scholarly journals The value of MRI examination on bilateral hands including proximal interphalangeal joints for disease assessment in patients with early rheumatoid arthritis: a cross-sectional cohort study

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying-Qian Mo ◽  
Ze-Hong Yang ◽  
Jun-Wei Wang ◽  
Qian-Hua Li ◽  
Xin-Yun Du ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Erosion ◽  
Whole Body ◽  
Disease Assessment ◽  
Mri Findings ◽  
Cross Sectional ◽  
Early Ra ◽  
Mri Examination ◽  
Mri Features ◽  
High Prevalence

Abstract Background Bilateral hands including proximal interphalangeal joints (PIPJs) are recommended on physical, X-ray radiographic, or ultrasonographic examination by clinical guidelines of rheumatoid arthritis (RA), but MRI still tends to examine unilateral wrists and/or MCPJs. We aimed to demonstrate the advantages of MRI examination on bilateral hands including PIPJs for disease assessment in early RA patients. Methods Active early RA patients received 3.0T whole-body MRI examination with contrast-enhanced imaging on bilateral wrists, MCPJs, and PIPJs. MRI features were scored referring to the updated RAMRIS. Clinical assessments were conducted on the day of MRI examination. Results The mean time of MRI examination was 24 ± 3 min. MRI bone erosion in MCPJs would be missed-diagnosed in 23% of patients if non-dominant MCPJs were scanned unilaterally, while osteitis in MCPJs would be missed-diagnosed in 16% of patients if dominant MCPJs were scanned unilaterally. MRI synovitis severity was also asymmetric: 21% of patients showing severe synovitis unilaterally in non-dominant MCPJs/PIPJs and other 20% showing severe synovitis unilaterally in dominant MCPJs/PIPJs. Among these early RA patients, MRI tenosynovitis occurred the most frequently in wrist extensor compartment I, while MRI examination on bilateral hands demonstrated no overuse influence present. However, overuse should be considered in dominant PIPJ2, PIPJ4, and IPJ of thumb of which MRI tenosynovitis prevalence was respectively 18%, 17%, or 16% higher than the non-dominant counterparts. Early MRI abnormality of nervus medianus secondary to severe tenosynovitis occurred either in dominant or non-dominant wrists; MRI of unilateral hands would take a risk of missed-diagnosis. Common MRI findings in PIPJs were synovitis and tenosynovitis, respectively in 87% and 69% of patients. MRI tenosynovitis prevalence in IPJ of thumb or PIPJ5 was much higher than the continued wrist flexor compartments. MRI synovitis or tenosynovitis in PIPJs independently increased more than twice probability of joint tenderness (OR = 2.09 or 2.83, both p < 0.001). Conclusions In consideration of asymmetric MRI features in early RA, potential overuse influence for certain tenosynovitis in dominant hands, and high prevalence of MRI findings in PIPJs, MRI examination on bilateral hands including PIPJs is deserved for disease assessment in early RA patients.

scholarly journals Magnetic Resonance Imaging of Bilateral Hands Is More Optimal Than MRI of Unilateral Hands for Rheumatoid Arthritis

2018 ◽  
Vol 45 (7) ◽  
pp. 895-904 ◽  
Author(s):  
Ying-Qian Mo ◽  
Ze-Hong Yang ◽  
Hai-Ning He ◽  
Jian-Da Ma ◽  
Jin-Jian Liang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Linear Models ◽  
Bone Erosion ◽  
Metacarpophalangeal Joint ◽  
Whole Body ◽  
Resonance Imaging ◽  
Mri Features ◽  
Scatter Plots

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.

scholarly journals Lipid, fatty acid, carnitine- and choline derivative profiles in rheumatoid arthritis outpatients with different degrees of periodontal inflammation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kathrin Beyer ◽  
Stein Atle Lie ◽  
Bodil Bjørndal ◽  
Rolf K. Berge ◽  
Asbjørn Svardal ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Fatty Acid ◽  
Mitochondrial Dysfunction ◽  
Inflammatory Diseases ◽  
Whole Body ◽  
Cross Sectional ◽  
Chronic Inflammatory Diseases ◽  
Periodontal Inflammation ◽  
Inflammatory Status ◽  
Lipid Fatty Acid

AbstractRheumatoid arthritis (RA) and periodontitis are chronic inflammatory diseases with several pathogenic pathways in common. Evidence supports an association between the diseases, but the exact underlying mechanisms behind the connection are still under investigation. Lipid, fatty acid (FA) and metabolic profile alterations have been associated with several chronic inflammatory diseases, including RA and periodontitis. Mitochondria have a central role in regulating cellular bioenergetic and whole-body metabolic homeostasis, and mitochondrial dysfunction has been proposed as a possible link between the two disorders. The aim of this cross-sectional study was to explore whole-blood FA, serum lipid composition, and carnitine- and choline derivatives in 78 RA outpatients with different degrees of periodontal inflammation. The main findings were alterations in lipid, FA, and carnitine- and choline derivative profiles. More specifically, higher total FA and total cholesterol concentrations were found in active RA. Elevated phospholipid concentrations with concomitant lower choline, elevated medium-chain acylcarnitines (MC-AC), and decreased ratios of MC-AC and long-chain (LC)-AC were associated with prednisolone medication. This may indicate an altered mitochondrial function in relation to the increased inflammatory status in RA disease. Our findings may support the need for interdisciplinary collaboration within the field of medicine and dentistry in patient stratification to improve personalized treatment. Longitudinal studies should be conducted to further assess the potential impact of mitochondrial dysfunction on RA and periodontitis.

scholarly journals Insulin-like Growth Factor 1 and Adiponectin and Associations with Muscle Deficits, Disease Characteristics, and Treatments in Rheumatoid Arthritis

2015 ◽  
Vol 42 (11) ◽  
pp. 2038-2045 ◽  
Author(s):  
Joshua F. Baker ◽  
Joan Marie Von Feldt ◽  
Sogol Mostoufi-Moab ◽  
Woojin Kim ◽  
Elena Taratuta ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Growth Factor ◽  
Disease Activity ◽  
Muscle Mass ◽  
Quantitative Computed Tomography ◽  
Whole Body ◽  
Insulin Like Growth Factor ◽  
Cross Sectional ◽  
Muscle Density ◽  
Age And Sex

Objective.Rheumatoid arthritis (RA) is associated with low muscle mass and density. The objective of our study was to evaluate associations between 2 serum biomarkers [insulin-like growth factor 1 (IGF-1) and adiponectin] and skeletal muscle in RA.Methods.Whole-body dual energy X-ray absorptiometry measures of the appendicular lean mass index (ALMI; kg/m2) and total fat mass index (kg/m2), as well as the peripheral quantitative computed tomography measures of the lower leg muscle and fat cross-sectional area (CSA; cm2) and muscle density (an index of fat infiltration) were obtained from 50 participants with RA, ages 18–70 years. Multivariable linear regression analyses evaluated associations between body composition and levels of adiponectin and IGF-1, adjusted for age, sex, and adiposity.Results.Greater age was associated with higher adiponectin (p = 0.06) and lower IGF-1 (p = 0.004). Eight subjects had IGF-1 levels below the reference range for their age and sex. These subjects had significantly lower ALMI and muscle CSA in multivariable models. Lower IGF-1 levels were associated with greater clinical disease activity and severity, as well as low ALMI, muscle CSA, and muscle density (defined as 1 SD below normative mean). After adjusting for age and sex, greater adiponectin levels were associated with lower BMI (p = 0.02) as well as lower ALMI, and lower muscle CSA, independent of adiposity (p < 0.05). Only greater Health Assessment Questionnaire scores were significantly associated with lower adiponectin levels.Conclusion.Low IGF-1 and greater adiponectin levels are associated with lower muscle mass in RA. Lower IGF-1 levels were seen in subjects with greater disease activity and severity.

scholarly journals DISEASE ACTIVITY PREDICTS WHOLE BODY AND REGIONAL LEAN TISSUE IN RHEUMATOID ARTHRITIS – A CROSS-SECTIONAL STUDY

2015 ◽  
Vol 24 (2) ◽  
pp. 74-83
Author(s):  
Claudiu Popescu ◽  
◽  
Violeta Bojinca ◽  
Daniela Opris ◽  
Ruxandra Ionescu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Disease Activity ◽  
Statistical Tests ◽  
Normal Subjects ◽  
Whole Body ◽  
Lean Tissue ◽  
Cross Sectional ◽  
Rheumatoid Cachexia ◽  
Postmenopausal Female

Aim. The study aims to assess the potential influences of rheumatoid arthritis (RA) and its specific disease measures on lean body composition phenotypes of female patients. Methods. The study was cross-sectionally designed to include Caucasian postmenopausal female RA patients and age-matched postmenopausal female controls. All the subjects gave written informed consent and the study was approved by the local ethics committee. Each subject underwent in the same day a clinical examination, laboratory tests, whole body dual X-ray absorptiometry (DXA) composition and physical activity estimation using a self-administered questionnaire. Correlations, differences and predictive power were analyzed with appropriate statistical tests. Results. The study included 107 RA patients and 104 controls. Compared to the normal subjects, who recorded higher levels of physical activity, the RA patients had significantly lower appendicular lean tissue absolute and relative indices and higher prevalence of sarcopenia. The whole body and appendicular lean tissue indices showed significant negative correlations with measures of disease severity (duration, inflammation, quality of life and radiographic progression), independent of age, levels of physical activity, body mass index and smoking. Conclusions. The measures of disease activity and severity independently predict lean tissue phenotypes in RA patients, behaving as risk factors for sarcopenia and rheumatoid cachexia. The diagnosis of RA in itself is a significant predictive factor of sarcopenia.

scholarly journals Lung involvement prevalence in patients with early rheumatoid arthritis without known pulmonary disease: a multicentric cross sectional study

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Francisco Paulin ◽  
Anastasia Secco ◽  
Federico Benavidez ◽  
Juan José Rodríguez Moncalvo ◽  
Orlando Gabriel Carballo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Lung Disease ◽  
Cross Sectional Study ◽  
Joint Disease ◽  
Joint Involvement ◽  
Lung Involvement ◽  
Functional Tests ◽  
Sectional Study ◽  
Cross Sectional ◽  
Early Ra

Abstract Background Clinically evident interstitial lung disease (ILD) affects between 10 and 42% of the patients with rheumatoid arthritis (RA). Airway involvement seems to be even more common. Most of the available evidence comes from studies performed in established RA patients. The aim of our study was to know the prevalence of non-diagnosed lung disease (airway and interstitial involvement) in patients with early RA and look for associated factors. Methods We designed an observational, multicenter, cross-sectional study, and included patients with RA of less than two years since diagnosis. We performed a structured questionnaire, HRCT and lung functional tests looking for lung disease, together with joint disease evaluation. We analyzed which variables were associated with the presence of lung disease on HRCT. Results We included 83 patients, 83% females. The median (IQR) of time since RA diagnosis was 3 (1–6) months. In the HRCT, 57 patients had airway compromisea (72%), and 6 had interstitial abnormalities (7.5%). The most common altertion found in lung functional tests was a reduced DLCO (14%). The presence of at least one abnormality in the physical exam was associated with lung involvement on HRCT [13 (21.6%) vs 0 (0%); p = 0.026]. Also, patients with lung involvement presented significantly lower values of FVC% and DLCO%, and higher values of RV/TLC. No variable related to joint involvement was found associated with alterations in HRCT. Conclusion Our study shows that a large proportion of early RA patients has abnormal findings in HRCT. Further studies are required to confirm these findings.

Are Rheumatoid Arthritis Patients Discernible from Other Early Arthritis Patients Using 1.5T Extremity Magnetic Resonance Imaging? A Large Cross-sectional Study

2014 ◽  
Vol 41 (8) ◽  
pp. 1630-1637 ◽  
Author(s):  
Wouter Stomp ◽  
Annemarie Krabben ◽  
Désirée van der Heijde ◽  
Tom W.J. Huizinga ◽  
Johan L. Bloem ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cross Sectional Study ◽  
Early Arthritis ◽  
Symptom Duration ◽  
Sectional Study ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Mri Features

Objective.Magnetic resonance imaging (MRI) is increasingly used in rheumatoid arthritis (RA) research. A European League Against Rheumatism (EULAR) task force recently suggested that MRI can improve the certainty of RA diagnosis. Because this recommendation may reflect a tendency to use MRI in daily practice, thorough studies on the value of MRI are required. Thus far no large studies have evaluated the accuracy of MRI to differentiate early RA from other patients with early arthritis. We performed a large cross-sectional study to determine whether patients who are clinically classified with RA differ in MRI features compared to patients with other diagnoses.Methods.In our study, 179 patients presenting with early arthritis (median symptom duration 15.4 weeks) underwent 1.5T extremity MRI of unilateral wrist, metacarpophalangeal, and metatarsophalangeal joints according to our arthritis protocol, the foot without contrast. Images were scored according to OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Scoring (RAMRIS) by 2 independent readers. Tenosynovitis was also assessed. The main outcome was fulfilling the 1987 American College of Rheumatology (ACR) criteria for RA. Test characteristics and areas under the receiver-operator-characteristic curves (AUC) were evaluated. In subanalyses, the 2010 ACR/EULAR criteria were used as outcome, and analyses were stratified for anticitrullinated protein antibodies (ACPA).Results.The ACR 1987 criteria were fulfilled in 43 patients (24.0%). Patients with RA had higher scores for synovitis, tenosynovitis, and bone marrow edema (BME) than patients without RA (p < 0.05). ACPA-positive patients had more BME (median scores 6.5 vs. 4.25, p = 0.016) than ACPA-negative patients. For all MRI features, the predictive value for the presence of RA was low (< 50%). For all MRI features the AUC were < 0.70. Patients who fulfilled ACR/EULAR 2010 criteria but not ACR87 criteria for RA had less synovitis than patients who were positive for RA according to both sets of criteria (p = 0.029).Conclusion.Although patients with RA had higher scores of MRI inflammation and ACPA-positive patients had more BME, the severity of MRI inflammation assessed according to RAMRIS does not accurately differentiate patients with RA from other early arthritis patients.

AB1020 High Prevalence of BF% Obesity in Chinese Patients with Rheumatoid Arthritis: A Cross-Sectional Study

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 1250.2-1250
Author(s):  
J.-Z. Lin ◽  
Y.-B. Chen ◽  
X.-T. Lin ◽  
J.-D. Ma ◽  
Y.-Q. Mo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cross Sectional Study ◽  
Chinese Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
High Prevalence

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

2011 ◽  
Vol 38 (9) ◽  
pp. 2014-2017 ◽  
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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