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Dactylitis, one of the most typical features of psoriatic arthritis (PsA), is the diffuse swelling of the digits and is determined by the involvement of different anatomic structures, including: the subcutaneous fibrous tissue “accessory pulley” system; flexor tendons, with their related structures; the articular synovium; the small enthesis of the hands. Dactylitis is currently considered both a marker of disease activity and severe prognosis and its importance in PsA is emphasized by the inclusion in the classification criteria of PsA. This review focuses on the role of imaging in the management of PsA patients with dactylitis in clinical practice and in a research setting. Furthermore, imaging could be a valuable tool to assist in unravelling some of the underlying mechanisms of the onset and chronicization of dactylitis in PsA patients.

Background TMJ is involved in about 50% of JIA cases, often bilateral and asymptomatic in up to 71% of cases1. Adult patients with JIA have been shown to have, compared to healthy individuals, higher rate of dysfunction and anatomical abnormalities2. Clinical examination has been shown to have high specificity but low sensitivity in revealing TMJ inflammation3. To date MRI is the gold standard to assess TMJ involvement 4 Objectives To investigate the prevalence of TMJ involvement in young adults with JIA and young adults with non-JIA inflammatory rheumatisms. Methods Patients were recruited prospectively in 2 clinical centers. Inclusion criteria were: patients Results 19 patients were included in the JIA group and 8 patients in the non-JIA group. Patients’ demographic and disease characteristics were reported in Table 1. MRI results are collected in Table 2. There are no statistically significant differences between groups for the presence of inflammation on MRI, while damage (in particular, disk abnormalities) is more likely in JIA rather than non-JIA patients (p= 0.02). Joint effusion is more likely to be mild rather than moderate/severe in JIA patients (p = 0.04). Conclusion It was found that it is more likely to find damage on MRI in patients of both groups rather than inflammation. Both groups show the same frequency of TMJ involvement, suggesting that TMJ involvement must be sought by the adult rheumatologist as it not only affects JIA patients, but also those with adult-onset inflammatory arthropathies. References [1] Billiau AD, et al. J Rheumatol. 2007 Sep;34(9):1925–33 [2] Arvidsson LZ, et al. Radiology 2010 Jul;256(1):191–200 [3] Koos B, et al. J Rheumatol. 2014 Sep;41(9):1871–7 [4] Hemke R, et al. Eur Radiol. 2014 Feb;24(2):327–34. Disclosure of Interests None declared

Background TMJ is involved in about 50% of JIA cases, often bilateral and asymptomatic in up to 71% of cases1, leading to higher rate of dysfunction and anatomical abnormalities (as retrognathia, facial asymmetry, limited mouth opening, pain)2. To date MRI is the gold standard to study both TMJ inflammation and damage3 but US is a widely used diagnostic imaging tool in rheumatic patients and may be a cheaper and more accessible alternative. Objectives To investigate the prevalence of TMJ involvement in young adults with JIA and young adults with non-JIA inflammatory rheumatisms, comparing MRI with US. Methods Patients were recruited prospectively in 2 clinical centers. Inclusion criteria were: patients Results 11 patients were included in the JIA group and 7 patients in the non-JIA group. Patients’ and TMJs involvement characteristics were reported in Table 1. Conclusion The concordance between MRI and ultrasound is not optimal, and existing TMJ US protocols are based on children. Further studies are needed to develop a suitable US protocol to detect TMJ involvement in adult patients as a screening tool. References [1] Billiau AD, et al. J Rheumatol. 2007Sep;34(9):1925–33. [2] Arvidsson LZ, et al. Radiology2010Jul;256(1):191–200. [3] Hemke R, et al. Eur Radiol. 2014Feb;24(2):327–34. Disclosure of Interests None declared