RV-009 is a de-identified extended longitudinal mixed axial-peripheral peripheral-SpA case. Disease history began with recurrent right-predominant knee synovitis/effusions from 2010, multiple aspirations/intra-articular steroid injections, two right-knee arthroscopies, later bilateral recurrence, and subsequent low-burden dactylitic/axial manifestations. Current state: remission. Current XR shows a low-burden stable structural profile; MRI chronology adds episodic effusion activity and a focal left stress-type event without major radiographic progression.
De-identified MRI reports
Research Analytic Addendum, cross modality (X rays and MRIs)
X rays only vs X rays + MRI discrepancy audit
RV-009 illustrates a longitudinal peripheral spondyloarthritis case in which the disease was initially dominated by recurrent knee inflammation rather than by early fixed radiographic damage. The clinical course began in 2010 with atraumatic right-knee pain, stiffness, swelling, partial NSAID response, repeated aspirations and intra-articular steroid injections, and eventually right-knee arthroscopy with cartilage resurfacing–type intervention and later lateral release. Symptoms improved for prolonged intervals, then recurred, including bilateral knee activity in 2020 with inflammatory synovial fluid but no crystals or infection, and later evolved into a broader peripheral-SpA phenotype. By 2026, the patient was clinically well controlled on secukinumab, with only one mild dactylitis flare over the prior interval and otherwise no significant active joint complaints.
What makes the case valuable is the separation between historical inflammatory burden and present structural burden. Serial radiographs show only a low-burden mixed pattern: subtle chronic bilateral sacroiliac change, mild cervical/thoracolumbar spondylotic change, mild hip contour/rim-spur change, mild non-erosive hand OA-pattern change, and minimal knee OA-pattern change, without measurable interval progression. The added MRI chronology does not overturn the XR phenotype, but it adds activity-sensitive context: recurrent effusions, exclusion of major internal derangement on prior studies, and a focal left stress-type bone event. The discrepancy audit therefore supports a multimodal reading in which XR captures structural trajectory, while MRI contributes interval inflammatory/mechanistic detail.
For clinicians, this is a practical follow-up case showing how treated peripheral SpA can have a substantial historical inflammatory footprint yet remain structurally stable on serial imaging. For research and pharma-facing audiences, it demonstrates how RheumaView can integrate clinical chronology, serial radiography, MRI history, and cross-modality audit into a reproducible, analysis-ready case narrative without blurring structure, activity, and progression.