RheumaCast (Dr. Denis Poddubnyy)

In this episode we discuss a recent multicenter study involving over 400 patients with spondyloarthritis, which explored the detection of enthesitis.Researchers compared ultrasound findings with physical examinations to assess agreement between the two methods across various lower limb entheses and different types of ultrasound lesions.

The study also examined the prevalence and clinical significance of subclinical enthesitis, where ultrasound detects inflammation that is not apparent during a physical exam. Findings revealed notable discrepancies between the two assessment approaches, underscoring the need for a more integrated strategy that combines both techniques for a more precise evaluation of enthesitis in spondyloarthritis.

These insights emphasize the importance of multimodal assessment in clinical practice and may contribute to refining diagnostic and treatment strategies for patients with spondyloarthritis.

This episode is based on Di Matteo A, et al. Arthritis Rheumatol 2025;77:22-33

and was developed with NotebookLM.

A new episode focusses on the recently published 2024 EULAR points to consider on the initiation of targeted therapies in patients with inflammatory arthritis and a history of cancer.

This importnat guideline provides practical advice for rheumatologists navigating the complexities of managing patients with both inflammatory arthritis like rheumatoid arthritis, spondyloarthritis, and psoriatic arthritis,and a past cancer diagnosis.

In this episode, we'll delve into key aspects of these recommendations, including:

• The importance of assessing the individualized risk of cancer recurrence,

• The necessity of co-management with oncology specialists and shared decision-making with patients,

• The recommendation to initiate appropriate targeted antirheumatic treatment without delay in patients with cancer in remission,

• Guidance on managing patients with active IA and a malignancy that is not in remission.

This episode is for rheumatologists, oncologists, primary care physicians, and anyone involved in the care of patients with inflammatory arthritis and a history of cancer. Understanding these 2024 EULAR points to consider can help enhance therapeutic decision-making and optimize patient outcomes.

This episode is based to the publication Sebbag E, et al.Ann Rheum Dis 2025;84:388-397

and was developed with NotebookLM.

This article presents expert consensus recommendations for diagnosing and treating chronic non-bacterial osteitis (CNO) in adults. A systematic review of existing literature and a multidisciplinary expert panel informed the creation of a standardized disease definition and proposed the term "CNO" to replace previous, less precise terminology. The recommendations cover diagnostic imaging, laboratory testing, and a tiered treatment approach starting with NSAIDs and moving to intravenous bisphosphonates or TNF-α inhibitors as needed. Long-term follow-up and a multidisciplinary care team are emphasized, along with a research agenda to improve understanding and treatment of this rare condition.

This study investigates the link between MRI-detected inflammation and clinical outcomes in axial spondyloarthritis (axSpA) patients treated with a TNF inhibitor etanercept. Using data from the ESTHER trial, the study found a strong association between the resolution of inflammation on MRI and improved clinical outcomes, as measured by the ASDAS score. Specifically, reducing inflammation on sacroiliac joint MRI scans significantly predicted better clinical outcomes six months later.

This podcast is based on the publication Torgutalp M, et al. RMD Open. 2025 Jan 6;11(1):e004921.

and is developed with NotebookLM.

In this episode of RheumaCast, we delve into common statistical missteps in rheumatology research—and how to avoid them. Professor Stian Lydersen shares insights from reviewing over 700 manuscripts for Annals of the Rheumatic Diseases and RMD Open. From handling missing data to the proper use of t-tests, this concise guide covers 15 essential statistical principles that every rheumatology researcher should know. Whether you're preparing your next manuscript or reviewing one, this episode is packed with practical guidance to improve the quality and clarity of your work.

This episode is based on the publication: Lydersen S, et al. Ann Rheum Dis 2025

and developed with NotebookLM.

This episode focuses on a randomized, placebo-controlled trial that evaluated the efficacy of infliximab, a tumor necrosis factor (TNF) inhibitor, in alleviating chronic low back pain in patients with Modic type 1 changes (degenerative disc disease with bone marrow edema) identified on magnetic resonance imaging (MRI). The results indicate that TNF blockade is not effective for this condition.

This podcast is based on the publication by Gjefsen E, et al (2024)

and was developed with NotebookLM.

This research investigates the impact of colchicine, a medication used to prevent gout flares, on cardiovascular events in patients initiating urate-lowering therapy. Using a large UK primary care database, the study compared patients prescribed colchicine prophylaxis with those who received no prophylaxis. The findings suggest that colchicine prophylaxis is associated with a reduced risk of myocardial infarction or stroke in gout patients starting urate-lowering therapy.

Based on Cipolletta E, et al. Lancet Rheumatol 2025

and developed with NotebookLM.

This research article investigates the relationship between osteo-proliferative lesions on finger phalanges, sex, age, and osteoarthritis. Using X-rays of 1153 patients, researchers examined the frequency and location of these lesions, finding that men showed more lesions than women, with age and osteoarthritis positively correlated with lesion extent. A modified Osseographic Scoring System was used to evaluate the findings, showing excellent inter-reader agreement. The study's anatomical dissection of a finger helped clarify the origin of these lesions, emphasizing the importance of differentiating normal aging changes from pathological conditions like psoriatic arthritis.

Based on Hermann S et al. Diagnostics 2022; 12: 618.

Develop with NotebookLM.

This episode of RheumaCast deals the long-anticipated global consensus on MRI protocols for the diagnosis and differential diagnosis of axial spondyloarthritis (axSpA).

Experts from ASAS and SPARTAN, including radiologists and rheumatologists, have developed a comprehensive, standardized imaging protocol designed to maximize diagnostic accuracy and aid early identification of axSpA. The protocol specifies a four-sequence approach focusing on inflammation, structural damage, and bone-cartilage interface visualization—essential elements to ensure consistency in detecting sacroiliitis and distinguishing it from other conditions.

This podcast is based on the publication ⁠Lambert R, et al. Ann Rheum Dis 2024 Aug 6:ard-2024-225882⁠

and is developed with NotebookLM.

This study explores the impact of axial spondyloarthritis (axSpA) subtype and sex on the discontinuation of first-line biologic DMARDs (bDMARDs). The key findings indicate that patients with non-radiographic axSpA (nr-axSpA) and female patients are more likely to discontinue bDMARD therapy and exhibit lower treatment survival rates compared to their counterparts. Listen to get more details in this deep dive.

Based onRemalante-Rayco P, et al. Ann Rheum Dis 2025

and develop with NotebookLM.

This study compares osteitis condensans ilii (OCI) and axial spondyloarthritis (axSpA), focusing on their clinical, laboratory, and MRI characteristics. Researchers found that OCI predominantly affects women and lacks the inflammatory markers typical of axSpA. While both conditions can present with sacroiliac joint osteitis on MRI, OCI shows anterior localization and an absence of erosions, distinguishing it from axSpA. The study highlights the challenges in differentiating these conditions and emphasizes the need for comprehensive clinical and imaging assessment. The findings provide valuable information for the differential diagnosis of these two conditions.

This episode is based on Poddubnyy D, et al. Rheumatology (Oxford) 2020;59(12):3798-3806.

and developed with NotebookLM.

In this episode, we explore a compelling review that tracesthe evolution of our understanding of nociplastic pain—from fibrositis to fibromyalgia and beyond.

🧠 Key Takeaways from the Discussion:
✅ The shift from peripheral to central painmechanisms in fibromyalgia
✅ How nociplastic painintersects with inflammatory rheumatic diseases
✅ Why traditional analgesics(NSAIDs, opioids) are ineffective—and what really works

✅ The role of functional brainimaging and quantitative sensory testing indiagnosing central sensitization

This episode is particularly relevant for clinicians, researchers, and anyone treating chronic pain syndromes in rheumatology. Tune in to hear how rheumatologists helped shape the understanding of nociplastic pain—and whatthis means for future treatment strategies!
This episode is based on Clauw DJ. Ann Rheum Dis 2024;83:1421–1427

and was developed with NotebookLM.

This episode deals with the development of a consensus-based expert definition for difficult-to-manage (D2M) axial spondyloarthritis (axSpA), including treatment-refractory (TR) disease. The Assessment of SpondyloArthritisInternational Society (ASAS) spearheaded this effort through a literature review and a two-round Delphi process. The resulting D2M definition encompasses treatment failure, suboptimal disease control, and acknowledgement ofproblematic signs/symptoms by physicians or patients. TRaxSpA falls under this D2M umbrella but requires evidence of treatment failure and objective signs of inflammatory activity. Endorsed by ASAS, the definition aims tostandardize the identification of patients with unmet needs and facilitate further research and improved clinical care in this area.

This episode is based on the publication Poddubnyy D, et al. Ann Rheum Dis 2025

and is developed with NotebookLM.

This episode of RheumaCast dives into the latest expert guidelines from the Assessment of Spondyloarthritis International Society (ASAS) for imaging referrals in patients with suspected or confirmed axial spondyloarthritis (axSpA). We explore how these recommendations, designed by an international task force, aim to improve communication between rheumatologists and radiologists, ensuring imaging requests are precise, informative, and clinically relevant. By standardizing essential clinical data in referral forms, these guidelines support more accurate diagnoses, enhanced report quality, and ultimately better patient management in axSpA. Join us as we discuss the significance, application, and expected impact of these recommendations in clinical practice.

This podcast is based on the publication Diekhoff T, et al. Ann Rheum Dis 2024 Sep 24:ard-2024-226280

and is developed with NotebookLM.

This episode deals with the development of extra-musculoskeletal manifestations (EMMs) in patients with psoriatic arthritis or axial spondyloarthritis treated with a Janus-kinase-1-Inhibitor upadacitinib. The study analyzed data from five clinical trials, comparing upadacitinib to placebo and adalimumab. Results indicate low rates of EMM development overall, with numerically lower uveitis rates observed in upadacitinib-treated patients compared to those receiving placebo, particularly in radiographic axial spondyloarthritis.

This episode is based on the publication Poddubnyy D, et al. Arthritis Rheumatol 2024, doi: 10.1002/art.43069.

and developed with Notebook LM.

This study assesses the accuracy and readability of four AI chatbots (ChatGPT 3.5, Bing, Bard, and ChatGPT 4.0) in answering common patient questions about low back pain (LBP). Researchers evaluated responses against established LBP guidelines, finding moderate accuracy overall, but with significant variations across topics (self-management, treatment, and risk factors).

This podcast is based on the publication by Simone P.S. Scaff et al. Ann Rheum Dis 2025;84(1):143-149

and is developed with NotebookLM.