In this episode of RheumaCast, we discuss one of the most frustrating aspects of axial spondyloarthritis (axSpA): treatment failure. Despite the availability of multiple biologic and targeted therapies, over half of patients do not achieve remission.

What causes this non-response? We explore two major culprits—misdiagnosis and the presence of nociplastic pain—and examine how imaging pitfalls, overlapping mechanical conditions like osteitis condensans ilii, and inadequate communication between clinicians and radiologists can lead to suboptimal management. Learn how standardized MRI protocols, expert interpretation, and emerging tools like AI and molecular imaging can improve diagnostic precision and patient outcomes.

This episode is based on the publication: Poddubnyy D and Baraliakos X. Nat Rev Rheumatol 2025; doi:10.1038/s41584-025-01254-5 and developed with NotebookLM.

In this episode of RheumaCast, we explore how anatomical variations of the sacroiliac joints (SIJ) can complicate the diagnosis and management of axial spondyloarthritis (axSpA). We walk you through common SIJ variants—such as crescent-shaped ilium, accessory joints, and transitional vertebrae—and explain how these can mimic sacroiliitis on MRI.

We discuss how to differentiate true inflammation from mechanical stress reactions, when to use CT for clarification, and the implications of these findings for diagnosis, treatment, and research. If you’ve ever wondered how much “background noise” anatomy adds to SIJ imaging, this episode is for you.

This episode is based on the publication: Diekhoff T and Ziegeler K. Curr Opin Rheumatol 2025 and developed with NotebookLM.

In this episode of RheumaCast, we delve into common statistical missteps in rheumatology research—and how to avoid them. Professor Stian Lydersen shares insights from reviewing over 700 manuscripts for Annals of the Rheumatic Diseases and RMD Open. From handling missing data to the proper use of t-tests, this concise guide covers 15 essential statistical principles that every rheumatology researcher should know. Whether you're preparing your next manuscript or reviewing one, this episode is packed with practical guidance to improve the quality and clarity of your work.

This episode is based on the publication: Lydersen S, et al. Ann Rheum Dis 2025

and developed with NotebookLM.