Imaging-First Phenotype Anchoring in Early Seronegative Arthritis: Microerosions, Enthesitis-Adjacent Changes, and Progression Prevention
When serology is silent and radiographs read “no erosions,” early seronegative arthritis stalls during the window that matters most. A narrative review proposing an XR-first, question-driven pathway — reading microerosions and enthesitis-adjacent changes as patterns rather than isolated findings — to anchor phenotype and support progression prevention.
Read article→The Axial Set: Why Spine, Pelvis, and Hips Are One Study
The spine, pelvis, and hips form one anatomical chain, yet they are ordered separately, read on different days, and the diagnosis often lives in the relationship between them. Eight clinical scenarios mapping the minimum imaging that answers nothing against the optimal coverage that answers the question — and what the gap costs the patient.
Read article→Radiation Is Not the Opposite of Safety
Plain radiographs sit on the “risk” side of the ledger while deferring imaging is treated as “safe” — but in suspected axial spondyloarthritis that comparison is wrong. The real choice is rarely radiation versus zero: it is a small, protocol-dependent exposure weighed against years of diagnostic delay in a systemic inflammatory disease, where imaging used in the right sequence becomes risk reduction rather than risk.
Read article→Distinguishing Ankylosing Spondylitis from DISH on Plain Radiography
Two patients, near-identical lumbar films — one has DISH, the other a decade of ankylosing spondylitis. The features that separate them are visible on plain radiography, but only when the study is designed to capture them: level count, ossification morphology, disc height, and sacroiliac joint status.
Read article→From Diagnostic Ambiguity to Pattern Clarity: Deterministic Radiographic Pattern Analytics in DISH vs Axial SpA Differentiation
A deliberately difficult axial case — overlapping DISH, degenerative, and sacroiliac signatures, plus an “AS?” label that entered from history rather than from imaging. A worked demonstration of blind, XR-first phenotype anchoring, with MRI brought in afterward to confirm the pattern rather than to decide it.
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