scholarly journals The role of imaging in predicting the development of rheumatoid arthritis

2021 ◽  
Vol 2 (1) ◽  
pp. 27-33
Author(s):  
Ho So ◽  
Isaac Cheng ◽  
Lai-Shan Tam

Abstract Rheumatoid arthritis (RA) remains a chronic debilitating disease with a significant negative societal impact, despite the expanding landscape of treatment options. This condition is often preceded by a phase of systemic autoimmunity with circulating autoantibodies, elevated pro-inflammatory cytokines, or subtle structural changes. The capability of identifying individuals in the preclinical phase of RA disease makes a “preventive window of opportunity” possible. Much recent work has focused on the role of imaging modalities including ultrasound (US), magnetic resonance imaging (MRI), and high-resolution peripheral quantitative computer tomography (HR-pQCT) in identifying at-risk individuals with or without early joint symptoms for the development of inflammatory arthritis. This article will review the evidence and discuss the challenges as well as opportunities of proactive risk assessment by imaging in RA.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1437.2-1438
Author(s):  
T. Kvlividze ◽  
V. Polyakov ◽  
В. Zavodovsky ◽  
Y. Polyakova ◽  
L. Seewordova ◽  
...  

Background:Interest in highly specialized tissue cytokines contributed to the discovery of new biologically active molecules. Nesfatin-1 (NF) - discovered in 2006 as an anorexigenic factor. NF-1 is believed to be involved in the regulation of energy homeostasis by regulating appetite and water intake. The role of NF-1 in the pathogenesis of inflammatory diseases is poorly understood. Recently, studies have found a relationship between an increased level of NF-1 and inflammatory markers in various pathologies.Objectives:Study of the level of nesfatin-1 in the blood serum of healthy people, determination of the correlation between the level of NF-1 with the severity of clinical symptoms and classic markers of inflammation in patients with RA.Methods:120 persons were examined: 90 patients with RA and 30 healthy people. All patients underwent a complete clinical and laboratory examination. Plasma NF-1 levels were determined using commercial test systems (RaiBiotech, cat # EIA-NESF) according to the manufacturer’s instructions. Patients with various forms of RA were comparable in age to the group of healthy individuals. Statistical processing of clinical examination data was carried out using the “STATISTICA 10.0 for Windows” software package. Quantitative data were processed statistically using the parametric Student’s t-test, qualitative data using the non-parametric chi-square test. The significance of differences between groups was determined using analysis of variance. The results were considered statistically significant at p <0.05.Results:The average level of NF-1 in blood serum in healthy individuals was 31.79 ± 3.21 ng / ml (M ± σ). The level of normal NF-1 values in healthy individuals, defined as M ± 2σ, ranged from 25.3 to 37.83 ng / ml. There was no significant difference in the levels of circulating NF-1 and BMI in healthy individuals and patients with RA (p> 0.05). The inverse relationship of a lower level of NF-1 with an increase in BMI was not significant.Group 1 (66 patients with RA) with increased serum NF-1 levels (> 37.83 ng / ml), and group 2 (44 patients) with normal values (<37.83 ng / ml). A high level of NF-1 was characteristic for patients with high activity according to DAS28, RF seropositive, ACCP-positive, with extra-articular manifestations, who had been ill for 10 years or more. A reliable relationship between the level of NF-1 in the blood serum and laboratory parameters of RA activity - ESR, CRP, was shown, and secondary synovitis was more common. Our data show a direct correlation between the NF-1 level of the pro-inflammatory markers of RA.Conclusion:The positive correlation between the level of NF-1 and classical markers of inflammation, such as CRP and ESR, confirms the involvement of NF-1 in the pathophysiology of inflammation in RA. This is also evidenced by the correlation of a high level of NF-1 in the blood serum with a more severe clinical picture of RA. It is known that NF-1 can promote the release of pro-inflammatory cytokines such as interleukin-8 (IL-8), interleukin-6 (IL-6), and macrophage inflammatory protein-1a (MIP-1a) in the chondrocytes of RA patients.It is necessary to further study the role of NF-1 in the pathogenesis of systemic inflammatory reactions and the possibility of targeting pro-inflammatory cytokines, the possibility of regulating the level of NF-1 by drugs.References:[1]Kvlividze T.Z., Zavodovsky B.V., Akhverdyan Yu.R. Kvlividze T.Z., Zavodovsky B.V., Akhverdyan Yu.R., Polyakova Yu.V., Sivordova L.E., Yakovlev A.T., Zborovskaya I.A. Serum nesfatin -1 as a marker of systemic inflammation in rheumatoid arthritis. Klinicheskaya Laboratornaya Diagnostika (Russian Clinical Laboratory Diagnostics). 2019; 64 (1): 53-56 (in Russ.).Disclosure of Interests:None declared


Hand Surgery ◽  
1996 ◽  
Vol 01 (02) ◽  
pp. 219-237 ◽  
Author(s):  
E.A. Zancolli ◽  
E.R. Zancolli ◽  
G.N. Kohut ◽  
J.C. Cagnone

This paper first describes the usual sequence of the structural changes affecting the wrist and the matacarpal arch in rheumatoid arthritis. Acccording to this sequence, four different types of wrist deformities and two different types of metacarpal arch deformities are determined and their specific features are presented. Treatment options are mentioned for each type, and the author’s preferred treatment is discussed in more detail.


2019 ◽  
Author(s):  
Ali Mobasheri ◽  
Mark Hinton ◽  
Olga Kubassova

Abstract In this commentary we discuss the potential of advanced imaging, particularly Dynamic Contrast Enhanced (DCE) magnetic resonance imaging (MRI) for the objective assessment of disease progression in rheumatoid arthritis (RA). We emphasise the potential DCE-MRI in advancing the field and exploring new areas of research and development in RA. We believe that different grades of bone marrow edema (BME) and synovitis in RA can be examined and monitored in a more sensitive manner with DCE-MRI. Future treatments for RA will be significantly improved by enhanced imaging of BMEs and synovitis. DCE-MRI will also facilitate enhanced stratification and phenotyping of patients enrolled in clinical trials.


2016 ◽  
Vol 16 (2) ◽  
pp. 54-56
Author(s):  
Karen Ka Man Ng ◽  
Tommy Tsang Cheung ◽  
Chak Sing Lau ◽  
Ho Yin Chung

AbstractWe report a 45-year-old lady with rheumatoid arthritis (RA) presented to us with unilateral swelling of the left hand and wrist, mimicking lymphedema. She was arranged to have a magnetic resonance imaging (MRI) of the affected hand and wrist. Lymphedema was successfully ruled out, and severe synovitis and tenosynovitis were found to be the causes of the extensive swelling. The case report aims to illustrate the importance of MRI in diagnosing and differentiating other important pathologies for lymphedema-like swelling in patients with RA.


Author(s):  
Andrew Filer ◽  
Maria Antonietta D’Agostino ◽  
Ilfita Sahbudin

Ultrasound in increasingly used in rheumatology practice in the assessment of inflammatory patient, including facilitating early diagnosis of rheumatoid arthritis (RA), predicting its outcome, measuring structural damage, and monitoring its progression. This imaging modality can visualize both inflammatory and structural changes in patients with unclassified arthritis and RA, as well as other inflammatory arthritides such as psoriatic arthritis (PsA), spondyloarthropathy (SpA), and crystal arthritis. This chapter aims to provide an overview of the recent advances of this technique for in the assessment of RA. Firstly, the principles which underpin the physics of ultrasound are summarized, followed by the musculoskeletal pathologies which are amenable to ultrasound examination. In addition, it also highlights the role of ultrasound in procedures (e.g. ultrasound-guided biopsy and ultrasound-guided injection).


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Georgi Vasilev ◽  
Irena Manolova ◽  
Mariana Ivanova ◽  
Iskren Stanilov ◽  
Lyuba Miteva ◽  
...  

AbstractWe aimed to analyze serum pro-inflammatory profiles of female rheumatoid arthritis (RA) patients and compare them with healthy women to establish the relative importance of pro-inflammatory cytokines in RA and their relation with different treatment regimens. Levels of six cytokines were determined by ELISA assays. A supervised dimensionality reducing approach (PLS-DA Analysis) was applied. All of the cytokines assayed were significantly elevated in the sera of RA female patients than healthy controls with fold change: 21-fold for IL-6; 6.1-fold for IL-17A; 2.5-fold for IL-23; 2.3-fold for IL-18; 1.94-fold for TNF-α; 1.7-fold for IL-12p40. According to the results of the PLS-DA analysis, IL-17A, IL-18, and TNF-α were of higher importance rank compared to IL-23 and IL-12p40. Women in the early stage of RA displayed significantly elevated IL-17A levels than those with longer disease duration: 8.04 pg/ml [8.04–175.3] vs 4.64 pg/ml [2.95–13.31], p = 0.007. IL-6 serum levels were related to higher disease activity. We have demonstrated altered cytokine production within female RA patients on different treatment regimens. Those on Tocilizumab therapy showed elevated IL-6 levels and decreased IL-17A versus the rest of the patients’ subgroups. In conclusion, our data support the pivotal role of IL-18 in addition to IL-6, IL-17A, and TNF-α as the hierarchical cytokines in the pathogenesis of RA, particularly valid for women. Therapy with biological agents targeting IL-18 in addition to the Th17 axis may be an adequate approach in RA patients.


2013 ◽  
Vol 4 (4) ◽  
pp. 40-44
Author(s):  
E. V Gladysheva ◽  
S. L Grishaev ◽  
V. S Nikiforov ◽  
A. S Svistov ◽  
V. N Solntsev

Evidence that has been progressively gathered implicates an important role of the immune system in the course of heart failure. In the majority of heart disease patients, disturbances of humoral immunity with production of cardiodepressant antibodies may play a functional role in cardiac dysfunction. This study evaluates the role of autoantibodies to the cardiac myosin. We examined 52 patients (from 14 till 61 years) with chronic myocarditis. The main examination methods were clinical and biochemical blood tests, ECG, ambulatory Holter ECG monitoring, echocardiography. Autoantibodies to the cardiac myosin were determined by ELISA. These autoantibodies correlate with myocardial inflammation. Also they are associated with structural changes of the heart (hypertrophy, dilation) and cardiac dysfunction (contractility, rhythm and conduction). The degree of expression of these disorders is related to the severity of chronic heart failure.


2018 ◽  
Vol 22 (02) ◽  
pp. 127-146 ◽  
Author(s):  
Annette Helm-Mil ◽  
Iris Eshed ◽  
Claudia Schueller-Weidekamm ◽  
Monique Reijnierse

AbstractBoth the fields of rheumatology and radiology are changing rapidly. Effective medication has become available for rheumatoid arthritis (RA) and transformed it from a progressive disabling disease into a chronic disease. Indications for magnetic resonance imaging (MRI) have changed accordingly, shifting toward early detection. There is also an overall increased clinical demand for high-end imaging. Together with improvement of MRI units and sequences, MRI protocols are adapted based on clinical indications. This article addresses (1) the clinical background and present role of MRI in early disease detection, (2) RA involvement of peripheral joints, (3) RA involvement of the spine, and (4) state-of-the-art RA MRI protocols. The key toward cost-effective MRI examination in RA is communication between radiologist and rheumatologist as well as awareness and knowledge of the basics and advancements in both fields.


2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
John L. Gillick ◽  
John Wainwright ◽  
Kaushik Das

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease affecting a significant percentage of the population. The cervical spine is often affected in this disease and can present in the form of atlantoaxial instability (AAI), cranial settling (CS), or subaxial subluxation (SAS). Patients may present with symptoms and disability secondary to these entities but may also be neurologically intact. Cervical spine involvement in RA can pose a challenge to the clinician and the appropriate role of surgical intervention is controversial. The aim of this paper is to describe the pathology, pathophysiology, clinical manifestations, and diagnostic evaluation of rheumatoid arthritis in the cervical spine in order to provide a better understanding of the indications and options for surgery. Both the medical and surgical treatment options for RA have improved, so has the prognosis of the cervical spine disease. With the advent of disease modifying antirheumatic drugs (DMARDs), fewer patients are presenting with cervical spine manifestations of RA; however, those that do, now have improved surgical techniques available to them. We hope that, by reading this paper, the clinician is able to better evaluate patients with RA in the cervical spine and determine in which patients surgery is indicated.


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