Annual Meeting Image Competition


Submit a case-based image for peer-review and display at ACR Convergence, the ACR's annual meeting. If accepted, your image may be digitally displayed at the meeting and will be added to the ACR Rheumatology Image Library collection. One image will be selected as the winner of the Image Competition and published in the Arthritis & Rheumatology journal. The winner will receive complimentary registration to ACR Convergence 2024.

Image Competition Call for Submissions

The Image Competition call for submissions is open. Please review the complete submission instructions and guidelines prior to submission.


Deadline: June 18, noon ET


Image Competition Submission Site


If your image is accepted, it will be added to the Rheumatology Image Library. In addition, prizes for the following categories will be awarded.

Best Overall Image

  • $1,500 cash prize
  • Published in an issue of Arthritis & Rheumatology
  • Complimentary registration to ACR Convergence 2024
  • Highlighted during the ACR Convergence 2024 - Plenary I

Regional Winners Circle

One contributor from each region* listed below will be added to the Regional Winners Circle. The Regional Winners Circle will be highlighted during the ACR Convergence 2024 – Plenary I, receive complimentary registration to ACR Convergence 2024, be eligible to win the 2024 People's Choice Award, plus the opportunity to be featured as the Image of Month in The Rheumatologist.

  • North America
  • Latin America & Caribbean
  • Europe & Central Asia
  • Middle East & North Africa
  • East Asia & Pacific
  • South Asia
  • Sub-Saharan Africa

*These regions are defined by the World Bank.

The People's Choice Award will showcase the regional winners, representing the global rheumatology community. The People's Choice Award winner will be selected during ACR Convergence 2024 and receive a $1,000 cash prize.

Image Submission Eligibility

Who is eligible to submit an image
ACR and ARP members and non-members are eligible to submit an image.

Images that are eligible for submission
The ACR seeks images representing a diverse range of patients that show either educational or remarkable manifestations of the rheumatic disease in the following categories:

Findings of Pediatric Rheumatic Diseases (including autoimmune, inflammatory, infectious and malignant drivers of pediatric rheumatic disease).

Images that are not eligible for submission

  • Images that have been published before the Image Competition submission deadline
  • Images that are copyrighted
  • Images that have been previously submitted to the Image Competition

Image Submission Guidelines

Image Permissions

See information about the use of Rheumatology Image Library images, including the annual meeting embargo policy.

ACR Convergence 2023 Image Competition Winner

Congratulations to the winner for their outstanding submission to the Image Competition!

2023 Image Competition Winner

Grand Prize
Mary Purcell, MD
Halifax, Nova Scotia

An 81-year-old male presented with a two-year history of progressive dysphagia associated with weight loss and generalized weakness. He had periorbital hyperpigmentation (A) and prominent submandibular glands (B). Creatine kinase (CK) was elevated and electromyography showed an irritable myopathy. Muscle biopsy demonstrated severe neurogenic atrophy without obvious myositis. Small and large perimysial and epimysial vessels showed glassy, pink thickening approaching nodularity in areas. The material was strongly positive for Congo red (C) and exhibited the characteristic birefringence of amyloid on polarization (D). Mass spectroscopy analysis demonstrated that the amyloid material was light chain in origin.

2023 Image Competition People's Choice Award & Regional Winners

Regional & People's Choice Winner

Rajat Ranka, MD
Rishikesh, Uttarakhand India

A 27-year-old male developed erythematous violaceous lesions over upper chest, face, and scalp over 6 months, associated with photosensitivity, non-scarring alopecia, oral ulcers, heliotrope rash, and Gottron papules. Progressive ulcers over bilateral malar areas and left angle of mandible followed. Ulcer edge biopsy showed perivascular and peri-adnexal lymphoid infiltrates, vacuolar interface dermatitis, and basement membrane zone thickening, with no clinical, radiological, or laboratory evidence of myositis, interstitial lung disease or arthritis. Anti-Melanoma-Differentiation-Associated gene5 (MDA-5) antibody was positive and amyopathic dermatomyositis was diagnosed. Anti-MDA5 is usually associated with digital and extensor ulcers, however, facial ulceration as in this case is rare.

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Regional Winner

Marco Fornaro, MD
Grottaglie, Taranto Italy

A 55-year-old patient with suspected polymyositis presented with limb weakness, elevated creatine phosphokinase levels (>3000 IU/L), and myopathic findings on electromyography. Thigh muscle magnetic resonance imaging revealed predominant diffuse fat replacement in the quadriceps and hamstring muscles (red arrows) and scattered muscle edema (red head arrow). Autoimmunity tests were negative. Deltoid muscle biopsy showed vacuoles on trichrome staining (Gomori's stain), positive periodic acid-Schiff (PAS) accumulation, and subsarcolemmal cytochrome c oxidase (COX) staining. The absence of myophosphorylase activity in the muscle biopsy, along with confirmation through genetic testing, established a diagnosis of glycogen storage disease type V (McArdle disease).

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Regional Winner

Doron Rimar, MD
Haifa, Israel

A 36-year-old man presented with arthralgia, dyspnea and a unilateral heliotrope rash [A]. Manual muscle testing was normal, but myositis was evident on MRI scan [B].HRCT demonstrated peripheral ground-glass opacities [C]. Capillaroscopy showed red blood cell extravasation, peri-capillary stippling (PCS) [D].

Laboratory tests revealed anti MDA5 antibodies and normal muscle enzymes. He was diagnosed with anti MDA5 dermatomyositis (DM).

Anti-MDA5 DM frequently presents various cutaneous manifestations including ulcerations, mechanic’s hands and alopecia. A unilateral heliotrope rash is a distinctive but rare manifestation. He was treated with rituximab and mycophenolate mofetil with clinical improvement and resolution of PCS [E].

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Regional Winner

David Mecham, DO
Rockville, Maryland, United States

A 22-year-old female with recent diagnosis of Anti-Melanoma Differentiation-Associated gene 5 (MDA-5) DM presented for evaluation of worsening skin rashes and pleuritic chest pain. Exam showed heliotrope rash of eyelids, digital pulp and third MCP joint ulcerations, and Gottrons sign of elbows. CT chest showed moderately sized pneumomediastinum (blue arrows) dissecting into deep neck spaces and multifocal peripheral reticular opacities (red arrows) consistent with early interstitial lung disease (ILD). MDA-5 DM represents an aggressive subset of myositis that can involve ulcerative cutaneous disease, rapidly progressive ILD, and rarely, spontaneous pneumomediastinum.

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