: Self funded
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: PhD Radiology dissertation study

Author Block: V. Burulday, A. Gündüz Uslu, S. Yolbaş; Malatya/TR
Purpose: To compare Achilles tendon elasticity, measured by shear wave elastography (SWE), between asymptomatic psoriatic arthritis (PsA) patients and healthy controls. PsA frequently involves entheseal structures, but subclinical changes often escape clinical detection. SWE provides a non-invasive, quantitative method to assess tendon stiffness and may reveal early abnormalities.
Methods or Background: This prospective case–control study was conducted at Inonu University (Oct 2024–Feb 2025). Thirty-four PsA patients (≥2 years disease duration, 18–65 years, no Achilles symptoms) and 34 age- and sex-matched healthy volunteers were enrolled. Exclusion criteria included diabetes, rheumatoid arthritis, ankylosing spondylitis, tendinopathy, systemic steroids or biologics, recent ankle trauma or surgery. Ultrasound and SWE were performed with a Mindray Resona I9, L14-3Ws probe. Participants lay prone with feet relaxed. Achilles thickness was measured 3 cm proximal to the calcaneal insertion. SWE was performed longitudinally with a 3 mm ROI; six measurements per tendon were averaged. Values were recorded in m/s and kPa. Only high-quality images (M-STB = 5) were analyzed.
Results or Findings: Demographics did not differ between groups. Tendon thickness was similar bilaterally (p>0.5). SWE values were significantly higher in PsA patients. Left tendon: 4.89 ± 2.52 m/s vs 3.23 ± 0.41 m/s (p<0.001). Right tendon: 4.88 ± 1.94 m/s vs 3.12 ± 0.30 m/s (p<0.001). kPa values showed the same pattern, indicating subclinical stiffening in PsA.
Conclusion: SWE demonstrated increased Achilles tendon stiffness in asymptomatic PsA patients despite normal thickness. Elastography may serve as a sensitive imaging biomarker for early detection and monitoring of enthesopathy. Larger, multicentre studies are needed.
Limitations: Single-centre design, modest sample, no EMG or histopathology, and no treatment-based analysis.
Funding for this study: Supported by Inonu University Scientific Research Projects Coordination Unit (BAP). No external funding.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Approved by Inonu University Clinical Research Ethics Committee (protocol 2024/119). Written informed consent was obtained from all participants.