Pre-treatment interleukin-6 levels strongly affect bone erosion progression and repair detected by magnetic resonance imaging in rheumatoid arthritis patients

Objective.To explore the advantages of magnetic resonance imaging (MRI) of bilateral hands in rheumatoid arthritis (RA).Methods.Consecutive patients with active RA were recruited for clinical assessments, radiographs, and MRI of bilateral hands. Bilateral hands were scanned simultaneously on 3.0 T whole-body MRI system and were scored on synovitis, osteitis, and bone erosion according to the RA MRI scoring (RAMRIS) system.Results.Among 120 patients included, wrist bones and metacarpophalangeal joint (MCPJ) 2 proximal showed bone erosion in early RA. The second to fifth metacarpal bases and the second to fourth MCPJ distal showed more bone erosion in mid-stage or late-stage RA. When MRI of dominant unilateral hand was analyzed, MRI synovitis and osteitis in 5% of wrists and 3 MRI features in 5–14% of MCPJ were misdiagnosed (McNemar test, all p < 0.05). There were 46% wrist synovitis, 29–52% MCPJ2–5 synovitis, 45% wrist osteitis, and 20%–34% MCPJ2–5 osteitis not detected by joint tenderness and/or swelling. When the clinically more severe hand was selected for MRI of unilateral hand according to physical examination, MRI synovitis in 5% of wrists and 3 MRI features in 7–15% of MCPJ were misdiagnosed (all p < 0.05). Scatter plots and linear regression analyses were used to illustrate RAMRIS between dominant or selected hand (Y values) and nondominant or nonselected hand (X values). All linear models were markedly different from a Y = X linear model, indicating the dominant or clinically more severe hand could not represent the contralateral hand to evaluate RAMRIS.Conclusion.MRI of bilateral hands is more optimal than MRI of the unilateral hand in RA.

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The Relationship Between Synovial Pathobiology and Magnetic Resonance Imaging Abnormalities in Rheumatoid Arthritis: A Systematic Review

The Journal of Rheumatology ◽

10.3899/jrheum.161314 ◽

2017 ◽

Vol 44 (9) ◽

pp. 1311-1324 ◽

Cited By ~ 4

Author(s):

Frances Humby ◽

Arti Mahto ◽

Muaaze Ahmed ◽

Andrew Barr ◽

Stephen Kelly ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Magnetic Resonance Imaging ◽

Systematic Review ◽

Bone Marrow ◽

Magnetic Resonance ◽

Bone Erosion ◽

Critical Role ◽

Joint Damage ◽

Resonance Imaging ◽

The Relationship

Objective.Magnetic resonance imaging (MRI) has been increasingly recognized as a critical tool for the assessment of patients with rheumatoid arthritis (RA) and is able to reliably identify synovitis, bone marrow edema, bone erosion, and joint space narrowing (JSN)/cartilage loss. Understanding the exact relationship between each MRI feature and local synovial pathobiology is critical to dissect disease pathogenesis as well as develop future predictive models.Methods.A systematic review was performed of the current published literature examining the relationship between MRI abnormalities and synovial pathobiology in patients with RA.Results.Eighteen studies were identified; most focused on validation of MRI as a tool to detect and quantify synovitis, with a significant relationship demonstrated. Additionally, from the limited data available, a critical role seems likely for synovial pathways, at least in driving joint damage. However, there was a lack of data examining the relationship between synovial pathobiology and bone marrow abnormalities and JSN.Conclusion.Although understanding the interrelationship of these disease biomarkers offers the potential to enhance the predictive validity of modern imaging with concomitant synovial pathobiological analysis, further studies integrating MRI with synovial tissue analysis in well-controlled cohorts at distinct disease stages before and after therapeutic intervention are required to achieve this.

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Magnetic Resonance Imaging of the Rheumatic Foot According to the RAMRIS System Is Reliable

The Journal of Rheumatology ◽

10.3899/jrheum.100906 ◽

2011 ◽

Vol 38 (6) ◽

pp. 1003-1008 ◽

Cited By ~ 19

Author(s):

HENRIËTTE BAAN ◽

ROLAND BEZOOIJEN ◽

JOHANNES K.A. AVENARIUS ◽

ROSEMARY DUBBELDAM ◽

WIEPKE K. DROSSAERS-BAKKER ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Scoring System ◽

Bone Erosion ◽

Outcome Measurement ◽

Random Sets ◽

Resonance Imaging ◽

Bone Edema ◽

Magnetic Resonance Imaging Mri

Objective.In rheumatology, magnetic resonance imaging (MRI) is predominantly applied in the assessment and outcome measurement of rheumatoid arthritis (RA) in hands and wrists, leading to the development of the RAMRIS (RA-MRI-Scoring) system. It was initiated by the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT). The RAMRIS system has not been applied widely in the measurement of feet. We investigated the interreader and intrareader agreement of the RAMRIS scoring system in the assessment of feet in RA.Methods.Twenty-nine patients with RA who had radiological damage and/or arthritis underwent MRI. Two experienced readers independently read both complete sets. One reader read 6 random sets after the initial session, in order to assess the intrareader agreement. For evaluation of the intrareader and interreader reliability, quadratic-weighted κ scores were calculated per joint and lesion.Results.For the forefeet, interreader scores were excellent, ranging from 0.77 (bone edema) to 0.95 (bone erosion). Hindfoot interreader agreement scores were highest for erosion (0.90) and synovitis global score (0.88), but edema and synovial thickness agreement were also acceptable (0.83 and 0.86). Intrareader scores were on the whole slightly lower, but excellent.Conclusion.Reliability (interreader and intrareader agreement) in the assessment of the rheumatoid foot according to the RAMRIS method is excellent.

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Patterns of Magnetic Resonance Imaging Bone Erosion in Rheumatoid Arthritis — Which Bones Are Most Frequently Involved and Show the Most Change?: Figure 1.

The Journal of Rheumatology ◽

10.3899/jrheum.110416 ◽

2011 ◽

Vol 38 (9) ◽

pp. 2014-2017 ◽

Cited By ~ 12

Author(s):

MIKKEL ØSTERGAARD ◽

UFFE MØLLER DØHN ◽

ANNE DUER-JENSEN ◽

MERETE LUND HETLAND ◽

KIM HØRSLEV-PETERSEN ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Disease Duration ◽

Bone Erosion ◽

Resonance Imaging ◽

Early Ra ◽

Established Disease ◽

Magnetic Resonance Imaging Mri ◽

Erosive Progression

Objective.To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA).Methods.MRI datasets from 258 RA patients [126 with early RA (disease duration < 6 months)] were analyzed, of whom 223, including 126 with early RA, had 1-year followup MRI. All patients had MRI of one wrist, whereas 86 patients had additional images of 2nd–5th MCP joints, and 46 patients additional images of the contralateral wrist. MRI were evaluated blinded by one reader, according to the OMERACT RA MRI scoring system (RAMRIS) for erosions, and presence/absence of erosions was noted in each bone, as was presence/absence of erosive progression.Results.The capitate, ulna, lunate, triquetrum, and scaphoid were the 5 bones with both most frequent baseline erosions and most frequently demonstrated erosive progression. No bones were without erosions. Patterns of erosions and progression were similar in early and established RA. No major difference between dominant and nondominant wrists was detected. In the fingers, the 2nd–3rd MCP joint most frequently displayed erosions and erosive progression.Conclusion.The distribution and frequency of bone erosion and erosive progression as detected by MRI in RA wrists and MCP joints were identified. No pattern differences between early versus established disease and dominant versus nondominant sides were detected. No bones showed erosive progression. Thus, no self-evident simplification of the RAMRIS erosion score was identified. Bone involvement patterns may be considered, when joints are selected for MRI protocols for clinical trials and practice.

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Diagnostic test accuracy of magnetic resonance imaging and ultrasound for detecting bone erosion in patients with rheumatoid arthritis

Clinical Rheumatology ◽

10.1007/s10067-019-04825-6 ◽

2019 ◽

Vol 39 (4) ◽

pp. 1283-1293

Author(s):

Haozheng Tang ◽

Xinhua Qu ◽

Bing Yue

Keyword(s):

Rheumatoid Arthritis ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Diagnostic Test ◽

Bone Erosion ◽

Diagnostic Test Accuracy ◽

Test Accuracy ◽

Resonance Imaging

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Detection of bone erosion in early rheumatoid arthritis: ultrasonography and conventional radiography versus non-contrast magnetic resonance imaging

Clinical Rheumatology ◽

10.1007/s10067-010-1423-5 ◽

2010 ◽

Vol 29 (8) ◽

pp. 883-891 ◽

Cited By ~ 27

Author(s):

Maryam Rahmani ◽

Hosein Chegini ◽

Seyed Reza Najafizadeh ◽

Mohammad Azimi ◽

Peiman Habibollahi ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Early Rheumatoid Arthritis ◽

Bone Erosion ◽

Conventional Radiography ◽

Resonance Imaging ◽

Contrast Magnetic Resonance Imaging ◽

Contrast Magnetic Resonance

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Significant improvement in synovitis, osteitis, and bone erosion following golimumab and methotrexate combination therapy as compared with methotrexate alone: A magnetic resonance imaging study of 318 methotrexate-naive rheumatoid arthritis patients

Arthritis & Rheumatism ◽

10.1002/art.30592 ◽

2011 ◽

Vol 63 (12) ◽

pp. 3712-3722 ◽

Cited By ~ 62

Author(s):

Mikkel Østergaard ◽

Paul Emery ◽

Philip G. Conaghan ◽

Roy Fleischmann ◽

Elizabeth C. Hsia ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Combination Therapy ◽

Bone Erosion ◽

Imaging Study ◽

Magnetic Resonance Imaging Study ◽

Resonance Imaging

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Magnetic Resonance Imaging Bone Edema at Enrollment Predicts Rapid Radiographic Progression in Patients with Early RA: Results from the Nagasaki University Early Arthritis Cohort

The Journal of Rheumatology ◽

10.3899/jrheum.150988 ◽

2016 ◽

Vol 43 (7) ◽

pp. 1278-1284 ◽

Cited By ~ 9

Author(s):

Yoshikazu Nakashima ◽

Mami Tamai ◽

Junko Kita ◽

Toru Michitsuji ◽

Toshimasa Shimizu ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Radiographic Progression ◽

Bone Erosion ◽

Early Stage ◽

Early Arthritis ◽

Resonance Imaging ◽

Multivariate Logistic Regression ◽

Bone Edema

Objective.To clarify whether magnetic resonance imaging (MRI) bone edema predicts the development of rapid radiographic progression (RRP) in the Nagasaki University Early Arthritis Cohort of patients with early-stage rheumatoid arthritis (RA).Methods.Patients with early-stage RA (n = 76) were enrolled and underwent 1.5-T MRI of both wrists and finger joints. Synovitis, bone edema, and bone erosion were evaluated using the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring (RAMRIS). RRP was defined as an annual increment > 3 at 1 year by the Genant-modified Sharp score of plain radiographs. A multivariate logistic regression analysis was performed to establish the risk factors for RRP.Results.Median disease duration at enrollment was 3 months. RRP was found in 12 of the 76 patients at 1 year. A univariate analysis revealed that matrix metalloprotease-3, RAMRIS bone edema score, and RAMRIS bone erosion score were associated with RRP. Multivariate logistic regression analyses demonstrated that the RAMRIS bone edema score at enrollment (5-point increase, OR 2.18, 95% CI 1.32–3.59, p = 0.002) was the only independent predictor of the development of RRP at 1 year. A receiver-operating characteristic analysis identified the best cutoff value for RAMRIS bone edema score as 5. RRP was significantly rare among the patients with a RAMRIS bone edema score < 5 at enrollment (2 from 50 patients).Conclusion.Our findings suggest that MRI bone edema is closely associated with the development of RRP in patients with early-stage RA. Physicians should carefully control the disease activity when MRI bone edema is observed in patients with early RA.

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Cellular characterisation of magnetic resonance imaging bone oedema in rheumatoid arthritis; implications for pathogenesis of erosive disease

Annals of the Rheumatic Diseases ◽

10.1136/ard.2008.096024 ◽

2008 ◽

Vol 68 (2) ◽

pp. 279-282 ◽

Cited By ~ 84

Author(s):

N Dalbeth ◽

T Smith ◽

S Gray ◽

A Doyle ◽

P Antill ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Plasma Cells ◽

Bone Erosion ◽

Resonance Imaging ◽

Rankl Expression ◽

Erosive Disease ◽

Local Bone ◽

Bone Oedema

Objectives:Magnetic resonance imaging (MRI) bone oedema is an important predictor of bone erosion in rheumatoid arthritis (RA). This study aimed to determine the cellular components of MRI bone oedema, and clarify the relationship between bone erosion and MRI bone oedema.Methods:Twenty-eight bones from 11 patients with RA undergoing orthopaedic surgery were analysed by quantitative and semi-quantitative immunohistochemistry. Pre-operative contrast-enhanced MRI scans were analysed for bone oedema.Results:The density of osteoclasts was higher in those samples with MRI bone oedema than those without MRI bone oedema (p = 0.01). Other cells identified within bone marrow included macrophages and plasma cells, and these were more numerous in samples with MRI bone oedema (p = 0.02 and 0.05 respectively). B cells were present in lower numbers, but B cell aggregates were identified in some samples with MRI bone oedema. There was a trend to increased RANKL expression in samples with MRI bone oedema (p = 0.09). Expression of RANKL correlated with the number of osteoclasts (r = 0.592, p = 0.004).Conclusions:The increased number of osteoclasts and RANKL expression in samples with MRI bone oedema supports the hypothesis that bone erosion in RA occurs through activation of local bone resorption mechanisms within subchondral bone as well as through synovial invasion into bone.

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