ARTHRITIS & RHEUMATOLOGY Vol. 66, No. 5, May 2014, pp 1070–1071 DOI 10.1002/art.38575 © 2014, American College of Rheumatology
SPECIAL ARTICLE
Winners of the 2013 American College of Rheumatology Annual Image Competition American College of Rheumatology Audiovisual Aids Subcommittee sitis (submitted by Siamak Moghadam-Kia, MD), dactylitis as the first manifestation of psoriatic arthritis in a 2 year-old (submitted by Hugle Boris, MD), Libman-Sacks endocarditis and coronary vessel thrombosis (submitted by Shikha Mehta, MD), monosodium urate–coated cartilage (submitted by Jiyeol Yoon, MD), rectus sheath hematoma and renal artery aneurism in type IV EhlersDanlos syndrome (submitted by Weihong Yang, MD), chronic nonbacterial osteomyelitis of the clavicle (submitted by Manisha Sharma, MD), and hereditary multiple exostoses (submitted by Rajaie Namas, MD). The winning images from the 2013 competition, as well as several additional outstanding images that were submitted, will be added to the ACR Rheumatology Image Bank. The Rheumatology Image Bank provides the medical community with 24/7 online access to the world’s foremost collection of rheumatology images. This collection features contributions from all over the world and is an invaluable resource for countless physicians and other health care professionals, researchers, and journalists. Since its launch in 2009, the Rheumatology Image Bank has received more than 1.5 million unique visitors worldwide. To view the winning images and many more, go to http://images.rheumatology.org. The ACR encourages the continued submission of high-quality images to its annual image competition. The Audiovisual Aids Subcommittee is targeting particular images to enhance the image bank. If you have high-quality images that illustrate rheumatic conditions or are relevant to the practice of rheumatology, please submit them for the 2014 competition. Competition rules and submission materials are available at http://images.rheumatology.org. If you have any questions regarding the image competition, please e-mail [email protected].
The Audiovisual Aids Subcommittee of the American College of Rheumatology is pleased to present the winners of the 2013 Annual Image Competition. Each year, the competition provides an opportunity for clinicians and other medical and research professionals to contribute to one of the preeminent image collections devoted to rheumatic diseases. For the 2013 competition, more than 220 entries were received. The selection process was a difficult but pleasurable task for the subcommittee. Each submitted image was evaluated not only for a competition prize, but also for inclusion in the ACR Rheumatology Image Bank. The 2013 grand prize competition winner was a series of fluorodeoxyglucose–positron emission tomography/computed tomography images of a woman with large vessel giant cell arteritis and secondary polymyalgia rheumatica (Figure 1). An image depicting wrist deformities in a patient with adult-onset Still’s disease was the winner in the still image category (Figure 2), and a composite showing skin manifestations and response to therapy in a patient with PAPA syndrome (pyogenic sterile arthritis, pyoderma gangrenosum, and acne) was the case study category winner (Figure 3). Honorable mention was awarded to images of heliotrope rash and periorbital edema in dermatomyoMembers of the Audiovisual Aids Subcommittee of the American College of Rheumatology Committee on Education: Brian E. Daikh, MD, Portland, Maine (2013 Chair); Erika H. Noss, MD, Boston, Massachusetts (2014 Chair); Alan N. Baer, MD, Baltimore, Maryland; Eric P. Gall, MD, Tucson, Arizona; Kristine M. Lohr, MD, Lexington, Kentucky; Janet Maynard, MD, Baltimore, Maryland; Kathleen M. O’Neil, MD, Oklahoma City, Oklahoma; Andrea Ramirez, MD, Houston, Texas; Lee Anderson, RN, BSN, Champlin, Minnesota (ARHP representative); Mary Christenson, PT, PhD, Berthoud, Colorado (ARHP representative); Iris Davidson, BSR, Vancouver, British Columbia, Canada (ARHP representative). Submitted for publication February 20, 2014; accepted February 20, 2014.
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ACR ANNUAL IMAGE COMPETITION
Figure 1. Large vessel giant cell arteritis. The patient, a 70-year-old woman, presented with low-grade fever, neck and pelvic girdle pain, jaw claudication and absent radial artery pulses. Laboratory examinations revealed a C-reactive protein level of 11 mg/dl and an erythrocyte sedimentation rate of 123 mm/hour. Fluorodeoxyglucose–positron emission tomography/computed tomography (FDG-PET/CT) demonstrated bilateral subclavian and carotid arteritis and aortitis (arrows) in addition to bursitis and enthesitis of the spinous process and pelvic girdle (arrowheads). The patient was diagnosed as having large vessel giant cell arteritis with secondary polymyalgia rheumatica. With glucocorticoid therapy, her symptoms resolved and the abnormal FDGPET/CT findings improved. Submitted by Yoshinori Taniguchi, MD, Kochi, Japan.
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Figure 2. Adult-onset Still’s disease: wrist deformities. This image depicts a posteroanterior view of the wrist showing loss of articular cartilage of the radiocarpal, intercarpal, and carpal metacarpal joints, fusion of the intercarpal and carpal metacarpal joints, and osteopenia. Submitted by Angeliki Giannelou, MD, Bethesda, MD.
Figure 3. PAPA syndrome (pyogenic sterile arthritis, pyoderma gangrenosum, and acne): skin manifestations and response to therapy. PAPA syndrome is an autosomal-dominant disorder. Patients typically present early in childhood with episodes of sterile monoarticular arthritis, and later in life develop pyoderma gangrenosum–like ulcerative skin lesions and cystic acne. These images depict several phases of pyoderma gangrenosum in a 26-year-old male patient, showing progressive healing with high-dose steroid and infliximab treatment. The patient currently receives maintenance therapy consisting of a combination of anakinra and infliximab, with occasional relapses of lesions. Submitted by Angeliki Giannelou, MD, Bethesda, MD.
SPECIAL ARTICLE
Winners of the 2013 American College of Rheumatology Annual Image Competition American College of Rheumatology Audiovisual Aids Subcommittee sitis (submitted by Siamak Moghadam-Kia, MD), dactylitis as the first manifestation of psoriatic arthritis in a 2 year-old (submitted by Hugle Boris, MD), Libman-Sacks endocarditis and coronary vessel thrombosis (submitted by Shikha Mehta, MD), monosodium urate–coated cartilage (submitted by Jiyeol Yoon, MD), rectus sheath hematoma and renal artery aneurism in type IV EhlersDanlos syndrome (submitted by Weihong Yang, MD), chronic nonbacterial osteomyelitis of the clavicle (submitted by Manisha Sharma, MD), and hereditary multiple exostoses (submitted by Rajaie Namas, MD). The winning images from the 2013 competition, as well as several additional outstanding images that were submitted, will be added to the ACR Rheumatology Image Bank. The Rheumatology Image Bank provides the medical community with 24/7 online access to the world’s foremost collection of rheumatology images. This collection features contributions from all over the world and is an invaluable resource for countless physicians and other health care professionals, researchers, and journalists. Since its launch in 2009, the Rheumatology Image Bank has received more than 1.5 million unique visitors worldwide. To view the winning images and many more, go to http://images.rheumatology.org. The ACR encourages the continued submission of high-quality images to its annual image competition. The Audiovisual Aids Subcommittee is targeting particular images to enhance the image bank. If you have high-quality images that illustrate rheumatic conditions or are relevant to the practice of rheumatology, please submit them for the 2014 competition. Competition rules and submission materials are available at http://images.rheumatology.org. If you have any questions regarding the image competition, please e-mail [email protected].
The Audiovisual Aids Subcommittee of the American College of Rheumatology is pleased to present the winners of the 2013 Annual Image Competition. Each year, the competition provides an opportunity for clinicians and other medical and research professionals to contribute to one of the preeminent image collections devoted to rheumatic diseases. For the 2013 competition, more than 220 entries were received. The selection process was a difficult but pleasurable task for the subcommittee. Each submitted image was evaluated not only for a competition prize, but also for inclusion in the ACR Rheumatology Image Bank. The 2013 grand prize competition winner was a series of fluorodeoxyglucose–positron emission tomography/computed tomography images of a woman with large vessel giant cell arteritis and secondary polymyalgia rheumatica (Figure 1). An image depicting wrist deformities in a patient with adult-onset Still’s disease was the winner in the still image category (Figure 2), and a composite showing skin manifestations and response to therapy in a patient with PAPA syndrome (pyogenic sterile arthritis, pyoderma gangrenosum, and acne) was the case study category winner (Figure 3). Honorable mention was awarded to images of heliotrope rash and periorbital edema in dermatomyoMembers of the Audiovisual Aids Subcommittee of the American College of Rheumatology Committee on Education: Brian E. Daikh, MD, Portland, Maine (2013 Chair); Erika H. Noss, MD, Boston, Massachusetts (2014 Chair); Alan N. Baer, MD, Baltimore, Maryland; Eric P. Gall, MD, Tucson, Arizona; Kristine M. Lohr, MD, Lexington, Kentucky; Janet Maynard, MD, Baltimore, Maryland; Kathleen M. O’Neil, MD, Oklahoma City, Oklahoma; Andrea Ramirez, MD, Houston, Texas; Lee Anderson, RN, BSN, Champlin, Minnesota (ARHP representative); Mary Christenson, PT, PhD, Berthoud, Colorado (ARHP representative); Iris Davidson, BSR, Vancouver, British Columbia, Canada (ARHP representative). Submitted for publication February 20, 2014; accepted February 20, 2014.
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ACR ANNUAL IMAGE COMPETITION
Figure 1. Large vessel giant cell arteritis. The patient, a 70-year-old woman, presented with low-grade fever, neck and pelvic girdle pain, jaw claudication and absent radial artery pulses. Laboratory examinations revealed a C-reactive protein level of 11 mg/dl and an erythrocyte sedimentation rate of 123 mm/hour. Fluorodeoxyglucose–positron emission tomography/computed tomography (FDG-PET/CT) demonstrated bilateral subclavian and carotid arteritis and aortitis (arrows) in addition to bursitis and enthesitis of the spinous process and pelvic girdle (arrowheads). The patient was diagnosed as having large vessel giant cell arteritis with secondary polymyalgia rheumatica. With glucocorticoid therapy, her symptoms resolved and the abnormal FDGPET/CT findings improved. Submitted by Yoshinori Taniguchi, MD, Kochi, Japan.
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Figure 2. Adult-onset Still’s disease: wrist deformities. This image depicts a posteroanterior view of the wrist showing loss of articular cartilage of the radiocarpal, intercarpal, and carpal metacarpal joints, fusion of the intercarpal and carpal metacarpal joints, and osteopenia. Submitted by Angeliki Giannelou, MD, Bethesda, MD.
Figure 3. PAPA syndrome (pyogenic sterile arthritis, pyoderma gangrenosum, and acne): skin manifestations and response to therapy. PAPA syndrome is an autosomal-dominant disorder. Patients typically present early in childhood with episodes of sterile monoarticular arthritis, and later in life develop pyoderma gangrenosum–like ulcerative skin lesions and cystic acne. These images depict several phases of pyoderma gangrenosum in a 26-year-old male patient, showing progressive healing with high-dose steroid and infliximab treatment. The patient currently receives maintenance therapy consisting of a combination of anakinra and infliximab, with occasional relapses of lesions. Submitted by Angeliki Giannelou, MD, Bethesda, MD.
