scholarly journals The role of imaging in rheumatoid arthritis

2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Kgomotso Kgoebane ◽  
Mahmood M.T.M. Ally ◽  
Martha C. Duim-Beytell ◽  
Farhana E. Suleman
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Process ◽  
Classification Criteria ◽  
Reactive Protein ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Soft Tissue Involvement ◽  
Imaging Detection ◽  
Hands And Feet

Conventional radiographs of the hands and feet have traditionally been used in the diagnosis, management and monitoring of patients with rheumatoid arthritis (RA). However, they are not sensitive enough to detect changes early in the disease process. Erosions may only be visible up to two years after the onset of disease, and soft tissue involvement may not be detected at all. Early diagnosis can also be made challenging as markers such as erythrocyte sedimentation rate and C-reactive protein may be normal in up to 20% – 25% of cases. The latest classification criteria (American College of Rheumatology/European League Against Rheumatism [ACR/EULAR] Rheumatoid Arthritis Classification criteria 2010), often used to diagnose RA, incorporate the role of ultrasound and magnetic resonance imaging detection of synovitis, enabling earlier diagnosis and correct classification of patients. This article looks at the role of the various imaging modalities used in the diagnosis and management of RA.

Rheumatoid Arthritis: Etiology and Pathogenesis

2014 ◽  
Author(s):  
Gary S. Firestein ◽  
Anna-Karin H. Ekwall
Keyword(s):  
Rheumatoid Arthritis ◽  
Intracellular Signaling ◽  
Cartilage Damage ◽  
Signs And Symptoms ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Citrullinated Proteins ◽  
Definition Of

Rheumatoid arthritis (RA) is among the most common forms of chronic inflammatory arthritis. It affects approximately 1% of adults and is two to three times more prevalent in women than in men. There are no specific laboratory tests for RA; diagnosis depends on a constellation of signs and symptoms that can be supported by serology and radiographs. The disease evolves over many years as a consequence of repeated environmental stress causing inflammation and immune activation followed by a breakdown of tolerance in individuals with a specific genetic background. This review describes the definition of RA; its etiology, including genetics, infections, the role of smoking and citrullination of proteins, and epigenetic mechanisms; and its pathogenesis, including synovial histopathology, bone and cartilage damage, adaptive and innate immunity, and the role of cytokines and intracellular signaling. Tables include the 1987 American Rheumatism Association criteria for the classification of RA and the 2010 American College of Rheumatology/European League Against Rheumatism classification for RA. Figures show citrullinated proteins in airway cells, a section of a proliferative synovium from a patient with a classic RA, and scalloped regions of erosion at the junction between a proliferative inflamed rheumatoid synovium and the bone. This review contains 3 highly rendered figures, 2 tables, and 71 references.

scholarly journals The prevalence of rheumatoid arthritis in middle-aged and elderly people living in Naqu City, Tibet, Autonomous Region of China

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Qingxi Zhang ◽  
Qiang Liu ◽  
Chutong Lin ◽  
Yangjin Baima ◽  
Hu Li ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Population Based ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Autonomous Region ◽  
Reactive Protein ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Tibet Autonomous Region ◽  
The Tibet Autonomous Region

Abstract Objective To estimate the prevalence of rheumatoid arthritis (RA) in the Tibet Autonomous Region (China). Methods A population-based cross-sectional survey was conducted on 1458 residents of Luoma Town, Tibet Autonomous Region, who were aged ≥ 40 years old. We interviewed participants using questionnaires, and rheumatoid factor (RF), anti-citrullinated protein antibodies (ACPA), and C-reactive protein (CRP) were determined. The identification of RA in this study was on the basis of criteria issued by the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) guideline. Results Herein, 782 participants completed all items of RA. The overall prevalence of RA was 4.86%, and the prevalence was higher in women than that in men (7.14% vs. 2.56%, p = 0.005). The age-standardized prevalence of RA was 6.30% (95% confidence interval (CI) 4.20–8.64%), which was 2.46% (95% CI 1.04%, 4.10%) and 9.59% (95% CI 5.93%, 13.77%) in men and women, respectively. Conclusion The prevalence of RA is relatively higher in the Tibet than that in other areas of China.

Role of erosions typical of rheumatoid arthritis in the 2010 ACR/EULAR rheumatoid arthritis classification criteria: results from a very early arthritis cohort

2017 ◽  
Vol 76 (11) ◽  
pp. 1911-1914 ◽  
Author(s):  
Gina Hetland Brinkmann ◽  
Ellen S Norli ◽  
Pernille Bøyesen ◽  
Désirée van der Heijde ◽  
Lars Grøvle ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Arthritis ◽  
Classification Criteria ◽  
Erosive Disease ◽  
American College Of Rheumatology ◽  
Number Of Patients ◽  
Definition Of ◽  
Hands And Feet ◽  
Almost All

ObjectiveTo determine how the European League Against Rheumatism (EULAR) definition of erosive disease (erosion criterion) contributes to the number of patients classified as rheumatoid arthritis (RA) according to the 2010 American College of Rheumatology/EULAR RA classification criteria (2010 RA criteria) in an early arthritis cohort.MethodsPatients from the observational study Norwegian Very Early Arthritis Clinic with joint swelling ≤16 weeks, a clinical diagnosis of RA or undifferentiated arthritis, and radiographs of hands and feet were included. Erosive disease was defined according to the EULAR definition accompanying the 2010 RA criteria. We calculated the additional number of patients being classified as RA based on the erosion criteria at baseline and during follow-up.ResultsOf the 289 included patients, 120 (41.5%) fulfilled the 2010 RA criteria, whereas 15 (5.2%) fulfilled only the erosion criterion at baseline. 118 patients had radiographic follow-up at 2 years, of whom 6.8% fulfilled the 2010 RA criteria and only one patient fulfilled solely the erosion criterion during follow-up.ConclusionFew patients with early arthritis were classified as RA based on solely the erosion criteria, and of those who did almost all did so at baseline.

scholarly journals The Adequacy of Evaluation by Rheumatologists before Undergoing Arthroscopic Synovectomy in Rheumatoid Arthritis Patients

2020 ◽  
Vol 25 (1) ◽  
pp. 2-7
Author(s):  
Neunghan Jeon ◽  
Hyun Jun Kim ◽  
Min Jong Park
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Response ◽  
Laboratory Tests ◽  
Arthroscopic Synovectomy ◽  
X Ray ◽  
Reactive Protein ◽  
Treatment Response Evaluation ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Remission Criteria

Purpose: The purpose of this study was to evaluate the relationship between the progression of arthritis and the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) through the treatment-resistant mono joint rheumatoid arthritis treated with arthroscopic synovectomy.Methods: We retrospectively reviewed 65 patients who underwent arthroscopic synovectomy for rheumatoid wrist or elbow which had not responded to systemic treatment for at least 6 months. The main treatment response evaluation methods of rheumatologists were the American College of Rheumatology (ACR) response criteria, and the ACR/EULAR (European League Against Rheumatism) remission criteria. The medical records, results of laboratory tests and radiographs of wrist or elbow that had been performed by rheumatologists before arthroscopic synovectomy were investigated. We examined whether the results of laboratory tests and arthritic change of radiograph had statistically significant correlation. Results: The mean duration of joint symptom until referral to orthopedic department was 23 months (range, 1 month to 9.2 years). During this period, rheumatologists had took average one X-ray (range, 0–3). Forty-seven patients (72.3%) had CRP of 1 mg/dL or less as included in the ACR/EULAR remission criteria. Seventeen out of 65 patients who had two or more X-ray were able to evaluate the progression of arthritis. The change of arthritis and mean ESR (p=0.787) or CRP (p=0.303) the same period didn’t have statistically significant relationship (Spearman correlation analysis).Conclusion: Since the method of evaluating the treatment response of rheumatologists is to assess the systemic condition, arthritis of one joint that is resistant to treatment is considered to require periodic radiographs as method to assess itself.

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