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Updated: Sep 13, 2025
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A Novel Application of Musculoskeletal Ultrasound Imaging
Published on: September 17, 2013
24.3K
Sonographic Signatures of Immune Checkpoint Inhibitor-Associated Musculoskeletal Adverse Events
Hans Vitzthum von Eckstaedt1, Kevin Weng2, Ingeborg Sacksen1
1Division of Rheumatology, University of Washington, Seattle, WA 98195, USA.
Cancers
|July 29, 2025
Summary
Musculoskeletal ultrasound (MSKUS) effectively diagnoses immune-related adverse events (irAEs) in cancer patients treated with immune checkpoint inhibitors (ICIs). This imaging tool aids in guiding treatment decisions for inflammatory arthritis and polymyalgia rheumatica-like syndromes.
Area of Science:
- Rheumatology
- Oncology
- Radiology
Background:
- Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy but can cause immune-related adverse events (irAEs).
- Common irAEs include inflammatory arthritis (IA) and polymyalgia rheumatica (PMR)-like syndromes, collectively termed musculoskeletal irAEs (MSK-irAEs).
Purpose of the Study:
- To systematically characterize musculoskeletal ultrasound (MSKUS) findings in patients with MSK-irAEs.
- To explore the utility of MSKUS in guiding treatment for these conditions.
Main Methods:
- A retrospective chart review of patients receiving ICIs who underwent MSKUS.
- US examinations interpreted by certified rheumatologists using a novel scoring system for inflammation.
- Descriptive statistics to analyze demographic, clinical, and treatment data.
Main Results:
- MSKUS identified inflammation in 74% of patients diagnosed with MSK-irAEs.
- Seventy percent of patients received escalated MSK-irAE treatment following MSKUS findings.
- Four patients (17%) presented with erosive disease, potentially linked to chronic, under-recognized inflammation.
Conclusions:
- MSKUS is a valuable diagnostic tool for identifying MSK-irAEs.
- MSKUS findings assist in guiding therapeutic interventions for patients experiencing irAEs.
- MSKUS can differentiate MSK-irAEs from other musculoskeletal conditions, potentially enabling continued cancer treatment.
