03 March 2021
Our Young Investigator Award encourages the work of young rheumatologists and recognises excellence in early career researchers. This year’s winner is Dr Varvara Choida, a rheumatology registrar who is studying her PhD at University College London. Dr Choida tells us more about her research, which involves whole-body MRI scanning to identify inflammation in adolescent patients with juvenile idiopathic arthritis.
Tell us more about your study
The project is about evaluating whole-body MRI scan as a tool to assess disease activity in juvenile idiopathic arthritis (JIA) patients between the ages of 12-24. It started with a patient who developed damage first in her knee and later in her hip joint, without any symptoms or signs on clinical examination in the previous visits. This led to a whole-body MRI scan, which confirmed the presence of synovitis. Therefore, this example made us think about ‘silent’ inflammation that you can’t see on examination. We’ve started a prospective study to see if whole-body MRI can help us identify ‘silent’ inflammation in JIA.
What have you discovered?
We’ve found that in 44% of patients, there was at least one joint with inflammation in the scan which wasn’t seen clinically. This is a remarkable proportion of patients, so it has created further questions about the clinical significance of this.
What are the next steps?
We have been recruiting more JIA patients and also controls, who don’t have clinical arthritis. Comparing the two groups will help us better understand to what extent the synovitis we are seeing is due to active disease. Once the recruitment is completed, a group of musculoskeletal radiologists will be rescoring all the images without knowing who has arthritis to reduce the risk of bias.
We’ll also be looking to validate our results in a larger cohort, including other centres across the UK. We still need to work out how to treat patients who have MRI-detected inflammation in the joints but don’t show any symptoms or signs on examination. Overall, we don’t know if treating them differently will improve their prognosis, so further research is needed.
How did it make you feel when you found out about your award?
I’m extremely honoured. BSR provided research funding from the beginning of our study in 2019, so we’re very thankful. It’s rewarding and encouraging that other esteemed colleagues see the value in our project. It’s also motivating for the whole team I work with.
I am fortunate to work in a very supportive team and my colleagues are passionate about the project, so this award means a lot to all of us. The award also gives us the opportunity to share the results with more people at the annual conference which might lead to new ideas and collaborations. We would like to work with other teams and further our research.
What about the future for your career?
After my PhD I’ll be returning to my final year of rheumatology training. I’d like to be able to continue with research as a Consultant, and work in an environment where there is a service for adolescents. I’ve enjoyed working with young people for the last three years – they are unique in terms of their needs. They’re at a time in their life when they undergo a lot of physical, emotional and social changes. It is very fulfilling to be able to provide the holistic care that they need.
Read our interviews with the winner of the Garrod award, Dr Matteo Vecellio, and the winner of the Michael Mason award, Dr Neil Basu.
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