Bone erosions and osteophytes in premenopausal women with long‐standing rheumatoid arthritis: association with systemic bone involvement by HR‐Pqct

Abstract Background rheumatoid arthritis is currently regarded as independent cardiovascular risk factor. Accelerated atherosclerosis considered as an extra-articular manifestation of RA that occurs as a result of interaction between traditional CV risk factors and inflammatory activity of joint disease. Both atherosclerosis and RA have in common inflammatory mediators. Objectives the presented study aimed to find the relation between cardiovascular affection and erosive articular changes in RA. Subjects and Methods The presented study included 40 patients’ men and premenopausal women that were diagnosed with rheumatoid arthritis fulfilling the 2010 ACR/EULAR classification criteria for rheumatoid arthritis recruited from the physical Medicine, Rheumatology, and Rehabilitation outpatient clinics of Ain Shams University, patients underwent laboratory investigation, carotid duplex, musculoskeletal ultrasound and echocardiography. Results Among 40 RA patients, 16 (40%) had erosions in both hands and 24 (60%) without erosion with no statistically significance difference between both sides of hand and feet, only 3 patients (7.5%) had active erosion exhibited by power Doppler. The presence of erosion positively correlated with the mean CIMT (p-value < 0.001) with mean 0.827±0.149, The presence of carotid plaques as a marker of advanced atherosclerosis showed statistically significant value with erosions (p = 0.001). There was positive relation between erosions with disease duration (p-value < 0.001), and negatively with DAS-28 (p = 0.083). Out of 33 patients with positive RF, 16 patients had erosions with statistically significant value (p = 0.017). Conclusion Since the presence of bone erosions was highly associated with higher mean CIMT, consequently, we recommend that when finding bone erosions in rheumatoid arthritis patient, good monitoring should be given to cardiovascular risk factors with early and proper treatment to limit the progression of erosions and protect against atherosclerosis and its complications.

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Scoring of Synovial Membrane Hypertrophy and Bone Erosions by MR Imaging in Clinically Active and Inactive Rheumatoid Arthritis of the Wrist

Scandinavian Journal of Rheumatology ◽

10.3109/03009749509100876 ◽

1995 ◽

Vol 24 (4) ◽

pp. 212-218 ◽

Cited By ~ 54

Author(s):

M. Østergaard ◽

P. Gideon ◽

K. Ssrensen ◽

M. Hansen ◽

M. Stoltenberg ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Mr Imaging ◽

Synovial Membrane ◽

Bone Erosions

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Increased Serum Interleukin 22 in Patients with Rheumatoid Arthritis and Correlation with Disease Activity

The Journal of Rheumatology ◽

10.3899/jrheum.111027 ◽

2012 ◽

Vol 39 (7) ◽

pp. 1320-1325 ◽

Cited By ~ 60

Author(s):

LAURINDO FERREIRA da ROCHA ◽

ÂNGELA LUZIA BRANCO PINTO DUARTE ◽

ANDRÉA TAVARES DANTAS ◽

HENRIQUE ATAÍDE MARIZ ◽

IVAN da ROCHA PITTA ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Mononuclear Cells ◽

Activity Index ◽

Elevated Serum ◽

Serum Levels ◽

Peripheral Blood Mononuclear ◽

Additional Tool ◽

Bone Erosions ◽

Interleukin 22

Objective.To analyze the role of interleukin 22 (IL-22) in rheumatoid arthritis (RA).Methods.IL-22 serum levels were measured in 83 patients with established RA under treatment with disease-modifying antirheumatic drugs and in 30 healthy controls matched for age and sex. Patients were assessed for clinical and laboratory variables. Correlations of IL-22 serum levels with disease activity measures [Clinical Disease Activity Index (CDAI) and Disease Activity Score for 28 joints (DAS28)], serological markers, bone erosions, and demographic factors were assessed. Peripheral blood mononuclear cells (PBMC) from 30 patients with RA and 14 controls were purified and stimulatedin vitrowith phorbol myristate acetate (PMA)/ionomycin. IL-22 production by PBMC and in serum was investigated by ELISA.Results.IL-22 levels were increased in patients with RA compared with controls (mean 432.37 pg/ml and 67.45 pg/ml, respectively; p < 0.001). Levels of IL-22 correlated with DAS28 and CDAI measures. Rheumatoid factor (RF) positivity was correlated with higher levels of IL-22 in patients with RA (mean 575.08 pg/ml; p = 0.001). The presence of bone erosions was associated with high IL-22 levels (p = 0.0001). PBMC stimulated with PMA/ionomycin expressed higher levels of IL-22 in patients with RA than controls but this was not significant (mean 584.75 pg/ml and 295.57 pg/ml; p = 0.553).Conclusion.IL-22 is elevated in the serum of patients with established RA. Elevated serum IL-22 allows discrimination between patients with different clinical and laboratory measures and indicates the potential of IL-22 as an additional tool for assessment of activity in RA, particularly in patients with RF antibodies and longterm disease. IL-22 is associated with bone-destructive disease.

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Heterogeneity of Cortical Breaks in Hand Joints of Patients with Rheumatoid Arthritis and Healthy Controls Imaged by High-resolution Peripheral Quantitative Computed Tomography

The Journal of Rheumatology ◽

10.3899/jrheum.160646 ◽

2016 ◽

Vol 43 (10) ◽

pp. 1914-1920 ◽

Cited By ~ 10

Author(s):

Andrea Scharmga ◽

Michiel Peters ◽

Astrid van Tubergen ◽

Joop van den Bergh ◽

Cheryl Barnabe ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Computed Tomography ◽

High Resolution ◽

Trabecular Bone ◽

Quantitative Computed Tomography ◽

Peripheral Quantitative Computed Tomography ◽

Healthy Controls ◽

Poor Prognostic Factor ◽

Bone Erosions ◽

Bone Changes

Objective.Conventional radiographs (CR) of the hands are the gold standard for imaging bone erosions. The presence of bone erosions, reflected by the presence of cortical breaks, is a poor prognostic factor in patients with rheumatoid arthritis (RA). The availability of high-resolution peripheral quantitative computed tomography (HR-pQCT) enables detailed investigation of cortical breaks in rheumatic diseases. The aim of this image review is to show HR-pQCT images of the spectrum of cortical breaks with and without underlying trabecular bone changes in metacarpophalangeal (MCP) joints of healthy controls (HC) and patients with RA, with corresponding images on CR and magnetic resonance imaging (MRI).Methods.Second and third MCP joints of 41 patients (of which 10 were early RA with ≤ 2 years and 24 longstanding RA with ≥ 10 years of disease duration) and 38 HC were imaged by CR, MRI, and HR-pQCT (XtremeCT1, Scanco Medical AG). Representative images of the spectrum of cortical breaks were selected.Results.Cortical breaks were found in early and longstanding RA, but also in HC. They were heterogeneous in size, location, and number per joint, with a variety of surrounding cortical and underlying trabecular bone characteristics.Conclusion.Using HR-pQCT images of MCP joints, heterogeneous cortical breaks with and without surrounding trabecular bone changes were found, not only in RA but also in HC. The underlying mechanisms and significance of this spectrum of cortical breaks as found with high 3-D resolution needs further investigation.

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