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Arani Vivekanantham has been awarded an NIHR Doctoral Fellowship and a Versus Arthritis Clinical Research Fellowship, and Rachel Kuo was awarded an NIHR Doctoral Research Fellowship.

Arani Vivekanantham and Rachel Kuo
Arani Vivekanantham (L) and Rachel Kuo (R)

Arani Vivekanantham

Arani's fellowships have enabled her to take time out of her Specialist Registrar training in Rheumatology and undertake a DPhil in the field of psoriatic arthritis using real world data.

Psoriatic arthritis is a type of arthritis that affects around 150,000 people in the UK, and millions worldwide. Around 1 in 3 people who have the skin condition psoriasis will develop psoriatic arthritis. However, there is no way of assessing the likelihood of people with psoriasis developing psoriatic arthritis. The condition is often diagnosed late, which can lead to irreversible joint damage and long-term disabilities.

In addition, people with psoriatic arthritis are more likely to have other medical problems such as heart and liver disease. Side-effects from psoriatic arthritis treatments could cause or worsen these medical problems but their impacts are not yet fully understood.

Arani's research will focus on investigating these two important topics. In the first part of her work, she aims to investigate which people with psoriasis develop psoriatic arthritis and to develop a prediction model that can be used in primary care to enable early diagnosis and treatment. In the second part of her research, Arani will look at the safety of the first line treatments used in people with psoriatic arthritis and the impact that other underlying co-morbidities may have in development of side-effects from these.

Arani commented "I am very grateful to both NIHR and Versus Arthritis for giving me this excellent opportunity to undertake a DPhil and my planned research work. Together with the bespoke training programme, this opportunity will be invaluable in providing me with the skills and knowledge to develop as a clinical academic researcher in Rheumatology."

Rachel Kuo

Rachel's NIHR Doctoral Research Fellowship will enable research into the diagnosis and treatment of scaphoid fractures.

The scaphoid is the most commonly broken wrist bone, accounting for eight-in-ten fractures. Generally caused by falls, road traffic accidents, and work or sports accidents scaphoid fractures can be severe and life-changing. After a fracture, sometimes the scaphoid does not heal properly, or part of it dies. This can lead to wrist collapse, chronic pain and arthritis, and the problem is much more likely if the diagnosis of a scaphoid fracture is missed or delayed.

However, diagnosing scaphoid fractures is difficult because the symptoms, such as wrist pain, are easily overlooked or mistaken for something else. X-rays are the usual test to check for a scaphoid fracture, but up to four-in-ten are missed on x-rays. When x-rays are unclear, a more accurate scan, known as magnetic resonance imaging (MRI), is recommended. Unfortunately, most hospitals in the UK are unable to offer this to patients straightaway, and many are left waiting for the right treatment.

Rachel's research will look at the use of artificial intelligence (AI) computer programmes, which have shown promise in diagnosing injuries. By reviewing a database of 30,000 x-rays of patients with and without a scaphoid fracture she will "teach" the AI to detect scaphoid fractures. The aim is to design a programme that will help health care professionals to diagnose scaphoid fractures and improve the UK's pathway to better treating patients.


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