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Objectives: The psoriatic arthritis magnetic resonance imaging scoring system (PsAMRIS-H) for the evaluation of inflammatory and destructive changes in PsA hands was validated on 0.6-T scanners. The applicability of the PsAMRIS-H on a low-field MRI system as a well-accepted, low-cost imaging modality was evaluated., Method: In 65 consecutive patients (31 males, median age 52 years), 73 scans on a 0.2-T dedicated extremity MRI system were obtained for evaluation of PsA. Images were scored for synovitis, tenosynovitis, periarticular enhancement, bone erosion, bone oedema, and proliferation, and the PsAMRIS-H score was calculated. The intraclass correlation coefficient (ICC) was calculated and the paired t-test conducted., Results: Intra-reader reliability for the total PsAMRIS-H score was good, with an ICC of 0.81 and 0.77 for readers 1 and 2, respectively, and inter-reader agreement was moderate (0.57 for each reader). However, the PsAMRIS-H score differed significantly between the two readers (22 vs. 31; p < 0.05). When individual components of the PsAMRIS were evaluated, intra- and inter-reader agreement was poor to moderate, especially for tenosynovitis and periarticular inflammation., Conclusions: Low-field 0.2-T MRI is capable of quantifying the PsAMRIS-H with good intra-reader reproducibility. However, low signal-to-noise ratio (SNR), low spatial resolution, and system artefacts limit the application of the PsAMRIS-H, leading to low inter- and intra-reader agreement for individual features.

Our observation of histoplasmosis cases augments the current knowledge on transmission by bats. In the presented cases, the only contact happened in the proximity of a bat cave but not inside the cave. We wish to communicate and stress that even outside of caves, bats may disperse the organism.

Objective: To compare different magnetic resonance imaging (MRI) based algorithms for assessment of spinal inflammation in patients with ankylosing spondylitis (AS) being treated with disease modifying drugs., Methods: Eleven patients (10 men, 1 woman) who fulfilled modified New York diagnostic criteria and had severe disease [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) > 4] were given intravenous infusion of infliximab (Remicade, 5 mg/kg) for 96 weeks. Whole-spine MRI was done at 0, 24, and 54 weeks. Measurements of the Ankylosing Spondylitis Spinal MRI Activity Score (ASspiMRI), paravertebral inflammatory lesion count (pILC), contrast:noise ratio (CNR) measurements of defined inflammatory lesions, and other scores together with C-reactive protein concentration were made at each visit. Examinations were anonymized and randomly presented twice to 2 radiologists. The significance of any changes in scores, their correlation with the BASDAI, and interobserver and intraobserver correlations were calculated., Results: The mean (+/- SD) BASDAI improved from 7.2 (+/- 1.5) to 1.3 (+/- 0.9) after 54 weeks (p < 0.001), and the ASspiMRI score improved from 12.0 (+/- 8.0) to 0.2 (+/- 0.5) (p < 0.001). Correlations between ASspiMRI score and BASDAI were 0.831, 0.746, and 0.369 (p < 0.001 each). The pILC improved significantly (p < 0.01). CNR showed no correlation with any clinical score., Conclusion: The ASspiMRI score performed best for assessment and quantification of spinal inflammation and disease activity in patients with AS, but should also quantify paravertebral inflammatory lesions, since we could show that this will significantly improve its correlation to clinical scores and increase its sensitivity to mild inflammatory processes.

Objective: To report on radiological and epidemiological characteristics of pulmonary disease in patients with HIV infection in times of highly active antiretroviral therapy (HAART)., Methods: Clinical data of 130 HIV infected adults with acute pulmonary symptoms were compared with findings in chest radiography (n = 130) and computed tomography (CT, n = 42). Presence and distribution of consolidation, interstitial changes, pleural effusion, and adenopathy were evaluated. Results were compared to findings from sputum, bronchoalveolar lavage, transbronchial biopsy, or empirical therapy results., Results: 48% of patients presented pathologic findings. Overall sensitivity for the detection of pulmonary involvement was 0.87 (chest radiography) vs. 0.97 (CT). Disease specific sensitivity was 0.33 compared to 0.70. Bacterial pneumonia (BP, n = 26, 20%) was the most frequent diagnosis, followed by pneumocystis jiroveci pneumonia (PJP, n = 17, 13%), mycobacterium avium complex (MAC, 6%), Kaposi's sarcoma and lymphoma (KS and NHL, each 4%), fungal pneumonia (2%), and tuberculosis (TBC, 1%). Focal pulmonary infiltration was predominantly present in BP (50%, n = 13). Reticular (35%; n = 6) and micronodular (35%; n = 6) infiltration were predominantly found in PJP., Conclusions: Despite HAART, lung involvement is still common. Only contrast-enhanced computed tomography shows an acceptable disease-specific sensitivity. In unclear cases, CT should be performed.