Publications by authors named "Kay Hermann"

Background: There is considerable practice variation in labelling, diagnosis and treatment of adults with sterile bone inflammation. We developed a expert consensus recommendations on the disease definition, diagnosis and treatment of this rare condition.

Methods: Systematic literature review and Grading of Recommendations, Assessment, Development and Evaluations-based appraisal of evidence, two Delphi surveys and three digital and in-person consensus meetings with a multidisciplinary expert panel and patient representatives.

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Objectives: This study aims to establish expert consensus recommendations for clinical information on imaging requests in suspected/known axial spondyloarthritis (axSpA), focusing on enhancing diagnostic clarity and patient care through guidelines.

Materials And Methods: A specialised task force was formed, comprising 7 radiologists, 11 rheumatologists from the Assessment of Spondyloarthritis International Society (ASAS) and a patient representative. Using the Delphi method, two rounds of surveys were conducted among ASAS members.

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Background: A range of sacroiliac joint (SIJ) MRI protocols are used in clinical practice but not all were specifically designed for diagnostic ascertainment. This can be confusing and no standard diagnostic SIJ MRI protocol is currently accepted worldwide.

Objective: To develop a standardised MRI image acquisition protocol (IAP) for diagnostic ascertainment of sacroiliitis.

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Article Synopsis
  • The study investigates the relationship between uric acid (UA) levels and bone mineral density (BMD) in men and women with rheumatoid arthritis (RA), particularly focusing on how these associations differ between premenopausal and postmenopausal women.
  • In a cohort of 206 RA patients, results showed a significant negative association between UA levels and T-scores in premenopausal women, while no such association was found in postmenopausal women.
  • The findings suggest that the effects of UA on bone health may be influenced by hormonal status, indicating that further research is needed to explore this relationship in larger patient populations.
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Objectives: Apply a modified Delphi-based approach and produce a practical, radiology-specific set of definitions for interpretation and standardization of the multiple MRI findings in axial spondyloarthritis (ax-SpA), specifically to aid the general radiologist with a musculoskeletal interest, working with gold standard basic MRI protocols.

Materials And Methods: We report the results of a modified Delphi-based consensus of 35 experts from 13 countries in the Arthritis Subcommittee of the European Society of Musculoskeletal Radiology (ESSR). Seventeen definitions were created (i.

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Whereas previous projects attempted to standardize imaging in patients with axial spondyloarthritis (axSpA), few studies have been published about the need for specific details regarding the image acquisition and lesions that may be less familiar to general radiologists. This work reports consensus recommendations developed by the Assessment of SpondyloArthritis International Society (ASAS) that aim to standardize the imaging reports in patients suspected of having or with known axSpA. A task force consisting of radiologists and rheumatologists from ASAS and one patient representative formulated two surveys that were completed by ASAS members.

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  • The phase IIIb SURPASS study aimed to compare spinal radiographic progression in patients with radiographic axial spondyloarthritis who were treated with secukinumab (an interleukin-17A inhibitor) versus adalimumab biosimilar (a tumor necrosis factor inhibitor).
  • The study involved 859 biologic-naive patients at high risk for progression, assessing outcomes like the proportion with no progression after 104 weeks and the safety of the treatments.
  • Results showed no significant difference in radiographic progression between secukinumab and adalimumab biosimilar, with overall low progression rates observed in all treatment groups and no unexpected safety issues reported.
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Objective: Reliable interpretation of imaging findings is essential for the diagnosis of axial spondyloarthritis (axSpA) and requires a high level of experience. We investigated experience-dependent differences in diagnostic accuracies using X-ray (XR), MRI and CT.

Methods: This post hoc analysis included 163 subjects with low back pain.

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Objective: Conventional magnetic resonance imaging (MRI) uses T1-weighted and short-tau inversion recovery (STIR) sequences to characterize bone marrow in axial spondyloarthritis. However, quantification is restricted to estimating the extent of lesions because signal intensities are highly variable both within individuals and across patients and MRI scanners. This study evaluates the performance of quantitative T1 mapping for distinguishing different types of bone marrow lesions of the sacroiliac joints.

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Background: The Computed Tomography Syndesmophyte Score (CTSS) was developed as a reliable and sensitive tool to assess syndesmophytes in low-dose CT images of the entire spine in patients with axial spondyloarthritis (axSpA). The original paper provided sparce examples of the CTSS grades.

Objectives: Provide an atlas tailored to assist readers in understanding and employing the CTSS method.

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Article Synopsis
  • The study investigates how sex-specific differences affect the diagnosis of axial spondyloarthritis (axSpA) in women compared to men, which may lead to delays in diagnosis.
  • A total of 526 patients were analyzed for MRI findings related to axSpA, focusing on lesions like bone marrow edema and fat metaplasia.
  • Results showed that while active inflammatory lesions had similar diagnostic performance in both sexes, structural markers were less reliable in women, increasing the chances of false positives.
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The diagnosis of axial spondyloarthritis depends on direct visualization of the sacroiliitis in addition to clinical assessment and determination of the histocompatibility antigen HLA-B27. While the value of conventional radiographic images has meanwhile been described in many studies as insufficient to diagnose the disease at an early stage, magnetic resonance imaging and also computed tomography now offer the possibility to visualize findings, such as bone marrow edema, erosion, fat metaplasia, backfill and ankylosis. Thus, it is necessary to decide which procedure should be used and when.

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  • The study compared MRI and CT scans of the sacroiliac (SI) joint spaces in patients with axial spondyloarthritis to understand inflammation and potential new bone formation.
  • Researchers categorized MRI joint lesions into three types, measuring the Hounsfield units (HU) to assess their density compared to surrounding bone and cartilage.
  • Findings indicated that all lesion types displayed increased density, indicating potential new bone formation, with type C lesions showing the highest density and calcified matrix.
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To assess the ability of low-dose dual-energy computed tomography (ld-DECT) virtual non-calcium (VNCa) images for detecting bone marrow pathologies of the sacroiliac joints (SIJs) in patients with axial spondyloarthritis (axSpA). : Sixty-eight patients with suspected or proven axSpA underwent ld-DECT and MRI of the SIJ. VNCa images were reconstructed from DECT data and scored for the presence of osteitis and fatty bone marrow deposition by two readers with different experience (beginner and expert).

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  • Pelvic radiography is often the first imaging test recommended for diagnosing axial spondyloarthritis (axSpA), but its effectiveness in identifying sacroiliitis is limited compared to CT and MRI.
  • Recent findings indicate that low-dose CT is more sensitive than traditional radiographs, and MRI is preferred for early detection of sacroiliac joint inflammation.
  • The debate is ongoing about the relevance of pelvic radiographs, as newer imaging techniques like low-dose CT and advanced MRI provide more accurate diagnoses for sacroiliitis.
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  • * The text explores the reliability of conventional radiographs compared to T1-weighted MRI in detecting sacroiliitis, questioning the effectiveness of current diagnostic methods.
  • * It also discusses the possibility of using other advanced MRI sequences for better detection of structural lesions and assesses whether we have sufficient data to classify sacroiliitis based on MRI findings.
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Background MRI is frequently used for early diagnosis of axial spondyloarthritis (axSpA). However, evaluation is time-consuming and requires profound expertise because noninflammatory degenerative changes can mimic axSpA, and early signs may therefore be missed. Deep neural networks could function as assistance for axSpA detection.

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Objectives: To assess the impact of joint shape variations on inflammatory lesions on SI joint MRIs in patients with axial spondyloarthritis (axSpA).

Methods: A total of 1194 patients from four different prospective cohorts were evaluated, with 684 (57.3%) having sufficient imaging data for inclusion (379 axSpA, 305 controls).

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Purpose Of Review: Recent technical advances in computed tomography (CT) such as low-dose CT and dual-energy techniques open new applications for this imaging modality in clinical practice and for research purposes. This article will discuss the latest innovations and give a perspective on future developments.

Recent Findings: Low-dose CT has increasingly been used for assessing structural changes at the sacroiliac joints and the spine.

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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.

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In 2009, the Assessment of SpondyloArthritis international Society (ASAS) published a definition of 'active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis'. This new definition of an 'ASAS-positive MRI' was integral to new classification criteria for axial spondyloarthritis that were published in the same year. The ASAS MRI definition had the considerable advantage of simplicity and the definition gained popularity as guidance for interpreting MRI of the sacroiliac joints in clinical practice.

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Article Synopsis
  • The study aims to create a data-driven definition for identifying structural changes in sacroiliac joints relevant to axial spondyloarthritis through CT imaging of a large population.
  • The research involved 546 individuals, assessing CT scans for specific joint lesions and comparing their occurrence across different groups, while establishing diagnostic metrics against clinical diagnoses.
  • Findings indicate that ankylosis and erosions in specific joint areas (middle and dorsal) are strong indicators for positive axSpA, whereas lesions like sclerosis and ventral erosions have lower specificity and diagnostic performance.
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Background: Involvement of the axial skeleton (sacroiliac joints and spine) is a relatively frequent manifestation associated with psoriatic skin disease, mostly along with involvement of peripheral musculoskeletal structures (peripheral arthritis, enthesitis, dactylitis), which are referred to as psoriatic arthritis (PsA). Data suggest that up to 30% of patients with psoriasis have PsA. Depending on the definition used, the prevalence of axial involvement varies from 25% to 70% of patients with PsA.

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