26rhk025 10.3205/26rhk025 urn:nbn:de:0183-26rhk0258 Meeting Abstract Klapa Klapa Sebastian S

Christian Albrechts Universität zu Kiel, Institut für Experimentelle Medizin, Sektion Maritime Medizin, Kiel, Deutschland Universität zu Lübeck, Klinik für Rheumatologie und klinische Immunologie, Lübeck, Deutschland Rheuma-Liga Schleswig-Holstein e.V., Kiel, Deutschland

author Nieberding Nieberding Relena R

Universität zu Lübeck, Klinik für Rheumatologie und klinische Immunologie, Lübeck, Deutschland Rheumazentrum Ostholstein, Stockelsdorf, Deutschland

author Harten Harten Pontus P

Rheumapraxis Kiel, Kiel, Deutschland

author Zeuner Zeuner Rainald R

St. Franziskus MVZ Am Hang, Harrislee, Deutschland

author Schwab Schwab Ulrich U

Gemeinschaftspraxis Dres. med. Bolouri & Schwab, Kiel, Deutschland

author Riemekasten Riemekasten Gabriela G

Universität zu Lübeck, Klinik für Rheumatologie und klinische Immunologie, Lübeck, Deutschland

author Fröhlich Fröhlich Gerda G

Rheuma-Liga Schleswig-Holstein e.V., Kiel, Deutschland

author Lamprecht Lamprecht Peter P

Universität zu Lübeck, Klinik für Rheumatologie und klinische Immunologie, Lübeck, Deutschland

author German Medical Science GMS Publishing House

Düsseldorf

610 20260909 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0656 025 Deutsche Gesellschaft für Rheumatologie Deutsche Gesellschaft für Orthopädische Rheumatologie Gesellschaft für Kinder- und Jugendrheumatologie 54. Kongress der Deutschen Gesellschaft für Rheumatologie und Klinische Immunologie (DGRh), 36. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR), 40. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh) Deutscher Rheumatologiekongress 2026 Digitale Rheumatologie Leipzig 20260909 20260912 DR.14 TextIntroduction: Epidemiological data indicate an increased prevalence of inflammatory rheumatic diseases (IRD) . For example, the global incidence of rheumatoid arthritis (RA) has risen from 11.66 in 1990 to 13.48 per 100,000 people in 2022 . Early diagnosis and initiation of therapy are essential to prevent permanent structural damage and comorbidities in RA patients . However, in some states, such as Schleswig-Holstein (SH) in northern Germany, there are differences in the availability of rheumatological care between urban and rural areas. Consequently, new models of early consultation and diagnostic and therapeutic approaches using AI-trained systems are needed. Automated robotic arthrosonography has demonstrated promising potential for the detection of IRD. Nevertheless, existing evidence is limited by the small number of studies conducted to date .This study, which was initiated by the patient organisation Rheuma-Liga SH, aimed to evaluate the real-world use of fully automated robotic arthrosonography (ARTHUR) with AI analysis (DIANA) to detect arthritis activity.Methods: Between October 2024 and November 2025, we set up a mobile contact point in various communities in SH. Using ARTHUR, we detected arthrosonographic signs of new-onset or relapsing arthritis according to the OMERACT-EULAR synovitis criteria . Data were collected from participants with suspected new-onset or relapsing Arthritis regarding their age, sex, morning stiffness, tender joint count (TJC), swollen joint count (SJC), and pain level on a numeric pain scale. CRP were measured using an AFIAS POC system. Health Assessment Questionnaire (HAQ-II) and Disease Activity Score-28 (DAS28) were also assessed. Participants with positive results, according to the DIANA AI analysis, were referred directly to a rheumatology specialist. Furthermore, participants with elevated CRP and/or severe symptoms were also referred to a rheumatology specialist after automated arthrosonography, even if the result was negative.Results: A total of 420 participants underwent ARTHUR screening. Of these, 119 were excluded due to missing data. One measurement failed. The remaining 300 participants were divided into two groups: those without a history of IRD (non-IRD; n=255; 1.912 joints; age: 62.0±12.2 years; 79.1% female; DAS28:3.7±1.1; HAQII:1.1±1.1; CRP:7.1±8.5 mg/L) and those with IRD (RA: n=40; 300 joints; PMR: n=5; SSc: n=1; SLE: n=1; GPA: n=1; psoriatic arthritis: n=3; age: 65.2±13.5 years; 86.7% female; DAS28:3.6±1.3; HAQ II:1.4±1.6; CRP: 7.2±6.4 mg/L). In the non-IRD group, 41 individuals tested positive for signs of synovitis. According to a rheumatologist, five of these participants had false positive results. Only one person with a negative ARTHUR result had received a false negative result (ROC-AUC: 0.9977, sensitivity 98.99%, specificity 100%, P<0.0001, number needed to diagnose:1.01) (Figure 1 ). Only patients with a suspected RA relapse were further investigated in the IRD group. Here, 6 RA patients with active disease were detected by ARTHUR, without any false positive results. Furthermore, in this group, there were no false negative results identified by a rheumatologist (ROC-AUC: 1.000, sensitivity 100%, specificity 100%, P=0.0016, number needed to diagnose: 1.010) (Figure 1 ).Conclusion: Fully automated robot-assisted arthrosonography with AI analysis demonstrated high sensitivity and specificity in detecting arthritis in patients with new-onset disease as well as in RA patients suspected of relapse.Disclosures: The authors declare no competing interests. Bournia VK Fragoulis GE Mitrou P Tsolakidis A Mathioudakis K Vassilopoulos D Tektonidou M Paraskevis D Sfikakis PP Increased prevalence of inflammatory arthritis, systemic lupus erythematosus and systemic sclerosis, during 2020-2023 versus 2016-2019 in a Nation-Wide Cohort Study 2024 Rheumatol Int 2837-2846 Bournia VK, Fragoulis GE, Mitrou P, Tsolakidis A, Mathioudakis K, Vassilopoulos D, Tektonidou M, Paraskevis D, Sfikakis PP. Increased prevalence of inflammatory arthritis, systemic lupus erythematosus and systemic sclerosis, during 2020-2023 versus 2016-2019 in a Nation-Wide Cohort Study. Rheumatol Int. 2024 Dec;44(12):2837-2846. DOI: 10.1007/s00296-024-05733-y http://dx.doi.org/10.1007/s00296-024-05733-y Zhang Z Gao X Liu S Wang Q Wang Y Hou S Wang J Zhang Y Global, regional, and national epidemiology of rheumatoid arthritis among people aged 20-54 years from 1990 to 2021 2025 Sci Rep 10736 Zhang Z, Gao X, Liu S, Wang Q, Wang Y, Hou S, Wang J, Zhang Y. Global, regional, and national epidemiology of rheumatoid arthritis among people aged 20-54 years from 1990 to 2021. Sci Rep. 2025 Mar 28;15(1):10736. DOI: 10.1038/s41598-025-92150-1 http://dx.doi.org/10.1038/s41598-025-92150-1 Frederiksen BA Hammer HB Terslev L Ammitzbøll-Danielsen M Savarimuthu TR Weber ABH Just SA Automated ultrasound system ARTHUR V.2.0 with AI analysis DIANA V.2.0 matches expert rheumatologist in hand joint assessment of rheumatoid arthritis patients 2025 RMD Open e005805 Frederiksen BA, Hammer HB, Terslev L, Ammitzbøll-Danielsen M, Savarimuthu TR, Weber ABH, Just SA. Automated ultrasound system ARTHUR V.2.0 with AI analysis DIANA V.2.0 matches expert rheumatologist in hand joint assessment of rheumatoid arthritis patients. RMD Open. 2025 Aug 5;11(3):e005805. DOI: 10.1136/rmdopen-2025-005805 http://dx.doi.org/10.1136/rmdopen-2025-005805 D'Agostino MA Terslev L Aegerter P Backhaus M Balint P Bruyn GA Filippucci E Grassi W Iagnocco A Jousse-Joulin S Kane D Naredo E Schmidt W Szkudlarek M Conaghan PG Wakefield RJ Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 1: definition and development of a standardised, consensus-based scoring system 2017 RMD Open e000428 D'Agostino MA, Terslev L, Aegerter P, Backhaus M, Balint P, Bruyn GA, Filippucci E, Grassi W, Iagnocco A, Jousse-Joulin S, Kane D, Naredo E, Schmidt W, Szkudlarek M, Conaghan PG, Wakefield RJ. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 1: definition and development of a standardised, consensus-based scoring system. RMD Open. 2017 Jul 11;3(1):e000428. DOI: 10.1136/rmdopen-2016-000428 http://dx.doi.org/10.1136/rmdopen-2016-000428 0

1 1 Figure 1: Sensitivity and specificity of ARTHUR in identifying arthritis in participants without a history of IRD (non-IRD, left) and in RA patients suspected of relapse (right).

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