Location and incidence of localized juxta-articular demineralizations and erosions at the wrist in early rheumatoid arthritis

International Nuclear Information System (INIS)

Fischer, E.

1988-01-01

In early rheumatoid arthritis the location and incidence of localized juxta-articular demineralizations and erosions were investigated at 53 points of the wrist. On the level of the metacarpal bases, the distal and proximal row of the carpal bones more changes are seen in the oblique vd. and the lateral view than in the dv. view. At the distal bones of the forearm more changes are seen at the radius than at the ulnar styloid. The most often changes at all occur at the volar middle third of the triquetrum in the oblique view and at the distal volar articular facet of the scaphoid in the lateral view. Close relations between localized juxta-articular demineralizations and erosions do not exist. If the early bone changes at the wrist in rheumatoid arthritis are to be detected additional oblique and lateral view are prerequisite. (orig.) [de

How to diagnose rheumatoid arthritis early: a prediction model for persistent (erosive) arthritis

NARCIS (Netherlands)

Visser, Henk; le Cessie, Saskia; Vos, Koen; Breedveld, Ferdinand C.; Hazes, Johanna M. W.

2002-01-01

To develop a clinical model for the prediction, at the first visit, of 3 forms of arthritis outcome: self-limiting, persistent nonerosive, and persistent erosive arthritis. A standardized diagnostic evaluation was performed on 524 consecutive, newly referred patients with early arthritis.

Shared epitope-antagonistic ligands: a new therapeutic strategy in mice with erosive arthritis.

Science.gov (United States)

Ling, Song; Liu, Ying; Fu, Jiaqi; Colletta, Alessandro; Gilon, Chaim; Holoshitz, Joseph

2015-05-01

The mechanisms underlying bone damage in rheumatoid arthritis (RA) are incompletely understood. We recently identified the shared epitope (SE), an HLA-DRB1-coded 5-amino acid sequence motif carried by the majority of RA patients as a signal transduction ligand that interacts with cell surface calreticulin and accelerates osteoclast (OC)-mediated bone damage in collagen-induced arthritis (CIA). Given the role of the SE/calreticulin pathway in arthritis-associated bone damage, we sought to determine the therapeutic targetability of calreticulin. A library of backbone-cyclized peptidomimetic compounds, all carrying an identical core DKCLA sequence, was synthesized. The ability of these compounds to inhibit SE-activated signaling and OC differentiation was tested in vitro. The effect on disease severity and OC-mediated bone damage was studied by weekly intraperitoneal administration of the compounds to DBA/1 mice with CIA. Two members of the peptidomimetics library were found to have SE-antagonistic effects and antiosteoclast differentiation effects at picomolar concentrations in vitro. The lead mimetic compound, designated HS(4-4)c Trp, potently ameliorated arthritis and bone damage in vivo when administered in picogram doses to mice with CIA. Another mimetic analog, designated HS(3-4)c Trp, was found to lack activity, both in vitro and in vivo. The differential activity of the 2 analogs depended on minor differences in their respective ring sizes and correlated with distinctive geometry when computationally docked to the SE binding site on calreticulin. These findings identify calreticulin as a novel therapeutic target in erosive arthritis and provide sound rationale and early structure/activity relationships for future drug design. © 2015, American College of Rheumatology.

MR imaging of arthropathies of juvenile arthritis and hemophilia

International Nuclear Information System (INIS)

Yulish, B.S.; Lieberman, J.; Mulopoulos, G.P.; Strandjord, S.; Newman, A.; Goodfellow, D.; Bryan, P.J.; Modic, M.T.

1986-01-01

The arthropathies of juvenile arthritis and hemophilia have in common abnormal hyperplastic synovium leading to marginal bone erosion, articular cartilage destruction, subchondral bone exposure, and dissolution and ultimately collapse of the affected joint. The authors examined children and young adults with juvenile arthritis and hemophilia by MR imaging and found that they could identify hyperplastic synovium, articular cartilage lesions, bone erosions, and joint effusions. This has therapeutic implications since identification of progressive synovial hyperplasia and/or early cartilage or marginal bone erosion may lead to earlier synovectomy in patients with hemophilia or switch to second line drugs in patients with juvenile arthritis, in an attempt to prevent progressive joint destruction

Severe erosive arthritis of large joints in chronic renal failure

International Nuclear Information System (INIS)

Griffin, C.N. Jr.

1984-01-01

Two cases of chronic renal failure are presented in which a large joint severe erosive arthritis was the prominent radiologic feature of their renal osteodystrophy. In one both knees were involved, and in the other both knees and one wrist. Distal clavicular erosions were present in both, but hands were not radiographically involved. The literature is reviewed in regards other reports of erosive arthritis complicating renal failure. (orig.)

Carpal erosions in children with juvenile idiopathic arthritis: repeatability of a newly devised MR-scoring system

International Nuclear Information System (INIS)

Boavida, Peter; Lambot-Juhan, Karen; Ording Mueller, Lil-Sofie; Damasio, Beatrice; Malattia, Clara; Tanturri de Horatio, Laura; Owens, Catherine M.; Rosendahl, Karen

2015-01-01

Juvenile idiopathic arthritis (JIA) is characterized by synovial inflammation, with potential risk of developing progressive joint destruction. Personalized state-of-the-art treatment depends on valid markers for disease activity to monitor response; however, no such markers exist. To evaluate the reliability of scoring of carpal bone erosions on MR in children with JIA using two semi-quantitative scoring systems. A total of 1,236 carpal bones (91 MR wrist examinations) were scored twice by two independent pediatric musculoskeletal radiologists. Bony erosions were scored according to estimated bone volume loss using a 0-4 scale and a 0-10 scale. An aggregate erosion score comprising the sum total carpal bone volume loss was calculated for each examination. The 0-4 scoring system resulted in good intra-reader agreement and moderate to good inter-observer agreement in the assessment of individual bones. Fair and moderate agreement were achieved for inter-reader and intra-reader agreement, respectively, using the 0-10 scale. Intra- and particularly inter-reader aggregate score variability were much less favorable, with wide limits of agreement. Further analysis of erosive disease patterns compared with normal subjects is required, and to facilitate the development of an alternative means of quantifying disease. (orig.)

Carpal erosions in children with juvenile idiopathic arthritis: repeatability of a newly devised MR-scoring system

Energy Technology Data Exchange (ETDEWEB)

Boavida, Peter [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); Lambot-Juhan, Karen [Hospital Necker Enfants Malades, Department of Radiology, Paris (France); Ording Mueller, Lil-Sofie [Oslo University Hospital, Department of Radiology, Oslo (Norway); Damasio, Beatrice; Malattia, Clara [Ospedale Pediatrico Gaslini, Department of Rheumatology, Genoa (Italy); Tanturri de Horatio, Laura [Ospedale Pediatrico Bambino Gesu, Department of Radiology, Rome (Italy); Owens, Catherine M. [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); UCL, Institute of Child Health, London (United Kingdom); Rosendahl, Karen [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Department of Clinical Medicine, Bergen (Norway)

2015-12-15

Juvenile idiopathic arthritis (JIA) is characterized by synovial inflammation, with potential risk of developing progressive joint destruction. Personalized state-of-the-art treatment depends on valid markers for disease activity to monitor response; however, no such markers exist. To evaluate the reliability of scoring of carpal bone erosions on MR in children with JIA using two semi-quantitative scoring systems. A total of 1,236 carpal bones (91 MR wrist examinations) were scored twice by two independent pediatric musculoskeletal radiologists. Bony erosions were scored according to estimated bone volume loss using a 0-4 scale and a 0-10 scale. An aggregate erosion score comprising the sum total carpal bone volume loss was calculated for each examination. The 0-4 scoring system resulted in good intra-reader agreement and moderate to good inter-observer agreement in the assessment of individual bones. Fair and moderate agreement were achieved for inter-reader and intra-reader agreement, respectively, using the 0-10 scale. Intra- and particularly inter-reader aggregate score variability were much less favorable, with wide limits of agreement. Further analysis of erosive disease patterns compared with normal subjects is required, and to facilitate the development of an alternative means of quantifying disease. (orig.)

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

Science.gov (United States)

Brinkmann, Gina Hetland; Norli, Ellen S; Bøyesen, Pernille; van der Heijde, Désirée; Grøvle, Lars; Haugen, Anne J; Nygaard, Halvor; Bjørneboe, Olav; Thunem, Cathrine; Kvien, Tore K; Mjaavatten, Maria D; Lie, Elisabeth

2017-11-01

To 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. Patients 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. Of 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. Few 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. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Significance of bone marrow edema in pathogenesis of rheumatoid arthritis

International Nuclear Information System (INIS)

Sudoł-Szopińska, Iwona; Kontny, Ewa; Maśliński, Włodzimierz; Prochorec-Sobieszek, Monika; Warczyńska, Agnieszka; Kwiatkowska, Brygida

2013-01-01

Assessing the pathology of the synovium, its thickening and increased vascularity through ultrasound and magnetic resonance examinations (more often an ultrasound study alone) is still considered a sensitive parameter in the diagnosis of rheumatoid arthritis and in monitoring of treatment efficacy. Magnetic resonance studies showed that, aside from the joint pannus, the subchondral bone tissue constitutes an essential element in the development of rheumatoid arthritis. Bone marrow edema correlates with inflammation severity, joint destruction, clinical signs and symptoms of rheumatoid arthritis, and thus is considered a predictor of rapid radiological progression of the disease. The newest studies reveal that bone marrow edema may be a more sensitive indicator of the response to therapy than appearance of the synovium. Bone marrow edema presents with increased signal in T2-weighted images, being most visible in fat saturation or IR sequences (STIR, TIRM). On the other hand, it is hypointense and less evident in T1-weighted images. It becomes enhanced (hyperintense) after contrast administration. Histopathological studies confirmed that it is a result of bone inflammation (osteitis/osteomyelitis), i.e. replacememt of bone marrow fat by inflammatory infiltrates containing macrophages, T lymphocytes, B lymphocytes, plasma cells and osteoclasts. Bone marrow edema appears after a few weeks from occurrence of symptoms and therefore is considered an early marker of inflammation. It correlates with clinical assessment of disease activity and elevated markers of acute inflammatory phase, i.e. ESR and CRP. It is a reversible phenomenon and may become attenuated due to biological treatment. It is considered a “herald” of erosions, as the risk of their formation is 6-fold higher in sites where BME was previously noted

Bone scintigraphy compared to MRI and ultrasound in the early diagnosis of arthritis

International Nuclear Information System (INIS)

Sandrock, D.

2006-01-01

Chronic inflammatory arthritis is recognized specifically by bone erosions, caused by characteristic pannus tissue. In the finger joints dynamic low-Tesla MRI is nearly double but not completely sensitive in the detection of erosions than conventional radiography, sonography takes an intermediate position. Less specific signs of synovitis and tenosynovitis are shown with high sensitivity by both 3(2)-phase bone scintigraphy and ultrasound, MRI is less sensitive in this respect. However, standard situation of inflammation in bone scintigraphy - positive finding in early as well as late phase - is of surprisingly low sensitivity, any singular finding in the early or late phase has to be regarded as positive. Specificity of these singular findings is nevertheless sufficiently high, acute inflammatory joint changes and even erosions are also seen with MRI in obviously healthy persons. Only 2-phase bone scintigraphy is easily able to present a simultaneous survey of all joints of the body. For this reason 2-phase bone scintigraphy is most suitable for exclusion but also for primary diagnosis of disease, specification must be done afterwards by other imaging modalities or by laboratory findings. (orig.)

Visualisation of subchondral erosion in rat monoarticular arthritis by magnetic resonance imaging

International Nuclear Information System (INIS)

Carpenter, T.A.; Everett, J.R.; Hall, L.D.; Harper, G.P.; Hodgson, R.J.; James, M.F.

1995-01-01

High-resolution magnetic resonance imaging (MRI) was used to investigate antigen-induced monoarticular arthritis (AIMA) in the rat. In sagittal, spin-echo images of the knee, characteristic parallel bands, in the order dark-light-dark, were consistently observed 5-8 days after arthritis induction; the bands ran concentric with, and just beneath, the femoral and tibial articular surfaces. Concurrent radiology, histology and MRI (chemical shift-selective imaging and contrast enhancement with magnetisation transfer and gadolinium) established that the phenomenon reflected subchondral erosion, not artefact. The outer hypointense band corresponded to calcified cartilage underlying the articular surface. The central hyperintense band reflected inflammatory matrix displacing normal haematopoietic tissue immediately subchondrally; here, trabecular bone had mostly disappeared, but adjacent articular cartilage, although under attack and lacking proteoglycan, appeared structurally normal. The inner hypointense band reflected deeper, truncated trabeculae within inflammatory matrix, layered with pallisading osteoblast-like cells. This study exemplifies the power of MRI for revealing localised joint pathology non-invasively, and shows that rat AIMA shares many pathological features with arthritis in human beings. (orig.)

Advanced imaging in rheumatoid arthritis. Part 2: Erosions

International Nuclear Information System (INIS)

Farrant, J.M.; O'Connor, P.J.; Grainger, A.J.

2007-01-01

Rheumatoid arthritis (RA) is a chronic and progressive inflammatory disorder primarily affecting the synovium. We now recognise that conventional radiographic images show changes of rheumatoid arthritis late after irreversible joint damage has occured. With the advent of powerful disease-modifying drugs there is a need for early demonstration of rheumatoid arthritis and to monitor progress of the disease and response to therapy. Advanced imaging techniques such as ultrasound and MRI have focussed on the demonstration and quanitification of synovitis and erosions and allow early diagnosis of RA. The technology to quantify synovitis and erosions is developing rapidly and now allows change in disease activity to be assessed. However, problems undoubtedly exist in quantification techniques and this review serves to highlight them. Much of the literature on advanced imaging in RA appears in rheumatological journals and may not be familiar to radiologists. This review article aims to increase the awareness of radiologists to this field and to encourage them to participate and contribute to the ongoing development of these modalities. Without this collaboration it is unlikely that these modalities will reach their full potential in the field of rheumatological imaging. This review is in two parts. This first part addresses synovitis imaging. The second part will look at advanced imaging of erosions in RA. (orig.)

Tuberculous arthritis and monoarticular rheumatoid arthritis in the knee : differential diagnosis using MR imaging

International Nuclear Information System (INIS)

Lim, Yeon Soo; Park, Jeong Mi; Shinn, Kwang Heun; Jee, Won Hee; Kim, Jee Young; Chun, Kyung Ah; Lee, Jae Mun

1999-01-01

To determine the extent to which magnetic resonance(MR) imaging findings can help differentiate between tuberculous arthritis (TA) and rheumatoid arthritis(RA). This study involved sixteen patients with pathologically proven arthritis of the knee. In eight patients(mean age, 29.6 years; M:F=4:4) this was of the tuberculous variety, while eight (mean age, 47.5 years; M:F=2:6) suffered from the rheumatoid variety, which was monoarticular. For 14 patients, contrast enhancement studies were available. We retrospectively analyzed MR findings according to the demonstrated pattern of synovial thickening (regular and even, or irregular and nodular), bone erosion or abscess, bone marrow(BM) edema, the sites at which bursae were present, para-articular mass formation, and lymphadenopathy. In five of eight TA cases (62.5%), irregular and nodular enhanced synovial thickening was present, while in six of eight RA cases (75%), thickening was regular and even. Bone erosions or subarticular abscesses were found in six TA cases (75%) and small erosions in three cases (37.5%) of RA. BM edema surrounding the erosion was found in four cases of TA (50%) and two of RA (25%). In TA, edema was more extensive. In both TA and RA, all suprapatella bursae were distended while popliteal bursae were present in two cases of TA (25%) and four of RA (50%). Para-articular masses with rim like enhancement were found in six cases of TA (75%) and in one case of RA (12.5%). In particular, para-articular lymphadenopathy was seen in six cases of TA (75%), but not in RA. MR findings of irregular and nodular synovial thickening, extensive bone erosion, extensive BM edema, particular, para-articular abscess formation and lymphadenopathy, may help differentiate tuberculous arthritis of the knee from the rhumatoid variety

Sensitivity and specificity of plain radiographic features of peripheral enthesopathy at major sites in psoriatic arthritis

Energy Technology Data Exchange (ETDEWEB)

Helliwell, P.S. [University of Leeds, Academic Unit of Musculoskeletal and Rehabilitation Medicine, Leeds (United Kingdom); Porter, G. [Airedale Hospital NHS Trust, Keighley, West Yorkshire (United Kingdom)

2007-11-15

It has been proposed that the defining difference between rheumatoid arthritis and spondyloarthropathy (including psoriatic arthritis) is the initial pathological lesion where the emphasis in psoriatic arthritis is on the enthesis and in rheumatoid arthritis on the synovium. Classical radiological descriptions of seronegative spondyloarthropathy include enthesopathy at major entheseal insertions characterised by erosions and exuberant new bone formation. In this study, the plain radiographic features of spondyloarthropathy are compared between psoriatic arthritis, other spondyloarthropathies and rheumatoid arthritis. The CASPAR study collected clinical, radiological and laboratory data on 588 patients with physician diagnosed psoriatic arthritis and 525 controls with other inflammatory arthritis, 70% of which had rheumatoid arthritis. Plain radiographs of the pelvis and heels were part of the study protocol, although radiographs of other potential entheseal sites such as the knee, elbow and shoulder, were interpreted if available. All radiographs were read blind by two observers working in tandem. Significant differences in entheseal erosion and entheseal new bone formation were found between psoriatic arthritis, ankylosing spondylitis, undifferentiated spondyloarthropathy, rheumatoid arthritis and other diagnoses (entheseal erosion, chi-squared 20.8, p = 0.008; entheseal new bone formation, chi-squared 24.5, p = 0.001). These differences were mainly due to a higher proportion of these features in ankylosing spondylitis. No differences in the plain radiographic features of enthesopathy were found between psoriatic arthritis and rheumatoid arthritis except in the case of entheseal new bone formation at sites of attachment of inguinal ligament, sartorius and rectus femoris muscles to the ilium (OR 3.01, 95% CI 1.13-8.02). Very few subjects with symptomatic heel involvement had radiographic changes and minimal differences were found between those with and without

Sensitivity and specificity of plain radiographic features of peripheral enthesopathy at major sites in psoriatic arthritis

International Nuclear Information System (INIS)

Helliwell, P.S.; Porter, G.

2007-01-01

It has been proposed that the defining difference between rheumatoid arthritis and spondyloarthropathy (including psoriatic arthritis) is the initial pathological lesion where the emphasis in psoriatic arthritis is on the enthesis and in rheumatoid arthritis on the synovium. Classical radiological descriptions of seronegative spondyloarthropathy include enthesopathy at major entheseal insertions characterised by erosions and exuberant new bone formation. In this study, the plain radiographic features of spondyloarthropathy are compared between psoriatic arthritis, other spondyloarthropathies and rheumatoid arthritis. The CASPAR study collected clinical, radiological and laboratory data on 588 patients with physician diagnosed psoriatic arthritis and 525 controls with other inflammatory arthritis, 70% of which had rheumatoid arthritis. Plain radiographs of the pelvis and heels were part of the study protocol, although radiographs of other potential entheseal sites such as the knee, elbow and shoulder, were interpreted if available. All radiographs were read blind by two observers working in tandem. Significant differences in entheseal erosion and entheseal new bone formation were found between psoriatic arthritis, ankylosing spondylitis, undifferentiated spondyloarthropathy, rheumatoid arthritis and other diagnoses (entheseal erosion, chi-squared 20.8, p = 0.008; entheseal new bone formation, chi-squared 24.5, p = 0.001). These differences were mainly due to a higher proportion of these features in ankylosing spondylitis. No differences in the plain radiographic features of enthesopathy were found between psoriatic arthritis and rheumatoid arthritis except in the case of entheseal new bone formation at sites of attachment of inguinal ligament, sartorius and rectus femoris muscles to the ilium (OR 3.01, 95% CI 1.13-8.02). Very few subjects with symptomatic heel involvement had radiographic changes and minimal differences were found between those with and without

Bone scintigraphy compared to MRI and ultrasound in the early diagnosis of arthritis; Skelettszintigraphie im Vergleich mit MRT und Sonographie beim Fruehnachweis der Arthritis

Energy Technology Data Exchange (ETDEWEB)

Sandrock, D. [Klinikum Chemnitz gGmbH, Klinik fuer Nuklearmedizin, Chemnitz (Germany)

2006-12-15

Chronic inflammatory arthritis is recognized specifically by bone erosions, caused by characteristic pannus tissue. In the finger joints dynamic low-Tesla MRI is nearly double but not completely sensitive in the detection of erosions than conventional radiography, sonography takes an intermediate position. Less specific signs of synovitis and tenosynovitis are shown with high sensitivity by both 3(2)-phase bone scintigraphy and ultrasound, MRI is less sensitive in this respect. However, standard situation of inflammation in bone scintigraphy - positive finding in early as well as late phase - is of surprisingly low sensitivity, any singular finding in the early or late phase has to be regarded as positive. Specificity of these singular findings is nevertheless sufficiently high, acute inflammatory joint changes and even erosions are also seen with MRI in obviously healthy persons. Only 2-phase bone scintigraphy is easily able to present a simultaneous survey of all joints of the body. For this reason 2-phase bone scintigraphy is most suitable for exclusion but also for primary diagnosis of disease, specification must be done afterwards by other imaging modalities or by laboratory findings. (orig.)

Computer-aided and manual quantifications of MRI synovitis, bone marrow edema-like lesions, erosion and cartilage loss in rheumatoid arthritis of the wrist

Energy Technology Data Exchange (ETDEWEB)

Yang, Haitao [The First Affiliated Hospital of Chongqing Medical University, Department of Radiology, Chongqing (China); University of California, San Francisco (UCSF), Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Rivoire, Julien; Hoppe, Michael; Link, Thomas M.; Li, Xiaojuan [University of California, San Francisco (UCSF), Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Srikhum, Waraporn [University of California, San Francisco (UCSF), Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Thammasat University, Department of Radiology, Pathumthani (Thailand); Imboden, John [San Francisco General Hospital, University of California, Department of Medicine, San Francisco and Division of Rheumatology, San Francisco, CA (United States)

2014-12-10

To investigate the reliability and validity of computer-aided automated and manual quantification as well as semiquantitative analysis for MRI synovitis, bone marrow edema-like lesions, erosion and cartilage loss of the wrist in rheumatoid arthritis (RA) compared to the OMERACT-RAMRIS. Wrist MRI was performed at 3 T in 16 patients with RA. Synovial volume and perfusion, bone marrow edema-like lesion (BMEL) volume, signal intensity and perfusion, and erosion dimensions were measured manually and using an in-house-developed automated software algorithm; findings were correlated with the OMERAC-RAMRIS gradings. In addition, a semiquantitative MRI cartilage loss score system was developed. Intraclass correlation coefficients (ICCs) were used to test the reproducibility of these quantitative and semiquantitative techniques. Spearman correlation coefficients were calculated between lesion quantifications and RAMRIS and between the MRI cartilage score and radiographic Sharp van der Heijde joint space narrowing scores. The intra- and interobserver ICCs were excellent for synovial, BMEL and erosion quantifications and cartilage loss grading (all >0.89). The synovial volume, BMEL volume and signal intensity, and erosion dimensions were significantly correlated with the corresponding RAMRIS (r = 0.727 to 0.900, p < 0.05). Synovial perfusion parameter maximum enhancement (Emax) was significantly correlated with synovitis RAMRIS (r = 0.798). BMEL perfusion parameters were not correlated with the RAMRIS BME score. Cartilage loss gradings from MRI were significantly correlated with the Sharp joint space narrowing scores (r = 0.635, p = 0.008). The computer-aided, manual and semiquantitative methods presented in this study can be used to evaluate MRI pathologies in RA with excellent reproducibility. Significant correlations with standard RAMRIS were found in the measurements using these methods. (orig.)

Bone pathology inpsoriatic arthritis

Directory of Open Access Journals (Sweden)

V. V. Badokin

2007-01-01

Full Text Available Objective. To study different variants of osteolysis in pts with psoriatic arthritis (PA and to reveal their relationship with other clinico-radiological features of joint damage. Material and methods. 370 pts with definite PA having different variants of joint damage were included. Radiological examination of bones and joints (in some cases large picture frame was performed. Morphological evaluation of synovial biopsies was done in 34 pts with PA and 10 pts with rheumatoid arthritis (RA. Results. Different types of osteolysis were revealed in 80 (21,6% pts. Osteolytic variant of joint damage was present in 29 pts. 33 pts had acral, 48 — intra-articular osteolysis and 16 - true bone atrophy. Frequency and intensity of bone resorption were associated with severity of PA. Acral osteolysis correlated with arthritis of distal interphalangeal joints and onychodystrophy. Intra-articular osteolysis was most often present in distal interphalangeal joints of hands and metacarpophalangeal joints (39,6% and 41,7% respectively. Characteristic feature of PA was combination of prominent resorption with formation of bone ankylosis and periosteal reaction. Ankylosis was present in 33,3% of pts with intra-articular osteolysis and in 60% of pts with combination of different osteolysis variants. Systemic reaction of microcirculation in synovial biopsies was most prominent in osteolytic variant: marked thickening of capillary and venule basal membrane with high level of acid phosphatase, increased capillary and precapillary blood flow with stasis features, vascular lymphocyte and macrophage infiltration, productive vasculitis with annular wall thickening, thrombovasculitis and villi deep layer sclerosis. Conclusion. Different variants of osteolysis show bone involvement in PA. Acral and intra- articular osteolysis association with bone ankylosis and periostitis proves their common pathogenetic entity.

Radiologic comparison of erosive polyarthritis with prominent interphalangeal involvement

International Nuclear Information System (INIS)

Gold, R.H.; Bassett, L.W.; Theros, E.G.

1982-01-01

Psoriatic arthritis, Reiter's disease, and multicentric reticulohistiocytosis may manifest prominent interphalangeal joint and cutaneous involvement. All three disorders may also affect the sacroiliac joints and spine. Despite these similarities, there are basic radiologic differences enabling distinction between the three disorders. Erosive osteoarthritis must also be considered in the differential diagnosis of interphalangeal erosive arthritis. Psoriatic erosions are characteristically ill defined, often bilaterally asymmetrical, usually unaccompanied by significant osteoporosis, and frequently associated with florid proliferation of subperiosteal new bone. An unilateral polyarticular pattern, which often occurs in a single ray, is the most prevalent of several patterns of involvement. Reiter's disease exhibits many clinical and radiologic similarities to psoriatic arthritis, but in the former there tends to be selective involvement of the joints of the lower limbs and particularly the feet, with relative sparing of the hands and wrists, while in the latter the joints of the upper and lower limbs tend to be involved to an equal extent. Multicentric reticulohistiocytosis (MR). Lesions predominate in skin and synovium and result in sharply circumscribed, rapidly progressive, strikingly bilaterally symmetrical erosions spreading from joint margins to articular surfaces. Most or all of the diarthrodial joints may be affected, but interphalangeal joint predominance and early and severe atlanto-axial involvement are characteristic. Erosive osteoarthritis is characterized by interphalangeal subchondral erosions, accompanying periosteal new bone that is more subtle than that of psoriatic arthritis, and interphalangeal bony ankylosis that occurs with the same frequency as that of psoriatic arthritis. (orig.)

[METHOD FOR DETERMINING EROSIVE LESIONS OF THE GASTRIC MUCOUSA IN CHILDREN WITH JUVENILE ARTHRITIS].

Science.gov (United States)

Listopadova, A P; Novikova, V P; Melnikova, I U; Petrovskiy, A N; Slizovskiy, N V

2015-01-01

To detect the clinical diagnostic criteria for non-invasive diagnosis of erosive gastritis in children with juvenile arthritis have been studied the 92 children aged 9 to 16 years (mean age-13,9 ± 2,3 years) with verified diagnosis of juvenile arthritis, of whom 10 had erosive gastritis (group 1) and 82 without erosions (group 2). A comparison of the groups on 23 grounds by analysis of contingency tables and the subsequent discriminant analysis, has developed a new non-invasive method for determining the erosive lesions of the mucous membrane of the stomach in children with juvenile arthritis, including a score of history, complaints and the results of laboratory studies the level of the G-17, pepsinogen I, pepsinogen II, and the ratio of pepsinogen I to pepsinogen II, the presence of autoantibodies to the H+, K+/ATPase of the parietal cells of the stomach, the test for occult blood "Colon View Hb and Hb/Hp". Developed a diagnostic table, including 11 features with scores each. The total score 27 or higher allows a high degree of probability to determine the erosive lesions of the gastric mucosa in children with juvenile arthritis.

Alteration In Bones Metabolism In Active Rheumatoid Arthritis

International Nuclear Information System (INIS)

Salem, E.S.

2013-01-01

The strength and integrity of the human skeleton depends on a delicate equilibrium between bone resorption and bone formation. Osteocalcin (OC) is synthesized by osteoblasts and is considered to be a marker of bone formation and helps in corporating calcium into bone tissue. Rheumatoid arthritis (RA) is an autoimmune inflammatory joint disease characterized by bone complication including bone pain, erosion and osteoporosis. The aim of the present study is to evaluate some factors responsible in bone metabolism termed OC, vitamin D (vit. D), oncostatin M (OSM), ionized calcium and alkaline phosphatase. Fifty pre-menopausal female patients with active RA and twenty healthy controls of the same age were included in the present study. Radioimmunoassay (RIA) was used to estimate serum OC and active vitamin D. The quantitative determination of ionized calcium and alkaline phosphatase were carried out colorimetrically. OSM was measured by ELISA and serum levels of OC and active vitamin D were significantly decreased in RA patients as compared to those of the control group. On the other hand, the levels of serum OSM, ionized calcium and alkaline phosphatase were significantly increased in the RA patients as compared to their healthy control subjects. The results of this study indicated that early investigation and therapy of disturbances of bone metabolism in active RA are necessary for better prognosis and exhibited the importance of OC as a diagnostic tool of alterations of bone metabolism in RA patients.

Paradiaphyseal calcific tendinitis with cortical bone erosion.

Science.gov (United States)

Fritz, P; Bardin, T; Laredo, J D; Ziza, J M; D'Anglejan, G; Lansaman, J; Bucki, B; Forest, M; Kuntz, D

1994-05-01

To determine the clinical, radiologic, and histologic features of calcific tendinitis with cortical bone erosion. The records of 6 patients with paradiaphyseal calcific tendinitis and adjacent bone cortex erosion were reviewed. Calcific tendinitis involved the linea aspera in 4 patients, the bicipital groove in 1 patient, and the deltoid insertion in another. Calcium deposits were associated with cortical bone erosions, revealed on plain radiographs in 4 patients and computed tomography scans in 2. Bone scans were performed in 2 patients and showed local hyperfixation of the isotope. In 4 patients, suspicion of a neoplasm led to a biopsy. Calcium deposits appeared to be surrounded by a foreign body reaction with numerous giant cells. Apatite crystals were identified by transmission electron microscopy and elemental analysis in 1 surgical sample. Paradiaphyseal calcific tendinitis with cortical bone erosion is an uncommon presentation of apatite deposition disease.

Anti-Arthritic Effect of Chebulanin on Collagen-Induced Arthritis in Mice.

Directory of Open Access Journals (Sweden)

Yinglan Zhao

Full Text Available Rheumatoid arthritis is a chronic degenerative autoimmune disease characterized by persistent inflammation of synovial membranes, which leads to cartilage destruction and bone erosion. To date, there are no effective therapies to slow the progress of this degenerative condition. Here, we evaluate the anti-arthritic effect of chebulanin, an abundant anti-inflammatory agent isolated from Terminalia chebula, in collagen induced arthritis in DBA/1 mice by intragastric administration. Arthritic severity was scored by performing histopathological evaluation of the joints and measuring the expression of inflammatory cytokines and relative enzymes by immunohistochemical staining. In parallel, bone destruction and erosion were confirmed by micro-CT. Our data revealed that chebulanin significantly improved the severity of arthritis. Specifically, the histopathological characteristics of the tissues were improved and expression of TNF-α, IL-6, MMP-3 and COX-2 in the paws and joints of the treated mice decreased in a dose-dependent manner compared with control mice. Furthermore, micro-CT analysis revealed that chebulanin induced a dose-dependent reduction in cartilage destruction and bone erosion. Taken together, our findings suggest that chebulanin suppresses the expression of inflammatory mediators and prevents cartilage destruction and bone erosion in mice. Therefore, chebulanin is a strong therapeutic alternative for the treatment of RA.

Insulin-Like Growth Factor I Does Not Drive New Bone Formation in Experimental Arthritis.

Directory of Open Access Journals (Sweden)

Melissa N van Tok

Full Text Available Insulin like growth factor (IGF-I can act on a variety of cells involved in cartilage and bone repair, yet IGF-I has not been studied extensively in the context of inflammatory arthritis. The objective of this study was to investigate whether IGF-I overexpression in the osteoblast lineage could lead to increased reparative or pathological bone formation in rheumatoid arthritis and/or spondyloarthritis respectively.Mice overexpressing IGF-I in the osteoblast lineage (Ob-IGF-I+/- line 324-7 were studied during collagen induced arthritis and in the DBA/1 aging model for ankylosing enthesitis. Mice were scored clinically and peripheral joints were analysed histologically for the presence of hypertrophic chondrocytes and osteocalcin positive osteoblasts.90-100% of the mice developed CIA with no differences between the Ob-IGF-I+/- and non-transgenic littermates. Histological analysis revealed similar levels of hypertrophic chondrocytes and osteocalcin positive osteoblasts in the ankle joints. In the DBA/1 aging model for ankylosing enthesitis 60% of the mice in both groups had a clinical score 1<. Severity was similar between both groups. Histological analysis revealed the presence of hypertrophic chondrocytes and osteocalcin positive osteoblasts in the toes in equal levels.Overexpression of IGF-I in the osteoblast lineage does not contribute to an increase in repair of erosions or syndesmophyte formation in mouse models for destructive and remodeling arthritis.

Influence of anti-cyclic citrullinated peptide on disease activity, structural severity, and bone loss in Moroccan women with rheumatoid arthritis

Directory of Open Access Journals (Sweden)

Imad Ghozlani

2018-04-01

Full Text Available Aim of the work: The aim of this study was to assess the influence of anti-cyclic citrullinated peptide (anti-CCP on disease activity, radiological severity, functional disability and bone loss in Moroccan women with rheumatoid arthritis (RA. Patients and methods: One hundred and thirty-six women with RA were recruited. Age, weight, height, disease duration and steroids cumulative dose were identified. Anti-CCP and Rheumatoid factor (RF were determined. Disease activity score (DAS28 was assessed and functional repercussion measured by the Health Assessment Questionnaire-disability index (HAQ-DI. Radiological status was assessed by the Sharp/van der Heijde (SvH erosion and narrowing score. Bone mineral density was determined by a Lunar Prodigy Vision Dual-energy X-ray absorptiometry and vertebral fracture assessment was classified using a combination of Genant semi-quantitative approach and morphometry. Results: Patients mean age was 49.6 ± 7.4 years and disease duration 7.7 ± 5 years. 109 (80.1% patients were anti-CCP positive. There was no significant difference in DAS28 between patients with and without anti-CCP. Nevertheless, weight, erythrocyte sedimentation rate (ESR, rheumatoid factor titer and positivity, SvH narrowing and erosion score and osteoporosis were significantly higher in patients with positive anti-CCP. Stepwise regression analysis showed that the presence of anti-CCP was independently associated with osteoporosis and SvH erosion score. Conclusions: Anti-CCP antibodies are strongly predictive for the development of osteoporosis and erosions in Moroccan RA patients. They not only have a valuable role in the disease prognosis prediction but also may be a relevant determinant of bone loss in RA. The presence of these antibodies warrants special attention. Keywords: Rheumatoid arthritis, Anti-cyclic citrullinated peptide, Disease activity, Joint damage, Bone loss

[Bone structure in rheumatoid arthritis].

Science.gov (United States)

Ono, Kumiko; Ohashi, Satoru; Tanaka, Sakae; Matsumoto, Takuya

2013-07-01

In rheumatoid arthritis (RA) , the osteoclast pathway is activated by abnormal immune conditions accompanied by chronic inflammation, resulting in periarticular osteoporosis and local bone destruction around joints. In addition, multiple factors, including reduced physical activity and pharmacotherapies such as steroids, lead to systemic osteoporosis. These conditions cause decreasing bone mineral density and deterioration of bone quality, and expose patients to increased risk of fracture. Understanding the bone structures of RA and evaluating fracture risk are central to the treatment of RA.

The roles of MR imaging in monitoring therapeutic effectiveness in rheumatoid arthritis: preliminary result

Energy Technology Data Exchange (ETDEWEB)

Yun, Mi Jin; Suh, Jin Suck; Lee, Soo Kon; Lee, Ji Soo [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of); Cho, Jae Hyun [Ajou Univ. College of Medicine, Asan (Korea, Republic of)

1996-07-01

It is difficult to determine objectively therapeutic response in rheumatoid arthritis. This study was carried out in order to assess the feasibility of MR imaging to determine disease status following antirheumatoid medication. Eight patients with rheumatoid arthritis underwent MR studies before treatment and approximately one year after the beginning of antirheumatoid medication. Coronal images were obtained, using a T1- and T2-weighted spin echo(n=8), contrast-enhanced T1-weighted image(n=8) and dynamic contrast-enhanced image(n=4). Bone erosions, synovial hypertrophy and bone marrow enhancement in pre-and post-medication studies were compared. On dynamic study, enhancement ratio(E) of pannus was measured(E=SNR at 30sec/ SNR at precontrast). Changes of MRI findings and enhancement ratio between pre- and post-medication were compared with disease status as assessed by clinical index. In three patients, improvement of bone marrow edema and synovial hypertrophy was noted, and in addition, there was no evidence of newly developed bone erosion. In two of these patients, complete remission was noted on the basis of the ARA criteria. In another three patients, despite improvement of bone marrow edema and synovial hypertrophy and improved clinical parameters including morning stiffness and ESR, discrete and newly developed bone erosions were noted. In one patient with a poor response to antirheumatoid medication, aggravation of bone marrow edema and synovial hypertrophy was seen, but no definite change in bone erosions was noted. In the remaining one patient, no remarkable changes were seen in bone marrow edema, synovial hypertrophy or bone erosion. Clinically this patient showed no morning stiffness or elevated ESR. The enhancement ratio of pannus decreased in all 4 cases, especially where there were complete remission. Synovial extent, bone marrow enhancement, bone erosions and enhancement ratio of pannus may be good parameters for monitoring disease activity in the

The roles of MR imaging in monitoring therapeutic effectiveness in rheumatoid arthritis: preliminary result

International Nuclear Information System (INIS)

Yun, Mi Jin; Suh, Jin Suck; Lee, Soo Kon; Lee, Ji Soo; Cho, Jae Hyun

1996-01-01

It is difficult to determine objectively therapeutic response in rheumatoid arthritis. This study was carried out in order to assess the feasibility of MR imaging to determine disease status following antirheumatoid medication. Eight patients with rheumatoid arthritis underwent MR studies before treatment and approximately one year after the beginning of antirheumatoid medication. Coronal images were obtained, using a T1- and T2-weighted spin echo(n=8), contrast-enhanced T1-weighted image(n=8) and dynamic contrast-enhanced image(n=4). Bone erosions, synovial hypertrophy and bone marrow enhancement in pre-and post-medication studies were compared. On dynamic study, enhancement ratio(E) of pannus was measured(E=SNR at 30sec/ SNR at precontrast). Changes of MRI findings and enhancement ratio between pre- and post-medication were compared with disease status as assessed by clinical index. In three patients, improvement of bone marrow edema and synovial hypertrophy was noted, and in addition, there was no evidence of newly developed bone erosion. In two of these patients, complete remission was noted on the basis of the ARA criteria. In another three patients, despite improvement of bone marrow edema and synovial hypertrophy and improved clinical parameters including morning stiffness and ESR, discrete and newly developed bone erosions were noted. In one patient with a poor response to antirheumatoid medication, aggravation of bone marrow edema and synovial hypertrophy was seen, but no definite change in bone erosions was noted. In the remaining one patient, no remarkable changes were seen in bone marrow edema, synovial hypertrophy or bone erosion. Clinically this patient showed no morning stiffness or elevated ESR. The enhancement ratio of pannus decreased in all 4 cases, especially where there were complete remission. Synovial extent, bone marrow enhancement, bone erosions and enhancement ratio of pannus may be good parameters for monitoring disease activity in the

MR imaging findings of acute gouty arthritis

International Nuclear Information System (INIS)

Lee, Gyung Kyu; Lee, Jee Young; Suh, Jin Suck

2006-01-01

The purpose of this study was to describe the clinical and MR imaging features of acute gouty arthritis and to define the characteristic findings that would be helpful for differentiating acute gouty arthritis from septic arthritis. The authors retrospectively studied seven patients who suffered from acute gouty arthritis. The MR imaging findings were analyzed by two musculoskeletal radiologists who focused on joint effusion, subchondral bone erosion, bone marrow edema, synovial thickening (regular and even, or irregular and nodular), and the soft tissue changes (edema or abscess). The clinical records of the patients were reviewed with regard to age and gender, the clinical presentation and the laboratory findings (serum uric acid, WBC, erythrocyte sedimentation rate, C-reactive protein and synovial fluid culture). The patients consisted of six men and one woman whose mean age was 41 years (age range:24-65 years). The joints involved were the knee (n=6), and ankle (n=1). Two patients had medical histories of gouty attacks that involved the first metatarsophalangeal joint. In six cases, the serum uric acid level during acute attacks was elevated. In all the patients, the affected joint became swollen, hot, erythematous and extremely tender, and this was accompanied by a high ESR and a high C-reactive protein level at the time of presentation. The results of Gram stain and culture of the synovial fluid were negative. In all patients, the MR images showed large amounts of joint effusion, thick irregular and nodular synovial thickening and soft tissue edema without subchondral bone erosions and soft tissue abscess. In one case, subchondral bone marrow edema of the medial femoral condyle was present. In five cases, there were multiple low signal foci in the joint on the spin-echo T2-weighted MR image. Even though the MR imaging findings of acute gouty arthritis are nonspecific, it should be considered as a possible diagnosis when a large amount of joint effusion

Magnetic resonance imaging of the wrist in early rheumatoid arthritis: a pictorial essay

International Nuclear Information System (INIS)

Stewart, N.R.; Crabbe, J.P.; McQueen, F.M.

2001-01-01

This pictorial essay describes the changes seen in the wrist in early rheumatoid arthritis (RA) on MRI. Magnetic resonance imaging can demonstrate bone erosions, bone marrow signal changes, synovitis and tenosynovitis in early rheumatoid arthritis. Magnetic resonance imaging of the wrist can identify erosions in RA earlier than plain radiographs and can detect more erosions. Common sites include the capitate, lunate and scaphoid. Bone marrow signal changes occur frequently and are most common in the capitate, lunate and triquetrum. Synovial thickening and enhancement are clearly demonstrated with MRI and are most commonly seen in the radiocarpal joint (RCJ). Tenosynovitis can be seen in the wrist in more than half of patients presenting with RA. This most commonly involves the extensor carpi ulnaris tendon and is seen as sheath fluid, thickening and enhancement. Copyright (2001) Blackwell Science Pty Ltd

Chronic erosive seropositive arthritis in a patient with chronic hepatitis C

Directory of Open Access Journals (Sweden)

L P Ananjeva

2008-01-01

Full Text Available Joint syndrome evolution was prospectively followed up in a 49-year-old woman who had serum hepatitis in 1990. When she came to a rheumatologist for the first time in 1999 she complained of occasional joint pain. She did not have joint inflammatory changes at that time but chronic hepatitis С was revealed at the examination. Hepatitis С diagnosis was confirmed by morphological and repeated virological evaluations. During antiviral treatment the pt developed symmetrical polyarthritis involving hand joints. Elevation of cryoglobuline, rheumatoid factor and antinuclear antibodies level was revealed. During the next year polyarthritis recurred and later acquired undulatory course with periods of exacerbation and stabilization. Attempts of treatment with sulfasalazine failed due to transaminase elevation. In 2006 ulnar deviation appeared and rheumatoid factor level remained elevated. MRI showed multiple erosions of carpal bones. Considering features of joint syndrome development joint damage in this pt was regarded as arthritis associated with chronic hepatitis C.

Locomotion and muscle mass measures in a murine model of collagen-induced arthritis

NARCIS (Netherlands)

Hartog, A.; Hulsman, J.; Garssen, J.

2009-01-01

Background: Rheumatoid arthritis (RA) is characterized by chronic poly-arthritis, synovial hyperplasia, erosive synovitis, progressive cartilage and bone destruction accompanied by a loss of body cell mass. This loss of cell mass, known as rheumatoid cachexia, predominates in the skeletal muscle and

Magnetic resonance imaging in psoriatic arthritis: a review of the literature

DEFF Research Database (Denmark)

McQueen, F.M.; Lassere, M.; Østergaard, Mikkel

2006-01-01

Psoriatic arthritis is a diverse condition that may be characterized by peripheral inflammatory arthritis, axial involvement, dactylitis and enthesitis. Magnetic resonance imaging (MRI) allows visualization of soft tissue, articular and entheseal lesions, and provides a unique picture of the dise....../sacroiliitis and subclinical arthropathy. Comparisons have been drawn with the more extensive literature describing the MRI features of rheumatoid arthritis and ankylosing spondylitis....... of the disease process that cannot be gained using other imaging modalities. This review focuses on the literature on MRI in psoriatic arthritis published from 1996 to July 2005. The MRI features discussed include synovitis, tendonitis, dactylitis, bone oedema, bone erosions, soft tissue oedema, spondylitis...

EULAR definition of erosive disease in light of the 2010 ACR/EULAR rheumatoid arthritis classification criteria.

Science.gov (United States)

van der Heijde, Désirée; van der Helm-van Mil, Annette H M; Aletaha, Daniel; Bingham, Clifton O; Burmester, Gerd R; Dougados, Maxime; Emery, Paul; Felson, David; Knevel, Rachel; Kvien, Tore K; Landewé, Robert B M; Lukas, Cédric; McInnes, Iain; Silman, Alan J; Smolen, Josef S; Stanislawska-Biernat, Ewa; Zink, Angela; Combe, Bernard

2013-04-01

The aim of this report was to propose a definition for erosive disease in the context of inflammatory arthritis in light of the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) rheumatoid arthritis (RA) criteria for use in clinical practice and studies. A EULAR task force was formed including 16 rheumatologists and one rheumatology fellow. The process was both evidence based and consensus based, and included, between March 2010 and April 2012, analyses of data from two cohorts, two face-to-face meetings, one online voting and one teleconference. The Leiden Early Arthritis Cohort and the French ESPOIR cohort were used for the evidence-based part. The outcome measures, which were initiation of methotrexate therapy, or any disease-modifying antirheumatic drug therapy within the first year of disease and arthritis persistency over 5 years, were studied with the aim to give the best definition of erosive disease. A decision was made to select a definition with a high specificity and focus on patients who did not otherwise fulfil the 2010 ACR/EULAR RA criteria (definition was selected: erosive disease for use in the 2010 ACR/EULAR RA classification criteria is defined when an erosion (defined as a cortical break) is seen in at least three separate joints at any of the following sites: the proximal interphalangeal, the metacarpophalangeal, the wrist (counted as one joint) and the metatarsophalangeal joints on radiographs of both hands and feet. A highly specific definition for erosive disease has thus been formulated.

Magnetic resonance imaging in rheumatoid arthritis advances and research priorities

DEFF Research Database (Denmark)

Østergaard, Mikkel; McQueen, FM; Bird, P

2005-01-01

Magnetic resonance imaging (MRI) has now been used extensively in cross-sectional and observational studies as well as in controlled clinical trials to assess disease activity and joint damage in rheumatoid arthritis (RA). MRI measurements or scores for erosions, bone edema, and synovitis have be......, and financial context of the study in question. We review the extent to which MRI assessments of joint erosion, bone edema, and synovitis fulfil these criteria, particularly as they relate to proof-of-concept RA clinical trials.......Magnetic resonance imaging (MRI) has now been used extensively in cross-sectional and observational studies as well as in controlled clinical trials to assess disease activity and joint damage in rheumatoid arthritis (RA). MRI measurements or scores for erosions, bone edema, and synovitis have been...... developed and validated by several groups. The OMERACT criteria require that outcome measures demonstrate adequate validity, discriminative power, and feasibility if they are to be useful in clinical trials. Specific performance targets for these criteria depend on the scientific, regulatory, logistical...

Technetium phosphate bone scan in the diagnosis of septic arthritis in childhood

International Nuclear Information System (INIS)

Sundberg, S.B.; Savage, J.P.; Foster, B.K.

1989-01-01

The technetium phosphate bone scans of 106 children with suspected septic arthritis were reviewed to determine whether the bone scan can accurately differentiate septic from nonseptic arthropathy. Only 13% of children with proved septic arthritis had correct blind scan interpretation. The clinically adjusted interpretation did not identify septic arthritis in 30%. Septic arthritis was incorrectly identified in 32% of children with no evidence of septic arthritis. No statistically significant differences were noted between the scan findings in the septic and nonseptic groups and no scan findings correlated specifically with the presence or absence of joint sepsis

MRI of the wrist in juvenile idiopathic arthritis: erosions or normal variants? A prospective case-control study

International Nuclear Information System (INIS)

Ording Muller, Lil-Sofie; Boavida, Peter; Avenarius, Derk; Eldevik, Odd Petter; Damasio, Beatrice; Malattia, Clara; Lambot-Juhan, Karen; Tanturri, Laura; Owens, Catherine M.; Rosendahl, Karen

2013-01-01

Bony depressions at the wrist resembling erosions are frequently seen on MRI in healthy children. The accuracy of MRI in detecting early bony destruction is therefore questionable. We compared findings on MRI of the wrist in healthy children and those with juvenile idiopathic arthritis (JIA) to investigate markers for true disease. We compared the number and localisation of bony depressions at the wrist in 85 healthy children and 68 children with JIA, ages 5-15 years. The size of the wrist was assessed from a radiograph of the wrist performed on the same day as the MRI. No significant difference in the number of bony depressions in the carpal bones was seen between healthy children and children with JIA at any age. Depressions are found in similar locations in the two groups, except for a few sites, where bony depressions were seen exclusively in the JIA group, particularly at the CMC joints. The wrist was significantly smaller in children with JIA (P < 0.001). Using adult scoring systems and standard MR sequences in the assessment of bone destruction in children may lead to overstaging or understaging of disease. At present, standard MRI sequences cannot easily be used for assessment of early signs of erosions in children. (orig.)

MRI of the wrist in juvenile idiopathic arthritis: erosions or normal variants? A prospective case-control study

Energy Technology Data Exchange (ETDEWEB)

Ording Muller, Lil-Sofie [University Hospital North Norway, Department of Radiology, Tromsoe (Norway); Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); Boavida, Peter [Homerton University Hospital, Department of Radiology, London (United Kingdom); Avenarius, Derk; Eldevik, Odd Petter [University Hospital North Norway, Department of Radiology, Tromsoe (Norway); Damasio, Beatrice [Ospedale Pediatrico Gaslini, Department of Radiology, Genoa (Italy); Malattia, Clara [Ospedale Pediatrico Gaslini, Department of Rhematology, Genoa (Italy); Lambot-Juhan, Karen [Hopital Necker Enfants Malades, Department of Radiology, Paris (France); Tanturri, Laura [Ospedale Pediatrico Bambino Gesu, Department of Radiology, Rome (Italy); Owens, Catherine M. [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); UCL, Institute of Child Health, London (United Kingdom); Rosendahl, Karen [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); UCL, Institute of Child Health, London (United Kingdom); Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Department of Surgical Sciences, Bergen (Norway)

2013-07-15

Bony depressions at the wrist resembling erosions are frequently seen on MRI in healthy children. The accuracy of MRI in detecting early bony destruction is therefore questionable. We compared findings on MRI of the wrist in healthy children and those with juvenile idiopathic arthritis (JIA) to investigate markers for true disease. We compared the number and localisation of bony depressions at the wrist in 85 healthy children and 68 children with JIA, ages 5-15 years. The size of the wrist was assessed from a radiograph of the wrist performed on the same day as the MRI. No significant difference in the number of bony depressions in the carpal bones was seen between healthy children and children with JIA at any age. Depressions are found in similar locations in the two groups, except for a few sites, where bony depressions were seen exclusively in the JIA group, particularly at the CMC joints. The wrist was significantly smaller in children with JIA (P < 0.001). Using adult scoring systems and standard MR sequences in the assessment of bone destruction in children may lead to overstaging or understaging of disease. At present, standard MRI sequences cannot easily be used for assessment of early signs of erosions in children. (orig.)

Triple-phase bone image abnormalities in Lyme arthritis

International Nuclear Information System (INIS)

Brown, S.J.; Dadparvar, S.; Slizofski, W.J.; Glab, L.B.; Burger, M.

1989-01-01

Arthritis is a frequent manifestation of Lyme disease. Limited triple-phase Tc-99m MDP bone imaging of the wrists and hands with delayed whole-body images was performed in a patient with Lyme arthritis. This demonstrated abnormal joint uptake in the wrists and hands in all three phases, with increased activity seen in other affected joints on delayed whole-body images. These findings are nonspecific and have been previously described in a variety of rheumatologic conditions, but not in Lyme disease. Lyme disease should be considered in the differential diagnosis of articular and periarticular bone scan abnormalities

Low bone mineral density among patients with newly diagnosed rheumatoid arthritis

International Nuclear Information System (INIS)

Arain, S.R.; Riaz, A.; Nazir, L.; Umer, T.P.; Rasool, T.

2016-01-01

Background: Osteoporosis is an early and common feature in rheumatoid arthritis. Apart from other manifestations, Osteoporosis is an extra-articular manifestation of rheumatoid arthritis which may result in increased risk of fractures, morbidity, mortality, and associated healthcare costs. This study evaluates bone mineral density changes in patients with rheumatoid arthritis of recent-onset. Methods: This descriptive case series was conducted in the Rheumatology Department of a tertiary care hospital in Karachi. Data was prospectively collected from 76 patients presenting with seropositive or seronegative rheumatoid arthritis. Bone mineral density of these patients measured at lumbar spine and hip by using dual energy x-ray absorptiometry scan. Variables like age, gender, BMI, menstrual status, disease duration, erythrocyte sedimentation rate, vitamin D level, clinical disease activity index and seropositivity for rheumatoid arthritis were measured along with outcome variables. Results: A total of 104 patients fulfilling inclusion criteria were registered with 28 excluded from study. Among the remaining 76 patients, 68 (89.50 percentage) were female, with mean age of patients (with low bone mineral density) as 50.95±7.87 years. Nineteen (25 percentage) patients had low bone mineral density, 68.52 percentage had low BMD at spine while 10.52 percentage at hip and 21.05 percentage at spine and hip both. Low bone mineral density was found higher in patients with seronegative 7 (50 percentage) as compared to seropositive patients 12 (19.4 percentage) (p-value 0.017), whereas low bone mineral density was found higher 12 (70.6 percentage) among post-menopausal women. Conclusion: Low BMD was found in 25 percentage of patients at earlier stage of the rheumatoid arthritis with seropositivity, age and menopausal status as significant risk factors. (author)

EULAR definition of erosive disease in light of the 2010 ACR/EULAR rheumatoid arthritis classification criteria

NARCIS (Netherlands)

van der Heijde, Désirée; van der Helm-van Mil, Annette H. M.; Aletaha, Daniel; Bingham, Clifton O.; Burmester, Gerd R.; Dougados, Maxime; Emery, Paul; Felson, David; Knevel, Rachel; Kvien, Tore K.; Landewé, Robert B. M.; Lukas, Cédric; McInnes, Iain; Silman, Alan J.; Smolen, Josef S.; Stanislawska-Biernat, Ewa; Zink, Angela; Combe, Bernard

2013-01-01

The aim of this report was to propose a definition for erosive disease in the context of inflammatory arthritis in light of the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) rheumatoid arthritis (RA) criteria for use in clinical practice and studies. A EULAR

Lactobacillus salivarius Isolated from Patients with Rheumatoid Arthritis Suppresses Collagen-Induced Arthritis and Increases Treg Frequency in Mice.

Science.gov (United States)

Liu, Xiaofei; Zhang, Juan; Zou, Qinghua; Zhong, Bing; Wang, Heng; Mou, Fangxiang; Wu, Like; Fang, Yongfei

2016-12-01

Previously, we demonstrated that Lactobacillus salivarius was more abundant in patients with rheumatoid arthritis (RA), an inflammatory autoimmune disease wherein the gut microbiota is altered, than in healthy individuals. However, the effect of L. salivarius in RA is unclear. Hence, we investigated the effect of L. salivarius isolated from patients with RA on collagen-induced arthritis (CIA) in mice. L. salivarius UCC118 or L. plantarum WCFS1 isolated from patients with RA was administered orally for 5 weeks, starting from 2 weeks before the induction of arthritis in DBA/1 mice. Clinical score progression, histological changes, serum cytokine concentrations, and the proportion of interleukin (IL)-17-producing T cells [T helper 17 (Th17)] and regulatory T cells (Tregs) in the spleen were evaluated. Bone erosion was evaluated by micro-computed tomography. CIA mice treated with either L. salivarius or L. plantarum showed lower arthritis scores, milder synovial infiltration, and less bone erosion when compared with phosphate-buffered, saline-treated CIA mice. Administration of L. salivarius and L. plantarum reduced the Th17 cell fraction and increased the Treg fraction. L. salivarius-treated CIA mice displayed a significant increase in serum anti-inflammatory IL-10 levels. Thus, pretreatment with L. salivarius could significantly improve CIA in mice and may help alleviate RA in a clinical setting.

Radiographic changes in the os calcis in rheumatoid arthritis

International Nuclear Information System (INIS)

Lakits, A.

1994-01-01

Plain films of the calcanea of 768 patients with confirmed rheumatoid arthritis were examined retrospectively with reference to inflammatory rheumatic changes. 42 patients (5.5%) showed an erosion of the posterior upper calcaneal margin related to an Achilles bursitis. In three patients there were additional plantar erosions. The Achilles bursitis was bilateral in 50% of cases, particularly in patients in stages 2 and 3 according to Steinbrocker. In the majority of bilateral cases (62%) the size or shape of the lesions was asymmetrical. Our observations indicate that involvement of the os calcis is not uncommon in rheumatoid arthritis; routine examination of this bone would appear to be indicated even in patients without symptoms. Since the defect is unilateral in half the patients, unilateral occurrence of an erosive lesion cannot be regarded as a criterion for a bacterial-inflammatory bursitis. Contrary to the symmetrical involvement of joints in the hands in rheumatoid arthritis, defects in the calcanea are often unilateral or asymmetrical. (orig.) [de

Treadmill Running Ameliorates Destruction of Articular Cartilage and Subchondral Bone, Not Only Synovitis, in a Rheumatoid Arthritis Rat Model

Directory of Open Access Journals (Sweden)

Seiji Shimomura

2018-06-01

Full Text Available We analyzed the influence of treadmill running on rheumatoid arthritis (RA joints using a collagen-induced arthritis (CIA rat model. Eight-week-old male Dark Agouti rats were randomly divided into four groups: The control group, treadmill group (30 min/day for 4 weeks from 10-weeks-old, CIA group (induced CIA at 8-weeks-old, and CIA + treadmill group. Destruction of the ankle joint was evaluated by histological analyses. Morphological changes of subchondral bone were analyzed by μ-CT. CIA treatment-induced synovial membrane invasion, articular cartilage destruction, and bone erosion. Treadmill running improved these changes. The synovial membrane in CIA rats produced a large amount of tumor necrosis factor-α and Connexin 43; production was significantly suppressed by treadmill running. On μ-CT of the talus, bone volume fraction (BV/TV was significantly decreased in the CIA group. Marrow star volume (MSV, an index of bone loss, was significantly increased. These changes were significantly improved by treadmill running. Bone destruction in the talus was significantly increased with CIA and was suppressed by treadmill running. On tartrate-resistant acid phosphate and alkaline phosphatase (TRAP/ALP staining, the number of osteoclasts around the pannus was decreased by treadmill running. These findings indicate that treadmill running in CIA rats inhibited synovial hyperplasia and joint destruction.

Joint cartilage thickness and automated determination of bone age and bone health in juvenile idiopathic arthritis

DEFF Research Database (Denmark)

Twilt, Marinka; Pradsgaard, Dan; Spannow, Anne Helene

2017-01-01

BACKGROUND: BoneXpert is an automated method to calculate bone maturation and bone health index (BHI) in children with juvenile idiopathic arthritis (JIA). Cartilage thickness can also be seen as an indicator for bone health and arthritis damage. The objective of this study was to evaluate...... the relation between cartilage thickness, bone maturation and bone health in patients with JIA. METHODS: Patients with JIA diagnosed according ILAR criteria included in a previous ultrasonography (US) study were eligible if hand radiographs were taken at the same time as the US examination. Of the 95 patients...... 67 met the inclusion criteria. RESULTS: Decreased cartilage thickness was seen in 27% of the examined joints. Decreased BHI was seen in half of the JIA patient, and delayed bone maturation was seen in 33% of patients. A combination of decreased BHI and bone age was seen in 1 out of 5 JIA patients...

Hamster and Murine Models of Severe Destructive Lyme Arthritis

Science.gov (United States)

Munson, Erik; Nardelli, Dean T.; Du Chateau, Brian K.; Callister, Steven M.; Schell, Ronald F.

2012-01-01

Arthritis is a frequent complication of infection in humans with Borrelia burgdorferi. Weeks to months following the onset of Lyme borreliosis, a histopathological reaction characteristic of synovitis including bone, joint, muscle, or tendon pain may occur. A subpopulation of patients may progress to a chronic, debilitating arthritis months to years after infection which has been classified as severe destructive Lyme arthritis. This arthritis involves focal bone erosion and destruction of articular cartilage. Hamsters and mice are animal models that have been utilized to study articular manifestations of Lyme borreliosis. Infection of immunocompetent LSH hamsters or C3H mice results in a transient synovitis. However, severe destructive Lyme arthritis can be induced by infecting irradiated hamsters or mice and immunocompetent Borrelia-vaccinated hamsters, mice, and interferon-gamma- (IFN-γ-) deficient mice with viable B. burgdorferi. The hamster model of severe destructive Lyme arthritis facilitates easy assessment of Lyme borreliosis vaccine preparations for deleterious effects while murine models of severe destructive Lyme arthritis allow for investigation of mechanisms of immunopathology. PMID:22461836

RANK, RANKL and osteoprotegerin in arthritic bone loss

Directory of Open Access Journals (Sweden)

M.C. Bezerra

2005-02-01

Full Text Available Rheumatoid arthritis is characterized by the presence of inflammatory synovitis and destruction of joint cartilage and bone. Tissue proteinases released by synovia, chondrocytes and pannus can cause cartilage destruction and cytokine-activated osteoclasts have been implicated in bone erosions. Rheumatoid arthritis synovial tissues produce a variety of cytokines and growth factors that induce monocyte differentiation to osteoclasts and their proliferation, activation and longer survival in tissues. More recently, a major role in bone erosion has been attributed to the receptor activator of nuclear factor kappa B ligand (RANKL released by activated lymphocytes and osteoblasts. In fact, osteoclasts are markedly activated after RANKL binding to the cognate RANK expressed on the surface of these cells. RANKL expression can be upregulated by bone-resorbing factors such as glucocorticoids, vitamin D3, interleukin 1 (IL-1, IL-6, IL-11, IL-17, tumor necrosis factor-alpha, prostaglandin E2, or parathyroid hormone-related peptide. Supporting this idea, inhibition of RANKL by osteoprotegerin, a natural soluble RANKL receptor, prevents bone loss in experimental models. Tumor growth factor-ß released from bone during active bone resorption has been suggested as one feedback mechanism for upregulating osteoprotegerin and estrogen can increase its production on osteoblasts. Modulation of these systems provides the opportunity to inhibit bone loss and deformity in chronic arthritis.

Wrist and finger joint MR imaging in rheumatoid arthritis

DEFF Research Database (Denmark)

Klarlund, Mette; Østergaard, Mikkel; Gideon, P

1999-01-01

PURPOSE: To elaborate the best MR imaging protocol for studies in rheumatoid arthritis (RA) and to evaluate the sensitivity and interobserver agreement with respect to detection of bone erosions (MR and radiography) and grading of synovial membrane hypertrophy (MR imaging only). MATERIAL...

The pathogenesis of rheumatoid arthritis in radiological studies. Part I: Formation of inflammatory infiltrates within the synovial membrane

Directory of Open Access Journals (Sweden)

Iwona Sudoł‑Szopińska

2012-06-01

Full Text Available Rheumatoid arthritis is a chronic inflammatory disease with a multifactorial etiology and varied course, which in the majority of patients leads to partial disability or to permanent handicap. Its characteristic trait is a persistent inflammation of the synovial membrane and the formation of an invasive synovial tissue, called the pannus, which in time leads to destruction of the cartilage, subchondral bone tissue, and the soft tissue of the affected joint(s. The pathogenesis of rheumatoid arthritis is complex and involves cells of both innate and adaptive immunity, a network of various cytokines and an immunoregulatory dysfunction. An important role in the discovery of rheumatoid arthritis pathogenesis was played by magnetic resonance imaging, which showed the disease process to extend beyond the synovium into the bone marrow. Many studies have shown a strict correlation between the vascularity of the synovium (assessed through the power Doppler ultrasound and magnetic resonance examinations, bone marrow edema and the clinical, laboratory and histopathological parameters of rheumatoid arthritis. From the current understanding of rheumatoid arthritis, bone erosions could occur from two directions: from the joint cavity and from the bone marrow. With power Doppler ultrasound, as well as in magnetic resonance imaging, it is possible to visualize the well-vascularized pannus and its destructive effects on joint structures and ligaments. In addition, the magnetic resonance study shows inflammatory and destructive changes within the bone marrow (bone marrow edema, inflammatory cysts, and erosions. Bone marrow edema occurs in 68–75% of patients with early rheumatoid arthritis and is considered to be a predictor of rapid disease progression.

Total glucosides of paeony prevents juxta-articular bone loss in experimental arthritis

OpenAIRE

Wei, Chen Chao; You, Fan Tian; Mei, Li Yu; Jian, Sun; Qiang, Chen Yong

2013-01-01

Background Total glucosides of paeony (TGP) is a biologically active compound extracted from Paeony root. TGP has been used in rheumatoid arthritis therapy for many years. However, the mechanism by which TGP prevents bone loss has been less explored. Methods TGP was orally administered for 3?months to New Zealand rabbits with antigen-induced arthritis (AIA). Digital x-ray knee images and bone mineral density (BMD) measurements of the subchondral knee bone were performed before sacrifice. Chon...

The Role of IL-17 in the Angiogenesis of Rheumatoid Arthritis

Science.gov (United States)

2015-06-01

Sonder, K. Bendtzen, and P. Holmstrup. 2008. Blood cell gene expression profiling in subjects with ag- gressive periodontitis and chronic arthritis. J...event that fosters chronic inflammation and bone erosion in RA by facilitating unbalanced leukocyte migration and pannus formation. Hence inhibition of...cell polarization and joint vascularization in vivo in chronic and acute arthritis models and in vitro in RA peripheral blood mononuclear cells (PBMC)s

Systemic immune markers characterizing early stages of rheumatoid arthritis

NARCIS (Netherlands)

Chalan, Paulina Luiza

2016-01-01

Rheumatoid arthritis is a chronic autoimmune disease occurring in ~1% of the world population. The main feature of the disease is ongoing joint inflammation, caused by immune cells and their soluble factors, leading to irreversible bone erosions and cartilage damage. Early treatment can halt

Gadolinium-DTPA enhanced magnetic resonance imaging of bone cysts in patients with rheumatoid arthritis.

Science.gov (United States)

Gubler, F M; Algra, P R; Maas, M; Dijkstra, P F; Falke, T H

1993-01-01

OBJECTIVES--To examine the contents of intraosseous cysts in patients with rheumatoid arthritis (RA) through the signal intensity characteristics on gadolinium-DTPA (Gd-DTPA) enhanced magnetic resonance imaging. METHODS--The hand or foot joints of nine patients with the cystic form of RA (where the initial radiological abnormality consisted of intraosseous cysts without erosions) were imaged before and after intravenous administration of Gd-DTPA. A 0.6 unit, T1 weighted spin echo and T2* weighted gradient echo were used to obtain images in at least two perpendicular planes. RESULTS--Most cysts showed a low signal intensity on the non-enhanced T1 weighted (spin echo) images and a high signal intensity on the T2* weighted (gradient echo) images, consistent with a fluid content. No cyst showed an enhancement of signal intensity on the T1 weighted images after intravenous administration of Gd-DTPA, whereas synovium hyperplasia at the site of bony erosions did show an increased signal intensity after Gd-DTPA. Magnetic resonance imaging detected more cysts (as small as 2 mm) than plain films, and the cysts were located truly intraosseously. In six patients no other joint abnormalities were identified by magnetic resonance imaging; the three other patients also showed, after Gd-DTPA administration, an enhanced synovium at the site of bony erosions. CONCLUSIONS--It is suggested that intraosseous bone cysts in patients with RA do not contain hyperaemic synovial proliferation. The bone cysts in patients with the cystic form of RA may be the only joint abnormality. Images PMID:8257207

Bone loss in rheumatoid arthritis

International Nuclear Information System (INIS)

Gotfredsen, A.; Als, O.S.; Hassager, C.; Christiansen, C.

1986-01-01

The authors studied 159 patients with rheumatoid arthritis (RA) treated with a variety of drugs. Stratification of the patients was done according to treatment, sex, menopausal state, duration of the disease, and functional impairment. Forearm bone mineral content (BMC) and total body bone mineral (TBBM) were measured by single and dual photon absorptiometry. Bone turnover was estimated by biochemical markers. All patients had significantly decreased BMC and TBBM compared to normals. Comparing glucocorticoid and penicillamine treatment in premenopausal patients, they found significantly lower BMC and TBBM values in the glucocorticoid treated group. However, no differences in BMC and TBBM values were found in the corresponding postmenopausal groups. In the premenopausal glucocorticoid group with the duration of treatment and cumulated dose correlated with BMC, whereas no such correlations were found in the postmenopausal women. In the patients who did not receive glucocorticoids they found significant relationships between BMC and functional impairment as well as duration of the disease. Indices of bone turnover rose with increasing functional, impairment, particularly those of bone resorption

Ultrasound-detected bone erosion is a relapse risk factor after discontinuation of biologic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis whose ultrasound power Doppler synovitis activity and clinical disease activity are well controlled.

Science.gov (United States)

Kawashiri, Shin-Ya; Fujikawa, Keita; Nishino, Ayako; Okada, Akitomo; Aramaki, Toshiyuki; Shimizu, Toshimasa; Umeda, Masataka; Fukui, Shoichi; Suzuki, Takahisa; Koga, Tomohiro; Iwamoto, Naoki; Ichinose, Kunihiro; Tamai, Mami; Mizokami, Akinari; Nakamura, Hideki; Origuchi, Tomoki; Ueki, Yukitaka; Aoyagi, Kiyoshi; Maeda, Takahiro; Kawakami, Atsushi

2017-05-25

In the present study, we explored the risk factors for relapse after discontinuation of biologic disease-modifying antirheumatic drug (bDMARD) therapy in patients with rheumatoid arthritis (RA) whose ultrasound power Doppler (PD) synovitis activity and clinical disease activity were well controlled. In this observational study in clinical practice, the inclusion criteria were based on ultrasound disease activity and clinical disease activity, set as low or remission (Disease Activity Score in 28 joints based on erythrocyte sedimentation rate Ultrasound was performed in 22 joints of bilateral hands at discontinuation for evaluating synovitis severity and presence of bone erosion. Patients with a maximum PD score ≤1 in each joint were enrolled. Forty patients with RA were consecutively recruited (November 2010-March 2015) and discontinued bDMARD therapy. Variables at the initiation and discontinuation of bDMARD therapy that were predictive of relapse during the 12 months after discontinuation were assessed. The median patient age was 54.5 years, and the median disease duration was 3.5 years. Nineteen (47.5%) patients relapsed during the 12 months after the discontinuation of bDMARD therapy. Logistic regression analysis revealed that only the presence of bone erosion detected by ultrasound at discontinuation was predictive of relapse (OR 8.35, 95% CI 1.78-53.2, p = 0.006). No clinical characteristics or serologic biomarkers were significantly different between the relapse and nonrelapse patients. The ultrasound synovitis scores did not differ significantly between the groups. Our findings are the first evidence that ultrasound bone erosion may be a relapse risk factor after the discontinuation of bDMARD therapy in patients with RA whose PD synovitis activity and clinical disease activity are well controlled.

Magnetic resonance imaging in rheumatoid arthritis advances and research priorities

DEFF Research Database (Denmark)

Østergaard, Mikkel; McQueen, FM; Bird, P

2005-01-01

Magnetic resonance imaging (MRI) has now been used extensively in cross-sectional and observational studies as well as in controlled clinical trials to assess disease activity and joint damage in rheumatoid arthritis (RA). MRI measurements or scores for erosions, bone edema, and synovitis have been...

Joint cartilage thickness and automated determination of bone age and bone health in juvenile idiopathic arthritis.

Science.gov (United States)

Twilt, Marinka; Pradsgaard, Dan; Spannow, Anne Helene; Horlyck, Arne; Heuck, Carsten; Herlin, Troels

2017-08-10

BoneXpert is an automated method to calculate bone maturation and bone health index (BHI) in children with juvenile idiopathic arthritis (JIA). Cartilage thickness can also be seen as an indicator for bone health and arthritis damage. The objective of this study was to evaluate the relation between cartilage thickness, bone maturation and bone health in patients with JIA. Patients with JIA diagnosed according ILAR criteria included in a previous ultrasonography (US) study were eligible if hand radiographs were taken at the same time as the US examination. Of the 95 patients 67 met the inclusion criteria. Decreased cartilage thickness was seen in 27% of the examined joints. Decreased BHI was seen in half of the JIA patient, and delayed bone maturation was seen in 33% of patients. A combination of decreased BHI and bone age was seen in 1 out of 5 JIA patients. Decreased cartilage thickness in the knee, wrist and MCP joint was negatively correlated with delayed bone maturation but not with bone health index. Delayed bone maturation and decreased BHI were not related to a thinner cartilage, but a thicker cartilage. No relation with JADAS 10 was found. The rheumatologist should remain aware of delayed bone maturation and BHI in JIA patients with cartilage changes, even in the biologic era.

Relationship of patient-reported outcomes with MRI measures in rheumatoid arthritis

DEFF Research Database (Denmark)

Baker, Joshua F; Conaghan, Philip G.; Emery, Paul

2017-01-01

PURPOSE: We assessed whether MRI measures of synovitis, osteitis and bone erosion were associated with patient-reported outcomes (PROs) in a longitudinal clinical trial setting among patients with rheumatoid arthritis (RA). METHODS: This longitudinal cohort of 291 patients with RA was derived from...

Tuberculous arthritis of the appendicular skeleton: MR imaging appearances

International Nuclear Information System (INIS)

Parmar, Hemant; Shah, Jeshil; Patkar, Deepak; Singrakhia, Manoj; Patankar, Tufail; Hutchinson, Charles

2004-01-01

Tuberculosis [TB] of the appendicular skeleton is an uncommon infection caused by the tuberculous bacilli and constitutes only 1-3% of all tuberculosis infections. MR imaging features of tuberculous arthritis include bone marrow oedema, cortical erosions, synovitis, joint effusion, tenosynovitis, soft tissue collections, and myositis. These imaging features are at times non-specific, but in the correct clinical context help in diagnosis of tuberculosis. We present the various pathological manifestations of TB arthritis involving the different joints of appendicular skeleton and discuss their MR imaging appearances

Tuberculous arthritis of the appendicular skeleton: MR imaging appearances

Energy Technology Data Exchange (ETDEWEB)

Parmar, Hemant E-mail: parurad@hotmail.com; Shah, Jeshil; Patkar, Deepak; Singrakhia, Manoj; Patankar, Tufail; Hutchinson, Charles

2004-12-01

Tuberculosis [TB] of the appendicular skeleton is an uncommon infection caused by the tuberculous bacilli and constitutes only 1-3% of all tuberculosis infections. MR imaging features of tuberculous arthritis include bone marrow oedema, cortical erosions, synovitis, joint effusion, tenosynovitis, soft tissue collections, and myositis. These imaging features are at times non-specific, but in the correct clinical context help in diagnosis of tuberculosis. We present the various pathological manifestations of TB arthritis involving the different joints of appendicular skeleton and discuss their MR imaging appearances.

Automated measurement of joint space width in early rheumatoid arthritis hand radiographs

NARCIS (Netherlands)

Huo, YH

2017-01-01

Rheumatoid arthritis (RA) is a chronic inflammatory disease, affecting predominantly small joints of hands and feet. The current gold standard for assessment of radiographic progression in RA is the Sharp/van der Heijde scoring method (SvdH), scoring both bone erosions and joint space narrowing

Tomosynthesis of the wrist and hand in patients with rheumatoid arthritis: comparison with radiography and MRI.

Science.gov (United States)

Aoki, Takatoshi; Fujii, Masami; Yamashita, Yoshiko; Takahashi, Hiroyuki; Oki, Hodaka; Hayashida, Yoshiko; Saito, Kazuyoshi; Tanaka, Yoshiya; Korogi, Yukunori

2014-02-01

The purpose of this article is to compare tomosynthesis with radiography and MRI of the wrist and hand for evaluating bone erosion in patients with rheumatoid arthritis (RA). Twenty consecutive patients with an established diagnosis of RA and five control patients were included in this study. They underwent radiography, tomosynthesis, and MRI of the bilateral hand and wrist within a week. The mean total dose of radiography and tomosynthesis was 0.13 and 0.25 mGy, respectively. MRI evaluation was performed according to the Outcome Measures in Rheumatology Clinical Trials recommendations. Bone erosion on images from the three modalities was independently reviewed by two certificated radiologists with a 4-point scale (0, normal; 1, discrete erosion; 2, tomosynthesis, and MRI were 26.5%, 36.1%, and 36.7%, respectively. Significantly more bone erosions were revealed with tomosynthesis and MRI than with radiography (p tomosynthesis. Interobserver agreement (kappa value) for bone erosion was good to excellent on tomosynthesis and MRI for all joints (0.65-1.00 and 0.68-1.00, respectively), whereas it was slight to fair on radiography for some carpal bones and bases of metacarpal bones (0.22-0.56). Tomosynthesis is superior to radiography and almost comparable to MRI for the detection of bone erosion in patients with RA.

MRI pattern of arthritis in systemic lupus erythematosus: a comparative study with rheumatoid arthritis and healthy subjects

Energy Technology Data Exchange (ETDEWEB)

Tani, Chiara; Possemato, Niccolo; Delle Sedie, Andrea; Bombardieri, Stefano; Mosca, Marta [University of Pisa, Rheumatology Unit, Department of Clinical and Experimental Medicine, Pisa (Italy); D' aniello, Dario; Caramella, Davide [Radiology Unit, University of Pisa, Pisa (Italy)

2014-10-24

In this study we aimed to describe the magnetic resonance imaging (MRI) pattern of the distribution of bone marrow edema (BME) and joint erosion in hands and wrists of patients with systemic lupus erythematosus (SLE) with arthritis in comparison with rheumatoid arthritis (RA) and healthy subjects (H). SLE patients with arthritis (n = 50), patients with RA (n = 22), and H (n = 48) were enrolled. Every patient underwent a non-dominant hand (2nd-5th metacarpophalangeal joints) and wrist MRI without contrast injection with a low-field extremity dedicated 0.2-Tesla instrument. BME was observed in two SLE patients in the hand (4 %) and in 15 in the wrist (13 %) versus three (30 %), and 14 (63 %) RA patients. No BME was found in H. Erosions were observed in the hand in 24 SLE patients (48 %), 15 RA patients (68 %), and 9 H (18 %); in the wrist, in 41 (82 %) SLE, all RA and 47 (97 %) H. The cumulative erosive burden in SLE was significantly higher than in H (c = 0.002) but similar to RA patients. Joint involvement of the wrist in SLE is similar to RA and is not as rare as expected, as shown by the comparison with healthy subjects. On the contrary, the involvement of the hand in SLE is significantly lower compared to RA. (orig.)

MRI pattern of arthritis in systemic lupus erythematosus: a comparative study with rheumatoid arthritis and healthy subjects

International Nuclear Information System (INIS)

Tani, Chiara; Possemato, Niccolo; Delle Sedie, Andrea; Bombardieri, Stefano; Mosca, Marta; D'aniello, Dario; Caramella, Davide

2015-01-01

In this study we aimed to describe the magnetic resonance imaging (MRI) pattern of the distribution of bone marrow edema (BME) and joint erosion in hands and wrists of patients with systemic lupus erythematosus (SLE) with arthritis in comparison with rheumatoid arthritis (RA) and healthy subjects (H). SLE patients with arthritis (n = 50), patients with RA (n = 22), and H (n = 48) were enrolled. Every patient underwent a non-dominant hand (2nd-5th metacarpophalangeal joints) and wrist MRI without contrast injection with a low-field extremity dedicated 0.2-Tesla instrument. BME was observed in two SLE patients in the hand (4 %) and in 15 in the wrist (13 %) versus three (30 %), and 14 (63 %) RA patients. No BME was found in H. Erosions were observed in the hand in 24 SLE patients (48 %), 15 RA patients (68 %), and 9 H (18 %); in the wrist, in 41 (82 %) SLE, all RA and 47 (97 %) H. The cumulative erosive burden in SLE was significantly higher than in H (c = 0.002) but similar to RA patients. Joint involvement of the wrist in SLE is similar to RA and is not as rare as expected, as shown by the comparison with healthy subjects. On the contrary, the involvement of the hand in SLE is significantly lower compared to RA. (orig.)

Magnetic resonance imaging of the wrist in rheumatoid arthritis: demonstration of progression between 1 and 6 years

Energy Technology Data Exchange (ETDEWEB)

Stewart, Neal R. [Auckland Hospital, Department of Radiology, Private Bag 92024, Auckland (New Zealand); Auckland Radiology Group, Auckland (New Zealand); Crabbe, Jeffrey P. [Auckland Radiology Group, Auckland (New Zealand); McQueen, Fiona M. [Auckland Hospital, Department of Rheumatology, Auckland (New Zealand)

2004-12-01

To describe the changes seen in the wrist in rheumatoid arthritis (RA) on magnetic resonance (MR) imaging obtained at 1 year and 6 years. A cohort of patients with RA has been studied prospectively from symptom onset. MR scans of the dominant wrist in 31 patients obtained at 1 year and 6 years were compared for bone erosions, marrow signal change (oedema), synovial thickness and tenosynovitis. Twenty-two patients had an increase in erosion score in the interval and three patients showed a decrease in erosion score suggesting erosion healing. Fourteen patients had an increase in oedema score in the interval and eight patients had a decrease in oedema score. Synovial thickness increased in 13 patients and decreased in eight. Tenosynovitis increased in 15 patients and decreased in five. Bone erosions developed immediately adjacent to the tenosynovitis in two patients. MR imaging is useful in following the progress of bone erosions, marrow oedema, synovitis and tenosynovitis in RA. (orig.)

Magnetic resonance imaging of the wrist in rheumatoid arthritis: demonstration of progression between 1 and 6 years

International Nuclear Information System (INIS)

Stewart, Neal R.; Crabbe, Jeffrey P.; McQueen, Fiona M.

2004-01-01

To describe the changes seen in the wrist in rheumatoid arthritis (RA) on magnetic resonance (MR) imaging obtained at 1 year and 6 years. A cohort of patients with RA has been studied prospectively from symptom onset. MR scans of the dominant wrist in 31 patients obtained at 1 year and 6 years were compared for bone erosions, marrow signal change (oedema), synovial thickness and tenosynovitis. Twenty-two patients had an increase in erosion score in the interval and three patients showed a decrease in erosion score suggesting erosion healing. Fourteen patients had an increase in oedema score in the interval and eight patients had a decrease in oedema score. Synovial thickness increased in 13 patients and decreased in eight. Tenosynovitis increased in 15 patients and decreased in five. Bone erosions developed immediately adjacent to the tenosynovitis in two patients. MR imaging is useful in following the progress of bone erosions, marrow oedema, synovitis and tenosynovitis in RA. (orig.)

Extremes in vitamin K status of bone are related to bone ultrasound properties in children with juvenile idiopathic arthritis

NARCIS (Netherlands)

van Summeren, M. J. H.; Vermeer, C.; Engelbert, R. H. H.; Schurgers, L. J.; Takken, T.; Fischer, K.; Kuis, W.

2008-01-01

Osteopenia is a common complication of juvenile idiopathic arthritis (JIA). In adults, low bone density and increased fracture risk are associated with low vitamin K status of bone. The vitamin K-dependent protein osteocalcin plays an important role in bone metabolism. Its activity depends upon

X-ray evaluation of bone tissue density in rheumatoid arthritis

International Nuclear Information System (INIS)

Kotlubej, O.V.; Kamenets'kij, M.S.; Tkachenko, G.D.; Momot, N.V.

1998-01-01

Densitometry of hand and foot films of 111 patients with rheumatoid arthritis was performed. Twelve patients underwent CT of lumbar vertebra with tomodensitometry followed by analysis of the obtained graphic histograms. Photo densitometry of plain x-ray films and histographic analysis of CT scans allows to perform quantitative evaluation of the bone tissue density in rheumatoid arthritis and to reveal osteoporosis at early stages when x-ray features of the disease are absent

Deep erosions of the palmar aspect of the navicular bone diagnosed by standing magnetic resonance imaging.

Science.gov (United States)

Sherlock, C; Mair, T; Blunden, T

2008-11-01

Erosion of the palmar (flexor) aspect of the navicular bone is difficult to diagnose with conventional imaging techniques. To review the clinical, magnetic resonance (MR) and pathological features of deep erosions of the palmar aspect of the navicular bone. Cases of deep erosions of the palmar aspect of the navicular bone, diagnosed by standing low field MR imaging, were selected. Clinical details, results of diagnostic procedures, MR features and pathological findings were reviewed. Deep erosions of the palmar aspect of the navicular bone were diagnosed in 16 mature horses, 6 of which were bilaterally lame. Sudden onset of lameness was recorded in 63%. Radiography prior to MR imaging showed equivocal changes in 7 horses. The MR features consisted of focal areas of intermediate or high signal intensity on T1-, T2*- and T2-weighted images and STIR images affecting the dorsal aspect of the deep digital flexor tendon, the fibrocartilage of the palmar aspect, subchondral compact bone and medulla of the navicular bone. On follow-up, 7/16 horses (44%) had been subjected to euthanasia and only one was being worked at its previous level. Erosions of the palmar aspect of the navicular bone were confirmed post mortem in 2 horses. Histologically, the lesions were characterised by localised degeneration of fibrocartilage with underlying focal osteonecrosis and fibroplasia. The adjacent deep digital flexor tendon showed fibril formation and fibrocartilaginous metaplasia. Deep erosions of the palmar aspect of the navicular bone are more easily diagnosed by standing low field MR imaging than by conventional radiography. The lesions involve degeneration of the palmar fibrocartilage with underlying osteonecrosis and fibroplasia affecting the subchondral compact bone and medulla, and carry a poor prognosis for return to performance. Diagnosis of shallow erosive lesions of the palmar fibrocartilage may allow therapeutic intervention earlier in the disease process, thereby preventing

Spleen and liver enlargement in a patient with rheumatoid arthritis.

Science.gov (United States)

Bedoya, María Eugenia; Ceccato, Federico; Paira, Sergio

2015-01-01

We describe the case of a 51-year-old woman with a seropositive, erosive, and non-nodular rheumatoid arthritis of 15 year of evolution. The patient had poor compliance with medical visits and treatment. She came to the clinic with persistent pancytopenia and spleen and liver enlargement. Liver and bone marrow biopsies were carried out and amyloidosis, neoplasias and infections were ruled out. We discuss the differential diagnosis of pancytopenia and spleen and liver enlargement in a long-standing rheumatoid arthritis patient. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Increased chemotaxis and activity of circulatory myeloid progenitor cells may contribute to enhanced osteoclastogenesis and bone loss in the C57BL/6 mouse model of collagen-induced arthritis.

Science.gov (United States)

Ikić Matijašević, M; Flegar, D; Kovačić, N; Katavić, V; Kelava, T; Šućur, A; Ivčević, S; Cvija, H; Lazić Mosler, E; Kalajzić, I; Marušić, A; Grčević, D

2016-12-01

Our study aimed to determine the functional activity of different osteoclast progenitor (OCP) subpopulations and signals important for their migration to bone lesions, causing local and systemic bone resorption during the course of collagen-induced arthritis in C57BL/6 mice. Arthritis was induced with chicken type II collagen (CII), and assessed by clinical scoring and detection of anti-CII antibodies. We observed decreased trabecular bone volume of axial and appendicular skeleton by histomorphometry and micro-computed tomography as well as decreased bone formation and increased bone resorption rate in arthritic mice in vivo. In the affected joints, bone loss was accompanied with severe osteitis and bone marrow hypercellularity, coinciding with the areas of active osteoclasts and bone erosions. Flow cytometry analysis showed increased frequency of putative OCP cells (CD3 - B220 - NK1.1 - CD11b -/lo CD117 + CD115 + for bone marrow and CD3 - B220 - NK1.1 - CD11b + CD115 + Gr-1 + for peripheral haematopoietic tissues), which exhibited enhanced differentiation potential in vitro. Moreover, the total CD11b + population was expanded in arthritic mice as well as CD11b + F4/80 + macrophage, CD11b + NK1.1 + natural killer cell and CD11b + CD11c + myeloid dendritic cell populations in both bone marrow and peripheral blood. In addition, arthritic mice had increased expression of tumour necrosis factor-α, interleukin-6, CC chemokine ligand-2 (Ccl2) and Ccl5, with increased migration and differentiation of circulatory OCPs in response to CCL2 and, particularly, CCL5 signals. Our study characterized the frequency and functional properties of OCPs under inflammatory conditions associated with arthritis, which may help to clarify crucial molecular signals provided by immune cells to mediate systemically enhanced osteoresorption. © 2016 British Society for Immunology.

Controlled release pharmaceutical composition useful for the treatment of diseases and conditions affecting metabolism and/or structural integrity of cartilage and/or bone in male comprises strontium salt

DEFF Research Database (Denmark)

2004-01-01

, hyperparathyroidism, periarticular erosions in rheumatoid arthritis, osteodystrophy, myositis ossificans, Bechterew's disease, osteolytic lesions produced by bone metastasis, bone pain due to bone metastasis, bone loss due to sex steroid hormone deficiency, bone abnormalities due to steroid hormone treatment, bone...

Neurostimulation of the cholinergic anti-inflammatory pathway ameliorates disease in rat collagen-induced arthritis.

Directory of Open Access Journals (Sweden)

Yaakov A Levine

Full Text Available The inflammatory reflex is a physiological mechanism through which the nervous system maintains immunologic homeostasis by modulating innate and adaptive immunity. We postulated that the reflex might be harnessed therapeutically to reduce pathological levels of inflammation in rheumatoid arthritis by activating its prototypical efferent arm, termed the cholinergic anti-inflammatory pathway. To explore this, we determined whether electrical neurostimulation of the cholinergic anti-inflammatory pathway reduced disease severity in the collagen-induced arthritis model.Rats implanted with vagus nerve cuff electrodes had collagen-induced arthritis induced and were followed for 15 days. Animals underwent active or sham electrical stimulation once daily from day 9 through the conclusion of the study. Joint swelling, histology, and levels of cytokines and bone metabolism mediators were assessed.Compared with sham treatment, active neurostimulation of the cholinergic anti-inflammatory pathway resulted in a 52% reduction in ankle diameter (p = 0.02, a 57% reduction in ankle diameter (area under curve; p = 0.02 and 46% reduction overall histological arthritis score (p = 0.01 with significant improvements in inflammation, pannus formation, cartilage destruction, and bone erosion (p = 0.02, accompanied by numerical reductions in systemic cytokine levels, not reaching statistical significance. Bone erosion improvement was associated with a decrease in serum levels of receptor activator of NF-κB ligand (RANKL from 132±13 to 6±2 pg/mL (mean±SEM, p = 0.01.The severity of collagen-induced arthritis is reduced by neurostimulation of the cholinergic anti-inflammatory pathway delivered using an implanted electrical vagus nerve stimulation cuff electrode, and supports the rationale for testing this approach in human inflammatory disorders.

Radiographic visualisation of seropositive rheumatoid arthritis in Carriers of HLA-B27

International Nuclear Information System (INIS)

Jurik, A.G.; Carvalho, A. de; Graudal, H.; Aarhus Univ.

1987-01-01

A group of 11 B27-positive, seropositive patients with rheumatoid arthritis was compared with 11 matched B27-negative seropositive patients. The radiographs of all limb joints, the sacroiliac joints, and the cervical spine were read blindly. Ten patients in each group were radiographed 2-6 times during observation periods of 3-13 years; one patient in each group was only examined once. The prevailing picture of both groups was that of progressive erosive rheumatoid arthritis, although two small differences were found: Erosions of the apophyseal joints of the cervical spine and slight periosteal new bone formation of the shoulder, hip, and knee regions occurred more often in the B27-positive than in the B27-negative group. (orig.) [de

Hand and wrist arthritis of Behcet disease: Imaging features

International Nuclear Information System (INIS)

Sugawara, Shunsuke; Ehara, Shigeru; Hitachi, Shin; Sugimoto, Hideharu

2010-01-01

Background: Reports on arthritis in Behcet disease are relatively scarce, and imaging features vary. Purpose: To document the various imaging features of articular disorders of the hand and wrist in Behcet disease. Material and Methods: Four patients, four women aged 26 to 65 years, fulfilling the diagnostic criteria of Behcet disease, with imaging findings of hand and wrist arthritis, were seen in two institutions. Radiography and magnetic resonance (MR) imaging were studied to elucidate the pattern and distribution. Results: Both non-erosive arthritis and erosive arthritis of different features were noted: one with non-erosive synovitis of the wrist, one with wrist synovitis with minimal erosion, and two with erosive arthritis of the distal interphalangeal joint. Conclusion: Imaging manifestations of arthritis of Behcet disease vary, and may be similar to other seronegative arthritides

Inter-observer reliability of high-resolution ultrasonography in the assessment of bone erosions in patients with rheumatoid arthritis: experience of an intensive dedicated training programme.

Science.gov (United States)

Gutierrez, Marwin; Filippucci, Emilio; Ruta, Santiago; Salaffi, Fausto; Blasetti, Patrizia; Di Geso, Luca; Grassi, Walter

2011-02-01

The present study was aimed at testing the ability of a rheumatologist without experience in ultrasound (US) who attended an intensive 4-week training programme focused on US assessing bone erosions in the hands and feet in patients with RA. Twenty patients diagnosed with RA according to the ACR criteria were included in the study. All US examinations were performed bilaterally by two investigators (with different experience in the field of musculoskeletal US) at the following sites: the dorsal, lateral and volar aspect of the second metacarpal, ulnar and fifth metatarsal head; and the dorsal and volar aspect of the third metacarpal and second proximal heads. Each quadrant was scanning in longitudinal and transverse scans for assessing the qualitative, semiquantitative and quantitative US findings indicative of bone erosions according the OMERACT preliminary definition. Both κ-values and overall agreement percentages of qualitative and semiquantitative assessments showed moderate to excellent agreement between the two investigators. Similar results were obtained for the quantitative assessment with the concordance correlation coefficient value always significant. The only exception was the volar aspects, in particular those of the fifth metatarsal head. Our study suggests that after a 4-week dedicated training programme, a rheumatologist without experience in US is able to detect and score bone erosions in the hands and feet of patients with RA.

The OMERACT rheumatoid arthritis magnetic resonance imaging (MRI) scoring system

DEFF Research Database (Denmark)

Østergaard, Mikkel; Peterfy, Charles G.; Bird, Paul

2017-01-01

Objective: The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Magnetic Resonance Imaging (MRI) scoring system (RAMRIS), evaluating bone erosion, bone marrow edema/osteitis, and synovitis, was introduced in 2002, and is now the standard method of objectively quantifying...... inflammation and damage by MRI in RA trials. The objective of this paper was to identify subsequent advances and based on them, to provide updated recommendations for the RAMRIS. Methods: MRI studies relevant for RAMRIS and technical and scientific advances were analyzed by the OMERACT MRI in Arthritis Working...... Group, which used these data to provide updated considerations on image acquisition, RAMRIS definitions, and scoring systems for the original and new RA pathologies. Further, a research agenda was outlined. Results: Since 2002, longitudinal studies and clinical trials have documented RAMRIS variables...

Hypermobility of the first metatarsal bone in patients with Rheumatoid arthritis treated by lapidus procedure

Directory of Open Access Journals (Sweden)

Popelka Stanislav

2012-08-01

Full Text Available Abstract Background Foot deformities and related problems of the forefoot are very common in patients with rheumatoid arthritis. The laxity of the medial cuneometatarsal joint and its synovitis are important factors in the development of forefoot deformity. The impaired joint causes the first metatarsal bone to become unstable in the frontal and sagittal planes. In this retrospective study we evaluated data of patients with rheumatoid arthritis who underwent Lapidus procedure. We evaluated the role of the instability in a group of patients, focusing mainly on the clinical symptoms and X-ray signs of the instability. Methods The study group included 125 patients with rheumatoid arthritis. The indications of the Lapidus procedure were a hallux valgus deformity greater than 15 degrees and varus deformity of the first metatarsal bone with the intermetatarsal angle greater than 15 degrees on anterio-posterior weight-bearing X-ray. Results Data of 143 Lapidus procedures of 125 patients with rheumatoid arthritis, who underwent surgery between 2004 and 2010 was evaluated. Signs and symptoms of the first metatarsal bone instability was found in 92 feet (64.3% in our group. The AOFAS score was 48.6 before and 87.6 six months after the foot reconstruction. Nonunion of the medial cuneometatarsal joint arthrodesis on X-rays occurred in seven feet (4.9%. Conclusion The Lapidus procedure provides the possibility to correct the first metatarsal bone varus position and its instability, as well as providing the possibility to achieve a painless foot for walking. We recommend using the procedure as a preventive surgery in poorly symptomatic patients with rheumatoid arthritis in case of the first metatarsal bone hypermobility.

Disk abnormality coexists with any degree of synovial and osseous abnormality in the temporomandibular joints of children with juvenile idiopathic arthritis

International Nuclear Information System (INIS)

Kirkhus, Eva; Smith, Hans-Joergen; Arvidsson, Linda Z.; Larheim, Tore A.; Flatoe, Berit; Hetlevik, Siri O.

2016-01-01

MRI manifestation of temporomandibular joint arthritis is frequently reported in children with juvenile idiopathic arthritis. However, little attention has been paid to temporomandibular joint disk abnormalities. To assess combinations of MRI findings in the symptomatic temporomandibular joint in children with juvenile idiopathic arthritis with focus on disk abnormalities. This was a retrospective study of 46 patients with juvenile idiopathic arthritis, mean age 12 years (range: 5-17 years). Mean disease duration was 70 months (standard deviation: 61 months). MR images of 92 temporomandibular joints were scored for thickness of abnormally enhancing synovium (synovitis), joint effusion, bone marrow oedema, abnormal bone shape, bone erosion and disk abnormalities. The 92 temporomandibular joints were categorized as A: No synovitis and normal bone shape (30/92; 33%), B: Synovitis and normal bone shape (14/92: 15%), C: Synovitis and abnormal bone shape (38/92; 41%) and D: No synovitis but abnormal bone shape (10/92; 11%). Thirty-six of the 46 patients (78%) had synovitis and 33/46 (72%) had abnormal bone shape, most frequently in combination (30/46; 65%). Disk abnormalities (flat disk, fragmented disk, adherent disk and displaced disk) were found in 29/46 patients (63%). Disk abnormalities were found in all categories of juvenile idiopathic arthritis involved temporomandibular joints (B: 8/14 [57%]; C: 25/38 [66%] and D: 7/10 [70%]). Disk displacement was found in half of the joints (7/14) in category B. Synovitis was most pronounced in this category. Disk abnormalities were frequent. Disk displacement also occurred in joints with early temporomandibular joint arthritis, i.e., with normal bone shape. Other disk abnormalities were found in joints with bone abnormalities. Attention should be paid to disk abnormalities both in early and long-standing temporomandibular joint arthritis in children with juvenile idiopathic arthritis. (orig.)

Disk abnormality coexists with any degree of synovial and osseous abnormality in the temporomandibular joints of children with juvenile idiopathic arthritis

Energy Technology Data Exchange (ETDEWEB)

Kirkhus, Eva; Smith, Hans-Joergen [Oslo University Hospital, Rikshospitalet, Department of Radiology and Nuclear Medicine, Oslo (Norway); University of Oslo, Institute of Clinical Medicine, Oslo (Norway); Arvidsson, Linda Z.; Larheim, Tore A. [University of Oslo, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, Oslo (Norway); Flatoe, Berit; Hetlevik, Siri O. [Oslo University Hospital, Rikshospitalet, Department of Rheumatology, Oslo (Norway); University of Oslo, Institute of Clinical Medicine, Oslo (Norway)

2016-03-15

MRI manifestation of temporomandibular joint arthritis is frequently reported in children with juvenile idiopathic arthritis. However, little attention has been paid to temporomandibular joint disk abnormalities. To assess combinations of MRI findings in the symptomatic temporomandibular joint in children with juvenile idiopathic arthritis with focus on disk abnormalities. This was a retrospective study of 46 patients with juvenile idiopathic arthritis, mean age 12 years (range: 5-17 years). Mean disease duration was 70 months (standard deviation: 61 months). MR images of 92 temporomandibular joints were scored for thickness of abnormally enhancing synovium (synovitis), joint effusion, bone marrow oedema, abnormal bone shape, bone erosion and disk abnormalities. The 92 temporomandibular joints were categorized as A: No synovitis and normal bone shape (30/92; 33%), B: Synovitis and normal bone shape (14/92: 15%), C: Synovitis and abnormal bone shape (38/92; 41%) and D: No synovitis but abnormal bone shape (10/92; 11%). Thirty-six of the 46 patients (78%) had synovitis and 33/46 (72%) had abnormal bone shape, most frequently in combination (30/46; 65%). Disk abnormalities (flat disk, fragmented disk, adherent disk and displaced disk) were found in 29/46 patients (63%). Disk abnormalities were found in all categories of juvenile idiopathic arthritis involved temporomandibular joints (B: 8/14 [57%]; C: 25/38 [66%] and D: 7/10 [70%]). Disk displacement was found in half of the joints (7/14) in category B. Synovitis was most pronounced in this category. Disk abnormalities were frequent. Disk displacement also occurred in joints with early temporomandibular joint arthritis, i.e., with normal bone shape. Other disk abnormalities were found in joints with bone abnormalities. Attention should be paid to disk abnormalities both in early and long-standing temporomandibular joint arthritis in children with juvenile idiopathic arthritis. (orig.)

X-ray diagnosis of gouty arthritis

International Nuclear Information System (INIS)

Quan Gaorong; Luo Jianyun; Huang Shaoying

2008-01-01

Objective: The X-ray findings of 38 cases with gouty arthritis were summarized. The X-ray diagnosis and differential diagnosis were discussed to improve the understanding and diagnostic accuracy of this disease. Methods: Combined with literatures, the X-ray findings, pathological and clinical manifestations, laboratory examinations of 38 cases pathologically proved with gouty arthritis were analyzed. Results: The gouty arthritis usually occurred in the small joints of limbs, especially in the first metatarsophalangeal joint. The X-ray findings were dissymmetric swellings of soft tissue, scattered calcified shadow; bony erosion in form of scuttling and honeycomb defect with sharp and hard edge, narrowed joint space and irregular articular surface, emergence of fiber stiffness, even joint malformations and subluxation or dislocation, associated with hyperosteogeny and nearby osteoporosis. Conclusion: Diversification was presented in X-ray findings of gouty arthritis, which can be easily confused with other single or multiple bone joint diseases. As a result, accurate diagnosis should be based on careful analysis about X-ray findings combined with clinical manifestations and laboratory examination. (authors)

A comparative study of the value of four imaging methods for the diagnosis of rheumatoid arthritis of the shoulder joint

International Nuclear Information System (INIS)

Tsvetkova, S.; Semova, R.; Matalova, A.

2008-01-01

The shoulder joint becomes involved later than the peripheral joints of the lower and upper limb in rheumatoid arthritis. The aim of the current study is to determine the value of plain radiography (PR), ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) in detecting bone erosions and soft tissue changes of the shoulder joint in patients with rheumatoid arthritis. 27 patients - 21 women and 6 men, mean age 59 years (range 39 - 78) with confirmed rheumatoid arthritis and a painful shoulder are included in the study. The mean duration of the disease is 10 years and the mean duration of the shoulder symptoms is 4 years. In every patient all the imaging modalities were performed within 30 days. PR shows depicted changes in 20 patients (74%), US - in 25 patients (93%), CT - in 23 patients (85%) and MRI - in 26 patients (96%). US and MRI are more sensitive than CT in depicting small erosions of the humeral head and soft tissue changes. MRI and CT are the best methods for the diagnosis of subchondral and intraosseous bone lesions. The traditionally used PR is less sensitive than the other methods, especially in the evaluation of the soft tissues and the small erosions. (authors)

Bone effects of biologic drugs in rheumatoid arthritis.

Science.gov (United States)

Corrado, Addolorata; Neve, Anna; Maruotti, Nicola; Cantatore, Francesco Paolo

2013-01-01

Biologic agents used in the treatment of rheumatoid arthritis (RA) are able to reduce both disease activity and radiographic progression of joint disease. These drugs are directed against several proinflammatory cytokines (TNF α , IL-6, and IL-1) which are involved both in the pathogenesis of chronic inflammation and progression of joint structural damage and in systemic and local bone loss typically observed in RA. However, the role of biologic drugs in preventing bone loss in clinical practice has not yet clearly assessed. Many clinical studies showed a trend to a positive effect of biologic agents in preventing systemic bone loss observed in RA. Although the suppression of inflammation is the main goal in the treatment of RA and the anti-inflammatory effects of biologic drugs exert a positive effect on bone metabolism, the exact relationship between the prevention of bone loss and control of inflammation has not been clearly established, and if the available biologic drugs against TNF α , IL-1, and IL-6 can exert their effect on systemic and local bone loss also through a direct mechanism on bone cell metabolism is still to be clearly defined.

The method for objective evaluation of the intensity of radial bone lesions in rheumatoid arthritis using digital image analysis

International Nuclear Information System (INIS)

Zielinski, K.W.; Krekora, K.

2004-01-01

The semiquantitative methods used in everyday diagnostic practice for scoring the intensity of bone lesions in rheumatoid arthritis are susceptible to a subjective error. The paper describes the original algorithm for an image analysis as a method for quantitative and objective evaluation of the intensity of radiological lesions in rheumatoid arthritis. 75 plain radiograms of the hand of patients diagnosed with rheumatoid arthritis, in various stages of bone pathology, were evaluated. The analysis focused on the signs of pathological rebuilding of the affected bone, especially in the distal epiphysis of the radial bone. The plain radiograms of the hand were digitally analysed based on the modified method, formerly used for quantitative assessment of bone trabeculation. The method allowed us to objectively verify various scoring systems of radiograms widely used in rheumatological diagnosis. (author)

Assessment of bone mineral density in adults with a history of juvenile chronic arthritis: a cross-sectional long-term followup study

DEFF Research Database (Denmark)

Zak, M; Hassager, C; Lovell, D J

1999-01-01

To assess bone mineral density (BMD) and bone turnover in adults with a history of juvenile chronic arthritis (JCA) or persistent JCA, and to identify predictors of reduced BMD.......To assess bone mineral density (BMD) and bone turnover in adults with a history of juvenile chronic arthritis (JCA) or persistent JCA, and to identify predictors of reduced BMD....

Rheumatoid arthritis, osteoporosis, possibilities for the correction of bone mineral density

Directory of Open Access Journals (Sweden)

Rimma Mikhailovna Balabanova

2012-01-01

Full Text Available The paper gives data on the causes of osteoporosis in rheumatoid arthritis (RA, including in autoimmune inflammation, during corticosteroid therapy. The role of bisphosphonates in correcting impaired bone mineral density in RA is shown.

Influence of Angiotensin-Aldosterone System on Ultrasound of Joints in Patients with Rheumatoid Arthritis

Directory of Open Access Journals (Sweden)

O.B. Komarova

2014-02-01

Full Text Available In patients with rheumatoid arthritis and high level of angiotensin II in the blood at ultrasound of joints there are often being detected effusion in the joint cavity, hypervascularization of synovium with 2–3 points and tenosynovitis characterizing inflammatory exudative processes. In patients with high level of aldosterone, hyperplasia of synovium, presence of pannus and bone and cartilage erosions, indicating proliferative-destructive processes, were predominated. Identified correlations show that with increasing levels of angiotensin II in the blood increases the intensity of the vascularization of the synovial membrane, joint effusion, and an increase in the concentration of aldosterone in the blood affects the synovial thickness indicators, the presence of pannus and bone erosions amount.

MRI findings of treated bacterial septic arthritis

International Nuclear Information System (INIS)

Bierry, Guillaume; Huang, Ambrose J.; Chang, Connie Y.; Torriani, Martin; Bredella, Miriam A.

2012-01-01

The purpose of this study was to report the MRI findings that can be encountered in successfully treated bacterial septic arthritis. The study included 12 patients (8 male and 4 female; mean age 38 years, range 9-85) with 13 proven cases of bacterial septic arthritis. The joints involved were hip (n = 3), knee (n = 3), shoulder (n = 2), sacroiliac (n = 2), ankle (n = 1), wrist (n = 1), and elbow (n = 1). MRI examinations following surgical debridement and at initiation of antibiotic therapy and after successful treatment were compared for changes in effusion, synovium, bone, and periarticular soft tissues. Imaging findings were correlated with microbiological and clinical findings. Joint effusions were present in all joints at baseline and regressed significantly at follow-up MRI (p = 0.001). Abscesses were present in 5 cases (38 %), and their sizes decreased significantly at follow-up (p = 0.001). Synovial enhancement and thickening were observed in all joints at both baseline and follow-up MRI. Myositis/cellulitis was present in 10 cases (77 %) at baseline and in 8 cases (62 %) at follow-up MRI. Bone marrow edema was present in 10 joints (77 %) at baseline and persisted in 8 joints (62 %). Bone erosions were found in 8 joints (62 %) and persisted at follow-up MRI in all cases. The sizes of joint effusions and abscesses appear to be the factors with the most potential for monitoring therapy for septic arthritis, since both decreased significantly following successful treatment. Synovial thickening and enhancement, periarticular myositis/cellulitis, and bone marrow edema can persist even after resolution of the infection. (orig.)

MRI findings of treated bacterial septic arthritis

Energy Technology Data Exchange (ETDEWEB)

Bierry, Guillaume; Huang, Ambrose J.; Chang, Connie Y.; Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital and Harvard Medical School, Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States)

2012-12-15

The purpose of this study was to report the MRI findings that can be encountered in successfully treated bacterial septic arthritis. The study included 12 patients (8 male and 4 female; mean age 38 years, range 9-85) with 13 proven cases of bacterial septic arthritis. The joints involved were hip (n = 3), knee (n = 3), shoulder (n = 2), sacroiliac (n = 2), ankle (n = 1), wrist (n = 1), and elbow (n = 1). MRI examinations following surgical debridement and at initiation of antibiotic therapy and after successful treatment were compared for changes in effusion, synovium, bone, and periarticular soft tissues. Imaging findings were correlated with microbiological and clinical findings. Joint effusions were present in all joints at baseline and regressed significantly at follow-up MRI (p = 0.001). Abscesses were present in 5 cases (38 %), and their sizes decreased significantly at follow-up (p = 0.001). Synovial enhancement and thickening were observed in all joints at both baseline and follow-up MRI. Myositis/cellulitis was present in 10 cases (77 %) at baseline and in 8 cases (62 %) at follow-up MRI. Bone marrow edema was present in 10 joints (77 %) at baseline and persisted in 8 joints (62 %). Bone erosions were found in 8 joints (62 %) and persisted at follow-up MRI in all cases. The sizes of joint effusions and abscesses appear to be the factors with the most potential for monitoring therapy for septic arthritis, since both decreased significantly following successful treatment. Synovial thickening and enhancement, periarticular myositis/cellulitis, and bone marrow edema can persist even after resolution of the infection. (orig.)

Direct magnification radiography of the hand for the study of erosions in reumathoid arthritis

Energy Technology Data Exchange (ETDEWEB)

Orzincolo, C; Corcione, S; Campanati, A; Scutellari, P N; Bonari, L R

1986-01-01

Plain films and direct magnification radiographs of the hands were performed in 34 patients affected by rheumatoid arthritis, using mammographic x-ray tube, achieved with 0.1 mm microfocus, and 1.85 x magnification factor. Direct magnification radiography has provided essential or useful diagnostic data in 44% of cases, particularly in recognizing early skeletal erosions. Nevertheless direct magnification radiography must be used only in those cases in which traditional mammographic techniques do not supply sactisfactory results.

18 F-Fluoride positron emission tomography/computed tomography for noninvasive in vivo quantification of pathophysiological bone metabolism in experimental murine arthritis

Science.gov (United States)

2014-01-01

Introduction Evaluation of disease severity in experimental models of rheumatoid arthritis is inevitably associated with assessment of structural bone damage. A noninvasive imaging technology allowing objective quantification of pathophysiological alterations of bone structure in rodents could substantially extend the methods used to date in preclinical arthritis research for staging of autoimmune disease severity or efficacy of therapeutical intervention. Sodium 18 F-fluoride (18 F-NaF) is a bone-seeking tracer well-suited for molecular imaging. Therefore, we systematically examined the use of 18 F-NaF positron emission tomography/computed tomography (PET/CT) in mice with glucose-6-phosphate isomerase (G6PI)–induced arthritis for quantification of pathological bone metabolism. Methods F-fluoride was injected into mice before disease onset and at various time points of progressing experimental arthritis. Radioisotope accumulation in joints in the fore- and hindpaws was analyzed by PET measurements. For validation of bone metabolism quantified by 18 F-fluoride PET, bone surface parameters of high-resolution μCT measurements were used. Results Before clinical arthritis onset, no distinct accumulation of 18 F-fluoride was detectable in the fore- and hindlimbs of mice immunized with G6PI. In the course of experimental autoimmune disease, 18 F-fluoride bone uptake was increased at sites of enhanced bone metabolism caused by pathophysiological processes of autoimmune disease. Moreover, 18 F-fluoride signaling at different stages of G6PI-induced arthritis was significantly correlated with the degree of bone destruction. CT enabled identification of exact localization of 18 F-fluoride signaling in bone and soft tissue. Conclusions The results of this study suggest that small-animal PET/CT using 18 F-fluoride as a tracer is a feasible method for quantitative assessment of pathophysiological bone metabolism in experimental arthritis. Furthermore, the

Erosive arthritis and hepatic granuloma formation induced by peptidoglycan polysaccharide in rats is aggravated by prasugrel treatment.

Directory of Open Access Journals (Sweden)

Analia E Garcia

Full Text Available Administration of the thienopyridine P2Y12 receptor antagonist, clopidogrel, increased the erosive arthritis induced by peptidoglycan polysaccharide (PG-PS in rats or by injection of the arthritogenic K/BxN serum in mice. To determine if the detrimental effects are caused exclusively by clopidogrel, we evaluated prasugrel, a third-generation thienopyridine pro-drug, that contrary to clopidogrel is mostly metabolized into its active metabolite in the intestine. Prasugrel effects were examined on the PG-PS-induced arthritis rat model. Erosive arthritis was induced in Lewis rats followed by treatment with prasugrel for 21 days. Prasugrel treated arthritic animals showed a significant increase in the inflammatory response, compared with untreated arthritic rats, in terms of augmented macroscopic joint diameter associated with significant signs of inflammation, histomorphometric measurements of the hind joints and elevated platelet number. Moreover, fibrosis at the pannus, assessed by immunofluorescence of connective tissue growth factor, was increased in arthritic rats treated with prasugrel. In addition to the arthritic manifestations, hepatomegaly, liver granulomas and giant cell formation were observed after PG-PS induction and even more after prasugrel exposure. Cytokine plasma levels of IL-1 beta, IL-6, MIP1 alpha, MCP1, IL-17 and RANTES were increased in arthritis-induced animals. IL-10 plasma levels were significantly decreased in animals treated with prasugrel. Overall, prasugrel enhances inflammation in joints and liver of this animal model. Since prasugrel metabolites inhibit neutrophil function ex-vivo and the effects of both clopidogrel and prasugrel metabolites on platelets are identical, we conclude that the thienopyridines metabolites might exert non-platelet effects on other immune cells to aggravate inflammation.

Erosive arthritis and hepatic granuloma formation induced by peptidoglycan polysaccharide in rats is aggravated by prasugrel treatment.

Science.gov (United States)

Garcia, Analia E; Rico, Mario C; Liverani, Elisabetta; DeLa Cadena, Raul A; Bray, Paul F; Kunapuli, Satya P

2013-01-01

Administration of the thienopyridine P2Y12 receptor antagonist, clopidogrel, increased the erosive arthritis induced by peptidoglycan polysaccharide (PG-PS) in rats or by injection of the arthritogenic K/BxN serum in mice. To determine if the detrimental effects are caused exclusively by clopidogrel, we evaluated prasugrel, a third-generation thienopyridine pro-drug, that contrary to clopidogrel is mostly metabolized into its active metabolite in the intestine. Prasugrel effects were examined on the PG-PS-induced arthritis rat model. Erosive arthritis was induced in Lewis rats followed by treatment with prasugrel for 21 days. Prasugrel treated arthritic animals showed a significant increase in the inflammatory response, compared with untreated arthritic rats, in terms of augmented macroscopic joint diameter associated with significant signs of inflammation, histomorphometric measurements of the hind joints and elevated platelet number. Moreover, fibrosis at the pannus, assessed by immunofluorescence of connective tissue growth factor, was increased in arthritic rats treated with prasugrel. In addition to the arthritic manifestations, hepatomegaly, liver granulomas and giant cell formation were observed after PG-PS induction and even more after prasugrel exposure. Cytokine plasma levels of IL-1 beta, IL-6, MIP1 alpha, MCP1, IL-17 and RANTES were increased in arthritis-induced animals. IL-10 plasma levels were significantly decreased in animals treated with prasugrel. Overall, prasugrel enhances inflammation in joints and liver of this animal model. Since prasugrel metabolites inhibit neutrophil function ex-vivo and the effects of both clopidogrel and prasugrel metabolites on platelets are identical, we conclude that the thienopyridines metabolites might exert non-platelet effects on other immune cells to aggravate inflammation.

Establishment of age- and sex-adjusted reference data for hand bone mass and investigation of hand bone loss in patients with rheumatoid arthritis treated in clinical practice

DEFF Research Database (Denmark)

Ørnbjerg, Lykke Midtbøll; Østergaard, Mikkel; Jensen, Trine

2016-01-01

remission (0.0032 vs. 0.0058 g/cm(2)/year; p clinical practice, and only......BACKGROUND: Rheumatoid arthritis is characterised by progressive joint destruction and loss of periarticular bone mass. Hand bone loss (HBL) has therefore been proposed as an outcome measure for treatment efficacy. A definition of increased HBL adjusted for age- and sex-related bone loss is lacking....... In this study, we aimed to: 1) establish reference values for normal hand bone mass (bone mineral density measured by digital x-ray radiogrammetry (DXR-BMD)); and 2) examine whether HBL is normalised in rheumatoid arthritis patients during treatment with tumour necrosis factor alpha inhibitors (TNFI). METHODS...

Computed tomographic feature of tuberculous arthritis

International Nuclear Information System (INIS)

Kim, Hak Hee; Lee, Hae Giu; Cha, Eun Suk; Kang, Kyung Jin; Jeon, Jeong Su; Park, Young Ha; Yim, Jung Ik; Bahk, Yong Whee

1992-01-01

The sparsity of publication concerning CT findings of tuberculous arthritis prompted authors to retrospectively evaluate 12 patients with tuberculous arthritis for characteristic CT findings. In each patients, the diagnosis of tuberculous arthritis was confirmed by surgery or biopsy. The CT examinations were evaluated by two radiologists retrospectively. Involved joints were the hip joint in seven patients, the sacroiliac joint in three patients, and the shoulder and ankle joint in one patient each. CT features included subchondral bony erosion(12 patients), soft tissue mass in the joint space(nine), widening of the joint space(eight), ipsilateral music atrophy(eight), thickening of the joint capsule(seven), intra-articular effusion(six), soft tissue abscess(five), and bony sclerosis(four). In seven patients with the duration of symptoms less than 1 year, thickening of joint capsule and intra-articular effusion were the predominant findings, while bony sclerosis, gross bone destruction, and soft tissue mass in joint space were seen in five patients with the duration of symptoms longer than 1 year. Our results indicate that CT is useful in the diagnosis of tuberculous arthritis by demonstrating characteristic pathologic changes of the joint space, soft tissue abnormality and bony involvement

Bone erosion and subacromial bursitis caused by diphtheria-tetanus-poliomyelitis vaccine.

Science.gov (United States)

Salmon, J H; Geoffroy, M; Eschard, J P; Ohl, X

2015-11-17

Revaxis(®) is a vaccine against diphtheria, tetanus and poliomyelitis (dT-IPV). This vaccine should not be administered by the intradermal or intravenous route. Poor injection techniques and related consequences are rare. We report a case of bursitis associated with reactive glenohumeral effusion complicated by bone erosion occurring after injection of the dT-IPV vaccine. A 26 year old patient was admitted for painful left shoulder causing functional impairment. Control magnetic resonance imaging showed bone oedema on the upper outer part of the humeral head, with a slight cortical irregularity, indicating that the vaccine was injected in contact with the bone at this location, causing erosion. Outcome was favourable after intra-articular corticosteroids. Reports of articular or periarticular injury after vaccination are extremely rare, in view of the substantial number of vaccines administered every year. The potential complications of vaccination are well known to general practitioners but under-reported in the literature. Copyright © 2015 Elsevier Ltd. All rights reserved.

Changes in synovial membrane and joint effusion volumes after intraarticular methylprednisolone. Quantitative assessment of inflammatory and destructive changes in arthritis by MRI

DEFF Research Database (Denmark)

Østergaard, Mikkel; Stoltenberg, M; Gideon, P

1996-01-01

OBJECTIVE: To evaluate synovial membrane volumes, effusion volumes, and cartilage and bone erosion scores determined by magnetic resonance imaging (MRI) as markers of disease activity and severity in arthritis. METHODS: Gadolinium-DTPA enhanced MRI of 18 arthritic knees was performed before and 1...

Septic arthritis of a lumbar facet joint: Detection with bone SPECT imaging

International Nuclear Information System (INIS)

Swayne, L.C.; Dorsky, S.; Caruana, V.; Kaplan, I.L.

1989-01-01

We present a rare case of septic arthritis of a lumbar facet joint with an associated epidural abscess resulting from Staphylococcus aureus. The infection was initially detected with planar bone scintigraphy and precisely localized with single photon emission computed tomography bone scintigraphy, despite an initially negative radiologic evaluation that included radiographs of the lumbar spine, lumbar myelography, and a postmyelography x-ray computed tomography scan. In the appropriate clinical setting, a bone scan demonstrating unilateral increased activity within the spine should raise the suspicion of inflammatory involvement of the posterior elements

JUVENILE RHEUMATOID ARTHRITIS

Directory of Open Access Journals (Sweden)

I N Sartika

2012-11-01

Full Text Available Juvenile rheumatoid arthritis (JRA is the most common rheumatic condition in children. JRA is defined as persistent arthritis in 1 or more joints for at least 6 weeks, with the onset before age 16 years. The etiology of JRA is unknown. Antigen activated CD4+ T cell stimulate monocytes, macrophages, and synovial fibroblasts to produce the cytokines Interleukin-1 (IL-1, IL-6, and tumor necrosis factor ? (TNF-? and to secrete matrix metalloproteinases, which lead to chronic inflammation due to infiltration of inflammatory cell, angiogenesis, destruction of cartilage and bone with pannus formation. The 3 major subtypes of JRA are based on the symptoms at disease onset and are designated systemic onset, pauciarticular onset, and polyarticular onset. For all patients, the goals of therapy are to decrease chronic joint pain and suppress the inflammatory process. Poor prognostic have been observed in patients with polyarticular onset, rheumatoid factor, persistent morning stiffness, tenosynovitis, involvement of the small joints, rapid appearance of erosions, active late onset childhood, subcutaneous nodules, or antinuclear antibody.

Wnt/β-catenin Signaling in Osteoarthritis and in Other Forms of Arthritis.

Science.gov (United States)

Zhou, Yachuan; Wang, Tingyu; Hamilton, John L; Chen, Di

2017-09-01

Arthritis defines a large group of diseases primarily affecting the joint. It is the leading cause of pain and disability in adults. Osteoarthritis (OA) affecting the knee or hip is the most common form among over 100 types of arthritis. Other types of arthritis include erosive hand OA, temporomandibular joint (TMJ) OA, facet joint OA, diffuse idiopathic skeletal hyperostosis (DISH), and spondyloarthritis (SpA). However, the specific molecular signals involved in the development and progression of OA and related forms of arthritis remain largely unknown. The canonical wingless/integrated (Wnt)/β-catenin signaling pathway could play a unique role in the pathogenesis of arthritis. In this review article, we will focus on the molecular mechanisms of Wnt/β-catenin signaling in the pathogenesis of OA and other types of arthritis. Emerging evidence demonstrates that Wnts and Wnt-related molecules are involved in arthritis development and progression in human genetic studies and in vitro studies. Also, mouse models have been generated to determine the role of Wnt/β-catenin signaling in the pathogenesis of arthritis. Wnt/β-catenin signaling represents a unique signaling pathway regulating arthritis development and progression, and the molecules in this particular pathway may serve as targets for the therapeutic intervention of arthritis. Mediators and downstream effectors of Wnt/β-catenin signaling are increased in OA as well other forms of arthritis, including DISH and SpA. Through extensive investigations, including pre-clinical studies in transgenic mice and translational and human studies, the Wnt/β-catenin signaling pathway has been proven to play roles in bone and joint pathology by directly affecting bone, cartilage, and synovial tissue; further, these pathologies can be reduced through targeting this pathway. Continued investigation into the distinct molecular signaling of the Wnt/β-catenin pathway will provide additional insights toward the therapeutic

Fractalkine in rheumatoid arthritis: a review to date.

LENUS (Irish Health Repository)

Murphy, G

2012-02-03

Rheumatoid arthritis (RA) is characterized by the expansion of the synovium, with infiltration of pro-inflammatory cells, neovascularization and an abundance of pro-inflammatory cytokines resulting in tissue destruction and bone erosion. Fractalkine (FKN), a recently described chemokine, possesses chemotactic, angiogenic and adhesive functions that associates it with all of these destructive processes. In this review, we describe the research to date, which implicates FKN and its receptor in the pathogenesis of RA and propose that this molecule may represent a future therapeutic target for RA.

Histopathology of Lyme arthritis in LSH hamsters

International Nuclear Information System (INIS)

Hejka, A.; Schmitz, J.L.; England, D.M.; Callister, S.M.; Schell, R.F.

1989-01-01

The authors studied the histopathologic evolution of arthritis in nonirradiated and irradiated hamsters infected with Borrelia burgdorferi. Nonirradiated hamsters injected in the hind paws with B. burgdorferi developed an acute inflammatory reaction involving the synovium, periarticular soft tissues, and dermis. This acute inflammatory reaction was short-lived and was replaced by a mild chronic synovitis as the number of detectable spirochetes in the synovium, periarticular soft tissues, and perineurovascular areas diminished. Exposing hamsters to radiation before inoculation with B. burgdorferi exacerbated and prolonged the acute inflammatory phase. Spirochetes also persisted longer in the periarticular soft tissues. A major histopathologic finding was destructive and erosive bone changes of the hind paws, which resulted in deformation of the joints. These studies should be helpful in defining the immune mechanism participating in the onset, progression, and resolution of Lyme arthritis

Psoriatic arthritis: imaging techniques

Directory of Open Access Journals (Sweden)

E. Lubrano

2012-06-01

Full Text Available Imaging techniques to assess psoriatic arthritis (PsA include radiography, ultrasonography (US, magnetic resonance imaging (MRI, computed tomography (CT and bone scintigraphy. The radiographic hallmark of PsA is the combination of destructive changes (joint erosions, tuft resorption, osteolysis with bone proliferation (including periarticular and shaft periostitis, ankylosis, spur formation and non-marginal syndesmophytes. US has an increasing important role in the evaluation of PsA. In fact, power Doppler US is useful mainly for its ability to assess musculoskeletal (joints, tendons, entheses and cutaneous (skin and nails involvement, to monitor efficacy of therapy and to guide steroid injections at the level of inflamed joints, tendon sheaths and entheses. MRI allows direct visualization of inflammation in peripheral and axial joints, and peripheral and axial entheses, and has dramatically improved the possibilities for early diagnosis and objective monitoring of the disease process in PsA. MRI has allowed explaining the relationships among enthesitis, synovitis and osteitis in PsA, supporting a SpA pattern of inflammation where enthesitis is the primary target of inflammation. CT has little role in assessment of peripheral joints, but it may be useful in assessing elements of spine disease. CT accuracy is similar to MRI in assessment of erosions in sacroiliac joint involvement, but CT is not as effective in detecting synovial inflammation. Bone scintigraphy lacks specificity and is now supplanted with US and MRI techniques.

Preliminary study for predicting better methotrexate efficacy in Japanese patients with rheumatoid arthritis

OpenAIRE

Hashiguchi, Masayuki; Tsuru, Tomomi; Miyawaki, Kumika; Suzaki, Midori; Hakamata, Jun; Shimizu, Mikiko; Irie, Shin; Mochizuki, Mayumi

2016-01-01

Background Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by systemic inflammatory status, joint destruction, disability, and pain. Methotrexate (MTX) has been confirmed to reduce disease activity and delay or stabilize the development of bone erosions. However, major drawbacks are that patients show great interindividual variability in response to MTX and the unpredictable occurrence of side effects. A strategy for personalized MTX treatment to predict its efficacy a...

Cartilage destruction in small joints by rheumatoid arthritis: assessment of fat-suppressed three-dimensional gradient-echo MR pulse sequences in vitro

International Nuclear Information System (INIS)

Uhl, M.; Allmann, K.H.; Hauer, M.P.; Langer, M.; Ihling, C.; Conca, W.

1998-01-01

Purpose. To assess the accuracy of different MR sequences for the detection of articular cartilage abnormalities in rheumatoid arthritis. Design and patients. Ten metacarpophalangeal joints and 10 metatarsophalangeal joints (specimens from arthritis patients undergoing ablative joint surgery) were examined with a fat-suppressed (FS) 3D FLASH, a FS 3D FISP, a FS 2D fast spin-echo T2-weighted, and a 2D FS spin-echo T1-weighted sequence. Each cartilage lesion and each cortical lesion was graded from 0 to 4 (modified Outerbridge staging system). Subsequently, the results of each sequence were compared with the macroscopic findings and statistically tested against each other. Results. The study shows that 3D gradient-echo sequences with fat suppression were best for imaging and grading of cartilage lesions in arthritis of the small joints of the hands and feet. Using 3D techniques, all grade 2, grade 3, and grade 4 lesions of cartilage or cortical bone were detected. Conclusion. FS 3D gradient-echo techniques were best for the detection and grading of hyaline cartilage and subchondral bone lesions in rheumatoid arthritis. MRI has a great potential as an objective method of evaluating cartilage damage and bone erosions in rheumatoid arthritis. (orig.)

Cartilage destruction in small joints by rheumatoid arthritis: assessment of fat-suppressed three-dimensional gradient-echo MR pulse sequences in vitro

Energy Technology Data Exchange (ETDEWEB)

Uhl, M.; Allmann, K.H.; Hauer, M.P.; Langer, M. [Department of Diagnostic Radiology, University Hospital Freiburg (Germany); Ihling, C. [Department of Pathology, University Hospital Freiburg, Freiburg (Germany); Conca, W. [Department of Rheumatology, University Hospital Freiburg (Germany)

1998-12-01

Purpose. To assess the accuracy of different MR sequences for the detection of articular cartilage abnormalities in rheumatoid arthritis. Design and patients. Ten metacarpophalangeal joints and 10 metatarsophalangeal joints (specimens from arthritis patients undergoing ablative joint surgery) were examined with a fat-suppressed (FS) 3D FLASH, a FS 3D FISP, a FS 2D fast spin-echo T2-weighted, and a 2D FS spin-echo T1-weighted sequence. Each cartilage lesion and each cortical lesion was graded from 0 to 4 (modified Outerbridge staging system). Subsequently, the results of each sequence were compared with the macroscopic findings and statistically tested against each other. Results. The study shows that 3D gradient-echo sequences with fat suppression were best for imaging and grading of cartilage lesions in arthritis of the small joints of the hands and feet. Using 3D techniques, all grade 2, grade 3, and grade 4 lesions of cartilage or cortical bone were detected. Conclusion. FS 3D gradient-echo techniques were best for the detection and grading of hyaline cartilage and subchondral bone lesions in rheumatoid arthritis. MRI has a great potential as an objective method of evaluating cartilage damage and bone erosions in rheumatoid arthritis. (orig.) With 5 figs., 19 refs.

Rheumatoid arthritis: MR imaging of the wrist(a preliminary report)

International Nuclear Information System (INIS)

Suh, Jin Suck; Lee, Soo Kon; Cho, Jae Hyun

1994-01-01

To evaluate the optimal pulse sequences in the detection of erosions and for the discrimination of the effusion from pannus. In 13 patients rheumatoid arthritis was established according to the American Rheumatism Association Criteria. There were nine female and four male patients. Erosions were assessed by comparing the count of the numbers of erosions depending on each imaging method. A four point scoring systems was used for the comparison of conspicuity of lesion. T2WI with fat suppression and postcontrast T1WI with fat suppression were better than conventional T2WI in the detection of erosions. The pannus had a heterogeneous signal on T2WI, some of which were enhanced after the intravenous injection of MR contrast a gents. We suggest that the fat suppression T1WI with enhancement or the fat suppression T2WI were better than conventional T2WI for detecting both bone erosion and pannus. The postcontrast MR imaging may often be helpful in distinguishing pannus from the effusion

Rheumatoid arthritis: MR imaging of the wrist(a preliminary report)

Energy Technology Data Exchange (ETDEWEB)

Suh, Jin Suck; Lee, Soo Kon; Cho, Jae Hyun [Medical College of Yonsei University, Seoul (Korea, Republic of)

1994-12-15

To evaluate the optimal pulse sequences in the detection of erosions and for the discrimination of the effusion from pannus. In 13 patients rheumatoid arthritis was established according to the American Rheumatism Association Criteria. There were nine female and four male patients. Erosions were assessed by comparing the count of the numbers of erosions depending on each imaging method. A four point scoring systems was used for the comparison of conspicuity of lesion. T2WI with fat suppression and postcontrast T1WI with fat suppression were better than conventional T2WI in the detection of erosions. The pannus had a heterogeneous signal on T2WI, some of which were enhanced after the intravenous injection of MR contrast a gents. We suggest that the fat suppression T1WI with enhancement or the fat suppression T2WI were better than conventional T2WI for detecting both bone erosion and pannus. The postcontrast MR imaging may often be helpful in distinguishing pannus from the effusion.

Total glucosides of paeony prevents juxta-articular bone loss in experimental arthritis.

Science.gov (United States)

Wei, Chen Chao; You, Fan Tian; Mei, Li Yu; Jian, Sun; Qiang, Chen Yong

2013-07-21

Total glucosides of paeony (TGP) is a biologically active compound extracted from Paeony root. TGP has been used in rheumatoid arthritis therapy for many years. However, the mechanism by which TGP prevents bone loss has been less explored. TGP was orally administered for 3 months to New Zealand rabbits with antigen-induced arthritis (AIA). Digital x-ray knee images and bone mineral density (BMD) measurements of the subchondral knee bone were performed before sacrifice. Chondrocytes were observed using transmission electron microscopy (TEM). Histological analysis and mRNA expression of receptor activator of nuclear factor-B ligand (RANKL) and osteoprotegerin (OPG) were evaluated in joint tissues. The BMD value in TGP rabbits was significantly higher compared with that seen in the AIA model rabbits. In addition, the subchondral bone plate was almost completely preserved by TGP treatment, while there was a decrease in bone plate integrity in AIA rabbits. There was less damage to the chondrocytes of the TGP treated group. Immunohistochemical examination of the TGP group showed that a higher percentage of TGP treated chondrocytes expressed OPG as compared to the chondrocytes isolated from AIA treated animals. In contrast, RANKL expression was significantly decreased in the TGP treated group compared to the AIA group. In support of the immunohistochemistry data, the expression of RANKL mRNA was decreased and OPG mRNA expression was enhanced in the TGP group when compared to that of the AIA model group. These results reveal that TGP suppresses juxta-articular osteoporosis and prevents subchondral bone loss. The decreased RANKL and increased OPG expression seen in TGP treated animals could explain how administration of TGP maintains higher BMD.

Bone scan and joint scan of hands and feet in rheumatoid arthritis

International Nuclear Information System (INIS)

Carpentier, N.; Verbeke, S.; Perdrisot, R.; Grilo, R.M.; Quenesson, E.; Bonnet, C.; Vergne, P.; Treves, R.; Bertin, P.; Boutros-Toni, F.

2000-01-01

The aim of this study was to determine the ability of joint scan and bone scan of hands and feet, in patients with rheumatoid arthritis, to localize the altered joints. The sensitivity, the specificity, the positive predictive value (PPV) and the negative predictive value (NPV) of joint scan were determined in comparison with clinical joint assessment. Fifteen patients (780 joints) were clinically examined (pain and synovitis); during the same day, a bone scan and a joint scan were realized by oxidronate 99m Tc intravenous injection. Patients were scanned 5 minutes (tissual time, T t ) and 3 hours 1/4 (bone time, T 0 ) after the administration. The uptake of the bi-phosphonate was evaluated with a qualitative method using a grey scale. The uptake of 99m Tc oxidronate was quantitated using an extra-articular region of interest. The sensitivity, specificity, PPV and NPV of the scan at Tt were 46%, 96%, 85% et 78%. The same parameters were 75%, 66%, 53% and 84% for the scan realized at T 0 . The joint scan has showed 22% of false positive. These false positives could be a consequence of an earlier detection of joint alterations by scan. The joint scan should forecast the evolution of joints in patients with rheumatoid arthritis. (author)

Magnetic resonance imaging of the hand in rheumatoid arthritis. New scientific insights and practical application

International Nuclear Information System (INIS)

Hermann, K.G.A.

2006-01-01

Magnetic resonance imaging (MRI) is a sensitive diagnostic modality for the detection of inflammatory changes in peripheral joints. Nevertheless, the widespread clinical use of MRI in assessing patients with early rheumatoid arthritis is still hampered by the technical complexity and higher cost of MRI compared with conventional radiography. This overview summarizes the results of recent research and gives practical tips on how to perform MRI of the hands. The authors present an MR protocol for hand imaging, discuss the pros and cons of low-field MR scanners, and outline pitfalls and artifacts. The MRI changes associated with rheumatoid arthritis such as synovitis, tenosynovitis, erosions, and bone marrow edema are described including their prognostic significance. The proven facts on the validation and grading of MR changes in rheumatoid arthritis are summarized. Finally, the role of MRI in the differential diagnosis of arthritis is critically discussed. (orig.) [de

Infectious Arthritis

Science.gov (United States)

Most kinds of arthritis cause pain and swelling in your joints. Joints are places where two bones meet, such as your elbow or knee. Infectious arthritis is an infection in the joint. The infection ...

Increased circulating rather than spinal cytokines accompany chronic pain behaviors in experimental bone cancer and arthritis

Directory of Open Access Journals (Sweden)

Line Pourtau

2014-12-01

Full Text Available Aim: Peripheral cytokines contribute to arthritis and bone cancer pain through sensory nerve actions. However, increased spinal cytokine and glial filament expression, coined neuroinflammation, has also been proposed to play a part in chronic pain. Therefore, spinal cord, dorsal root ganglia and circulating cytokines were compared in murine arthritis and bone cancer models in relationship to behavioral signs of pain. Methods: Exploratory behaviors were studied after intra-articular complete Freund's adjuvant or bone intramedullary sarcoma cell injection. Nervous tissue and blood cytokine expression were determined by real-time polymerase chain reaction (PCR and multiplex immunoassays, respectively. Results: PCR analysis did not reveal any hallmark of spinal neuroinflammation in spontaneously-behaving mice with cartilage or bone lesions. However, imposed paw stimulation during joint inflammation increased spinal interleukin-1β (IL-1β expression. Spontaneous paw guarding during rearing was displayed by animals with joint inflammation and bone destruction and was accompanied by increased circulating IL-6 and monocyte chemoattractant protein-1, respectively. In addition, dorsal root ganglia were found to constitutively express receptors for this chemotactic cytokine. Conclusion: Our findings indicate that spinal neuroinflammation is not a necessary condition for chronic pain and suggest that circulating cytokine action in dorsal root ganglia may contribute to experimental joint inflammation and bone cancer pain.

High-fat diet exacerbates pain-like behaviors and periarticular bone loss in mice with CFA-induced knee arthritis.

Science.gov (United States)

Loredo-Pérez, Aleyda A; Montalvo-Blanco, Carlos E; Hernández-González, Luis I; Anaya-Reyes, Maricruz; Fernández Del Valle-Laisequilla, Cecilia; Reyes-García, Juan G; Acosta-González, Rosa I; Martínez-Martínez, Arisai; Villarreal-Salcido, Jaira C; Vargas-Muñoz, Virginia M; Muñoz-Islas, Enriqueta; Ramírez-Rosas, Martha B; Jiménez-Andrade, Juan M

2016-05-01

Our aim was to quantify nociceptive spontaneous behaviors, knee edema, proinflammatory cytokines, bone density, and microarchitecture in high-fat diet (HFD)-fed mice with unilateral knee arthritis. ICR male mice were fed either standard diet (SD) or HFD starting at 3 weeks old. At 17 weeks, HFD and SD mice received intra-articular injections either with Complete Freund's Adjuvant (CFA) or saline into the right knee joint every 7 days for 4 weeks. Spontaneous pain-like behaviors and knee edema were assessed for 26 days. At day 26 post-first CFA injection, serum levels of IL-1β, IL-6, and RANKL were measured by ELISA, and microcomputed tomography analysis of knee joints was performed. HFD-fed mice injected with CFA showed greater spontaneous pain-like behaviors of the affected extremity as well as a decrease in the weight-bearing index compared to SD-fed mice injected with CFA. Knee edema was not significantly different between diets. HFD significantly exacerbated arthritis-induced bone loss at the distal femoral metaphysis but had no effect on femoral diaphyseal cortical bone. HFD did not modify serum levels of proinflammatory cytokines. HFD exacerbates pain-like behaviors and significantly increases the magnitude of periarticular trabecular bone loss in a murine model of unilateral arthritis. © 2016 The Obesity Society.

Quantitative Analysis of Micro-CT Imaging and Histopathological Signatures of Experimental Arthritis in Rats

Directory of Open Access Journals (Sweden)

Matthew D. Silva

2004-10-01

Full Text Available Micro-computed tomographic (micro-CT imaging provides a unique opportunity to capture 3-D architectural information in bone samples. In this study of pathological joint changes in a rat model of adjuvant-induced arthritis (AA, quantitative analysis of bone volume and roughness were performed by micro-CT imaging and compared with histopathology methods and paw swelling measurement. Micro-CT imaging of excised rat hind paws (n = 10 stored in formalin consisted of approximately 600 30-μm slices acquired on a 512 × 512 image matrix with isotropic resolution. Following imaging, the joints were scored from H&E stained sections for cartilage/bone erosion, pannus development, inflammation, and synovial hyperplasia. From micro-CT images, quantitative analysis of absolute bone volumes and bone roughness was performed. Bone erosion in the rat AA model is substantial, leading to a significant decline in tarsal volume (27%. The result of the custom bone roughness measurement indicated a 55% increase in surface roughness. Histological and paw volume analyses also demonstrated severe arthritic disease as compared to controls. Statistical analyses indicate correlations among bone volume, roughness, histology, and paw volume. These data demonstrate that the destructive progression of disease in a rat AA model can be quantified using 3-D micro-CT image analysis, which allows assessment of arthritic disease status and efficacy of experimental therapeutic agents.

Enteropathic arthritis in the sacroiliac joint. Imaging and differential diagnosis

Energy Technology Data Exchange (ETDEWEB)

Mester, Adam R. E-mail: mester@radi.sote.hu; Mako, Erno K.; Karlinger, Kinga; Gyoerke, Tamas; Tarjan, Zsolt; Marton, Erika; Kiss, Katalin

2000-09-01

Objectives: A new high resolution computed tomography (HRCT) scoring system of sacroiliac joint (SIJ) involvement in enteropathic arthritis is introduced. Patients and methods: SIJ's of 100 patients were studied. A total of 25 patients presented with pain syndrome, 25 with suspicious seronegative spondylarthritis, 25 with inflammatory bowel diseases and 25 without joint or bowel diseases, as a control group. HRCT was carried out in all 100 patients. For comparison, a plain film radiography (PFR), conventional CT (slices of 10 mm) and bone scan were used. Results: Quantitative differences: In the pain syndrome group, there were no erosions identified neither intraarticular calcifications. Disc degeneration was seen in 12/25 cases. In 4/25 patients, vacuum phenomena appeared in the SIJ. In 3/25 patients, ventral capsular calcification occurred in the ventral sacroiliac ligament (anterior capsule complex). In the seronegative spondylarthritis group, 16/25 patients had positive findings, while PFR documented erosions only in 3/25 cases. In the bowel diseases group, erosions were detected in 17/25 cases with HRCT, while the plain film was positive only in three cases and in seven cases the findings were questionable. Intraarticular calcification with erosion was documented in three cases and in seven cases without erosion. The bone scan was positive in 7/25 of this cases, but in 5/7 there was mismatching with HRCT. Important new finding was the HRCT detected erosion which was not detected on BS but was obvious on Anti-Granulocyte-Antibody scintigraphy. In the control group, only degenerative changes were seen in 4/25 cases and no erosions. Conclusion: HRCT is: (1) the reliable imaging of definitive (often 'cold stage') sacroileitis; (2) gives optimal detection of erosion; and (3) appears to be the only method in the documentation of calcifications in the posterior ligamental portion of the SIJ.

Validation of the OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) for the Hand and Foot in a Randomized Placebo-controlled Trial

DEFF Research Database (Denmark)

Glinatsi, Daniel; Bird, Paul; Gandjbakhch, Frederique

2015-01-01

Objective. To assess changes following treatment and the reliability and responsiveness to change of the Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) in a randomized controlled trial. Methods. Forty patients with PsA randomized to either...... placebo or abatacept (ABA) had MRI of either 1 hand (n = 20) or 1 foot (n = 20) at baseline and after 6 months. Images were scored blindly twice by 3 independent readers according to the PsAMRIS (for synovitis, tenosynovitis, periarticular inflammation, bone edema, bone erosion, and bone proliferation...

Reducing invasiveness, duration, and cost of magnetic resonance imaging in rheumatoid arthritis by omitting intravenous contrast injection -- Does it change the assessment of inflammatory and destructive joint changes by the OMERACT RAMRIS?

DEFF Research Database (Denmark)

Østergaard, Mikkel; Conaghan, Philip G; O'Connor, Philip

2009-01-01

OBJECTIVE: Gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) provides highly sensitive assessment of inflammatory and destructive changes in rheumatoid arthritis (RA) joints, but intravenous (IV) Gd injection prolongs examination time and increases cost, invasiveness, and patient discomfort...... images, whereas complete image sets were available for the second reading. RESULTS: Gd contrast injection appeared unimportant to MRI scores of bone erosions and bone edema in RA wrist and MCP joints. However, when post-Gd MRI was considered the standard reference, MRI without Gd provided only moderate......: Omitting IV contrast injection did not change scores of bone erosions and bone edema, but decreased the reliability of synovitis scores. However, this disadvantage may for some purposes be outweighed by the possibility to assess more joints and/or greater feasibility....

Three-dimensional morphological condylar and mandibular changes in a patient with juvenile idiopathic arthritis: interdisciplinary treatment

Directory of Open Access Journals (Sweden)

G. Farronato

2014-11-01

Full Text Available Temporomandibular joint (TMJ involvement is common but usually delayed in patients with juvenile idiopathic arthritis (JIA. We describe the case of a JIA patient with bilateral TMJ involvement, mandibular retrognathia, bone erosion, and severely restricted mouth opening. The use of cone beam computed tomography and a 3D diagnostic protocol in young patients with JIA provides reliable, accurate and precise quantitative data and images of the condylar structures and their dimensional relationships. Analgesics and conventional disease modifying antirheumatic drugs were ineffective, but interdisciplinary treatment with etanercept and a Herbst functional appliance improved functional TMJ movement and bone resorption.

Value of contrast-enhanced ultrasound in rheumatoid arthritis

International Nuclear Information System (INIS)

Zordo, Tobias de; Mlekusch, Sabine P.; Feuchtner, Gudrun M.; Mur, Erich; Schirmer, Michael; Klauser, Andrea S.

2007-01-01

The purpose of this review is to describe the spectrum of sonographic findings in rheumatic diseases with respect to the diagnostic potential using US contrast media which prove activity or inactivity in synovial tissue where new treatment regimes target. Synovial activity can be found in non-erosive and erosive forms of primary and secondary osteoarthritis, and in inflammatory forms of joint diseases like rheumatoid arthritis and peripheral manifestations of spondyloarthritis including, ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis and enteropathic arthritis. It can also be present in metabolic and endocrine forms of arthritis, in connective tissue arthropathies like systemic lupus erythematosus or scleroderma and in infectious arthritis. Ultrasound should be used as first-line imaging modality in suspected early cases of RA and other forms of arthritis, whereas contrast-enhanced ultrasound (CEUS) can further enable for sensitive assessment of vascularity which correlates with disease activity

Value of contrast-enhanced ultrasound in rheumatoid arthritis

Energy Technology Data Exchange (ETDEWEB)

Zordo, Tobias de; Mlekusch, Sabine P.; Feuchtner, Gudrun M. [Department of Radiology II, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Mur, Erich [Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Schirmer, Michael [Department of Internal Medicine, Hospital of the Elisabethines Klagenfurt, Voelkermarkter Strasse 15-19, 9020 Klagenfurt (Austria); Klauser, Andrea S. [Department of Radiology II, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria)], E-mail: andrea.klauser@i-med.ac.at

2007-11-15

The purpose of this review is to describe the spectrum of sonographic findings in rheumatic diseases with respect to the diagnostic potential using US contrast media which prove activity or inactivity in synovial tissue where new treatment regimes target. Synovial activity can be found in non-erosive and erosive forms of primary and secondary osteoarthritis, and in inflammatory forms of joint diseases like rheumatoid arthritis and peripheral manifestations of spondyloarthritis including, ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis and enteropathic arthritis. It can also be present in metabolic and endocrine forms of arthritis, in connective tissue arthropathies like systemic lupus erythematosus or scleroderma and in infectious arthritis. Ultrasound should be used as first-line imaging modality in suspected early cases of RA and other forms of arthritis, whereas contrast-enhanced ultrasound (CEUS) can further enable for sensitive assessment of vascularity which correlates with disease activity.

Registration-based Bone Morphometry for Shape Analysis of the Bones of the Human Wrist

Science.gov (United States)

Joshi, Anand A.; Leahy, Richard M.; Badawi, Ramsey D.; Chaudhari, Abhijit J.

2015-01-01

We present a method that quantifies point-wise changes in surface morphology of the bones of the human wrist. The proposed method, referred to as Registration-based Bone Morphometry (RBM), consists of two steps: an atlas selection step and an atlas warping step. The atlas for individual wrist bones was selected based on the shortest l2 distance to the ensemble of wrist bones from a database of a healthy population of subjects. The selected atlas was then warped to the corresponding bones of individuals in the population using a non-linear registration method based on regularized l2 distance minimization. The displacement field thus calculated showed local differences in bone shape that then were used for the analysis of group differences. Our results indicate that RBM has potential to provide a standardized approach to shape analysis of bones of the human wrist. We demonstrate the performance of RBM for examining group differences in wrist bone shapes based on sex and between those of the right and left wrists in healthy individuals. We also present data to show the application of RBM for tracking bone erosion status in rheumatoid arthritis. PMID:26353369

MRI assessment of bone marrow in children with juvenile idiopathic arthritis: intra- and inter-observer variability

Energy Technology Data Exchange (ETDEWEB)

Tanturri de Horatio, Laura; Barbuti, Domenico; Toma, Paolo [Ospedale Pediatrico Bambino Gesu, Department of Radiology, Rome (Italy); Damasio, Maria Beatrice [Ospedale G. Gaslini, Department of Radiology, Genoa (Italy); Bracaglia, Claudia [Ospedale Pediatrico Bambino Gesu, Department of Paediatrics, Rome (Italy); Lambot-Juhan, Karen [Hopital Necker-Enfants Malades, Department of Radiology, Paris (France); Boavida, Peter [Great Ormond Street Hospital, Department of Radiology, London (United Kingdom); Ording Mueller, Lil-Sofie [University Hospital North Norway, Department of Radiology, Tromsoe (Norway); Malattia, Clara [Ospedale G. Gaslini, Department of Pediatrics, Genoa (Italy); Rava, Lucilla [Ospedale Pediatrico Bambino Gesu, Department of Epidemiology, Rome (Italy); Rosendahl, Karen [Great Ormond Street Hospital, Department of Radiology, London (United Kingdom); Haukeland University Hospital, Department of Pediatric Radiology, Bergen (Norway)

2012-06-15

Bone marrow oedema (BMO) is included in MRI-based scoring systems of disease activity in adults with rheumatoid arthritis. Similar systems in juvenile idiopathic arthritis (JIA) are lacking. To assess the reproducibility in a multi-centre setting of an MRI BMO scoring system in children with JIA. Seventy-six wrist MRIs were read twice, independently, by two experienced paediatric radiologists. BMO was defined as ill-defined lesions within the trabecular bone, returning high and low signal on T2- and T1-weighted images respectively, with or without contrast enhancement. BMO extension was scored for each of 14 bones at the wrist from 0 (none) to 3 (extensive). The intra-observer agreement was moderate to excellent, with weighted kappa ranging from 0.85 to 1.0 and 0.49 to 1.0 (readers 1 and 2 respectively), while the inter-observer agreement ranged from 0.41 to 0.79. The intra- and inter-observer intraclass correlation coefficients were excellent and satisfactory, respectively. The scoring system was reliable and may be used for grading bone marrow abnormality in JIA. The relatively large variability in aggregate scores, particularly between readers, underscores the need for thorough standardisation. (orig.)

MRI assessment of bone marrow in children with juvenile idiopathic arthritis: intra- and inter-observer variability

International Nuclear Information System (INIS)

Tanturri de Horatio, Laura; Barbuti, Domenico; Toma, Paolo; Damasio, Maria Beatrice; Bracaglia, Claudia; Lambot-Juhan, Karen; Boavida, Peter; Ording Mueller, Lil-Sofie; Malattia, Clara; Rava, Lucilla; Rosendahl, Karen

2012-01-01

Bone marrow oedema (BMO) is included in MRI-based scoring systems of disease activity in adults with rheumatoid arthritis. Similar systems in juvenile idiopathic arthritis (JIA) are lacking. To assess the reproducibility in a multi-centre setting of an MRI BMO scoring system in children with JIA. Seventy-six wrist MRIs were read twice, independently, by two experienced paediatric radiologists. BMO was defined as ill-defined lesions within the trabecular bone, returning high and low signal on T2- and T1-weighted images respectively, with or without contrast enhancement. BMO extension was scored for each of 14 bones at the wrist from 0 (none) to 3 (extensive). The intra-observer agreement was moderate to excellent, with weighted kappa ranging from 0.85 to 1.0 and 0.49 to 1.0 (readers 1 and 2 respectively), while the inter-observer agreement ranged from 0.41 to 0.79. The intra- and inter-observer intraclass correlation coefficients were excellent and satisfactory, respectively. The scoring system was reliable and may be used for grading bone marrow abnormality in JIA. The relatively large variability in aggregate scores, particularly between readers, underscores the need for thorough standardisation. (orig.)

Radiographic outcome in Hispanic early rheumatoid arthritis patients treated with conventional disease modifying anti-rheumatic drugs

International Nuclear Information System (INIS)

Contreras-Yanez, Irazu; Rull-Gabayet, Marina; Vazquez-LaMadrid, Jorge; Pascual-Ramos, Virginia

2011-01-01

Objectives: To determine rates of incident erosive disease in early rheumatoid arthritis patients, to identify baseline predictors and to evaluate erosion's impact on patient-reported outcomes. Methods: 82 patients with ≤12 months of disease duration, ≥3 years of follow-up and conventional treatment were included. Consecutive evaluations assessed swollen and tender joint counts, treatment and comorbidity, acute reactant-phase determinations and patient-reported outcomes. Digitized radiographs of the hands and feet were obtained at baseline and yearly thereafter. RA was defined as erosive when at least one unequivocal cortical bone defect was detected. Descriptive statistics and Cox regression analysis were performed. Results: At baseline, 71 of the patients were Female Sign , population median (range) age was of 38.7 (16-78.2) years, 58 patients had antibodies and all the patients had active disease and substantial disability. Follow-up cohort was of 299.3 person-years. At last follow-up (49 ± 13.8 months), 28 patients developed erosions. Erosion's location was the feet, in 12 patients. Incident rates of erosive disease at one, two, three and four years were of 8.1, 12.8, 13.8 and 5.6 per 100 person-years, respectively. Higher C-reactive protein (HR: 1.20, 95%CI: 1.04-1.4, p = 0.01) and positive antibodies (HR: 5.09, 95%CI: 1.08-23.86, p = 0.04) were baseline predictors of incident erosive disease. Erosions had minor impact on patient-reported outcomes. Conclusion: Rheumatoid arthritis patients with antibodies and higher C reactive protein at baseline are at risk for incident erosions which appear most frequently at the feet. Up to 1/3 patients conventionally treated develop incident erosions, which minimally impact function.

Radiographic outcome in Hispanic early rheumatoid arthritis patients treated with conventional disease modifying anti-rheumatic drugs

Energy Technology Data Exchange (ETDEWEB)

Contreras-Yanez, Irazu, E-mail: uzari02@hotmail.com.mx [Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico); Rull-Gabayet, Marina, E-mail: rull.marina@gmail.com [Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico); Vazquez-LaMadrid, Jorge, E-mail: docjvlradiologo@yahoo.com [Department of Radiology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico); Pascual-Ramos, Virginia, E-mail: virtichu@gmail.com.mx [Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico)

2011-08-15

Objectives: To determine rates of incident erosive disease in early rheumatoid arthritis patients, to identify baseline predictors and to evaluate erosion's impact on patient-reported outcomes. Methods: 82 patients with {<=}12 months of disease duration, {>=}3 years of follow-up and conventional treatment were included. Consecutive evaluations assessed swollen and tender joint counts, treatment and comorbidity, acute reactant-phase determinations and patient-reported outcomes. Digitized radiographs of the hands and feet were obtained at baseline and yearly thereafter. RA was defined as erosive when at least one unequivocal cortical bone defect was detected. Descriptive statistics and Cox regression analysis were performed. Results: At baseline, 71 of the patients were Female Sign , population median (range) age was of 38.7 (16-78.2) years, 58 patients had antibodies and all the patients had active disease and substantial disability. Follow-up cohort was of 299.3 person-years. At last follow-up (49 {+-} 13.8 months), 28 patients developed erosions. Erosion's location was the feet, in 12 patients. Incident rates of erosive disease at one, two, three and four years were of 8.1, 12.8, 13.8 and 5.6 per 100 person-years, respectively. Higher C-reactive protein (HR: 1.20, 95%CI: 1.04-1.4, p = 0.01) and positive antibodies (HR: 5.09, 95%CI: 1.08-23.86, p = 0.04) were baseline predictors of incident erosive disease. Erosions had minor impact on patient-reported outcomes. Conclusion: Rheumatoid arthritis patients with antibodies and higher C reactive protein at baseline are at risk for incident erosions which appear most frequently at the feet. Up to 1/3 patients conventionally treated develop incident erosions, which minimally impact function.

Bone loss and aggravated autoimmune arthritis in HLA-DRβ1-bearing humanized mice following oral challenge with Porphyromonas gingivalis.

Science.gov (United States)

Sandal, Indra; Karydis, Anastasios; Luo, Jiwen; Prislovsky, Amanda; Whittington, Karen B; Rosloniec, Edward F; Dong, Chen; Novack, Deborah V; Mydel, Piotr; Zheng, Song Guo; Radic, Marko Z; Brand, David D

2016-10-26

The linkage between periodontal disease and rheumatoid arthritis is well established. Commonalities among the two are that both are chronic inflammatory diseases characterized by bone loss, an association with the shared epitope susceptibility allele, and anti-citrullinated protein antibodies. To explore immune mechanisms that may connect the two seemingly disparate disorders, we measured host immune responses including T-cell phenotype and anti-citrullinated protein antibody production in human leukocyte antigen (HLA)-DR1 humanized C57BL/6 mice following exposure to the Gram-negative anaerobic periodontal disease pathogen Porphyromonas gingivalis. We measured autoimmune arthritis disease expression in mice exposed to P. gingivalis, and also in arthritis-resistant mice by flow cytometry and multiplex cytokine-linked and enzyme-linked immunosorbent assays. We also measured femoral bone density by microcomputed tomography and systemic cytokine production. Exposure of the gingiva of DR1 mice to P. gingivalis results in a transient increase in the percentage of Th17 cells, both in peripheral blood and cervical lymph nodes, a burst of systemic cytokine activity, a loss in femoral bone density, and the generation of anti-citrullinated protein antibodies. Importantly, these antibodies are not produced in response to P. gingivalis treatment of wild-type C57BL/6 mice, and P. gingivalis exposure triggered expression of arthritis in arthritis-resistant mice. Exposure of gingival tissues to P. gingivalis has systemic effects that can result in disease pathology in tissues that are spatially removed from the initial site of infection, providing evidence for systemic effects of this periodontal pathogen. The elicitation of anti-citrullinated protein antibodies in an HLA-DR1-restricted fashion by mice exposed to P. gingivalis provides support for the role of the shared epitope in both periodontal disease and rheumatoid arthritis. The ability of P. gingivalis to induce disease

High-resolution MRI of the wrist and finger joints in patients with rheumatoid arthritis: comparison of 1.5 Tesla and 3.0 Tesla

International Nuclear Information System (INIS)

Wieners, Gero; Detert, Jacqueline; Burmester, Gerd; Backhaus, Marina; Streitparth, Florian; Fischbach, Frank; Bruhn, Harald; Pech, Maciej; Ricke, Jens

2007-01-01

The goal of this study was to compare magnetic resonance (MR) image quality at different field strengths for evaluating lesions in wrist and finger joints of patients with rheumatoid arthritis (RA) in order to determine whether the higher field strength provides diagnostic gain. The hand mainly affected in 17 RA patients was examined at 1.5 Tesla (T) and 3.0 T with comparable MR imaging (MRI) protocols. MR images were reviewed twice by two experienced radiologists using the Rheumatoid Arthritis MRI Scoring System (RAMRIS) of the OMERACT (Outcome Measures in Rheumatoid Arthritis Clinical Trials) group. Image quality was rated on a five-point scale using Friedmann's test and Kendall's W-test for statistical analysis. Image comparison revealed better image quality at higher field strength. Image quality of T1-weighted images was rated 14-22% better at 3.0 T compared with 1.5 T by both readers. Moreover, the rating for the T2-weighted-images acquired at 3.0 T was one point better in the five-point scale used. Inter-reader correlation for image quality, bone erosions/defects, edema and synovitis ranged between 0.6 and 0.9 at 3.0 T and between 0.6 and 0.8 at 1.5 T. Intra-reader correlation for these parameters was high at 0.8-1.0. MRI image quality of RA hands is superior at 3.0 T, while an acceptable image quality is achieved at 1.5 T, which improves the evaluation of extent of bone edema, synovitis and identification of small bone erosions. (orig.)

[Correlation of RANKL/OPG, dickkopf-1 and bone marrow edema in rheumatoid arthritis with the complaint of knee pain].

Science.gov (United States)

Li, Min; Wu, Xiao-hui; Yin, Geng; Xie, Qi-bing

2015-03-01

To investigate the correlation of the receptor activator of nuclear factor kappa-B ligand (RANKL)/serum osteoprotegerin (OPG) system, Dickkopf-1 (DKK-1) and bone marrow edema (BME) in rheumatoid arthritis (RA) with the complaint of knee pain. The clinical data of 50 cases of RA with the complaint of knee pain were collected. According to MRI finding, half of them (25 cases) had bone marrow edema (BME). Each patient received the measurement of serum OPG, RANKL, DKK-1, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), anti cyclic citrullinated peptide antibody (CCP), rheumatoid factort(RF). The clinical symptoms, disease activity score 28 (DAS28), were compared between BME and non-BME griups, and the correlation between RANKL/OPG system, DKK-1 and BME of RA was analyzed. Compared with non BME group, BME group had shorter course (P=0.000), higher DAS28 score (P=0.009), CRP (P=0:000), RF (P=0.033) and CCP (P=0.012). lower level of serum OPG (P=0.000), higher level of RANKL (P=0.000), RANKL/OPG (P=0.000), and DKK-1 (P=0.001). The severity of bone marrow edema was correlated with the serum RANKL (volume r(s)=0.31, P=0.027; degree r(s)=0.33, P=0.022), RANKL/OPG (volume r(s)=0.29, P=0.039; degree r(s)=0.28, P=0.043), DKK-1 (volume r(s)=0.33, P=0.021; degree r(s)=0.34, P=0.019). BME is one of the early signs of bone erosion in RA, there were more active inflammation, autoantibodies, and osteocasts in RA patients with BME.

The assessment of bee venom responses in an experimental model of mono-arthritis using Tc-99m DPD bone scintigraphy

International Nuclear Information System (INIS)

Yang, Chung-Yong; Park, Soon-Ah; Oh, Kyung-Jae; Yang, Yun-Sik

2010-01-01

Several recent studies have shown that bee venom (BV) has an anti-nociceptive and anti-inflammatory effect on arthritis. However, objective methods for evaluation of the therapeutic effect of BV is insufficient in animal studies and clinical trials. Our purpose was to determine the usefulness of bone scintigraphy using Tc-99m DPD (3,3-diphosphono-1,2-propan-dicarbonacid) about effects of BV applied to carrageenan-induced mono-arthritis (CIA) model. Mono-arthritis was induced by an intra-articular injection of carrageenan in Sprague-Dawley rats. Administration of BV (0.8 mg/kg) was performed at 30 min before and at 4 h after the induction of mono-arthritis. We assigned rats to BV-before, BV-after, control-before and control-after groups and compared the results of each group by the weight-loading test and bone scintigraphy. The rats received an intravenous injection of 37 MBq of Tc-99m DPD by the tail vein and then scanning was performed at 4 and 24 h after the injection. Visual assessment and quantitative analysis were performed for both knees. The BV-before and BV-after groups were more improved than the control groups on the weight load test (p<0.05). Bone scintigraphy showed lower activity in the BV-before group than in the control-before group (p<0.05) on the 4 h imaging. However, a significant difference in the BV-before and BV-after groups was not observed on the 24 h imaging. BV had therapeutic effects by anti-nociceptive and anti-inflammatory activity in the CIA and bone scintigraphy performed on 4 h imaging provided visual and quantitative information for the assessment of the therapeutic response to BV as an objective method in mono arthritis model. (author)

Total skeletal uptake of diphosphonate in Paget's bone disease and rheumatoid arthritis

International Nuclear Information System (INIS)

Cabrejas, M.J.; Mautclen, C.A.; Fromm, G.

1982-01-01

Sup(99m) Technetium-diphosphonates (99m-Tc-DP) are very satifactory agents to quantify total skeletal uptake (TSU) in normal and pathological conditions. Although the intimate mechanism of skeletal localization of 99m-Tc-DP is not completely understood the test appears to be a very sensitive index of increased bone turnover. TSU can be determined by several methods: urine collection, whole body counter retention and gamma camara body retention studies. The urine collection method seems to be an easy and reliable method, having the advantage that no expensive device is needed. Further studies on the skeletal uptake of 99m-Tc-DP, in normal subjects and pathological conditions, with special emphasis on patients with rheumatoid arthritis, are reported. Correlation of these data with other tests indicating bone turnover, such as cortical bone loss determined by densitometry or urinary hydroxyproline excretion, supports previous reports that the TSU is a useful parameter to evaluate bone metabolism

Insulin-Like Growth Factor I Does Not Drive New Bone Formation in Experimental Arthritis

NARCIS (Netherlands)

van Tok, Melissa N.; Yeremenko, Nataliya G.; Teitsma, Christine A.; Kream, Barbara E.; Knaup, Véronique L.; Lories, Rik J.; Baeten, Dominique L.; van Duivenvoorde, Leonie M.

2016-01-01

Insulin like growth factor (IGF)-I can act on a variety of cells involved in cartilage and bone repair, yet IGF-I has not been studied extensively in the context of inflammatory arthritis. The objective of this study was to investigate whether IGF-I overexpression in the osteoblast lineage could

The performance of MRI in detecting subarticular bone erosion of sacroiliac joint in patients with spondyloarthropathy: A comparison with X-ray and CT

International Nuclear Information System (INIS)

Hu, Libin; Huang, Zhenguo; Zhang, Xuezhe; Chan, Queenie; Xu, Yanyan; Wang, Guochun; Wang, Wu

2014-01-01

Highlights: • MRI 3D-WS-bSSFP sequence has high spatial resolution and short scanning time. • This is the first time this sequence was applied to detect bone erosion of SI joint. • Its performance was compared with other commonly used diagnostic methods. • Result shows that this sequence is better than X-ray and T1W in the detection of bone erosion. • This sequence can be considered an alternative to CT in showing erosion in SpA patients. - Abstract: Objective: To assess the sensitivity and specificity of detecting subarticular bone erosion of sacroiliac (SI) joint in patients with spondyloarthritis (SpA) using MRI three-dimensional water selective balanced steady-state free precession sequence (3D-WS-bSSFP) and T1-weighted (T1W) sequence. Materials and methods: Radiography, CT and MRI of SI joint from 43 SpA patients were retrospectively analyzed. MRI examination sequences include T1W, short tau inversion recovery (STIR) and 3D-WS-bSSFP. Two radiologists, blinded to clinical data, independently determined bone erosion at bilateral sacral and iliac sides of the SI joint on radiography, CT, T1W and 3D-WS-bSSFP respectively. X 2 test was used to compare the sensitivity of detecting bone erosion among different diagnostic methods. Results: Of the 86 sacral and 86 iliac articular surfaces from the 43 cases, radiography, CT, MRI T1W and 3D-WS-bSSFP showed the presence of bone erosion in 40, 74, 50 and 71 articular surfaces respectively. CT and MRI 3D-WS-bSSFP demonstrated similar sensitivity (x 2 = 0.11, P = 0.74), and both were superior to radiography (x 2 = 15.17, P < 0.01 and x 2 = 12.78, P < 0.01, respectively) and T1W (x 2 = 7.26, P < 0.01 and x 2 = 5.62, P < 0.05). Using CT diagnosis as the gold standard, the sensitivity and specificity of detecting bone erosion for MRI 3D-WS-bSSFP and T1W sequences were 91.8%, 96.9%, and 60.8%, 94.9% respectively. Conclusion: MRI 3D-WS-bSSFP sequence is associated with short scanning time, zero ionizing radiation, high

The performance of MRI in detecting subarticular bone erosion of sacroiliac joint in patients with spondyloarthropathy: A comparison with X-ray and CT

Energy Technology Data Exchange (ETDEWEB)

Hu, Libin [Department of Radiology, China-Japan Friendship Hospital, Beijing (China); Huang, Zhenguo, E-mail: zhuang680911@163.com [Department of Radiology, China-Japan Friendship Hospital, Beijing (China); Zhang, Xuezhe [Department of Radiology, China-Japan Friendship Hospital, Beijing (China); Chan, Queenie [Philips Healthcare, Hong Kong (China); Xu, Yanyan [Department of Radiology, China-Japan Friendship Hospital, Beijing (China); Wang, Guochun [Department of Rheumatology, China-Japan Friendship Hospital, Beijing (China); Wang, Wu [Department of Radiology, China-Japan Friendship Hospital, Beijing (China)

2014-11-15

Highlights: • MRI 3D-WS-bSSFP sequence has high spatial resolution and short scanning time. • This is the first time this sequence was applied to detect bone erosion of SI joint. • Its performance was compared with other commonly used diagnostic methods. • Result shows that this sequence is better than X-ray and T1W in the detection of bone erosion. • This sequence can be considered an alternative to CT in showing erosion in SpA patients. - Abstract: Objective: To assess the sensitivity and specificity of detecting subarticular bone erosion of sacroiliac (SI) joint in patients with spondyloarthritis (SpA) using MRI three-dimensional water selective balanced steady-state free precession sequence (3D-WS-bSSFP) and T1-weighted (T1W) sequence. Materials and methods: Radiography, CT and MRI of SI joint from 43 SpA patients were retrospectively analyzed. MRI examination sequences include T1W, short tau inversion recovery (STIR) and 3D-WS-bSSFP. Two radiologists, blinded to clinical data, independently determined bone erosion at bilateral sacral and iliac sides of the SI joint on radiography, CT, T1W and 3D-WS-bSSFP respectively. X{sup 2} test was used to compare the sensitivity of detecting bone erosion among different diagnostic methods. Results: Of the 86 sacral and 86 iliac articular surfaces from the 43 cases, radiography, CT, MRI T1W and 3D-WS-bSSFP showed the presence of bone erosion in 40, 74, 50 and 71 articular surfaces respectively. CT and MRI 3D-WS-bSSFP demonstrated similar sensitivity (x{sup 2} = 0.11, P = 0.74), and both were superior to radiography (x{sup 2} = 15.17, P < 0.01 and x{sup 2} = 12.78, P < 0.01, respectively) and T1W (x{sup 2} = 7.26, P < 0.01 and x{sup 2} = 5.62, P < 0.05). Using CT diagnosis as the gold standard, the sensitivity and specificity of detecting bone erosion for MRI 3D-WS-bSSFP and T1W sequences were 91.8%, 96.9%, and 60.8%, 94.9% respectively. Conclusion: MRI 3D-WS-bSSFP sequence is associated with short scanning time

Raman spectroscopy detects deterioration in biomechanical properties of bone in a glucocorticoid-treated mouse model of rheumatoid arthritis

Science.gov (United States)

Maher, Jason R.; Takahata, Masahiko; Awad, Hani A.; Berger, Andrew J.

2011-08-01

Although glucocorticoids are frequently prescribed for the symptomatic management of inflammatory disorders such as rheumatoid arthritis, extended glucocorticoid exposure is the leading cause of physician-induced osteoporosis and leaves patients at a high risk of fracture. To study the biochemical effects of glucocorticoid exposure and how they might affect biomechanical properties of the bone, Raman spectra were acquired from ex vivo tibiae of glucocorticoid- and placebo-treated wild-type mice and a transgenic mouse model of rheumatoid arthritis. Statistically significant spectral differences were observed due to both treatment regimen and mouse genotype. These differences are attributed to changes in the overall bone mineral composition, as well as the degree of phosphate mineralization in tibial cortical bone. In addition, partial least squares regression was used to generate a Raman-based prediction of each tibia's biomechanical strength as quantified by a torsion test. The Raman-based predictions were as accurate as those produced by microcomputed tomography derived parameters, and more accurate than the clinically-used parameter of bone mineral density. These results suggest that Raman spectroscopy could be a valuable tool for monitoring bone biochemistry in studies of bone diseases such as osteoporosis, including tests of drugs being developed to combat these diseases.

US findings of metacarpophalangeal joints in children with idiopathic juvenile arthritis

International Nuclear Information System (INIS)

Karmazyn, Boaz; Bowyer, Suzanne L.; Murphy Schmidt, Kara; Ballinger, Susan H.; Beam, Thuy T.; Buckwalter, Kenneth; Ying, Jun

2007-01-01

Juvenile idiopathic arthritis (JIA) is the most common cause of chronic arthritis in children, with frequent involvement of the metacarpophalangeal joints (MCPJ). To compare US findings with those of radiography and clinical examination. All MCPJs in 20 children with JIA (17 females, median age 9.7 years, range 3.6 to 16.8 years) were evaluated clinically and imaged with gray-scale and color Doppler US, and 90 MCPJs were also imaged radiographically. Each MCPJ was graded on physical examination from 0 (normal) to 4 (severe) by the patient's rheumatologist. US demonstrated abnormalities in 64 of 200 MCPJs (32.0%), including pannus vascularity and/or tenosynovitis in 55 joints (27.5%) (pannus vascularity in 43, tenosynovitis in 40) and bone destruction in 25 joints (12.5%). Overall, US abnormalities and physical examination scores were significantly associated (P < 0.001). However, interobserver agreement between US and clinical evaluation was poor (kappa 0.1) and between US and radiography was only fair (kappa 0.4). US of the MCPJ in children with JIA can demonstrate cartilage thinning, bone erosions, and pannus vascularity. Abnormal US findings are significantly correlated with severity of disease as evaluated clinically. (orig.)

US findings of metacarpophalangeal joints in children with idiopathic juvenile arthritis

Energy Technology Data Exchange (ETDEWEB)

Karmazyn, Boaz [Riley Hospital for Children, Radiology, Indianapolis, IN (United States); Bowyer, Suzanne L.; Murphy Schmidt, Kara; Ballinger, Susan H.; Beam, Thuy T. [Indiana University, Pediatric Rheumatology, Indianapolis, IN (United States); Buckwalter, Kenneth [University Hospital, Radiology, Indianapolis, IN (United States); Ying, Jun [University of Cincinnati, Biostatistics, Institute for the Study of Health, Cincinnati, OH (United States)

2007-05-15

Juvenile idiopathic arthritis (JIA) is the most common cause of chronic arthritis in children, with frequent involvement of the metacarpophalangeal joints (MCPJ). To compare US findings with those of radiography and clinical examination. All MCPJs in 20 children with JIA (17 females, median age 9.7 years, range 3.6 to 16.8 years) were evaluated clinically and imaged with gray-scale and color Doppler US, and 90 MCPJs were also imaged radiographically. Each MCPJ was graded on physical examination from 0 (normal) to 4 (severe) by the patient's rheumatologist. US demonstrated abnormalities in 64 of 200 MCPJs (32.0%), including pannus vascularity and/or tenosynovitis in 55 joints (27.5%) (pannus vascularity in 43, tenosynovitis in 40) and bone destruction in 25 joints (12.5%). Overall, US abnormalities and physical examination scores were significantly associated (P < 0.001). However, interobserver agreement between US and clinical evaluation was poor (kappa 0.1) and between US and radiography was only fair (kappa 0.4). US of the MCPJ in children with JIA can demonstrate cartilage thinning, bone erosions, and pannus vascularity. Abnormal US findings are significantly correlated with severity of disease as evaluated clinically. (orig.)

Ultrasonographic findings of septic arthritis and osteomyelitis in neonatal hip

International Nuclear Information System (INIS)

Lee, Seung Hoon; Jung, Kun Sik; Koh, Jung Kon; Im, Myung Ah; Kwon, Kwi Ryun; Kim, Sung Soo

2000-01-01

To evaluate ultrasonographic findings of neonatal patients who confirmed and treated as hip joint septic arthritis and osteomyelitis. We retrospectively examined clinical feature and radiologic findings of 7 neonatal patients ranging from 8 to 28 days of age who were examined from January 1966 to December 1998 at nursery and were confirmed and treated on the diagnosis of septic arthritis and osteomyelitis. Clinical features of the patients were comparatively analyzed with radiologic findings including plain radiographs, ultrasonography, bone scan and MRI. We emphasized importance of ultrasonographic findings of these patients. Ultrasonography was performed first of all in all cases after the symptom onset. Other examinations were performed on the same day or a few days later after ultrasonography. Ultrasonography revealed abnormal finding in 85.7% (6/7) of all cases. Plain radiographs revealed abnormal findings in 28.6% (2/7). Bone scan revealed decreased uptake in 66.7%(2/3). MRI revealed abnormal signal intensity in 100%(3/3). Ultrasonographic findings of the patients were deep soft swelling in 85.7% (6/7) of all cases, periosteal elevation in 57.1% (4/7), synovial thickening in 42.8% (3/7), synovial effusion in 42.8%(3/7), echogenic debris or clot in 28.5% (2/7), cortical erosion in 28.5% (2/7), and subperiosteal abscess in 14.2% (1/7). Ultrasonography is a useful modality to diagnose septic arthritis and osteomyelitis in neonatal hip.

Effects of Trichilia monadelpha (Meliaceae extracts on bone histomorphology in complete Freund’s adjuvant-induced arthritis

Directory of Open Access Journals (Sweden)

INEMESIT OKON BEN

2017-06-01

Full Text Available Aim: To assess the effect of petroleum ether extract (PEE, ethyl acetate extract (EthE, and ethanol extract (EAE of Trichilia monadelpha stem bark on bone histomorphology in arthritis. Methods: Percentage inhibition of edema and arthritic scores in complete Freund’s adjuvant-induced (0.1 ml of 5 mgml-1 of heat killed Mycobacterium tuberculosis in paraffin oil injected sub-plantar into the right hind paw arthritic Sprague-Dawley rats treated with PEE, EthE, or EAE (10, 30, and 100 mgkg-1, dexamethasone (0.3-3.0 mgkg-1 or methotrexate (0.1–1.0 mgkg-1 over a 28-day period were estimated. Rat paws were radiographed and scored. Body weights were taken and paw tissues harvested for histopathological studies. Results: The extracts significantly (P≤0.01-0.0001 and dose-dependently reduced the polyarthritic phase of arthritis. EAE and PEE significantly (P≤0.01-0.0001 minimized edema spread from acute arthritic phase (day 0-10 to polyarthritic phase (day 10-28. EthE improved deteriorated body weight in arthritis. All extracts significantly (P≤0.05-0.01 improved arthritic score; reducing erythema, swelling and joint rigidity, and also significantly (P≤0.05-0.01 reduced hyperplasia, pannus formation, and exudation of inflammatory cells into synovial spaces. Conclusion: The stem bark extracts of Trichilia monadelpha reduce bone tissue damage and resorption associated with adjuvant-induced arthritis, hence could be useful in managing arthritis in humans. [J Complement Med Res 2017; 6(2.000: 177-185

Reliability and sensitivity to change of the Simple Erosion Narrowing Score compared with the Sharp-van der Heijde method for scoring radiographs in rheumatoid arthritis

NARCIS (Netherlands)

Dias, E. M.; Lukas, C.; Landewé, R.; Fatenejad, S.; van der Heijde, D.

2008-01-01

To compare the performance of a simplified scoring method for structural damage on radiographs of patients with rheumatoid arthritis (the Simple Erosion Narrowing Score or SENS) with the Sharp-van der Heijde Score (SHS) as reference. We used the radiographic data from the Trial of Etanercept and

A study comparing MRI with clinical examinations on wrists with rheumatoid arthritis

International Nuclear Information System (INIS)

Wang Jun; Niu Jinliang; Xie Weina; Song Zhizhen; Zheng Jie; Ma Qiang

2004-01-01

Objective: To study the appearances of rheumatoid arthritis (RA) on MRI, and compare MRI with clinical examinations on wrists with RA. Methods: Fifty patients, fulfilled 1987 American Rheumatism Association (ARA) revised criteria, and 10 age-matched healthy controls entered the study. T 1 -weighted spin echo, short time inversion recovery (STIR) of both wrists, gadolinium contrast material-enhanced sequences of dominant wrists were performed in the coronal planes. MRl, plain wrist radiographs, clinical date, including swollen joint, patient global assessment (AIMS), and laboratory examinations including ESR, RF, APF, and AKA were obtained at the same time. Functional disability was assessed using the Health Assessment Questionnaire Disability Score. Results: In 50 patients, all had pannus on MRI of wrists, 38 patients had enhanced signal intensity for pannus, 21 patients had bone marrow edema, 37 patients had joint effusion, and 37 patients had bone erosions. There were significant difference in the ESR, HAQ, AIMS as well as swollen joint count between patients with bone marrow edema and patients without bone marrow edema (P 2 =5.06, P=0.025; χ 2 =5.59, P=0.018). Number of patients with MRI erosion of wrists was associated with the number of patients without MRI bone marrow edema of wrists (χ 2 =5.11, P=0.024). Conclusion: MRI can find the appearances of wrists with RA. Comparing MRI with clinical examinations on wrists with RA, authors can assess and evaluate the role of MRI on RA

Magnetic resonance imaging of the hand in rheumatoid arthritis. New scientific insights and practical application; Magnetresonanztomographie der Hand bei rheumatoider Arthritis. Wissenschaftliche Ergebnisse und praktische Anwendung

Energy Technology Data Exchange (ETDEWEB)

Hermann, K.G.A. [Charite - Universitaetsmedizin Berlin, Institut fuer Radiologie am Campus Mitte, Berlin (Germany)

2006-05-15

Magnetic resonance imaging (MRI) is a sensitive diagnostic modality for the detection of inflammatory changes in peripheral joints. Nevertheless, the widespread clinical use of MRI in assessing patients with early rheumatoid arthritis is still hampered by the technical complexity and higher cost of MRI compared with conventional radiography. This overview summarizes the results of recent research and gives practical tips on how to perform MRI of the hands. The authors present an MR protocol for hand imaging, discuss the pros and cons of low-field MR scanners, and outline pitfalls and artifacts. The MRI changes associated with rheumatoid arthritis such as synovitis, tenosynovitis, erosions, and bone marrow edema are described including their prognostic significance. The proven facts on the validation and grading of MR changes in rheumatoid arthritis are summarized. Finally, the role of MRI in the differential diagnosis of arthritis is critically discussed. (orig.) [German] Die Magnetresonanztomographie (MRT) ist ein sensitives Verfahren zur Detektion entzuendlicher Veraenderungen der peripheren Gelenke. Den breiten Einsatz der MRT im Fruehstadium der rheumatoiden Arthritis behindern derzeit jedoch der im Vergleich zur konventionellen Roentgendiagnostik hoehere technische Aufwand und vermehrte Kosten. Diese Uebersichtsarbeit fasst wichtige Studienergebnisse zusammen und gibt praktische Hinweise fuer Hand-MRTs. Ein geeignetes Sequenzprotokoll wird vorgestellt, Vor- und Nachteile von Niederfeld-MRTs werden beruecksichtigt, moegliche Fehlerquellen und Artefakte diskutiert. Magnetresonanztomographische Befunde bei rheumatoider Arthritis wie Synovitis, Tenosynovitis, Erosionen und Knochenmarkoedeme werden beschrieben und deren prognostische Bedeutung dargestellt. Gesicherte Fakten zur Validierung und Moeglichkeiten der Graduierung MR-tomographischer Veraenderungen bei rheumatoider Arthritis werden zusammengefasst. Der Nutzen der MRT zur differenzialdiagnostischen

[Resection of a carpal bone row in a Pustertaler Sprinze cow with chronic purulent arthritis of the carpal joint and osteomyelitis].

Science.gov (United States)

Kofler, J; Peterbauer, C

2014-01-01

This case report describes the clinical and radiographic findings and the surgical treatment of a serofibrinous arthritis of the antebrachiocarpal joint and of a chronic purulent arthritis of the intercarpal and carpometacarpal joints with osteomyelitis of the distal carpal bones and subchondral osteomyelitis of the proximal metacarpal bones in a cow of the breed "Pustertaler Sprinze". The therapy comprised an arthrotomy of both joint spaces and the resection of the distal row of the carpal bones. The right forelimb had been immobilised for 70 days by a full limb cast. After this period, radiographs revealed an ob- vious ankylosis of the carpal joint, and the cow showed only a slight lameness. Six years postoperatively this cow was still in the herd and had produced six calves.

Determination of elements in bone of tuberculous-arthritis patients by radioisotope X-ray fluorescence analysis

International Nuclear Information System (INIS)

Akyuez, T.; Bassari, A.; Akyuez, S.

1998-01-01

The quantitative analysis of the human femoral bone of 17 tuberculosis-arthritis (Koch-arthritis) patients (9 males and 8 females) in the age range of 45-65, for Ca, P, Zn, Sr, Ba, La and Ce were performed by using radioisotope energy dispersive X-ray fluorescence (EDXRF) and the results were compared with those of 12 healthy control groups (8 males and 4 females) in the range of 37-58. The results indicate that the concentrations of P, Ca and Sr in the control group are higher than those in the patient group, while the concentrations of Zn, Ba, La and Ce are not significantly different. (author)

Mechanisms involved in the therapeutic effects of Paeonia lactiflora Pallas in rheumatoid arthritis.

Science.gov (United States)

Zhang, Wei; Dai, Sheng-Ming

2012-09-01

Paeonia lactiflora Pallas, also named Chinese Paeony, is a Chinese herb. A decoction of its root has been used to treat painful or inflammatory disorders in traditional Chinese medicine. A water/ethanol extract of Radix Paeoniae is known as total glycosides of paeony (TGP), of which paeoniflorin is the major active component. Preclinical studies show that TGP/paeoniflorin is able to diminish pain, joint swelling, synovial hypertrophy, and the severity of bone erosion and cartilage degradation in experimental arthritis. TGP/paeoniflorin suppresses inflammatory process by reducing the production of prostaglandin E2, leukotriene B4, nitric oxide, reactive oxygen species, proinflammatory cytokines and chemokines. TGP/paeoniflorin also inhibits the proliferation of lymphocytes and fibroblast-like synoviocytes, the formation of new blood vessels, and the production of matrix metalloproteinases. Clinical data show that TGP is effective to relieve the symptoms and signs of rheumatoid arthritis without significant adverse effects. Recently, TGP is widely used to treat rheumatoid arthritis in China. Copyright © 2012 Elsevier B.V. All rights reserved.

Corelations between radiological score with clinical and laboratory parameters in rheumatoid arthritis

Directory of Open Access Journals (Sweden)

Mihaela Chicu

2016-12-01

Full Text Available Staging in rheumatoid arthritis (RA and evaluating the effectiveness of drug treatment involves the determination of radiological scores (for narrowing and erosions, this being the most specific changes and most commonly found in RA.Matherials and methods: Our study was condacted over a period of 12 months in Medical Rehabilitation Clinic of „Sf. Spiridon” Iasi Hospital, on a group of 40 women patients with RA in various stages of evolution. X-ray examination was done on hands and feet at the beginning and the end of the study period. There were computed radiographic Sharp scores for narrowing and erosions and the total score. Erosions were examined for 16 joints in each hand. For narrowing five joints were evaluated. For accuracy, radiological examination was done on mammography film. Rezults:After calculating Sharp scores - Van der Heide version - I compared them with the levels of clinical (HAQ, NAT, NAD, DAS28, bone densitometry and laboratory (ESR, CRP, rheumatoid factor, IL-1β parameters.Conclusions: The values of radiological scores for narrowing and erosions are directly correlate with DAS28, HAQ, rheumatoid factors levels and IgG values, and indirectly correlated with IL-1β levels.

Monosodium urate monohydrate crystals inhibit osteoblast viability and function: implications for development of bone erosion in gout.

Science.gov (United States)

Chhana, Ashika; Callon, Karen E; Pool, Bregina; Naot, Dorit; Watson, Maureen; Gamble, Greg D; McQueen, Fiona M; Cornish, Jillian; Dalbeth, Nicola

2011-09-01

Bone erosion is a common manifestation of chronic tophaceous gout. To investigate the effects of monosodium urate monohydrate (MSU) crystals on osteoblast viability and function. The MTT assay and flow cytometry were used to assess osteoblast cell viability in the MC3T3-E1 and ST2 osteoblast-like cell lines, and primary rat and primary human osteoblasts cultured with MSU crystals. Quantitative real-time PCR and von Kossa stained mineralised bone formation assays were used to assess the effects of MSU crystals on osteoblast differentiation using MC3T3-E1 cells. The numbers of osteoblasts and bone lining cells were quantified in bone samples from patients with gout. MSU crystals rapidly reduced viability in all cell types in a dose-dependent manner. The inhibitory effect on cell viability was independent of crystal phagocytosis and was not influenced by differing crystal length or addition of serum. Long-term culture of MC3T3-E1 cells with MSU crystals showed a reduction in mineralisation and decreased mRNA expression of genes related to osteoblast differentiation such as Runx2, Sp7 (osterix), Ibsp (bone sialoprotein), and Bglap (osteocalcin). Fewer osteoblast and lining cells were present on bone directly adjacent to gouty tophus than bone unaffected by tophus in patients with gout. MSU crystals have profound inhibitory effects on osteoblast viability and differentiation. These data suggest that bone erosion in gout occurs at the tophus-bone interface through alteration of physiological bone turnover, with both excessive osteoclast formation, and reduced osteoblast differentiation from mesenchymal stem cells.

The Anti-Inflammatory Activity of Toonaciliatin K against Adjuvant Arthritis

Directory of Open Access Journals (Sweden)

HaiXing Gou

2017-01-01

Full Text Available Toonaciliatin K is a natural limonoid purified from the Toona ciliata Roem. var. ciliata (Meliaceae. This study is to reveal the inflammatory suppression effect of toonaciliatin K and further the intrinsic mechanism. Firstly, anti-inflammatory effect of toonaciliatin K was evaluated in lipopolysaccharide- (LPS- induced RAW264.7 cells. RT-PCR results indicated that the mRNA expressions of TNF-α, IL-6, and IL-1β were downregulated by toonaciliatin K. The toonaciliatin K inhibited TNF-α, IL-6, and IL-1β levels stimulated by LPS. Furthermore, LPS elicited the excess iNOS and COX-2 mRNA and protein production and toonaciliatin K attenuated the excess production. Western blot assay demonstrated that MAPK and NF-κB signaling pathways play critical roles in the toonaciliatin K’s anti-inflammatory activity. Secondly, toonaciliatin K inhibited carrageenan-induced paw edema in rats. Thirdly, toonaciliatin K alleviated the paw swelling and improved arthritis clinical scores in the adjuvant arthritis rats. Toonaciliatin K decreased the proinflammatory cytokines levels and Mankin scores in adjuvant arthritis rats. The HE staining, safranin O-fast green, and toluidine blue staining results demonstrated that toonaciliatin K alleviated the histological changes of paw, for example, pannus formation, focal loss of cartilage, bone erosion, and presence of extra-articular inflammation. Hence, toonaciliatin K is a promising agent for treatment of arthritis.

THE CYSTIC FORM OF RHEUMATOID-ARTHRITIS

NARCIS (Netherlands)

Dijkstra, P. F.; Gubler, F. M.; Maas, M.

1988-01-01

A non-erosive form of rheumatoid arthritis (R.A.) was found in 62 patients out of 660 patients with R.A. These 62 patients exhibit slowly progressive cystic changes in about the same joints in which usually erosions develop in classic R.A. The E.S.R. is often low, half of the patients remained

New aspects of osteoporosis: Bone mineral content (BMC) measurement in osteoporosis associated with drugs, arthritis, and related conditions

International Nuclear Information System (INIS)

Gross, M.D.; Shapiro, B.

1987-01-01

Sensitive, non-invasive measurements of bone mineral content (BMC) provide the means to identify and characterize, prior to the development of symptoms, osteoporosis associated with drugs, rheumatoid arthritis, inflammatory bowel disease, diabetes mellitus, anorexia nervosa and immobilization. Moreover, BMC can be used to effectively screen populations at risk for the development of osteoporosis and longitudinal studies in individual patients can be used to guide effective anti-osteopenia therapy. This review will briefly detail recent BMC measurements in osteoporosis due to drugs, arthritis and related conditions. (orig.) [de

New aspects of osteoporosis: Bone mineral content (BMC) measurement in osteoporosis associated with drugs, arthritis, and related conditions

Energy Technology Data Exchange (ETDEWEB)

Gross, M.D.; Shapiro, B.

1987-02-01

Sensitive, non-invasive measurements of bone mineral content (BMC) provide the means to identify and characterize, prior to the development of symptoms, osteoporosis associated with drugs, rheumatoid arthritis, inflammatory bowel disease, diabetes mellitus, anorexia nervosa and immobilization. Moreover, BMC can be used to effectively screen populations at risk for the development of osteoporosis and longitudinal studies in individual patients can be used to guide effective anti-osteopenia therapy. This review will briefly detail recent BMC measurements in osteoporosis due to drugs, arthritis and related conditions.

Bone loss in rheumatoid arthritis. Influence of disease activity, duration of the disease, functional capacity, and corticosteroid treatment

DEFF Research Database (Denmark)

Hansen, M; Florescu, A; Stoltenberg, M

1996-01-01

Axial and appendicular bone mass were studied in 95 patients with rheumatoid arthritis. The aims were to quantify bone mineral density (BMD) and to evaluate the importance of disease activity, duration of disease, functional capacity, and corticosteroid treatment for bone loss in patients...... after the start of the disease. The overall functional capacity in terms of physical activity increased BMD in the axial skeleton. The local functional capacity in terms of grip strength was positively related to BMD in the appendicular skeleton. Patients with severe functional impairment had the lowest...

Dietetic recommendations in rheumatoid arthritis

Directory of Open Access Journals (Sweden)

María Rosa Alhambra-Expósito

2013-12-01

Full Text Available Rheumatoid arthritis (RA is a chronic autoimmune disease that has a significant effect on patients’ physical, emotional, and social functioning. For decades, patients have used different diets to try to improve the symptoms of RA. The possible benefits of dietary therapy for rheumatoid arthritis are reviewed in this article. Nutritional objectives for RA, are to halt the loss of bone mass, promote healing of bone fractures and improving bone-associated inflammatory disorders and joints. In general, diets low in saturated fat, rich in polyunsaturated fats: omega 3 and omega 6, rich in complex carbohydrates and fiber are recommended.

Productive osseous changes about the wrist in rheumatoid arthritis

International Nuclear Information System (INIS)

Cantor, R.M.; Braunstein, E.M.

1987-01-01

Radiographs of 225 consecutive patients with adult-form rheumatoid arthritis were examined for evidence of productive osseous changes about the wrist. The prevalence of new bone on the ulnar styloid was 10%. This form of new bone is probably due to overlying chronic tenosynovitis. A collar of new bone around the ulnar head is a result of degenerative change in the distal radioulnar joint. In general, productive osseous changes in theumatoid arthritis may represent inflammatory periosteal bone formation, osteophytosis, or contact remodeling. We found no evidence of an association between diffuse idiopathic skeletal hyperostosis and extensive productive osseous changes in patients with rheumatoid arthritis. (orig.)

Productive osseous changes about the wrist in rheumatoid arthritis

Energy Technology Data Exchange (ETDEWEB)

Cantor, R.M.; Braunstein, E.M.

1987-07-01

Radiographs of 225 consecutive patients with adult-form rheumatoid arthritis were examined for evidence of productive osseous changes about the wrist. The prevalence of new bone on the ulnar styloid was 10%. This form of new bone is probably due to overlying chronic tenosynovitis. A collar of new bone around the ulnar head is a result of degenerative change in the distal radioulnar joint. In general, productive osseous changes in theumatoid arthritis may represent inflammatory periosteal bone formation, osteophytosis, or contact remodeling. We found no evidence of an association between diffuse idiopathic skeletal hyperostosis and extensive productive osseous changes in patients with rheumatoid arthritis.

OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Summary of OMERACT 6 MR Imaging Module

DEFF Research Database (Denmark)

McQueen, F; Lassere, M; Edmonds, J

2003-01-01

correlates closely with histological evidence and work continues on validating MR erosions with reference to radiographic techniques. The RAMRIS has demonstrated good reliability for bone erosion and synovitis at the wrists and metacarpophalangeal joints subject to reader training, with slightly lower levels......Magnetic resonance image (MRI) scanning is a new method for imaging and quantifying joint inflammation and damage in rheumatoid arthritis (RA). Over the past 4 years, the OMERACT MR Imaging Group has been developing and testing the RA-MRI scoring system (RAMRIS) for use in RA. The OMERACT filter...... and scoring, as well as cost and safety issues. The OMERACT RAMRIS provides a framework for scoring inflammation and damage in RA upon which further modifications can be built. It has been endorsed by the MRI working group and OMERACT 6 participants as useful for inclusion as an outcome measure in clinical...

Radiographic changes in the os calcis in rheumatoid arthritis; Radiographische Veraenderungen am Fersenbein im Rahmen der chronischen Polyarthritis

Energy Technology Data Exchange (ETDEWEB)

Lakits, A. [Krankenhaus Lainz (Austria). Zentralroentgeninstitut; Haller, J. [Hanusch-Krankenhaus, Vienna (Austria). Roentgenabteilung; Steiner, E. [Vienna Univ. (Austria). Klinik fuer Roentgendiagnostik; Stenzel, I. [Krankenhaus Lainz (Austria). Zentralroentgeninstitut; Schneider, B. [Vienna Univ. (Austria). Inst. fuer Medizinische Statistik und Dokumentation; Czembirek, H. [Krankenhaus Lainz (Austria). Zentralroentgeninstitut; Smolen, J. [Krankenhaus Lainz (Austria). 2. Medizinische Abt. (Rheumatologie)

1994-02-01

Plain films of the calcanea of 768 patients with confirmed rheumatoid arthritis were examined retrospectively with reference to inflammatory rheumatic changes. 42 patients (5.5%) showed an erosion of the posterior upper calcaneal margin related to an Achilles bursitis. In three patients there were additional plantar erosions. The Achilles bursitis was bilateral in 50% of cases, particularly in patients in stages 2 and 3 according to Steinbrocker. In the majority of bilateral cases (62%) the size or shape of the lesions was asymmetrical. Our observations indicate that involvement of the os calcis is not uncommon in rheumatoid arthritis; routine examination of this bone would appear to be indicated even in patients without symptoms. Since the defect is unilateral in half the patients, unilateral occurrence of an erosive lesion cannot be regarded as a criterion for a bacterial-inflammatory bursitis. Contrary to the symmetrical involvement of joints in the hands in rheumatoid arthritis, defects in the calcanea are often unilateral or asymmetrical. (orig.) [Deutsch] Die Nativroentgenaufnahmen des Fersenbeins von 768 Patienten mit gesicherter chronischer Polyarthritis wurden retrospektiv hinsichtlich des Auftretens entzuendlich-rheumatischer Veraenderungen beurteilt. 42 Patienten (5,5%) zeigten eine Erosion der hinteren oberen Fersenbeinkante im Sinne eines Achillobursitisdefektes. Bei drei Patienten gelangte zusaetzlich eine plantare Erosion zur Darstellung. Der Achillobursitisdefekt war in 50% der Faelle beidseitig ausgebildet, wobei das bilaterale Auftreten bei Patienten in den Stadien II und III nach Steinbrocker ueberwog. Bei bilateralem Befall waren die Laesionen allerdings in der Mehrzahl der Faelle (62%) hinsichtlich Groesse und/oder Form asymmetrisch ausgebildet. Unsere Beobachtungen belegen, dass eine Fersenbeinbeteiligung im Rahmen der chronischen Polyarthritis nicht selten auftritt, weshalb routinemaessig Roentgenaufnahmen des Fersenbeins bei Patienten mit

MR findings of tuberculous arthritis; significance of tuberculoma

International Nuclear Information System (INIS)

Jang, Han Won; Kim, Jeen Woo; Cho, Kil Ho

2001-01-01

To determine the magnetic resonance (MR) imaging findings of tuberculous arthritis, and the frequency-in such cases-with which tuberculoma occurs. MR images of 26 patients (M;F, 14;12: mean age, 46.2 years) with pathologically proven tuberculous arthritis were retrospectively reviewed. The presence of joint effusion, subchondral erosion, synovial proliferation and soft tissue abscess, and whether the inner wall of this abscess was smooth, were assessed. In particular, we determined whether a nodular lesion which showed low SI on T1WI, central low SI with peripheral hjigh SI on T2WI, and rim enhancement on contrast study, was a tuberculoma. The joints involved were those of the knee (n=7), hip (n=7), shoulder (n=4), sacroiliac region (n=3), elbow (n=3), and ankle (n=2). Joint effusion was noted in 15 cases (58%), and subchondral erosion in 24 (92%). synovial proliferation was found in 23 cases (88%), and soft tissue abscess in 24 (92%). The inner wall of this abscess was irregular in 17 cases (71%). A tuberculoma was present in intra-or extra-or extra-articular soft tissue in 18 cases (69%). The MR findings of tuberculous arthritis were subchondral erosion, synovial proliferation, and soft tissue abscess. The presence of a tuberculoma in intra-or extra-articular soft tissue, a specific finding in tuberculous arthritis, was noted in 69% of our cases

MR findings of tuberculous arthritis; significance of tuberculoma

Energy Technology Data Exchange (ETDEWEB)

Jang, Han Won; Kim, Jeen Woo; Cho, Kil Ho [Yeungnam Univ. College of Medicine, Taegu (Korea, Republic of)

2001-02-01

To determine the magnetic resonance (MR) imaging findings of tuberculous arthritis, and the frequency-in such cases-with which tuberculoma occurs. MR images of 26 patients (M;F, 14;12: mean age, 46.2 years) with pathologically proven tuberculous arthritis were retrospectively reviewed. The presence of joint effusion, subchondral erosion, synovial proliferation and soft tissue abscess, and whether the inner wall of this abscess was smooth, were assessed. In particular, we determined whether a nodular lesion which showed low SI on T1WI, central low SI with peripheral hjigh SI on T2WI, and rim enhancement on contrast study, was a tuberculoma. The joints involved were those of the knee (n=7), hip (n=7), shoulder (n=4), sacroiliac region (n=3), elbow (n=3), and ankle (n=2). Joint effusion was noted in 15 cases (58%), and subchondral erosion in 24 (92%). synovial proliferation was found in 23 cases (88%), and soft tissue abscess in 24 (92%). The inner wall of this abscess was irregular in 17 cases (71%). A tuberculoma was present in intra-or extra-or extra-articular soft tissue in 18 cases (69%). The MR findings of tuberculous arthritis were subchondral erosion, synovial proliferation, and soft tissue abscess. The presence of a tuberculoma in intra-or extra-articular soft tissue, a specific finding in tuberculous arthritis, was noted in 69% of our cases.

Establishment and evaluation of a transgenic mouse model of arthritis induced by overexpressing human tumor necrosis factor alpha

Directory of Open Access Journals (Sweden)

Ge Li

2016-04-01

Full Text Available Tumor necrosis factor alpha (TNFα plays a key role in the pathogenesis of rheumatoid arthritis (RA. Blockade of TNFα by monoclonal antibody has been widely used for the therapy of RA since the 1990s; however, its mechanism of efficacy, and potential safety concerns of the treatment are still not fully understood. This study sought to establish a transgenic arthritic mouse model by overexpressing human TNFα (hTNFα and to apply this model as a means to evaluate therapeutic consequences of TNFα inhibitors. The transgenic mouse line (TgTC with FVB background was generated by incorporating 3′-modified hTNFα gene sequences. A progressively erosive polyarthritis developed in the TgTC mice, with many characteristics observed in human rheumatoid arthritis, including polyarticular swelling, impairment of movement, synovial hyperplasia, and cartilage and bone erosion. Gene expression analysis demonstrated that hTNFα is not only expressed in hyperplastic synovial membrane, but also in tissues without lesions, including brain, lung and kidney. Treatment of the TgTC mice with anti-hTNFα monoclonal antibodies (mAb significantly decreased the level of hTNFα in the diseased joint and effectively prevented development of arthritis in a dose-dependent response fashion. Our results indicated that the TgTC mice represent a genetic model which can be used to comprehensively investigate the pathogenesis and therapeutics of TNFα-related diseases.

Haemodynamics in acute arthritis of the knee in puppies

DEFF Research Database (Denmark)

Bünger, C; Hjermind, J; Harving, S

1984-01-01

not significantly changed. A decrease of femoral muscle blood flow was encountered. Intraosseous pressure recordings during venous tamponade of the knee-joint capsules suggested a qualitative change of bone vasculature in acute arthritis. The juxta-articular bone blood flow in arthritis appears to be influenced...

Senescent T-Cells Promote Bone Loss in Rheumatoid Arthritis

Directory of Open Access Journals (Sweden)

Johannes Fessler

2018-02-01

Full Text Available ObjectiveT-cells are critical players in the pathogenesis of osteoporosis in patients with rheumatoid arthritis (RA. Premature senescence of lymphocytes including the accumulation of senescent CD4+ T-cells is a hallmark feature of RA. Whether T-cell senescence is associated with bone loss in RA patients is elusive so far.MethodsThis includes a prospective study of consecutive patients with RA (n = 107, patients with primary osteopenia/-porosis (n = 75, and healthy individuals (n = 38. Bone mineral density (BMD was determined by dual-energy X-ray absorptiometry scan. Flow cytometry, magnetic-associated cell sorting, and cell culture experiments were performed to analyze the pro-osteoclastic phenotype and the function of senescent CD4+CD28− T-cells.ResultsPatients with osteopenia/-porosis yielded a higher prevalence of senescent CD4+CD28− T-cells than individuals with normal BMD, in the RA, as well as in the non-RA cohort. Receptor activator of nuclear factor kappa-B ligand (RANKL was expressed at higher levels on CD4+CD28− T-cells as compared to CD28+ T-cells. Stimulation with interleukin-15 led to an up-regulation of RANKL expression, particularly on CD28− T-cells. CD4+CD28− T-cells induced osteoclastogenesis more efficiently than CD28+ T-cells.ConclusionOur data indicate that senescent T-cells promote osteoclastogenesis more efficiently than conventional CD28+ T-cells, which might contribute to the pathogenesis of systemic bone loss in RA and primary osteoporosis.

A probable case of rheumatoid arthritis from the middle Anglo-Saxon period.

Science.gov (United States)

Mckinnon, Katie; Van Twest, Melanie S; Hatton, Martin

2013-06-01

We present here a case of erosive polyarthropathy in an incomplete skeleton from a middle-Saxon period (c. AD 650-900) cemetery site in Sedgeford, Norfolk, England. After a differential diagnosis that includes erosive osteoarthritis and psoriatic arthritis, we believe rheumatoid arthritis (RA) to be the most probable cause. This example may therefore add to the evidence for an early date for the appearance of RA in Europe. Copyright © 2013 Elsevier Inc. All rights reserved.

Smoking and polymorphisms of genes encoding mannose-binding lectin and surfactant protein-D in patients with rheumatoid arthritis

DEFF Research Database (Denmark)

Kristiansen, Malthe; Frisch, Morten; Madsen, Hans Ole

2014-01-01

genotype at codon 11, and HLA-shared epitope were determined in 456 patients with rheumatoid arthritis and 533 sex- and age-matched controls. Patients were grouped according to the presence of ACPA antibodies and RA-associated bone erosions and sub-stratified according to smoking status as never or ever...... smokers. Odds ratios with 95% confidence interval (OR, 95% CI) were calculated using multiple logistic regression analyses controlling for shared epitope. The low-producing SFTPD genotype was not associated with risk of RA or ACPA positive RA, but with erosive disease in the RA patients (OR = 1.8; 95% CI...... 1.1-3.0) particularly in RA ever smokers (OR = 2.4; 95% CI 1.3-4.3). The high-producing MBL2 genotype YA/YA was associated with ACPA positive RA (OR = 1.4; 95% CI 1.0-1.9) and erosive joint disease in RA ever smokers (OR = 1.8; 95% CI 1.1-3.0). Genetic disposition for low SP-D was not associated...

The OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging (MRI) Scoring System: Updated Recommendations by the OMERACT MRI in Arthritis Working Group.

Science.gov (United States)

Østergaard, Mikkel; Peterfy, Charles G; Bird, Paul; Gandjbakhch, Frédérique; Glinatsi, Daniel; Eshed, Iris; Haavardsholm, Espen A; Lillegraven, Siri; Bøyesen, Pernille; Ejbjerg, Bo; Foltz, Violaine; Emery, Paul; Genant, Harry K; Conaghan, Philip G

2017-11-01

The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Magnetic Resonance Imaging (MRI) scoring system (RAMRIS), evaluating bone erosion, bone marrow edema/osteitis, and synovitis, was introduced in 2002, and is now the standard method of objectively quantifying inflammation and damage by MRI in RA trials. The objective of this paper was to identify subsequent advances and based on them, to provide updated recommendations for the RAMRIS. MRI studies relevant for RAMRIS and technical and scientific advances were analyzed by the OMERACT MRI in Arthritis Working Group, which used these data to provide updated considerations on image acquisition, RAMRIS definitions, and scoring systems for the original and new RA pathologies. Further, a research agenda was outlined. Since 2002, longitudinal studies and clinical trials have documented RAMRIS variables to have face, construct, and criterion validity; high reliability and sensitivity to change; and the ability to discriminate between therapies. This has enabled RAMRIS to demonstrate inhibition of structural damage progression with fewer patients and shorter followup times than has been possible with conventional radiography. Technical improvements, including higher field strengths and improved pulse sequences, allow higher image resolution and contrast-to-noise ratio. These have facilitated development and validation of scoring methods of new pathologies: joint space narrowing and tenosynovitis. These have high reproducibility and moderate sensitivity to change, and can be added to RAMRIS. Combined scores of inflammation or joint damage may increase sensitivity to change and discriminative power. However, this requires further research. Updated 2016 RAMRIS recommendations and a research agenda were developed.

MRI findings of juvenile psoriatic arthritis

International Nuclear Information System (INIS)

Lee, Edward Y.; Kleinman, Paul K.; Sundel, Robert P.; Kim, Susan; Zurakowski, David

2008-01-01

The aim of this study was to describe the magnetic resonance imaging (MRI) features of juvenile psoriatic arthritis (JpsA) in children in order to facilitate early diagnosis and proper management. Two pediatric radiologists retrospectively reviewed in consensus a total of 37 abnormal MRI examinations from 31 pediatric patients (nine boys, 22 girls; age range 1-17 years; mean age 9.4 years) who had a definite diagnosis of JpsA and underwent MRI. Each MRI was evaluated for synovium abnormality (thickening and enhancement), joint effusion (small, moderate, and large), bone marrow abnormality (edema, enhancement, and location of abnormality), soft tissue abnormality (edema, enhancement, atrophy, and fatty infiltration), tendon abnormality (thickening, edema, tendon sheath fluid, and enhancement), and articular abnormality (joint space narrowing and erosion). The distribution of abnormal MRI findings among the six categories for the 37 MRI examinations was evaluated. The number of abnormal MRI findings for each MRI examination was assessed. Age at MRI examination and all six categories of abnormal MRI findings according to gender were evaluated. There were a total 96 abnormal MRI findings noted on 37 abnormal MRI examinations from 31 pediatric patients. The 37 abnormal MRI examinations included MRI of the hand (n=8), knee (n = 8), ankle (n = 5), pelvis (n = 5), temporomandibular joint (n = 4), wrist (n = 3), foot (n = 2), elbow (n = 1), and shoulder (n = 1). Twenty-eight diffuse synovial thickening and/or enhancement were the most common MRI abnormality (29.2%). Joint effusion comprised 22 abnormal MRI findings (22.9%). There were 16 abnormal MRI bone marrow edema and/or enhancement findings (16.7%), and in seven (7.3%) the edema involved non-articular sites. Soft tissue abnormality manifested as edema and/or enhancement constituted 14 abnormal MRI findings (14.5%). There were ten MRI abnormalities (10.4%) involving tendons. Articular abnormality seen as joint space

MRI findings of juvenile psoriatic arthritis

Energy Technology Data Exchange (ETDEWEB)

Lee, Edward Y.; Kleinman, Paul K. [Harvard Medical School, Department of Radiology, Boston, MA (United States); Children' s Hospital Boston, MA (United States); Sundel, Robert P.; Kim, Susan [Harvard Medical School, Rheumatology Program, Division of Immunology and the Department of Pediatrics, Boston, MA (United States); Children' s Hospital Boston, MA (United States); Zurakowski, David [Harvard Medical School, Department of Radiology, Boston, MA (United States); Harvard Medical School, Department of Orthopaedic Surgery, Boston, MA (United States); Children' s Hospital Boston, MA (United States)

2008-11-15

The aim of this study was to describe the magnetic resonance imaging (MRI) features of juvenile psoriatic arthritis (JpsA) in children in order to facilitate early diagnosis and proper management. Two pediatric radiologists retrospectively reviewed in consensus a total of 37 abnormal MRI examinations from 31 pediatric patients (nine boys, 22 girls; age range 1-17 years; mean age 9.4 years) who had a definite diagnosis of JpsA and underwent MRI. Each MRI was evaluated for synovium abnormality (thickening and enhancement), joint effusion (small, moderate, and large), bone marrow abnormality (edema, enhancement, and location of abnormality), soft tissue abnormality (edema, enhancement, atrophy, and fatty infiltration), tendon abnormality (thickening, edema, tendon sheath fluid, and enhancement), and articular abnormality (joint space narrowing and erosion). The distribution of abnormal MRI findings among the six categories for the 37 MRI examinations was evaluated. The number of abnormal MRI findings for each MRI examination was assessed. Age at MRI examination and all six categories of abnormal MRI findings according to gender were evaluated. There were a total 96 abnormal MRI findings noted on 37 abnormal MRI examinations from 31 pediatric patients. The 37 abnormal MRI examinations included MRI of the hand (n=8), knee (n = 8), ankle (n = 5), pelvis (n = 5), temporomandibular joint (n = 4), wrist (n = 3), foot (n = 2), elbow (n = 1), and shoulder (n = 1). Twenty-eight diffuse synovial thickening and/or enhancement were the most common MRI abnormality (29.2%). Joint effusion comprised 22 abnormal MRI findings (22.9%). There were 16 abnormal MRI bone marrow edema and/or enhancement findings (16.7%), and in seven (7.3%) the edema involved non-articular sites. Soft tissue abnormality manifested as edema and/or enhancement constituted 14 abnormal MRI findings (14.5%). There were ten MRI abnormalities (10.4%) involving tendons. Articular abnormality seen as joint space

The Impact of Conventional and Biological Disease Modifying Antirheumatic Drugs on Bone Biology. Rheumatoid Arthritis as a Case Study.

Science.gov (United States)

Barreira, Sofia Carvalho; Fonseca, João Eurico

2016-08-01

The bone and the immune system have a very tight interaction. Systemic immune-mediated inflammatory diseases, such as rheumatoid arthritis (RA), induce bone loss, leading to a twofold increase in osteoporosis and an increase of fragility fracture risk of 1.35-2.13 times. This review focuses on the effects of conventional and biological disease modifying antirheumatic drugs (DMARDs) on bone biology, in the context of systemic inflammation, with a focus on RA. Published evidence supports a decrease in osteoclastic activity induced by DMARDs, which leads to positive effects on bone mineral density (BMD). It is unknown if this effect could be translated into fracture risk reduction. The combination with antiosteoclastic drugs can have an additional benefit.

Etanercept Promotes Bone Formation via Suppression of Dickkopf-1 Expression in Rats with Collagen-Induced Arthritis

Science.gov (United States)

Tanida, Atsushi; Kishimoto, Yuji; Okano, Toru; Hagino, Hiroshi

2013-01-01

Background Various clinical reports suggest etanercept (ETN) has some efficacy in bone formation in rheumatoid arthritis (RA). To examine this effect, we investigated the gene expression of cytokines relevant to osteoblast/osteoclast differentiation, and evaluated histomorphometric findings in mature rats with collagen-induced arthritis (CIA). Methods Total RNA was extracted from knee joints with CIA after ETN or placebo administration. Subsequently, realtime-PCR was carried out to quantify the mRNAs encoding Wnt-1, Dickkopf-1 (DKK-1), receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegelin (OPG) and TNF (tumor necrosis factor)-alpha. In histomorphometric analysis, the infiltrating pannus volume and pannus surface, and the following items in contact with pannus surface were measured: osteoclast number, osteoid surface, osteoid volume and labeling surface. These were evaluated in the distal femur with CIA with or without ETN administration. Results TNF-alpha, RANKL and OPG mRNA expressions, linked to osteoclastogenesis, were not significantly different with or without ETN administration. ETN administration significantly increased Wnt-1 mRNA expression, the osteoblast promoter, and decreased DKK-1 mRNA expression, the Wnt signal inhibitor. In histomorphometric analysis, pannus volume, pannus surface and osteoclast number, parameters of bone destruction, were not significantly different among groups. Osteoid volume, osteoid surface and labeling surface, parameters of bone formation, increased significantly with ETN administration. Conclusion Our results suggest that ETN suppresses DDK-1 expression, and, as a result, Wnt expression is promoted and osteoblastogenesis becomes more active, independent of the regulation of osteoclast activity. Marked bone formation is attributed to the fact that ETN directly promotes osteoblastogenesis, not as a result of suppressing osteoclastogenesis. PMID:24031147

Contrast-enhanced MRI compared with the physical examination in the evaluation of disease activity in juvenile idiopathic arthritis

International Nuclear Information System (INIS)

Hemke, Robert; Maas, Mario; Veenendaal, Mira van; Kuijpers, Taco W.; Dolman, Koert M.; Rossum, Marion A.J. van; Berg, J.M. van den

2014-01-01

To assess the value of magnetic resonance imaging (MRI) in discriminating between active and inactive juvenile idiopathic arthritis (JIA) patients and to compare physical examination outcomes with MRI outcomes in the assessment of disease status in JIA patients. Consecutive JIA patients with knee involvement were prospectively studied using an open-bore MRI. Imaging findings from 146 JIA patients were analysed (59.6 % female; mean age, 12.9 years). Patients were classified as clinically active or inactive. MRI features were evaluated using the JAMRIS system, comprising validated scores for synovial hypertrophy, bone marrow oedema, cartilage lesions and bone erosions. Inter-reader reliability was good for all MRI features (intra-class correlation coefficient [ICC] = 0.87-0.94). No differences were found between the two groups regarding MRI scores of bone marrow oedema, cartilage lesions or bone erosions. Synovial hypertrophy scores differed significantly between groups (P = 0.016). Nonetheless, synovial hypertrophy was also present in 14 JIA patients (35.9 %) with clinically inactive disease. Of JIA patients considered clinically active, 48.6 % showed no signs of MRI-based synovitis. MRI can discriminate between clinically active and inactive JIA patients. However, physical examination is neither very sensitive nor specific in evaluating JIA disease activity compared with MRI. Subclinical synovitis was present in >35 % of presumed clinically inactive patients. (orig.)

MR imaging of the early rheumatoid arthritis: usefulness of contrast enhanced fat suppressed SPGR imaging

Energy Technology Data Exchange (ETDEWEB)

Kim, Sun Mi; Joo, Kyung Bin; Kim, Seong Tae; Hahm, Chang Kok [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

1995-06-15

To evaluate value of post-contrast 3-Dimensional fat suppressed Spoiled GRASS (FS SPGR) in detecting subtle bony erosion and tenosynovitis of hands and wrists due to early rheumatoid arthritis. Fourteen MR imagings of the hands and wrists were performed in 7 early rheumatoid arthritis without any abnormalities in plain radiography and in 7 healthy volunteers. All subjects underwent MR sequence of coronal 3D FS SPGR with and without contrast enhancement in 1.5T MR unit. We evaluated the number of the bony erosion and tenosynovitis respectively in pre-and post-contrast FS SPGR images. The abnormal enhancing areas were not demonstrated in 7 healthy volunteers. Seven patients had 25 bony erosions in pre-contrast FS SPGR and 52 bony erosions with tenosynovitis (n = 10) in post-contrast FS SPGR. Enhancing joint spaces were shown in 8 cases. Post-contrast FS SPGR was better than pre-contrast FS SPGR in the evaluation of early rheumatoid arthritis and is valuable as a baseline study.

MR imaging of the early rheumatoid arthritis: usefulness of contrast enhanced fat suppressed SPGR imaging

International Nuclear Information System (INIS)

Kim, Sun Mi; Joo, Kyung Bin; Kim, Seong Tae; Hahm, Chang Kok

1995-01-01

To evaluate value of post-contrast 3-Dimensional fat suppressed Spoiled GRASS (FS SPGR) in detecting subtle bony erosion and tenosynovitis of hands and wrists due to early rheumatoid arthritis. Fourteen MR imagings of the hands and wrists were performed in 7 early rheumatoid arthritis without any abnormalities in plain radiography and in 7 healthy volunteers. All subjects underwent MR sequence of coronal 3D FS SPGR with and without contrast enhancement in 1.5T MR unit. We evaluated the number of the bony erosion and tenosynovitis respectively in pre-and post-contrast FS SPGR images. The abnormal enhancing areas were not demonstrated in 7 healthy volunteers. Seven patients had 25 bony erosions in pre-contrast FS SPGR and 52 bony erosions with tenosynovitis (n = 10) in post-contrast FS SPGR. Enhancing joint spaces were shown in 8 cases. Post-contrast FS SPGR was better than pre-contrast FS SPGR in the evaluation of early rheumatoid arthritis and is valuable as a baseline study

Hearing status in patients with rheumatoid arthritis.

Science.gov (United States)

Ahmadzadeh, A; Daraei, M; Jalessi, M; Peyvandi, A A; Amini, E; Ranjbar, L A; Daneshi, A

2017-10-01

Rheumatoid arthritis is thought to induce conductive hearing loss and/or sensorineural hearing loss. This study evaluated the function of the middle ear and cochlea, and the related factors. Pure tone audiometry, speech reception thresholds, speech discrimination scores, tympanometry, acoustic reflexes, and distortion product otoacoustic emissions were assessed in rheumatoid arthritis patients and healthy volunteers. Pure tone audiometry results revealed a higher bone conduction threshold in the rheumatoid arthritis group, but there was no significant difference when evaluated according to the sensorineural hearing loss definition. Distortion product otoacoustic emissions related prevalence of conductive or mixed hearing loss, tympanometry values, acoustic reflexes, and speech discrimination scores were not significantly different between the two groups. Sensorineural hearing loss was significantly more prevalent in patients who used azathioprine, cyclosporine and etanercept. Higher bone conduction thresholds in some frequencies were detected in rheumatoid arthritis patients that were not clinically significant. Sensorineural hearing loss is significantly more prevalent in refractory rheumatoid arthritis patients.

Inhibition of bone resorption by Tanshinone VI isolated from Salvia miltiorrhiza Bunge

Directory of Open Access Journals (Sweden)

V. Nicolin

2010-05-01

Full Text Available During the last decade, a more detailed knowledge of molecular mechanisms involved in osteoclastogenesis has driven research efforts in the development and screening of compound libraries of several small molecules that specifically inhibit the pathway involved in the commitment of the osteoclast precursor cells. Natural compounds that suppress osteoclast differentiation may have therapeutic value in treating osteoporosis and other bone erosive diseases such as rheumatoid arthritis or metastasis associated with bone loss. In ongoing investigation into anti-osteoporotic compounds from natural products we have analyzed the effect of Tanshinone VI on osteoclasts differentiation, using a physiologic three-dimensional osteoblast/bone marrow model of cell co-culture. Tanshinone VI is an abietane diterpene extracted from the root of Salvia miltiorrhiza Bunge (Labiatae, a Chinese traditional crude drug, ‘’Tan-Shen’’. Tashinone has been widely used in clinical practice for the prevention of cardiac diseases, arthritis and other inflammation-related disorders based on its pharmacological actions in multiple tissues. Although Tanshinone VI A has been used as a medicinal agent in the treatment of many diseases, its role in osteoclast-related bone diseases remains unknown. We showed previously that Tanshinone VI greatly inhibits osteoclast differentiation and suppresses bone resorption through disruption of the actin ring; subsequently, we intended to examine the precise inhibitory mechanism of Tanshinone VI on osteoclast differentiating factor. This study shows, for the first time, that Tanshinone VI prevents osteoclast differentiation by inhibiting RANKL expression and NFkB induction.

99mTc-DPD uptake in juvenile arthritis

International Nuclear Information System (INIS)

Stender Hansen, E.; Holm, I.E.; Buenger, C.; Knudsen, V.; Noer, I.; Bach Christensen, S.

1986-01-01

Unilateral arthritis of the knee was induced in mongrel puppies by intraarticular injections of 1% Carragheenan. Bone metabolism was studied by a scintimetric technique on static 99m Tc-diphosphonate bone scans every 2nd week during the induction of arthritis for 3 months and monthly in a postarthritic phase of another 3 months. Changes in uptake of radionuclide were present after 2 weeks. The induction phase was characterized by a decreased uptake in the calcification layer of the juxta-articular growth plates and a moderately increased epiphyseal uptake. The postarthritic phase was characterized by normalization of growth plate uptake and a marked increase in epiphyseal uptake. Using contact autoradiography, the epiphyseal uptake was seen mainly in a narrow subchondral and subsynovial bone layer, around bone cysts and osteophytes, whereas central epiphyseal bone was osteopenic with decreased uptake of tracer. The study suggests that the early scintigraphic appearance of juvenile non-suppurative arthritis may be an overall decrease in uptake of 99m Tc-diphosphonate due to a depression of growth plate metabolism. (author)

Sarcopenia in rheumatoid arthritis: prevalence, influence of disease activity and associated factors.

Science.gov (United States)

Ngeuleu, Ange; Allali, F; Medrare, L; Madhi, A; Rkain, H; Hajjaj-Hassouni, N

2017-06-01

Evaluate the prevalence of sarcopenia on patients with rheumatoid arthritis (RA), the influence of sarcopenia on disease activity and factors associated with sarcopenia. One hundred and twenty-three patients aged over 18 years with RA based on the 1987 ACR/EULAR classification criteria were enrolled. We performed a whole body DXA scan using a dual-energy X-ray absorptiometry (DXA) scanner lunar prodigy to measure fat mass, lean mass, and bone mass in the whole body and body parts. According to the anthropometric equation by Baumgartner et al., sarcopenia was defined as Relative skeletal mass index (RSMI) sarcopenia with the r of Pearson and Spearman. Factors associated and related to sarcopenia were assessed using multiple regression analysis and t independent test. We included 123 patients (107 women). 49 subjects (39.8%) where suffering from sarcopenia, of which 40 women. Most of the sarcopenic patients were between 41 and 50 years old. Sarcopenia on female subjects was not related to parameters of disease activity evaluated by DAS 28, CDAI and SDAI. Most of the sarcopenic patients had normal BMI and abnormal waist circumference. In simple regression analysis sarcopenia was related to BMI, DAS 28 ESR, bone erosion, waist circumference and HAQ. In multiple regression analysis, sarcopenia was positively related to an increase cardiometabolic risk [p = 0.025, OR 0.176, CI (0.038-0.980)], normal BMI [p = 0.004, OR 12.3, CI (2.27-67.6)], over fat BMI [p = 0.004, OR 12.3, CI (2.27-67.6)] and bone erosion [p = 0.012, OR 0.057 CI (0.006-0.532)]. No statistical difference was found according to disease duration and steroids use between sarcopenic and non sarcopenic patients. Sarcopenia is prevalent and related to age, bone erosion, normal/over fat BMI and high cardiometabolic risk according to waist circumference but not with disease activity.

What People with Rheumatoid Arthritis Need to Know about Osteoporosis

Science.gov (United States)

... Need to Know About Osteoporosis What Is Rheumatoid Arthritis? Rheumatoid arthritis is an autoimmune disease, a disorder in ... new habits for healthy bones. The Link Between Rheumatoid Arthritis and Osteoporosis Studies have found an increased risk ...

The OMERACT MRI in Arthritis Working Group - Update on Status and Future Research Priorities.

Science.gov (United States)

Østergaard, Mikkel; Bird, Paul; Gandjbakhch, Frédérique; Eshed, Iris; Haugen, Ida K; Haavardsholm, Espen A; Lillegraven, Siri; Foltz, Violaine; Glinatsi, Daniel; Peterfy, Charles; Ejbjerg, Bo; Bøyesen, Pernille; Mease, Philip J; Hermann, Kay-Geert; Emery, Paul; Genant, Harry K; Conaghan, Philip G

2015-12-01

To provide an update on the status and future research priorities of the Outcome Measures in Rheumatology (OMERACT) magnetic resonance imaging (MRI) in arthritis working group. A summary is provided of the activities of the group within rheumatoid arthritis (RA), psoriatic arthritis (PsA), and osteoarthritis (OA), and its research priorities. The OMERACT RA MRI score (RAMRIS) evaluating bone erosion, bone edema (osteitis), and synovitis is now the standard method of quantifying articular pathology in RA trials. Cartilage loss is another important part of joint damage, and at the OMERACT 12 conference, we provided longitudinal data demonstrating reliability and sensitivity to change of the RAMRIS JSN component score, supporting its use in future clinical trials. The MRI group has previously developed a PsA MRI score (PsAMRIS). At OMERACT 12, PsAMRIS was evaluated in a randomized placebo-controlled trial of patients with PsA, demonstrating the responsiveness and discriminatory ability of applying the PsAMRIS to hands and feet. A hand OA MRI score (HOAMRIS) was introduced at OMERACT 11, and has subsequently been further validated. At OMERACT 12, good cross-sectional interreader reliability, but variable reliability of change scores, were reported. Potential future research areas were identified at the MRI session at OMERACT 12 including assessment of tenosynovitis in RA and enthesitis in PsA and focusing on alternative MRI techniques. MRI has been further developed and validated as an outcome measure in RA, PsA, and OA. The group will continue its efforts to optimize the value of MRI as a robust biomarker in rheumatology clinical trials.

Thumb Arthritis

Science.gov (United States)

... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Thumb Arthritis Email to a friend * required fields ...

Bile salt-stimulated lipase plays an unexpected role in arthritis development in rodents.

Directory of Open Access Journals (Sweden)

Susanne Lindquist

Full Text Available OBJECTIVE: The present study aimed to explore the hypothesis that bile salt-stimulated lipase (BSSL, in addition to being a key enzyme in dietary fat digestion during early infancy, plays an important role in inflammation, notably arthritis. METHODS: Collagen-induced arthritis (CIA and pristane-induced arthritis (PIA in rodents are commonly used experimental models that reproduce many of the pathogenic mechanisms of human rheumatoid arthritis, i.e. increased cellular infiltration, synovial hyperplasia, pannus formation, and erosion of cartilage and bone in the distal joints. We used the CIA model to compare the response in BSSL wild type (BSSL-WT mice with BSSL-deficient 'knock-out' (BSSL-KO and BSSL-heterozygous (BSSL-HET littermates. We also investigated if intraperitoneal injection of BSSL-neutralizing antibodies affected the development or severity of CIA and PIA in mice and rats, respectively. RESULTS: In two consecutive studies, we found that BSSL-KO male mice, in contrast to BSSL-WT littermates, were significantly protected from developing arthritis. We also found that BSSL-HET mice were less prone to develop disease compared to BSSL-WT mice, but not as resistant as BSSL-KO mice, suggesting a gene-dose effect. Moreover, we found that BSSL-neutralizing antibody injection reduced both the incidence and severity of CIA and PIA in rodents. CONCLUSION: Our data strongly support BSSL as a key player in the inflammatory process, at least in rodents. It also suggests the possibility that BSSL-neutralizing agents could serve as a therapeutic model to reduce the inflammatory response in humans.

First diagnosis of septic arthritis in a dinosaur.

Science.gov (United States)

Anné, Jennifer; Hedrick, Brandon P; Schein, Jason P

2016-08-01

Identification and interpretation of pathologies in the fossil record allows for unique insights into the life histories of extinct organisms. However, the rarity of such finds limits not only the sample size for palaeopathologic studies, but also the types of analyses that may be performed. In this study, we present the first occurrence of a palaeopathology in a vertebrate from the Mesozoic of the East Coast of North America (Appalachia), a pathologic ulna and radius of an indeterminate hadrosaur from the Navesink Formation (New Jersey). X-ray microtomography allowed for both detailed and more accurate diagnosis of the pathologic condition as well as virtual conservation of the specimen. Based on extant archosaurian comparisons, the hadrosaur was diagnosed with severe septic arthritis affecting the proximal ulna and radius. Diagnosis was based on erosion of the joint and highly reactive periosteal bone growth and fusion of the elements. To the best of our knowledge, this is the first recorded account of septic arthritis in dinosaurs. The severity of the pathology suggests the animal suffered with this condition for some time before death. Unfortunately, only the ulna and radius were found. Thus, the extent to which the condition spread to other parts of the body is unknown.

First diagnosis of septic arthritis in a dinosaur

Science.gov (United States)

Anné, Jennifer; Hedrick, Brandon P.; Schein, Jason P.

2016-08-01

Identification and interpretation of pathologies in the fossil record allows for unique insights into the life histories of extinct organisms. However, the rarity of such finds limits not only the sample size for palaeopathologic studies, but also the types of analyses that may be performed. In this study, we present the first occurrence of a palaeopathology in a vertebrate from the Mesozoic of the East Coast of North America (Appalachia), a pathologic ulna and radius of an indeterminate hadrosaur from the Navesink Formation (New Jersey). X-ray microtomography allowed for both detailed and more accurate diagnosis of the pathologic condition as well as virtual conservation of the specimen. Based on extant archosaurian comparisons, the hadrosaur was diagnosed with severe septic arthritis affecting the proximal ulna and radius. Diagnosis was based on erosion of the joint and highly reactive periosteal bone growth and fusion of the elements. To the best of our knowledge, this is the first recorded account of septic arthritis in dinosaurs. The severity of the pathology suggests the animal suffered with this condition for some time before death. Unfortunately, only the ulna and radius were found. Thus, the extent to which the condition spread to other parts of the body is unknown.

Bone scan in diagnosis of infectious osteoarthritis

International Nuclear Information System (INIS)

Marandian, M.H.; Mortazavi, H.; Behvad, A.; Haghigat, H.; Lessani, M.; Youssefian, B.

1979-01-01

Bone scan with Technetium 99m is harmless method of evaluation of skeletal lesions. It is safe in pediatrics age group and it can be used in early diagnosis of infectious osteoarthritis. Bone scan differentiate osteomyelitis from cellulitis, and also it may help in diagnosis of subclinical involvement of rheumatoid arthritis, benign and malignant bone tumors, stress fractures and periostitis. We report results of bone scan in 30 pediatrics patients as follow: osteomyelitis 9 cases, cellulitis 4 cases, infectious arthritis 7 cases, tuberculous osteoarthritis 2 cases, rheumatoid arthritis 2 cases, and other different diseases 9 cases [fr

Arthritis in the buff

International Nuclear Information System (INIS)

Rothschild, B.; Williams, E.M.; Poteat, G.B.; Woods, R.

1987-01-01

Understanding the significance of radiologic perturbations in articular diseases is facilitated by correlation with its representation in intact macerated skeletons (from the collections of the Cleveland Museum of Natural History). Classic skeletal involvement is illustrated grossly and radiographically for the following conditions: rheumatoid arthritis calcium pyrophosphate deposition disease, osteoarthritis, ankylosing spondylitis, reactive (Reiter syndrome, psoriatic arthritis) diffuse idiopathic skeletal hyperostosis, and infectious arthritis. Distribution and lesion character is reviewed. Visualization of the gross bone lesion ''in the buff'' provides clear explanation of its radiologic appearance and facilitates the transition from x-ray image to the pathophysiology proposed in the interpretation

Three-dimensional microarchitecture of the proximal femur in osteoarthritis and rheumatoid arthritis

DEFF Research Database (Denmark)

Wang, B. L.; Ding, Ming; Overgaard, Søren

2015-01-01

microstructure has an important impact on bone quality. Recently, the quantification of bone architecture based on micro-CT has been widely used in the research of various bone diseases. OBJECTIVE: To observe the osteoarthritis- and rheumatoid arthritis-related changes in the properties of the proximal femur...... based on micro-CT, thus to compare the bone microstructure in osteoarthritis and rheumatoid arthritis patients. METHODS: Femoral heads were collected from primary osteoarthritis (n=10) and rheumatoid arthritis (n=7) patients undergoing total hip replacement. A 10-mm segment of the femoral neck was cut...... from each individual femur, perpendicular to the main trabecular direction on X-ray films. The specimens were analyzed by using micro-CT system. After scanning, the data were transferred to three-dimensional images, and then detailed structural parameters of the cortical bone, cancellous bone...

Advanced imaging in rheumatoid arthritis. Part 1: Synovitis

International Nuclear Information System (INIS)

Farrant, J.M.; O'Connor, P.J.; Grainger, A.J.

2007-01-01

Rheumatoid arthritis (RA) is a chronic and progressive inflammatory disorder primarily affecting the synovium. We now recognise that conventional radiographic images show changes of rheumatoid arthritis long after irreversible joint damage has occured. With the advent of powerful disease-modifying drugs, there is a need for early demonstration of rheumatoid arthritis and a need to monitor progress of the disease and response to therapy. Advanced imaging techniques such as ultrasound and MRI have focussed on the demonstration and quantification of synovitis and erosions and allow early diagnosis of RA. The technology to quantify synovitis and erosions is developing rapidly and now allows change in disease activity to be assessed. However, problems undoubtedly exist in quantification techniques, and this review serves to highlight them. Much of the literature on advanced imaging in RA appears in rheumatological journals and may not be familiar to radiologists. This review article aims to increase the awareness of radiologists about this field and to encourage them to participate and contribute to the ongoing development of these modalities. Without this collaboration, it is unlikely that these modalities will reach their full potential in the field of rheumatological imaging. This review is in two parts. The first part addresses synovitis imaging. The second part will look at advanced imaging of erosions in RA. (orig.)

Value of bone scintigraphy in psoriasis

International Nuclear Information System (INIS)

Nakayama, Chikashi; Nakata, Hajime; Kimoto, Tatsuya; Nakayama, Takashi; Yokomizo, Yu

1982-01-01

We performed bone scintigraphy on 16 cases of psoriasis to evaluate its possible value in this disease and obtained the following results: 1) Bone scintigraph was abnormal in 15 of 16 cases and the frequent association of arthritis in psoriasis was confirmed. 2) Abnormal uptake on bone scintigraph was noted in various joints including peripheral joints of extremities, sternoclavicular joint, shoulder and rib. Abnormality of sacroiliac joint or ankle was less frequent than previously reported. 3) Findings of bone scintigraph were not necessarily related with clinical symptoms or laboratory data. Abnormal uptake was also noted in many joints whose X-ray examinations were negative. Bone scintigraphy thus seems to be useful in early detection of arthritis and to become an initial therapeutic indicator of arthritis in psoriasis. (author)

Radiological imaging in early diagnosis of rheumatoid arthritis. The role of ultrasound and magnetic resonance imaging; Radiologische Fruehdiagnostik der rheumatoiden Arthritis. Stellenwert von Ultraschall und Magnetresonanztomographie

Energy Technology Data Exchange (ETDEWEB)

Platzgummer, H.; Schueller-Weidekamm, C. [AKH, Medizinische Universitaet Wien, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

2012-02-15

For optimal therapy management of patients with rheumatoid arthritis (RA) specific and sensitive diagnostic methods are essential for assessment of disease activity. In addition to projection radiography, imaging techniques, in particular magnetic resonance imaging (MRI) and ultrasound (US) are becoming increasingly more important for the early diagnosis of RA. The MRI and US techniques play a key role in the early imaging diagnostics of RA. Measurement of inflammation activity represents the basis of therapeutic decision-making and can be quantitatively and qualitatively determined with MRI and US. Synovitis and bone marrow edema are predictors of erosion. (orig.) [German] Fuer das optimale Therapiemanagement bei Patienten mit rheumatoider Arthritis (RA) sind spezifische und sensible diagnostische Methoden zur Beurteilung der Krankheitsaktivitaet unerlaesslich. Neben der Projektionsradiographie gewinnen die bildgebenden Methoden zur Fruehdiagnostik der RA, insbesondere die Magnetresonanztomographie (MRT) und der Ultraschall (US), zunehmend an Bedeutung. MRT und US spielen eine Schluesselrolle in der bildgebenden Fruehdiagnostik der RA. Die Messung der Entzuendungsaktivitaet stellt die Basis fuer die Therapieentscheidung dar. Sie kann mit dem US und der MRT quantitativ und semiquantitativ bestimmt werden. Synovialitis und Knochenmarkoedem sind Praediktoren fuer Erosionen. (orig.)

Patterns of radiographic changes in hands and feet of rheumatoid arthritis in Saudi Arabia

International Nuclear Information System (INIS)

Al-Arfaj, Abdurhman S.; Al-Boukai, Ahmad A.

2005-01-01

The aim of the study was to characterize the pattern of radiographic changes in the hands and feet of rheumatoid arthritis in Saudi patients. The radiographs of hands and feet of rheumatoid arthritis patients attending rheumatology outpatient clinics of King Khalid University Hospital in Riyadh, Kingdom of Saudi Arabia, over the period extending from March to June 2001, were examined and reported for the presence of osteopenia, joint space narrowing, and erosions. Fifty-six rheumatoid arthritis patients were studied. Their mean age was 50 + 1.9 years, and mean disease duration was 9.07 + 0.84 years. Generalized osteopenia was seen in 16/56 (29%) and periarticular osteopenia in 38/56 (68%). Joint space narrowing was present in 9/56 (16%) of feet and 35/56 (63%) of hand x-rays. Erosions were seen in 3/56 (6%) of feet and in 22/56 (39%) of hand x-rays. Significant correlation was seen between joints space narrowing, joint erosions, and disease duration. Radiographic changes in hands and feet of Saudi rheumatoid arthritis patients are less severe than those reported from the West, and the pattern is also different with less affection of the feet. (author)

Correlation of serum Dickkopf-1 content with bone destruction, inflammatory response and oxidation reaction in patients with gouty arthritis

Directory of Open Access Journals (Sweden)

Yu-Mei He

2017-09-01

Full Text Available Objective: To study the correlation of serum Dickkopf-1 (DKK-1 content with bone destruction, inflammatory response and oxidation reaction in patients with gouty arthritis. Methods: A total of 40 patients with acute gouty arthritis who were treated in our hospital between 2013 and 2016 were selected as the group A of the study, 56 patients with asymptomatic hyperuricemia who were treated in our hospital during the same period were selected as the group B of the study, and 60 healthy volunteers who received physical examination in our hospital during the same period were selected as the control group of the study. The serum was collected to detect the contents of DKK-1, bone destruction indexes, inflammatory response indexes and oxidation reaction indexes. Results: Serum DKK-1, TRACP5b, RANKL, β-CTX, PGE2, sICAM-1, sVCAM-1, sCD14, MDA, 8-OHdG and 3-NT levels of group A and group B were significantly higher than those of control group while SOD and GSH-Px levels were significantly lower than those of control group; serum DKK-1, TRACP5b, RANKL, β-CTX, PGE2, sICAM-1, sVCAM-1, sCD14, MDA, 8-OHdG and 3-NT levels of group A were significantly higher than those of group B while SOD and GSH-Px levels were significantly lower than those of group B; serum DKK-1 level was positively correlated with TRACP5b, RANKL, β-CTX, PGE2, sICAM-1, sVCAM-1, sCD14, MDA, 8-OHdG and 3-NT levels, and negatively correlated with SOD and GSH-Px levels. Conclusion: Abnormally elevated DKK-1 in patients with gouty arthritis can induce articular bone destruction as well as inflammatory response and oxidative stress response activation.

The effect of X-rays on the experimental arthritis in rats

International Nuclear Information System (INIS)

Trott, K.R.; Parker, R.; Seed, M.P.

1995-01-01

We investigated the therapeutic efficacy of low doses of X-rays on different in-vivo models of monoarticular arthritis which have been developed for the investigation of anti-inflammatory drugs. Zymosan or heat-inactivated mycobacterium tuberculosis was injected into 1 knee joint of Wistar rats to produce, via different pathogenetic mechanisms, an acute monoarticular arthritis. Five days later, the amount of joint swelling, bone destruction and cartilage catabolism were measured. Immediately after arthritis induction, the knees were irradiated with a single dose of 5 Gy or with 4 daily fractions of 1 Gy. X-irradiation with daily doses of 1 Gy significantly reduced bone loss and cartilage degradation in Zymosan-induced arthritis and joint swelling in mycobacterium tuberculosis induced arthritis. However, a single high radiation dose significantly increased bone loss in mycobacterium tuberculosis induced arthritis. These data confirm the hypothesis of an anti-inflammatory effect of low radiation doses which so far has been based only on clinical experience. By using an established model of monoarticular arthritis we have now the opportunity to study the mechanism of the anti-inflammatory radiation effect in comparison to that of anti-inflammatory drugs. This way, we hope to provide a scientific basis for the use of radiotherapy in various painful degenerative joint disorders. (orig.) [de

Optimal use of MRI in clinical trials, clinical care and clinical registries of patients with rheumatoid arthritis

DEFF Research Database (Denmark)

Østergaard, Mikkel; Møller-Bisgaard, Signe

2014-01-01

the benefits of including MRI in treat-to-target strategies. The benefits of incorporating MRI into clinical registries are not yet known, but may include improved knowledge about the real-life advantages of MRI, as well as opportunities to develop better clinical and laboratory composite measures to monitor......Magnetic resonance imaging (MRI) clearly is more sensitive than clinical examination and conventional radiography (x-ray) for detection of inflammation (synovitis, bone marrow oedema (osteitis) and tenosynovitis) and damage (bone erosion and cartilage loss/joint space narrowing) in patients...... with rheumatoid arthritis (RA). The question is when and how MRI should be used. The present article reviews our knowledge about, and provides suggestions for, the use of MRI in clinical trials, clinical care and clinical registries. In clinical trials, the OMERACT RA MRI scoring system (RAMRIS) is a thoroughly...

Role of bone scan in rheumatic disease

International Nuclear Information System (INIS)

Choi, Yun Young

2003-01-01

Rheumatic diseases can be categorized by pathology into several specific types of musculoskeletal problems, including synovitis (e.g. rheumatoid arthritis), enthesopathy (e.g. ankylosing spondylitis) and cartilage degeneration (e.g. osteoarthritis). Skeletal radiographs have contributed to the diagnosis of these articular diseases, and some disease entities need typical radiographic changes as a factor of the diagnostic criteria. However, they sometimes show normal radiographic findings in the early stage of disease, when there is demineralization of less than 30-50%. Bone scans have also been used in arthritis, but not widely because the findings are nonspecific and it is thought that bone scans do not add significant information to routine radiography. Bone scans do however play a different role than simple radiography, and it is a complementary imaging method in the course of management of arthritis. The image quality of bone scans can be improved by obtaining regional views and images under al pin-hole collimator, and through a variety of scintigraphic techniques including the three phase bone scan and bone SPECT. Therefore, bone scans could improve the diagnostic value, and answer multiple clinical questions, based on the pathophysiology of various forms of arthritis

Comparing the effects of tofacitinib, methotrexate and the combination, on bone marrow oedema, synovitis and bone erosion in methotrexate-naive, early active rheumatoid arthritis: results of an exploratory randomised MRI study incorporating semiquantitative and quantitative techniques

DEFF Research Database (Denmark)

Conaghan, Philip G.; Ostergaard, Mikkel; Bowes, Michael A.

2016-01-01

OBJECTIVES: To explore the effects of tofacitinib-an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA)-with or without methotrexate (MTX), on MRI endpoints in MTX-naive adult patients with early active RA and synovitis in an index wrist or hand. METHODS: In this exploratory......, phase 2, randomised, double-blind, parallel-group study, patients received tofacitinib 10 mg twice daily + MTX, tofacitinib 10 mg twice daily + placebo (tofacitinib monotherapy), or MTX + placebo (MTX monotherapy), for 1 year. MRI endpoints (Outcome Measures in Rheumatology Clinical Trials RA MRI score...... differences in RAMRIS bone marrow oedema (BME) at month 6 were -1.55 (90% CI -2.52 to -0.58) for tofacitinib + MTX and -1.74 (-2.72 to -0.76) for tofacitinib monotherapy (both ptofacitinib + MTX...

Comparison of three radiographic methods in screening of temporomandibular joint involvement in patients with psoriatic arthritis

International Nuclear Information System (INIS)

Koenoenen, M.; Kilpinen, E.

1990-01-01

Fifty-three randomly selected subjects with psoriatic arthritis (PA) were examined radiographically by means of orthopantomography, transcranial radiography, and transmaxillary radiography. Two examiners graded the radiographic signs of flattening, osteophytes, erosion, and sclerosis. The findings obtained were then compared to determine the best technique for screening of temporomandibular joint (TMJ) bone changes. Together the techniques showed definite (24%) and possible (6%) changes, suggesting TMJ involvement in 31 of 106 joints. In all projections, radiographic signs suggesting TMJ involvement were most frequent in the condyle. Erosion in the condyle was the most frequent finding. Agreement with regard to definite changes in the condyle was found in only one-third to half of the cases. It is concluded that in radiography of the TMJ in subjects with PA, a combination of radiographic techniques should be used to obtain maximum information. However, orthopantomography is well suited for screening of TMJ involvement in subjects with PA. 30 refs., 2 figs., 3 tabs

Ultrasonography, magnetic resonance imaging, radiography, and clinical assessment of inflammatory and destructive changes in fingers and toes of patients with psoriatic arthritis

DEFF Research Database (Denmark)

Wiell, Charlotte; Szkudlarek, Marcin; Hasselquist, Maria

2007-01-01

The aim of the present study was to assess ultrasonography (US) for the detection of inflammatory and destructive changes in finger and toe joints, tendons, and entheses in patients with psoriasis-associated arthritis (PsA) by comparison with magnetic resonance imaging (MRI), projection radiography...... (x-ray), and clinical findings. Fifteen patients with PsA, 5 with rheumatoid arthritis (RA), and 5 healthy control persons were examined by means of US, contrast-enhanced MRI, x-ray, and clinical assessment. Each joint of the 2nd-5th finger (metacarpophalangeal joints, proximal interphalangeal [PIP...... tendons of the fingers were assessed for the presence of insertional changes and tenosynovitis. One hand was assessed by means of MRI for the aforementioned changes. X-rays of both hands and feet were assessed for bone erosions and proliferations. US was repeated in 8 persons by another ultrasonographer...

Detailed analysis of contrast-enhanced MRI of hands and wrists in patients with psoriatic arthritis

International Nuclear Information System (INIS)

Tehranzadeh, Jamshid; Ashikyan, Oganes; Anavim, Arash; Shin, John

2008-01-01

The objective was to perform detailed analysis of the involved soft tissues, tendons, joints, and bones in the hands and wrists of patients with psoriatic arthritis (PsA). We reviewed 23 contrast-enhanced MR imaging studies (13 hands and 10 wrists) in 10 patients with the clinical diagnosis of PsA. We obtained clinical information from medical records and evaluated images for the presence of erosions, bone marrow edema, joint synovitis, tenosynovitis, carpal tunnel, and soft tissue involvement. Two board-certified musculoskeletal radiologists reviewed all images independently. Differences were resolved during a subsequent joint session. The average duration of disease was 71.3 months, ranging from 1 month to 25 years. Eight of the 10 wrists (80%) and 6 of the 13 hands demonstrated bone erosions. Bone marrow abnormalities were shown in 5 of the 10 wrists (50%) and 4 of the 14 hands (31%). Triangular fibrocartilage tears were seen in 6 of the 10 wrists (60%). Wrist and hand joint synovitis were present in all studies (67 wrist joints and 101 hand joints). Wrist soft tissue involvement was detected in 9 of the 10 wrists (90%) and hand soft tissue involvement was present in 12 of the 13 wrists (92%). Findings adjacent to the region of soft tissue involvement included synovitis (4 wrists) and tenosynovitis (3 wrists). Bone marrow edema adjacent to the region of soft tissue involvement was seen in one wrist. Bulge of the flexor retinaculum was seen in 4 of the 10 wrists (40%) and median nerve enhancement was seen in 8 of the 10 wrists (80%). Tenosynovitis was seen in all studies (all 10 of the hands and all 13 of the wrists). The ''rheumatoid'' type of distribution of bony lesions was common in our study. Interobserver agreement for various findings ranged from 83% to 100%. Contrast-enhanced MRI unequivocally demonstrated bone marrow edema, erosions, tendon and soft-tissue disease, and median nerve involvement, with good interobserver reliability in patients with PsA of

Detailed analysis of contrast-enhanced MRI of hands and wrists in patients with psoriatic arthritis

Energy Technology Data Exchange (ETDEWEB)

Tehranzadeh, Jamshid [University of California, Department of Radiological Sciences, Irvine (United States); University of California Medical Center, Department of Radiological Sciences R-140, Orange, CA (United States); Ashikyan, Oganes; Anavim, Arash; Shin, John [University of California, Department of Radiological Sciences, Irvine (United States)

2008-05-15

The objective was to perform detailed analysis of the involved soft tissues, tendons, joints, and bones in the hands and wrists of patients with psoriatic arthritis (PsA). We reviewed 23 contrast-enhanced MR imaging studies (13 hands and 10 wrists) in 10 patients with the clinical diagnosis of PsA. We obtained clinical information from medical records and evaluated images for the presence of erosions, bone marrow edema, joint synovitis, tenosynovitis, carpal tunnel, and soft tissue involvement. Two board-certified musculoskeletal radiologists reviewed all images independently. Differences were resolved during a subsequent joint session. The average duration of disease was 71.3 months, ranging from 1 month to 25 years. Eight of the 10 wrists (80%) and 6 of the 13 hands demonstrated bone erosions. Bone marrow abnormalities were shown in 5 of the 10 wrists (50%) and 4 of the 14 hands (31%). Triangular fibrocartilage tears were seen in 6 of the 10 wrists (60%). Wrist and hand joint synovitis were present in all studies (67 wrist joints and 101 hand joints). Wrist soft tissue involvement was detected in 9 of the 10 wrists (90%) and hand soft tissue involvement was present in 12 of the 13 wrists (92%). Findings adjacent to the region of soft tissue involvement included synovitis (4 wrists) and tenosynovitis (3 wrists). Bone marrow edema adjacent to the region of soft tissue involvement was seen in one wrist. Bulge of the flexor retinaculum was seen in 4 of the 10 wrists (40%) and median nerve enhancement was seen in 8 of the 10 wrists (80%). Tenosynovitis was seen in all studies (all 10 of the hands and all 13 of the wrists). The 'rheumatoid' type of distribution of bony lesions was common in our study. Interobserver agreement for various findings ranged from 83% to 100%. Contrast-enhanced MRI unequivocally demonstrated bone marrow edema, erosions, tendon and soft-tissue disease, and median nerve involvement, with good interobserver reliability in patients with

MP Joint Arthritis

Science.gov (United States)

... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy MP Joint Arthritis Email to a friend * required ...

ASSESSMENT OF BONE TISSUE CONDITION BY METHOD OF COMPUTED TOMOGRAPHY IN PTS WITH RHEUMATOID ARTHRITIS

Directory of Open Access Journals (Sweden)

T A Raskina

2002-01-01

Full Text Available Aim: To estimate the bone mineral density (BMD in patients with dilVerent variants of rheumatoid arthritis (RA. Materials and methods: The study included 65 patients with the acknowledged RA, who were not treated with corticosteroids, basic remedies and antiosteoporosis therapies. The group comprises 26 women оГ reproductive age (I group and 28 women in postmenopause period. The investigations were held with the computer tomograph “Tomoscan” Philips. Results: The comparative analysis of BMD disorders frequency in the studied groups shows that in RA women of postmenopause period osteopenia accounts for 57,1%, osteoporosis - for 32,1% of patients, which is twice as often as in premenopausal women period: 30,8% and 15,4% respectively. BMD levels in RA are correlated with rheumatoid lactor, destructive tendency in bones and high activity of disease.

Synovial DKK1 expression is regulated by local glucocorticoid metabolism in inflammatory arthritis

OpenAIRE

Hardy, Rowan; Juarez, Maria; Naylor, Amy; Tu, Jinwen; Rabbitt, Elizabeth H; Filer, Andrew; Stewart, Paul M; Buckley, Christopher D; Raza, Karim; Cooper, Mark S

2012-01-01

Introduction: Inflammatory arthritis is associated with increased bone resorption and suppressed bone formation. The Wnt antagonist dickkopf-1 (DKK1) is secreted by synovial fibroblasts in response to inflammation and this protein has been proposed to be a master regulator of bone remodelling in inflammatory arthritis. Local glucocorticoid production is also significantly increased during joint inflammation. Therefore, we investigated how locally derived glucocorticoids and inflammatory cytok...

Serum levels of parathyroid hormone and markers of bone metabolism in patients with rheumatoid arthritis. Relationship to disease activity and glucocorticoid treatment

DEFF Research Database (Denmark)

Jensen, Tonny Joran; Hansen, M; Madsen, J C

2001-01-01

OBJECTIVE: To evaluate the influence of inflammatory activity and glucocorticoid (GC) treatment on serum parathyroid hormone (s-PTH) and bone metabolism in patients with rheumatoid arthritis (RA). Furthermore, in patients with active RA, to examine the PTH secretion and Ca2+ set point before and ....... The increased levels of markers of type I collagen metabolism (s-ICTP, Pyr) and s-AlbCorrCa2+ in patients with active disease and patients treated with GC may be a result of increased degradation in synovium, cartilage and bone due to the inflammatory process.......OBJECTIVE: To evaluate the influence of inflammatory activity and glucocorticoid (GC) treatment on serum parathyroid hormone (s-PTH) and bone metabolism in patients with rheumatoid arthritis (RA). Furthermore, in patients with active RA, to examine the PTH secretion and Ca2+ set point before...... groups. The levels of urine pyridinoline (Pyr) and s-albumin-corrected calcium (s-AlbCorrCa2+) were elevated in patients with active disease and patients treated with GC. S-PTH and s-phosphate were within normal ranges. S-TAP, s-ICTP, Pyr and s-AlbCorrCa2+ correlated positively with indices of disease...

Characteristic Magnetic Resonance Imaging Findings in Rheumatoid Arthritis of the Temporomandibular Joint: Focus on Abnormal Bone Marrow Signal of the Mandibular Condyle, Pannus, and Lymph Node Swelling in the Parotid Glands.

Science.gov (United States)

Hirahara, Naohisa; Kaneda, Takashi; Muraoka, Hirotaka; Fukuda, Taiga; Ito, Kotaro; Kawashima, Yusuke

2017-04-01

The purpose of this study was to determine the characteristic magnetic resonance imaging (MRI) findings indicating bone and soft tissue involvement in patients with rheumatoid arthritis (RA) of the temporomandibular joints (TMJs). Twenty-one patients with RA and TMJ pain who underwent MRI examination of the TMJs at the authors' hospital from August 2006 to December 2014 were included in this study. Twenty-two patients with normal TMJs who underwent MRI examination at the authors' hospital from November to December 2014 were included as controls. MRI findings were compared between the 2 groups. MRI findings of RA in the TMJ included 1) abnormal disc position (95.2%), 2) abnormal disc morphology (83.3%), 3) joint effusion (30.9%), 4) osseous changes in the mandibular condyle (83.3%), 5) synovial proliferation (pannus; 85.7%), 6) erosion of the articular eminence and glenoid fossa (9.52%), 7) deformity of the articular eminence and glenoid fossa (16.6%), 8) abnormal bone marrow signal in the mandibular condyle (83.3%), and 9) swelling of lymph nodes in the parotid glands (78.5%). The abnormal bone marrow signal and pannus in the mandibular condyle and lymph node swelling in the parotid glands were markedly more common in patients with RA than in controls. MRI findings of RA of the TMJs were characterized by bone and soft tissue involvement, including abnormal bone marrow signal of the mandibular condyle, pannus, and swelling of lymph nodes in the parotid glands. These characteristic MRI findings could be useful in detecting RA in the TMJ in a clinical situation. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Role of ultrasound in managing rheumatoid arthritis

DEFF Research Database (Denmark)

Hammer, Hilde Berner; Terslev, Lene

2012-01-01

Ultrasound (US) is a valid and reliable imaging tool for evaluation of joint and tendon inflammation as well as cartilage and erosions in patients with rheumatoid arthritis (RA). Synovitis is usually scored semiquantitatively for both gray scale synovitis and power Doppler activity, and use...

Tissue factor expression in rheumatoid synovium: a potential role in pannus invasion of rheumatoid arthritis.

Science.gov (United States)

Chen, Lujun; Lu, Yahua; Chu, Yang; Xie, Jun; Ding, Wen'ge; Wang, Fengming

2013-09-01

Angiogenesis, as well as pannus formation within the joint, plays an important role in the erosion of articular cartilage and bone in the pathological process of rheumatoid arthritis (RA). Tissue factor (TF), an essential initiator of the extrinsic pathway of blood coagulation, is also involved in the angiogenesis and the pannus formation of RA progression. In the present study, we used immunofluorescence and confocal scanning methods to characterize TF immunolocalization in RA synovium. We showed that positive staining of TF could be immunolocalized in synoviocytes, CD19(+) B cells and CD68(+) macrophages, whereas weak or negative staining of tissue factor could be found in CD34(+) endothelial cells of neo-vessels, CD3(+) T cells and CD14(+) monocytes in RA synovium tissues. Our study demonstrates a detailed local expression of TF in the rheumatoid synovium, and supports the notion that TF, expressed not only by the synoviocytes themselves, but also the infiltrating CD19(+) B cells and CD68(+) macrophages, is involved in the pannus invasion in the progression of rheumatoid arthritis. Copyright © 2013 Elsevier GmbH. All rights reserved.

Dynamics of body composition and bone in patients with juvenile idiopathic arthritis treated with growth hormone.

Science.gov (United States)

Bechtold, Susanne; Ripperger, Peter; Dalla Pozza, Robert; Roth, Johannes; Häfner, Renate; Michels, Hartmut; Schwarz, Hans Peter

2010-01-01

GH has a positive impact on growth, bone, and muscle development. The objectives of this study were to demonstrate the effects of GH treatment on regional body composition and bone geometry at final height in patients with juvenile idiopathic arthritis (JIA). In this longitudinal study, parameters of bone mineral density and geometry as well as muscle and fat cross-sectional area (CSA) in the nondominant forearm were recorded using peripheral quantitative computed tomography at yearly intervals until final height in 12 patients (seven females) receiving GH treatment. Data at final height were compared with 13 patients (nine females) with JIA not treated with GH. Patients were treated with GH for a mean of 5.35 +/- 0.7 yr. Correcting for height, total bone CSA (+0.89 +/- 0.5 sd) and muscle CSA (+1.14 +/- 0.6 sd) increased significantly and normalized at final height. Compared with JIA patients without GH at final height, there was a significantly higher muscle CSA and a lower fat CSA in GH-treated patients. Additionally, in relation to total bone CSA, there was significantly more cortical and less marrow CSA in boys with GH treatment. During GH treatment, there was a significant increase and normalization of total bone and muscle CSA at final height. In accordance with an anabolic effect of GH, fat mass stabilized at the lower limit of healthy children. At final height, cortical and marrow CSA, relative to total bone CSA, were normalized in GH-treated patients.

Gout on CT of the feet: A symmetric arthropathy

International Nuclear Information System (INIS)

Doyle, Anthony J.; Boyer, Lucinda; Dong, Jing; Dalbeth, Nicola; McQueen, Fiona; Rome, Keith; Frecklington, Mike

2016-01-01

The aim of this study was to assess the distribution of bone erosions in the feet of patients with gout using CT and thereby to test the hypothesis that gout is an asymmetric arthropathy. CT scans of both feet were obtained from 25 patients with chronic gout. CT scans were scored for bone erosion using a semi-quantitative method based on the rheumatoid arthritis MRI scoring system (RAMRIS). CT bone erosion was assessed at 22 bones in each foot (total 1,100 bones) by two independent radiologists. Symmetry was assessed by two methods: (i) comparing right and left foot scores for each patient; and (ii) calculating the proportion of paired joints with or without erosions. Observer agreement was excellent (intra-class correlation coefficient 0.92). In the group overall, the difference in scores between the feet was not significant (Student's t-test P = 0.8). In 17 of 25 patients, the difference in erosion scores between the two feet was less than the inter-observer difference. In 24 of 25 patients, the proportion of paired joints was greater than 0.5, indicating symmetric disease. Erosive disease from gout is, in fact, a symmetric process in our patient group. This finding is contrary to the established view of gout as an asymmetric arthritis and lends new insight into the behaviour of this common disease.

Validity and reliability of 3D US for the detection of erosions in patients with rheumatoid arthritis using MRI as the gold standard

DEFF Research Database (Denmark)

Ellegaard, K; Bliddal, H; Møller Døhn, U

2014-01-01

PURPOSE: To test the reliability and validity of a 3D US erosion score in RA using MRI as the gold standard. MATERIALS AND METHODS: RA patients were examined with 3D US and 3 T MRI over the 2nd and 3rd metacarpophalangeal joints. 3D blocks were evaluated by two investigators. The erosions were...... estimated according to a semi-quantitative score (SQS) (0 - 3) and a quantitative score (QS) (mm²). MRI was evaluated according to the RAMRIS score. For the estimation of reliability, intra-class correlation coefficients (ICC) were used. Validity was tested using Spearman's rho (rs). The sensitivity...... and specificity were also calculated. RESULTS: 28 patients with RA were included. The ICC for the inter-observer reliability in the QS was 0.41 and 0.13 for the metacarpal bone and phalangeal bone, respectively, and 0.86 and 0.16, respectively, in the SQS.  The ICC for the intra-observer reliability in the QS...

Bone X-Ray (Radiography)

Medline Plus

Full Text Available ... replacement and fracture reductions. look for injury, infection, arthritis , abnormal bone growths and bony changes seen in ... injuries, including fractures, and joint abnormalities, such as arthritis. X-ray equipment is relatively inexpensive and widely ...

Significance of magnetic resonance imaging for early rheumatoid arthritis activity

Directory of Open Access Journals (Sweden)

E Y Pogozeva

2009-01-01

Full Text Available Objective. To assess possibility of magnetic resonance image (MRI application for rheu- matoid arthritis (RA activity and severity assessment.Material and methods. 100 pts with RA who fulfilled the 1987 ACR criteria with disease duration less than 12 months were included. Standard clinical examination with evaluation of tender and swollen joint counts, acute phase markers, hand and foot X-ray and hand MRI with 0,2 T Artoscan apparatus (ESAOTE Biomedica, Italy were performed.Results. MRI showed hand joint synovitis in 94,5%, erosions – in 67,3% of cases. X-ray examination revealed erosions in only 20,8% of pts. Localization of erosions revealed by X-ray and MRI coincided in 36,4% of cases and in 61,8% of pts erosions were detected only by MRI. MRI confirmed clinical conclusion about presence or absence of metacarpophalangeal and wrist joint synovitis in 64,5% and 74,5% of cases respectively. In8,2% and 21,8% MRI revealed signs of synovitis in clinically intact joints. MRI synovitis score correlated with clinical and laboratory measures of disease activity – DAS 28 (r=0,37, p=0,001, CRP(r=0,30, p=0,001, ESR (r=0,42, p=0,001, HAQ (r=0,24, p=0,001. Weak correlation was revealed between ESR and presence of erosions (r=0,29, CRP, ESR and MRI signs of bone marrow edema (r=0,27, p=0,005 and r=0,29, p=0,002 respectively. Relationship between laboratory and clinical features was weaker and referred only to CRP level and swollen joint count (p=0,05.Conclusion. MRI signs may be used as additional and independent measures of inflammatory activity (particularly synovitis score and severity of RA

MR imaging of transient synovitis: differentiation from septic arthritis

International Nuclear Information System (INIS)

Yang, W.J.; Im, S.A.; Lim, G.Y.; Chun, H.J.; Jung, N.Y.; Sung, M.S.; Choi, B.G.

2006-01-01

Transient synovitis is the most common cause of acute hip pain in children. However, MR imaging findings in transient synovitis and the role of MR imaging in differentiating transient synovitis from septic arthritis have not been fully reported. To describe the MR findings of transient synovitis and to determine whether the MR characteristics can differentiate this disease entity from septic arthritis. Clinical findings and MR images of 49 patients with transient synovitis (male/female 36/13, mean age 6.1 years) and 18 patients with septic arthritis (male/female 10/8, mean age 4.9 years) were retrospectively reviewed. MR findings of transient synovitis were symptomatic joint effusion, synovial enhancement, contralateral joint effusion, synovial thickening, and signal intensity (SI) alterations and enhancement in surrounding soft tissue. Among these, SI alterations and enhancement in bone marrow and soft tissue, contralateral joint effusion, and synovial thickening were statistically significant MR findings in differentiating transient synovitis from septic arthritis. The statistically significant MR findings in transient synovitis are contralateral (asymptomatic) joint effusions and the absence of SI abnormalities of the bone marrow. It is less common to have SI alterations and contrast enhancement of the soft tissues. The statistically significant MR findings in septic arthritis are SI alterations of the bone marrow, and SI alterations and contrast enhancement of the soft tissue. Ipsilateral effusion and synovial thickening and enhancement are present in both diseases

Differences in MRI findings between subgroups of recent-onset childhood arthritis

International Nuclear Information System (INIS)

Kirkhus, Eva; Flatoe, Berit; Smith, Hans-Joergen; Riise, Oeystein; Reiseter, Tor

2011-01-01

MRI is sensitive for joint inflammation, but its ability to separate subgroups of arthritis in children has been questioned. Infectious arthritis (IA), postinfectious arthritis (PA), transient arthritis (TA) and juvenile idiopathic arthritis (JIA) are subgroups that may need early, different treatment. To determine whether MRI findings differ in IA, PA/TA and JIA in recent-onset childhood arthritis. Fifty-nine children from a prospective study of incidence of arthritis (n = 216) were, based on clinical and biochemical criteria, examined by MRI. Joint fluid, synovium, bone marrow, soft tissue and cartilage were scored retrospectively and analysed by Pearson chi-square test and logistic regression analysis. Fifty-nine children had MRI of one station. IA was suggested by bone marrow oedema (OR 7.46, P = 0.011) and absence of T1-weighted and T2-weighted low signal intensity synovial tissue (OR 0.06, P = 0.015). Furthermore, soft-tissue oedema and reduced contrast enhancement in the epiphyses were more frequent in children with IA. JIA correlated positively with low signal intensity synovial tissue (OR 13.30, P < 0.001) and negatively with soft-tissue oedema (OR 0.20, P = 0.018). No significant positive determinants were found for PA/TA, but bone marrow oedema, soft-tissue oedema, irregular thickened synovium and low signal intensity synovial tissue was less frequent than in IA/JIA. In children with high clinical suspicion of recent onset arthritis, there was a significant difference in the distribution of specific MRI features among the diagnostic groups. (orig.)

Radiographic manifestations of arthritis in AIDS patients

International Nuclear Information System (INIS)

Rosenberg, Z.S.; Norman, A.; Solomon, G.

1988-01-01

The purpose of this study is to familiarize the radiologist with a newly discovered association between arthritis and acquired immunodeficiency syndrome (AIDS). The authors retrospectively reviewed the clinical and radiographic findings in 31 patients with human immunodeficiency virus (HIV) infection referred to their rheumatology clinic with musculoskeletal complaints. The patients carried a wide range of clinical diagnosis including Reiter syndrome, psoriatic arthritis, undifferentiated seronegative arthritis, isolated enthesopathies, rheumatoid arthritis and osteonecrosis. Radiographs were available in 24 of the 31 patients, and in 20 they showed radiographic features of arthritis, which included soft-tissue swelling periarticular osteoporosis, synovial effusions, sacroiliitis, periosteal reaction, joint space narrowing, marginal erosions, and osteonecrosis. Although the radiographic abnormalities were frequently mild, they were significant, given the short duration of disease in many of their patients (weeks to months) at the time radiographs were obtained. The range of radiographic findings in their series was varied and paralleled the wide range of clinical diagnoses. No findings were pathognomonic for HIV-associated arthritis. Nevertheless, HIV infection needs to be considered in any patient belonging to a recognized risk group who presents with musculoskeletal disease. This is particularly important since immunosupressive drugs used for the treatment of arthritis can be detrimental to patients with HIV infection

Cystic form of rheumatoid arthritis

Energy Technology Data Exchange (ETDEWEB)

Dijkstra, P.F.; Gubler, F.M.; Maas, A.

1988-10-01

A nonerosive form of rheumatoid arthritis (R.A.) was found in 62 patients out of 660 patients with R.A.. These 62 patients exhibit slowly progressive cystic changes in about the same joints in which usually erosions develop in classic R.A.. The E.S.R. is often low, half of the patients remained seronegative and there are 35 males and 27 females in the group. A smaller group of 15 out of these patients could be followed from a stage wherein the radiographs were normal to a stage of extensive cystic changes, over a period of at least 6 years. An attempt is made to delineate this group within the rheumatoid arthritis disease entity.

Soluble TAM receptor tyrosine kinases in rheumatoid arthritis: correlation with disease activity and bone destruction.

Science.gov (United States)

Xu, L; Hu, F; Zhu, H; Liu, X; Shi, L; Li, Y; Zhong, H; Su, Y

2018-04-01

The TAM receptor tyrosine kinases (TAM RTK) are a subfamily of receptor tyrosine kinases, the role of which in autoimmune diseases such as systemic lupus erythematosus has been well explored, while their functions in rheumatoid arthritis (RA) remain largely unknown. In this study, we investigated the role of soluble TAM receptor tyrosine kinases (sAxl/sMer/sTyro3) in patients with RA. A total of 306 RA patients, 100 osteoarthritis (OA) patients and 120 healthy controls (HCs) were enrolled into this study. The serum concentrations of sAxl/sMer/sTyro3 were measured by enzyme-linked immunosorbent assay (ELISA), then the associations between sAxl/sMer/sTyro3 levels and clinical features of RA patients were analysed. We also investigated whether sTyro3 could promote osteoclast differentiation in vitro in RA patients. The results showed that compared with healthy controls (HCs), sTyro3 levels in the serum of RA patients were elevated remarkably and sMer levels were decreased significantly, whereas there was no difference between HCs and RA patients on sAxl levels. The sTyro3 levels were correlated weakly but positively with white blood cells (WBC), immunoglobulin (Ig)M, rheumatoid factor (RF), swollen joint counts, tender joint counts, total sharp scores and joint erosion scores. Conversely, there were no significant correlations between sMer levels and the above indices. Moreover, RA patients with high disease activity also showed higher sTyro3 levels. In-vitro osteoclast differentiation assay showed further that tartrate-resistant acid phosphatase (TRAP) + osteoclasts were increased significantly in the presence of sTyro3. Collectively, our study indicated that serum sTyro3 levels were elevated in RA patients and correlated positively with disease activity and bone destruction, which may serve as an important participant in RA pathogenesis. © 2017 British Society for Immunology.

Rheumatoid arthritis: Skeletal manifestations observed on portable chest roentgenograms

International Nuclear Information System (INIS)

Levine, R.B.; Sullivan, K.L.

1985-01-01

This report describes the thoracic skeletal radiographic findings of rheumatoid arthritis, observed on portable chest examinations of 21 patients. Their pathophysiology is reviewed and additional examples of a recently described finding are illustrated: erosion of the medial surface of the proximal humerus with subsequent pathologic fracture, associated with superior and medial migration of the humeral head [11]. It has been proposed that erosion of the medial aspect of the proximal humerus is due to impingement wear, and that pathologic fracture results from the fulcrum effect of the inferior lip of the glenoid on the humerus. Rheumatoid arthritis is often diagnosed by the clinician rather than the radiologist. However, in acutely ill patients receiving portable chest radiographs, complete history and laboratory findings are often unavailable. Attention to the thoracic skeleton may clarify pleural and/or parenchymal lung disease in these patients. (orig.)

Cystic rheumatoid arthritis: description of a nonerosive form

NARCIS (Netherlands)

Gubler, F. M.; Maas, M.; Dijkstra, P. F.; de Jongh, H. R.

1990-01-01

In a study of patients with rheumatoid arthritis (RA), 9% (n = 70) were found to have a cystic form. At radiologic examination of these patients with cystic RA, the first abnormality seen consisted of periarticular intraosseous cysts without erosions. The cysts were distributed symmetrically, most

[Low bone mineral density in juvenile idiopathic arthritis: Prevalence and related factors].

Science.gov (United States)

Galindo Zavala, Rocío; Núñez Cuadros, Esmeralda; Martín Pedraz, Laura; Díaz-Cordovés Rego, Gisela; Sierra Salinas, Carlos; Urda Cardona, Antonio

2017-10-01

Height adjustment is currently recommended for Z-score bone mineral density (BMD) assessed by dual energy X-ray absorptiometry. At present there are no studies that evaluate the prevalence of low BMD in paediatric patients with Juvenile Idiopathic Arthritis (JIA) in Spain following current recommendations. To evaluate low BMD in JIA in paediatric patients with JIA in Spain following the latest recommendations, as well as to assess associated factors. Observational cross-sectional study of Spanish JIA patients from 5 to 16 years-old, followed-up in a Paediatric Rheumatology Unit between July 2014 and July 2015. Anthropometric, clinical and treatment data were recorded. Dual energy X-ray absorptiometry, and bone metabolism parameters were collected, and a completed diet and exercise questionnaire was obtained. A total of 92 children participated. The population prevalence estimation of low BMD was less than 5% (95% CI). A significant positive correlation was found in the multiple linear regression analysis between the body mass index percentile (B: 0.021; P<.001) and lean mass index (B: 0.0002; P=.012), and BMD Z-score adjusted for height (Z-SAH). A significant negative correlation was found between fat mass index (B: -0.0001; P=.018) and serum type I collagen N-propeptide (B: -0,0006; P=.036) and Z-SAH. Low BMD prevalence in JIA patients in our population is low. An adequate nutritional status and the prevalence of lean over fat mass seem to promote the acquisition of bone mass. Those JIA patients with lower BMD could be subjected to an increase of bone turnover. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Angled BIO-RSA (bony-increased offset-reverse shoulder arthroplasty): a solution for the management of glenoid bone loss and erosion.

Science.gov (United States)

Boileau, Pascal; Morin-Salvo, Nicolas; Gauci, Marc-Olivier; Seeto, Brian L; Chalmers, Peter N; Holzer, Nicolas; Walch, Gilles

2017-12-01

Glenoid deficiency and erosion (excessive retroversion/inclination) must be corrected in reverse shoulder arthroplasty (RSA) to avoid prosthetic notching or instability and to maximize function, range of motion, and prosthesis longevity. This study reports the results of RSA with an angled, autologous glenoid graft harvested from the humerus (angled BIO-RSA). A trapezoidal bone graft, harvested from the humeral head and fixed with a long-post baseplate and screws, was used to compensate for residual glenoid bone loss/erosion. For simple to moderate (25°) and complex (multiplanar) glenoid bone defects, patient-specific grafts and guides were used after 3-dimensional planning. Patients were reviewed with minimum 2 years of follow-up. Mean follow-up was 36 months (range, 24-81 months). Preoperative and postoperative measurements of inclination and version were performed in the plane of the scapula on computed tomography images. The study included 54 patients (41 women, 13 men; mean 73 years old). Fifteen patients had combined vertical and horizontal glenoid bone deficiency. Among E2/E3 glenoids, inclination improved from 37° (range, 14° to 84°) to 10.2° (range -28° to 36°, P RSA predictably corrects glenoid deficiency, including severe (>25°) multiplanar deformity. Graft incorporation is predictable. Advantages of using an autograftharvested in situ include bone stock augmentation, lateralization, low donor-site morbidity, low relative cost, and flexibility needed to simultaneously correct posterior and superior glenoid defects. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Burden of childhood-onset arthritis

Directory of Open Access Journals (Sweden)

Hassett Afton L

2010-07-01

Full Text Available Abstract Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality. The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs.

IMAGING OF PSORIATIC ARTHRITIS

Directory of Open Access Journals (Sweden)

S. D'Angelo

2011-09-01

Full Text Available Imaging of psoriatic arthritis (PsA is important for two reasons: the differential diagnosis from other arthritides and the assessment of structural damage that can be inhibited by the new drugs such as the anti-TNFα agents. Plain film radiographic findings of peripheral arthritis have been important in elaborating the concept of PsA as a separate disease entity. Characteristic aspects of psoriatic peripheral arthritis help the differentiation from rheumatoid arthritis. High-resolution ultrasonography (US, US combined with power Doppler (PDUS and magnetic resonance imaging (MRI can be used to image joint synovitis of PsA. Radiologic features of spondylitis associated with psoriasis are similar to spondylitis associated with reactive arthritis and differ from those of primary ankylosing spondylitis (AS and the spondylitis associated with inflammatory bowel disease. MRI is very sensitive for the early diagnosis of sacroiliitis. There have been no MRI studies on the spine of patients with PsA. In primary AS bone oedema in the vertebral bodies is an indicator of active disease and can ameliorate during anti-TNFα therapy. Historically, plain film radiography have played a pivotal role in defining enthesitis lesions of SpA. However, entheseal bone changes appear late. US and MRI have proved to be a highly sensitive and non invasive tools. Recent US and MRI studies on both finger and toe dactylitis have established that dactylitis is due to flexor tenosynovitis and marked adjacent soft tissue swelling with a variable degree of small joint synovitis. There is no evidence of enthesitis of the insertion of the flexor digitorum tendons and of the attachment of the caspsule of the digit joints. Key words: Enthesitis, dactylitis, spondyloarthritis, ultrasound, magnetic resonance, imaging

The role of anti-cyclic citrullinated peptide antibodies in predicting rheumatoid arthritis.

Science.gov (United States)

Rexhepi, Sylejman; Rexhepi, Mjellma; Sahatçiu-Meka, Vjollca; Tafaj, Argjend; Izairi, Remzi; Rexhepi, Blerta

2011-01-01

The study presents the results of predicting role of anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis, compared to rheumatoid factor. 32 patients with rheumatoid arthritis were identified from a retrospective chart review. The results of our study show that presence of the rheumatoid factor has less diagnostic and prognostic significance than the anti-cyclic citrullinated peptide, and suggests its superiority in predicting an erosive disease course.

Inter- relationship between rheumatoid arthritis and periodontitis.

Science.gov (United States)

Rajkarnikar, J; Thomas, B S; Rao, S K

2013-01-01

Periodontal medicine defines a rapidly emerging branch of Periodontology focusing on establishing a strong relationship between periodontal health and systemic health. It is speculated that the major common dysregulation which links Periodontitis with Rheumatoid arthritis (RA) is being played by the mediators of immune inflammatory response. To determine whether there is any relationship between periodontal disease and Rheumatoid arthritis. A total of 100 patients were included for the present study which was divided into two groups: one group (cases) included 50 patients attending the Department of Orthopedics, Kasturba Medical College, Manipal who were diagnosed of Rheumatoid arthritis. Another subject population included 50 patients as controls attending the Department of Oral Medicine, Manipal College of Dental Sciences, Manipal with age and gender matched with those of rheumatoid arthritis group. Specific measures for periodontitis included plaque index, gingival index, number of missing teeth, and radiographic alveolar bone loss scores. Measures of rheumatoid arthritis included health assessment questionaires, levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Various periodontal parameters were compared between the cases and controls. The average alveolar bone loss was statistically more severe in Rheumatoid arthritis (RA) group than in the controls although there were similar plaque index in both the groups. The gingival index was statistically higher in the RA group. The Erythrocyte Sedimentation Rate (ESR) and C- Reactive Protein (CRP) levels of RA patients were also significantly associated with the severity of periodontal disease. There was a significant association between Rheumatoid arthritis and Periodontitis which may be due to a common underlying deregulation of the inflammatory response in these individuals.

Enthesopathic reactions at the wrist in psoriatic arthritis, rheumatoid arthritis and diffuse idiopathic skeletal hyperostosis. Results of low-kV radiographs in three views

International Nuclear Information System (INIS)

Fischer, E.

1989-01-01

Twenty-six sites of muscle and ligament attachment around the wrist were evaluated for enthesopathic proliferative bone changes in psoriatic arthritis (PA), rheumatoid arthritis (RA), and diffuse idiopathic skeletal hyperostosis (DISH). Proliferations were found to be most frequent, most irregular, and largest in PA, followed in declining order by RA and DISH. In PA only, the bony proliferations and the underlying bone often had the appearance of mineralized woven bone, though smooth proliferations with a regular bone structure do occur in PA as well as in RA. The entheses of the trapezium, scaphoid and the radial styloid process are most frequently affected, followed by the bases of the first and fifth metacarpals and the pisiform. It is exceptional for huge bony proliferations to be observed at the entheses in DISH. (orig.) [de

Imbalanced expression of RANKL and osteoprotegerin mRNA in pannus tissue of rheumatoid arthritis.

Science.gov (United States)

Ainola, M; Mandelin, J; Liljeström, M; Konttinen, Y T; Salo, J

2008-01-01

To test if the pannus tissue is characterized by a high receptor activator of nuclear factor kappaB ligand to osteoprotegerin (RANKL:OPG) ratio, which could explain local osteoclastogenesis and formation of bony erosions. Messenger RNA and protein expressions of RANKL and OPG in rheumatoid and osteoarthritic tissue samples were measured using quantitative real-time RT-PCR and Western blot/densitometry. Pannus and synovitis fibroblasts explanted from tissue samples were cultured in vitro without and with TNF-alpha, IL-1Beta or IL-17 and analyzed quantitatively for RANKL expression. The ability of pannus fibroblasts to induce formation of multinuclear osteoclast-like cells from human monocytes, with macrophage-colony stimulating factor (M-CSF) but without RANKL added, was tested. Histochemical staining was used to assess the eventual presence of RANKL and tartrate resistant acid phosphatase positive osteoclast-like cells at the pannus-bone interface. RANKL:OPG ratios of messenger RNA (ppannus (2.06+/-0.73 and 2.2+/-0.65) compared to rheumatoid (0.62+/-0.13 and 1.31+/-0.69) and osteoarthritis (0.62+/-0.32 and 0.52+/-0.16) synovial membranes. Resting and stimulated (p dependent on the cytokine used) pannus fibroblasts produced RANKL in excess (p=0.0005) and unstimulated pannus fibroblasts also effectively induced osteoclast-like cell formation from monocytes in vitro without any exogenous RANKL added. Compatible with these findings, multinuclear osteoclasts-like cells were frequent in the fibroblast- and macrophage-rich pannus tissue at the soft tissue-to-bone interface. The high RANKL:OPG ratio, together with close fibroblast-to-monocyte contacts in pannus tissue, probably favor local generation of bone resorbing osteoclasts at the site of erosion in rheumatoid arthritis.

The effects of bone erosion from aortic aneurysm on the regional uptake of FDG

DEFF Research Database (Denmark)

Louring-Andersen, J.; Law, I.

2008-01-01

aorta just below the carina. An abnormal crescent-shaped uptake was identified at the margin between the aneurysm and the adjacent thoracic vertebral bodies. At this site a correspondingly shaped bone erosion on CT was proof of the chronic effects of the aneurysm. There were no signs of regional......A 71-year-old white man with a known right-sided apical nonsmall cell lung carcinoma was referred for a F-18 FDG whole body PET-CT examination after chemotherapy before radiotherapy. A staging CT scan had revealed an asymptomatic fusiform 65 mm in diameter nondissecting aneurysm of the thoracic...

Total shoulder replacement in rheumatoid arthritis

DEFF Research Database (Denmark)

Sneppen, O; Fruensgaard, S; Johannsen, Hans Viggo

1996-01-01

A prospective study of 62 Neer mark II total shoulder arthroplasties performed during the period from 1981 to 1990 on 51 patients with rheumatoid arthritis was undertaken to evaluate factors associated with component loosening and proximal humeral migration. Thirty-two (51%) showed proximal......, range of movement, abduction force, or function. The risk of clinical asymptomatic loosening is a relatively late complication that is eventually followed by pronounced bone destruction related to the loose component. Long-term radiographic control of total shoulders with rheumatoid arthritis...... is recommended. Hemiarthroplasty with a cemented humeral prosthesis may be a better treatment in the end stage of rheumatoid arthritis of the shoulder....

The cystic form of rheumatoid arthritis

International Nuclear Information System (INIS)

Dijkstra, P.F.; Gubler, F.M.; Maas, A.

1988-01-01

A nonerosive form of rheumatoid arthritis (R.A.) was found in 62 patients out of 660 patients with R.A.. These 62 patients exhibit slowly progressive cystic changes in about the same joints in which usually erosions develop in classic R.A.. The E.S.R. is often low, half of the patients remained seronegative and there are 35 males and 27 females in the group. A smaller group of 15 out of these patients could be followed from a stage wherein the radiographs were normal to a stage of extensive cystic changes, over a period of at least 6 years. An attempt is made to delineate this group within the rheumatoid arthritis disease entity. (orig.) [de

Bone X-Ray (Radiography)

Medline Plus

Full Text Available ... reductions. look for injury, infection, arthritis , abnormal bone growths and bony changes seen in metabolic conditions. assist ... of the unaffected limb, or of a child's growth plate (where new bone is forming), for comparison ...

Structural joint damage and hand bone loss in patients with rheumatoid arthritis.

Science.gov (United States)

Lykke, Midtbøll Ørnbjerg

2018-03-01

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by pain, swelling and progressive destruction of the joints leading to loss of function and invalidity. The bone destruction in RA is characterised by two distinct features: structural joint damage and hand bone loss, and their prevention is an important treatment goal. Inhibitors of tumour necrosis factor alpha (TNF-inhibitors) have markedly improved the treatment options in RA patients who fail treatment with conventional synthetic Disease Modifying Anti Rheumatic Drugs (sDMARDS), but their effectiveness with regards to structural joint damage and hand bone loss, predictors thereof and the association with disease activity during treatment have mainly been investigated in randomized controlled trials (RCTs) with limited generalizability due to strict in- and exclusion criteria.
 The main aim of the PhD thesis was to assess and predict structural joint damage and hand bone loss in patients with early and established RA treated with sDMARDs and TNF-inhibitors. This was investigated in two cohorts: A) The "DANBIO X-ray study": an observational, nationwide, longitudinal cohort study of established RA patients treated in clinical practice who initiated TNF-inhibitor treatment after failure of sDMARDs and B) The "OPERA study": a randomized controlled trial of sDMARD-naïve patients with early RA treated with methotrexate (MTX) and intraarticular glucocorticoid injections in combination with adalimumab or placebo-adalimumab. Structural joint damage progression was assessed with the Sharp/van der Heijde radiographic method and hand bone loss was assessed with Digital X-ray Radiogrammetry. 
From the studies presented in the PhD thesis the following was concluded:
 Structural joint damage progression and hand bone loss were significantly lower during two years of TNF-inhibitor treatment compared to the previous two years of sDMARD-treatment in the DANBIO X-ray Study. The majority of patients had

Arthritis severity locus Cia4 is an early regulator of IL-6, IL-1β, and NF-κB activators' expression in pristane-induced arthritis

OpenAIRE

Brenner, Max; Laragione, Teresina; Gulko, Pércio S.

2013-01-01

Cia4 is a locus on rat chromosome 7 that regulates disease severity and joint damage in models of rheumatoid arthritis, including pristane-induced arthritis (PIA). To identify molecular processes regulated by Cia4, synovial tissues from MHC-identical DA (severe erosive) and DA.F344(Cia4) congenics (mild nonerosive) rats were collected at preclinical and recent onset stages following the induction of PIA and analyzed for gene expression levels. Il6 levels were significantly higher in DA compar...

AUTOANTIBODIES TO CIRTULLINATED ANTIGENS FOR DIAGNOSIS AND PREDICTION OF CLINICAL COURSE IN EARLY RHEUMATOID ARTHRITIS

Directory of Open Access Journals (Sweden)

I. B. Belyaeva

2007-01-01

Full Text Available Abstract. To study the value of antibodies to cirtullinated antigens in diagnosis and their significance in prediction of erosion formation of rheumatoid arthritis (RA, we examined serological status in 129 patients with early RA (ERA and 55 cases of undifferentiated arthritis, lasting less than 12 months. Another group consisted of 39 patients with long-standing rheumatoid arthritis, in whom the disease persisted for > 2 years. Control group included 39 patients with osteoarthrosis and 29 patients with reactive arthritis. The titers of rheumatoid factor (RF, antikeratin antibodies (AKA, antiperinuclear factor (APF and antibodies to cyclic citrullinated peptide (anti-CCP were studied during initial examination and 12 months later. Serial cryosections of rat esophagus and normal human buccal epithelial cells served as substrates for AKA and APF detection. AntiCCPs were revealed by means of DIASTAT technique (Axis Shield, UK.Upon initial observation of the patients with ERA, sensitivity and specificity of anti-CCP was, resp., 63.5% and 97,8%, thus exceeding both parameters for RF (48,8% и 86,7%. Sensitivity of AKA and APF for the same group was 17% and 24 %, with specificity of 97.7%. In RF-seronegative cases of early RA, anti-CCP were detected in 37% with ERA and 42% long-standing RA. In patients with non-differentiated arthritis who developed RA within one year, RF and anti-CCP were found in 12,2% and 45,5%. Following a one-year observation, a statistically significant increase was found in incidence of RF and anti-CCP in ERA patients.Positivity for anti-citrulline antibodies (AKA, APF and anti-CCP in ERA patients were associated with higher levels of CRP, increased HAQ, DAS4, Sharp scores, as compared to the patients who were seronegative. In ERA patients positive for anti-citrulline antibodies, higher frequencies of synovitis and erosive arthritis were detected by means of ultrasound and magnetic resonance imaging. In the patients with ERA

Arthritis of the hand - Rheumatoid

Science.gov (United States)

... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Rheumatoid Arthritis Email to a friend * required fields ...

Characteristics of Rheumatoid Arthritis relative to HLA-DR in Saudi Arabia

International Nuclear Information System (INIS)

Al-Arfaj, Abdurhman S.

2001-01-01

The objective was to determine the clinical characteristics of rheumatoid arthritis in Saudi Arabia in relation to human leukocyte antigen type. A group of 91 rheumatoid arthritis patients, 72 females and 19 males were studied for the various clinical, laboratory and radiological parameters along with human leukocyte antigen-DR phenotypes. Since human leukocyte antigen-DR10 was most commonly associated with rheumatoid arthritis in our population, we compared those patients with human leukocyte antigen-DR10 to those without. The comparison yielded differences in the presence of rheumatoid nodules, erosions, corticosteroid treatment, and joint involvement at presentation, hemoglobin levels, and white cell count. Only the last 3 parameters showed a statistical significance. Human leukocyte antigen type of Saudi patients with rheumatoid arthritis influenced the course of the disease but only to a limited extent. (author)

Roentgenographic study of the temporomandibular joint in rheumatoid arthritis

International Nuclear Information System (INIS)

Yun, Ho Jung; You, Dong Soo

1984-01-01

For the study of the temporomandibular joint in rheumatoid arthritis 30 patients were selected who were diagnosis as rheumatoid arthritis through the clinical, radiographic examination and laboratory finding. Temporoman dibular joint involvement was evaluated through the clinical, radiographic examination. The results were as follows; 1. TMJ was involved in 15 patients of 30 patients with rheumatoid arthritis. (50% involvement). 2. Duration of rheumatoid arthritis was more longer in patients with TMJ involvement than in patients without TMJ involvement. 3. Osseous changes in TMJ were in order of frequency erosion, flattening, osteophyte, sclerosis, deformity, and most common involved site was mandibular condyle. 4. Most common positional change of condyle was forward position in centric occlusion, and restricted movement of condyle in 1 inch mouth opening. 5. TMJ involvement of rheumatoid arthritis was almost bilateral. 6. Main symptoms of TMJ were pain, stiffness, tenderness, limitation of mouth opening, crepitation. 7. There was not the case of ankylosis. 8. There was statistically insignificant correlation between mandibular deviation and TMJ involvement, but some cases showed severe deviation on mouth opening.

Clinical Utility of bone Scan in the Diagnosis of Temporomandibular disorders

International Nuclear Information System (INIS)

Kim, In Joo; Kang, Yang Ho; Son, Seok Man; Lee, Kyoung Seog; Lee, Jae Bok; Kim, Yong Ki; Seo, Bong Jik; Park, June Sang; Park, June Sang; Ko, Myung Yun; Son, Seong Pyo

1995-01-01

Bone scan is a very sensitive diagnostic imaging test for detecting bone and joint disorders. So it might be useful in the diagnosis of temporomandibular disorders of the joint origin. Thus, the effectiveness of bone scan for detecting temporomandibular joint(TMJ) diseases and differentiating the TMJ disc displacement from the TMJ arthritis was evaluated. Bone scan was done in 21 patients with TMJ disc displacement (I3 unilaterally affected, 8 bilaterally affected), 26 patients with TMJ arthritis (23 unilateral, 3 bilateral), and 39 volunteers with no signs, symptoms, or history of TMJ disease TMJ simple uptake rate(SUR) and difference of both TMJ SUR were calculated from the 100,000 count lateral image of head and neck region in 99m Tc MDP bone scan. Transcranial and panorama X-ray examination was also done in all patients. TMJ SUR(%) were 1.67 ±0.606 in TMJs affected with arthritis, 1.350±0.351 in TMJs affected with disc displacement, and 1.084±0.172 in TMJs of controls Significant differences were demonstrated among them(p mean+2SD of controls) in unilateral TMJ arthritis patients were significantly higher than those in patients with unilateral TMJ disc displacement(69.6% and 87% vs 23.1% and 23%). Conclusively, bone scan may help to detect TMJ disease and differentiate TMJ disc displacement from TMJ arthritis.

Erosions of the Petrous Temporal Bone

African Journals Online (AJOL)

tumours of the parotid gland; tumours of the paranasal sinuses; and tumours of ... showed severe erosion of the anterior and posterior walls and floor of the external .... sphenoid sinus, the pituitary fossa, and the greater and lesser wings of the ...

Osteoscintigraphy in the diagnosis of psoriatic arthritis

International Nuclear Information System (INIS)

Milevskaya, S.G.; Borodulin, V.F.

1989-01-01

The authors presented the results of clinical, X-ray and osteoscintigraphic investigations of 133 psoriasic arthritis patients and 72 patients with common psoriasis. Osteoscintigraphy was performed using a routine method with 99m Tc-pyrophos (USSR) and 99m Tc-phosphone (Hungary) on gamma-camera LFOV (Nuclear-Chicago, USA). X-ray signs of the involvement of the osteoarticular system were noted in 69 (51%) patients with psoriasic arthritis and in 16 (22%) patients with common psoriasis. The method permitted the detection of the foci of RP hyperfixation in 129 (97%) potients with psoriasic arthritis and in 51 (70.8%) patients with common psoriasis. They were observed mostly in large and small limb joints, less frequently-in the vertebral column, cranial bones, thorax, and ribs. Thus, osteoscintigraphy is a highly sensitive method for the detection of active inflammatory foci of the osteoarticular system in psoriasis at all stages of arthritis development. It makes it possible to detect the spreading of arthritis and its preclinical forms

Repeated administration of mazindol reduces spontaneous pain-related behaviors without modifying bone density and microarchitecture in a mouse model of complete Freund’s adjuvant-induced knee arthritis

Science.gov (United States)

Robledo-González, LE; Martínez-Martínez, A; Vargas-Muñoz, VM; Acosta-González, RI; Plancarte-Sánchez, R; Anaya-Reyes, M; Fernández del Valle-Laisequilla, C; Reyes-García, JG; Jiménez-Andrade, JM

2017-01-01

Background The role of dopaminergic system in the development of rheumatoid arthritis-related pain, a major symptom in this disease, has not been explored. Therefore, the anti-nociceptive effect of mazindol, a dopamine uptake inhibitor, was evaluated in a model of complete Freund’s adjuvant (CFA)-induced arthritis. Furthermore, as studies have shown that the dopaminergic system regulates bone metabolism, the effect of mazindol on bone mass and microarchitecture was determined. Methods Adult ICR male mice received intra-articular injections of either CFA or saline into the right knee joint every week. Spontaneous pain-like behaviors (flinching and guarding) and locomotor activity were assessed at day 26 post-first CFA, following which, a single intraperitoneally (i.p.) administered dose of mazindol was given (1, 3 and 10 mg/kg). Then, the antinociceptive effect of a repeated administration of 3 mg/kg mazindol (daily, i.p.; day 15–day 26) was evaluated. Additionally, at day 26, the participation of D1-like, D2-like or opioid receptors in the antinociceptive effect of mazindol was evaluated. The effect of mazindol on bone density and microarchitecture was evaluated by micro-computed tomography. Results Acute administration of mazindol decreased the spontaneous pain-like behaviors in a dose-dependent manner without reducing the knee edema. However, mazindol at 10 mg/kg significantly increased the locomotor activity; therefore, 3 mg/kg mazindol was used for further studies. Repeated administration of 3 mg/kg mazindol significantly decreased the pain-like behaviors without modifying locomotor activity. The antinociceptive effect of mazindol was blocked by administration of a D2-like receptor antagonist (haloperidol), but not by administration of D1-like receptor antagonist (SCH 23390) or an opioid receptor antagonist (naloxone). Repeated administration of mazindol did not significantly modify the density and microarchitecture of periarticular bone of the arthritic

Ghrelin plasma levels, gastric ghrelin cell density and bone mineral density in women with rheumatoid arthritis.

Science.gov (United States)

Maksud, F A N; Kakehasi, A M; Guimarães, M F B R; Machado, C J; Barbosa, A J A

2017-05-18

Generalized bone loss can be considered an extra-articular manifestation of rheumatoid arthritis (RA) that may lead to the occurrence of fractures, resulting in decreased quality of life and increased healthcare costs. The peptide ghrelin has demonstrated to positively affect osteoblasts in vitro and has anti-inflammatory actions, but the studies that correlate ghrelin plasma levels and RA have contradictory results. We aimed to evaluate the correlation between total ghrelin plasma levels, density of ghrelin-immunoreactive cells in the gastric mucosa, and bone mineral density (BMD) in twenty adult women with established RA with 6 months or more of symptoms (mean age of 52.70±11.40 years). Patients with RA presented higher ghrelin-immunoreactive cells density in gastric mucosa (P=0.008) compared with healthy females. There was a positive relationship between femoral neck BMD and gastric ghrelin cell density (P=0.007). However, these same patients presented a negative correlation between plasma ghrelin levels and total femoral BMD (P=0.03). The present results indicate that ghrelin may be involved in bone metabolism of patients with RA. However, the higher density of ghrelin-producing cells in the gastric mucosa of these patients does not seem to induce a corresponding elevation in the plasma levels of this peptide.

Ghrelin plasma levels, gastric ghrelin cell density and bone mineral density in women with rheumatoid arthritis

Directory of Open Access Journals (Sweden)

F.A.N. Maksud

Full Text Available Generalized bone loss can be considered an extra-articular manifestation of rheumatoid arthritis (RA that may lead to the occurrence of fractures, resulting in decreased quality of life and increased healthcare costs. The peptide ghrelin has demonstrated to positively affect osteoblasts in vitro and has anti-inflammatory actions, but the studies that correlate ghrelin plasma levels and RA have contradictory results. We aimed to evaluate the correlation between total ghrelin plasma levels, density of ghrelin-immunoreactive cells in the gastric mucosa, and bone mineral density (BMD in twenty adult women with established RA with 6 months or more of symptoms (mean age of 52.70±11.40 years. Patients with RA presented higher ghrelin-immunoreactive cells density in gastric mucosa (P=0.008 compared with healthy females. There was a positive relationship between femoral neck BMD and gastric ghrelin cell density (P=0.007. However, these same patients presented a negative correlation between plasma ghrelin levels and total femoral BMD (P=0.03. The present results indicate that ghrelin may be involved in bone metabolism of patients with RA. However, the higher density of ghrelin-producing cells in the gastric mucosa of these patients does not seem to induce a corresponding elevation in the plasma levels of this peptide.

Crossreactive autoantibodies directed against cutaneous and joint antigens are present in psoriatic arthritis.

Directory of Open Access Journals (Sweden)

Marzia Dolcino

Full Text Available Psoriatic arthritis (PsA is a chronic inflammatory disease of unknown origin, characterized by erosions and new bone formation. Diagnosis of PsA is mainly clinical and there are no biomarkers available. Moreover in PsA autoantibodies have not been described so far. Indeed an autoimmune origin has been suggested but never proven. Aim of the study was to investigate the possible presence of autoantibodies typically associated with PsA.We used pooled IgG immunoglobulins derived from 30 patients with PsA to screen a random peptide library in order to identify disease relevant autoantigen peptides.Among the selected peptides, one was recognised by nearly all the patients' sera. The identified peptide (PsA peptide: TNRRGRGSPGAL shows sequence similarities with skin autoantigens, such as fibrillin 3, a constituent of actin microfibrils, desmocollin 3, a constituent of the desmosomes and keratin 78, a component of epithelial cytoskeleton. Interestingly the PsA peptide shares homology with the nebulin-related anchoring protein (N-RAP, a protein localized in the enthesis (point of insertion of a tendon or ligament to the bone, which represents the first affected site during early PsA. Antibodies affinity purified against the PsA peptide recognize fibrillin, desmocollin, keratin and N-RAP. Moreover antibodies directed against the PsA peptide are detectable in 85% of PsA patients. Such antibodies are not present in healthy donors and are present in 13/100 patients with seroposive rheumatoid arthritis (RA. In seronegative RA these antibodies are detectable only in 3/100 patients.Our results indicate that PsA is characterized by the presence of serum autoantibodies crossreacting with an epitope shared by skin and joint antigens.

Polymerized-Type I Collagen Induces Upregulation of Foxp3-Expressing CD4 Regulatory T Cells and Downregulation of IL-17-Producing CD4+ T Cells (Th17 Cells in Collagen-Induced Arthritis

Directory of Open Access Journals (Sweden)

Janette Furuzawa-Carballeda

2012-01-01

Full Text Available Previous studies showed that polymerized-type I collagen (polymerized collagen exhibits potent immunoregulatory properties. This work evaluated the effect of intramuscular administration of polymerized collagen in early and established collagen-induced arthritis (CIA in mice and analyzed changes in Th subsets following therapy. Incidence of CIA was of 100% in mice challenged with type II collagen. Clinimorphometric analysis showed a downregulation of inflammation after administration of all treatments (P<0.05. Histological analysis showed that the CIA-mice group had extensive bone erosion, pannus and severe focal inflammatory infiltrates. In contrast, there was a remarkable reduction in the severity of arthritis in mice under polymerized collagen, methotrexate or methotrexate/polymerized collagen treatment. Polymerized Collagen but not methotrexate induced tissue joint regeneration. Polymerized Collagen and methotrexate/polymerized collagen but not methotrexate alone induces downregulation of CD4+/IL17A+ T cells and upregulation of Tregs and CD4+/IFN-γ+ T cells. Thus, Polymerized Collagen could be an effective therapeutic agent in early and established rheumatoid arthritis by exerting downregulation of autoimmune inflammation.

High frequency of vertebral fracture and low bone quality in patients with rheumatoid arthritis-Results from TOMORROW study.

Science.gov (United States)

Okano, Tadashi; Inui, Kentaro; Tada, Masahiro; Sugioka, Yuko; Mamoto, Kenji; Wakitani, Shigeyuki; Koike, Tatsuya; Nakamura, Hiroaki

2017-05-01

Osteoporosis is one of the complications in patients with rheumatoid arthritis (RA). In this study, we researched the morbidity of existing vertebral fractures and the risk factors for vertebral fractures in patients with RA. This study included 413 participants, 208 patients with RA, and 205 age- and sex-matched controls without RA. Clinical data, radiographic assessment of vertebral fracture from T4 to L4 in thoracic and lumber spine, bone mineral density (BMD), and bone metabolic markers (BMM) were analyzed. Vertebral fractures were observed more frequently, severe and multiple in patients with RA. In the logistic regression analysis, age (adjusted odds ratios (OR): 1.07, 95% confidence interval (CI): 1.04-1.09) and RA (adjusted OR: 1.72, 95% CI: 1.04-2.83) were risk factors for existing vertebral fracture. Moreover, two bone matrix-related markers, undercarboxylated osteocalcin (ucOC) (adjusted OR: 1.68, 95% CI: 1.02-2.78), and urinary pentocidine (adjusted OR: 2.51, 95% CI: 1.48-4.24) were associated with existing vertebral fracture. High frequent, multiple, and severe vertebral fractures were found in patients with RA compared to the controls. Low bone quality might be the cause of the frequent prevalence of vertebral fracture in patients with RA.

Clinical and radiological features of rheumatoid arthritis in British black Africans.

Science.gov (United States)

Ravindran, Vinod; Seah, May-Ai; Elias, David A; Choy, Ernest H; Scott, David L; Gordon, Patrick A

2008-01-01

The objective of this study was to determine whether radiographic damage is different in British black African patients with rheumatoid arthritis compared to Caucasian patients. Data on demographics, disease- and disability-related variables were obtained from all black African patients and their age-, gender- and disease-duration-matched Caucasian controls. After all features identifying the patients were concealed, X-rays of hands and feet were scored by using the Sharp/van der Heijde method. Data were analysed using Mann-Whitney U test, t test and chi (2) test. Sixty-four patients (32 in each ethnic group) were studied. The median age was 52 years and median disease duration 6 years. Seventy-two percent of patients were female. Black Africans and Caucasians did not differ significantly in rheumatoid factor positivity, disease-modifying anti-rheumatic drugs and biological treatment use. British black African patients had significantly more tender joints and disability. Joint space narrowing was significantly greater in Caucasian patients [48 (27-85) vs 56 (34-107), p = 0.01]. Caucasian patients had more number of erosions (172 vs 220) and higher erosion score; however, the difference in the erosion scores was not statistically significant [2 (0-48) vs 4.5 (0-46), p = 0.17]. Radiographic damage was less severe in black African patients with rheumatoid arthritis compared to their age-, gender- and disease-duration-matched Caucasian controls. A large prospective study is required to confirm the findings of this study and to establish the factors which might be accountable for any differences in the expression of rheumatoid arthritis in this ethnic group.

Gadolinium-enhanced MR imaging of the wrist in rheumatoid arthritis: value of fat suppression pulse sequences

International Nuclear Information System (INIS)

Nakahara, N.; Uetani, M.; Hayashi, K.; Kawahara, Y.; Matsumoto, T.; Oda, J.

1996-01-01

Objective. To determine the usefulness of fat-suppressed gadolinium (Gd)-enhanced MR imaging of the wrist in patients with rheumatoid arthritis (RA). Design and patients. Fat-suppressed Gd-enhanced T1-weighted spin-echo (SE) images were obtained and compared with other standard techniques in 38 wrists of 27 patients (22-77 years) with RA. Scoring based on the degree of synovial enhancement of each joint was developed and the total scores (J-score) were correlated with radiographic stage, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and symptomatic change in the follow-up study. Results. Synovial proliferations showed marked enhancement in all the wrists. In addition, contrast enhancement in the bone marrow and tenosynovium was seen in 36 and eight wrists respectively. Fat-suppressed Gd-enhanced T1-weighted images demonstrated these abnormalities better than other techniques. The J-scores correlated well with values of CRP (P=0.0034), but not with radiographic stages and ESR. Conclusion. Fat-suppressed Gd-enhanced T1-weighted SE images can clearly demonstrate most of the essential lesions in RA including the proliferative synovium, bone erosion, bone marrow inflammatory change, and tenosynovitis. Scoring based on the extent of Gd-enhancement of synovium can be useful in the assessment of the inflammatory status. (orig.). With 8 figs

Gadolinium-enhanced MR imaging of the wrist in rheumatoid arthritis: value of fat suppression pulse sequences

Energy Technology Data Exchange (ETDEWEB)

Nakahara, N. [Department of Radiology, Nagasaki University School of Medicine, Sakamoto 1-7-1, Nagasaki 852 (Japan); Uetani, M. [Department of Radiology, Nagasaki University School of Medicine, Sakamoto 1-7-1, Nagasaki 852 (Japan); Hayashi, K. [Department of Radiology, Nagasaki University School of Medicine, Sakamoto 1-7-1, Nagasaki 852 (Japan); Kawahara, Y. [Department of Radiology, Nagasaki University School of Medicine, Sakamoto 1-7-1, Nagasaki 852 (Japan); Matsumoto, T. [Department of Orthopedics, Nagasaki University School of Medicine, Nagasaki (Japan); Oda, J. [Department of Orthopedics, Nagasaki University School of Medicine, Nagasaki (Japan)

1996-10-01

Objective. To determine the usefulness of fat-suppressed gadolinium (Gd)-enhanced MR imaging of the wrist in patients with rheumatoid arthritis (RA). Design and patients. Fat-suppressed Gd-enhanced T1-weighted spin-echo (SE) images were obtained and compared with other standard techniques in 38 wrists of 27 patients (22-77 years) with RA. Scoring based on the degree of synovial enhancement of each joint was developed and the total scores (J-score) were correlated with radiographic stage, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and symptomatic change in the follow-up study. Results. Synovial proliferations showed marked enhancement in all the wrists. In addition, contrast enhancement in the bone marrow and tenosynovium was seen in 36 and eight wrists respectively. Fat-suppressed Gd-enhanced T1-weighted images demonstrated these abnormalities better than other techniques. The J-scores correlated well with values of CRP (P=0.0034), but not with radiographic stages and ESR. Conclusion. Fat-suppressed Gd-enhanced T1-weighted SE images can clearly demonstrate most of the essential lesions in RA including the proliferative synovium, bone erosion, bone marrow inflammatory change, and tenosynovitis. Scoring based on the extent of Gd-enhancement of synovium can be useful in the assessment of the inflammatory status. (orig.). With 8 figs.

Altered composition of bone as triggered by irradiation facilitates the rapid erosion of the matrix by both cellular and physicochemical processes.

Directory of Open Access Journals (Sweden)

Danielle E Green

Full Text Available Radiation rapidly undermines trabecular architecture, a destructive process which proceeds despite a devastated cell population. In addition to the 'biologically orchestrated' resorption of the matrix by osteoclasts, physicochemical processes enabled by a damaged matrix may contribute to the rapid erosion of bone quality. 8w male C57BL/6 mice exposed to 5 Gy of Cs(137 γ-irradiation were compared to age-matched control at 2d, 10d, or 8w following exposure. By 10d, irradiation had led to significant loss of trabecular bone volume fraction. Assessed by reflection-based Fourier transform infrared imaging (FTIRI, chemical composition of the irradiated matrix indicated that mineralization had diminished at 2d by -4.3±4.8%, and at 10d by -5.8±3.2%. These data suggest that irradiation facilitates the dissolution of the matrix through a change in the material itself, a conclusion supported by a 13.7±4.5% increase in the elastic modulus as measured by nanoindentation. The decline in viable cells within the marrow of irradiated mice at 2d implies that the immediate collapse of bone quality and inherent increased risk of fracture is not solely a result of an overly-active biologic process, but one fostered by alterations in the material matrix that predisposes the material to erosion.

Bone mineral density in children with systemic lupus erythematosus and juvenile rheumatoid arthritis

International Nuclear Information System (INIS)

Kashef, S.; Saki, F.; Karamizadeh, Z.; Kashef, Mohammed Amin

2007-01-01

Although there is increasing interest in bone metabolism in patients with rheumatic disorders, few data exist on bone mineral density (BMD) in children with rheumatic disorders or on the association of BMD with disease-related variables. We determined BMD in Iranian children with systemic lupus erythematosus (SLE) and juvenile rheumatoid arthritis (JRA) to evaluate the relationship between disease related variables and BMD. Twenty patients (13 girls and 7 boys) with SLE (n=5) and JRA (n=5) with a mean age of 13.10+-3.29 years (range, 6-17 years), attending a pediatric rheumatology clinic and 20 healthy controls (matched for age and sex with each patient) were enrolled in a cross-sectional study between 2001 and 2003. BMD (g/cm) of the femoral neck (BMD-F) and lumbar vertebrae (BMD-L) were measured by dual energy x-ray absorptiometry (DEXA). The correlation between BMD and cumulative dose of steroids, daily dose of steroid, disease duration, disease activity, height, weight and age was investigated. BMD in the patients (BMD-F=0.72+-0.15, BMD-L=0.70+-0.19) was significantly lower than controls (BMD-F=0.95+-0.17, BMD-L=0.98+-0.20, P<0.001). The severity of decreased BMD was more prominent in lumbar vertebrae than the femoral neck (P=0.04). None of the variables were consistently related to decrease in BMD. BMD was significantly lower in patients compared with controls. It was more prominent in lumbar vertebrae (trabecular bone). Although cumulative doses of steroids and disease duration appeared to have some influence on BMD, none were independently correlated with BMD. (author)

Salmonella enterica serovar Ohio septic arthritis and bone abscess in an immunocompetent patient: a case report

Directory of Open Access Journals (Sweden)

Kato Hideaki

2012-07-01

Full Text Available Abstract Introduction Non-typhi Salmonella species cause severe extra-intestinal focal infection after occult bacteremia. Although the number of cases of non-typhi salmonellosis is increasing worldwide among patients with immunocompromising conditions such as human immunodeficiency virus infection, infection is uncommon in immunocompetent subjects. We report a case of septic arthritis and bone abscess due to a rare non-typhi Salmonella organism that developed after a prolonged asymptomatic period. Case presentation A 44-year-old Japanese immunocompetent man presented with acute-onset left knee pain and swelling. He had no history of food poisoning, and his most recent travel to an endemic area was 19 years ago. Salmonella enterica serovar Ohio was identified from samples of bone abscess and joint tissue. Arthrotomy and necrotic tissue debridement followed by intravenous ceftriaxone was successful. Conclusions Non-typhi Salmonella species only rarely cause extra-intestinal focal infections in immunocompetent patients. Our case suggests that non-typhi Salmonella species can cause severe focal infections many years after the occult bacteremia associated with food poisoning.

Sterile Osteitis and Suppurative Arthritis Associated with Pannus Responding to Colchicine

Directory of Open Access Journals (Sweden)

Mehmet Engin Tezcan

2013-01-01

Full Text Available Sterile suppurative arthritis is characterized by neutrophilic infiltration of joints without any causative pathogen. Here, we present a 32-year-old man with refractory osteitis and erosive suppurative oligoarthritis with pannus. Treatments with multiple disease modifying antirheumatic drugs were all unsuccessful. However, he had clinical response to colchicine and the synovial hypertrophy and the pannus in the MRI of his left shoulder resolved. In this case, the effects of colchicine on neutrophils might have played a role in treating neutrophilic sterile suppurative arthritis, which, in adults, might be a distinct oligoarticular disease.

Sterile osteitis and suppurative arthritis associated with pannus responding to colchicine.

Science.gov (United States)

Tezcan, Mehmet Engin; Ekinci, Ozgür; Uçar, Murat; Göker, Berna

2013-01-01

Sterile suppurative arthritis is characterized by neutrophilic infiltration of joints without any causative pathogen. Here, we present a 32-year-old man with refractory osteitis and erosive suppurative oligoarthritis with pannus. Treatments with multiple disease modifying antirheumatic drugs were all unsuccessful. However, he had clinical response to colchicine and the synovial hypertrophy and the pannus in the MRI of his left shoulder resolved. In this case, the effects of colchicine on neutrophils might have played a role in treating neutrophilic sterile suppurative arthritis, which, in adults, might be a distinct oligoarticular disease.

Magnetic resonance imaging for early diagnosis of rheumatoid arthritis; Magnetresonanztomographie in der Fruehdiagnostik der rheumatoiden Arthritis

Energy Technology Data Exchange (ETDEWEB)

Uhl, M. [Universitaetsklinik Freiburg (Germany). Abt. fuer Radiologische Diagnostik; Allmann, K.H. [Universitaetsklinik Freiburg (Germany). Abt. fuer Radiologische Diagnostik; Hauer, M.P. [Universitaetsklinik Freiburg (Germany). Abt. fuer Radiologische Diagnostik; Laubenberger, J. [Universitaetsklinik Freiburg (Germany). Abt. fuer Radiologische Diagnostik; Kempis, J. v. [Universitaetsklinik Freiburg (Germany). Abt. fuer Rheumatologie und Klinische Immunologie; Langer, M. [Universitaetsklinik Freiburg (Germany). Abt. fuer Radiologische Diagnostik

1997-06-01

Nuclear magnetic resonance tomography (MRI) represents essential progress in the diagnostic means for evaluation of lesions of the muskuloskeletal system. The imaging of bone joints including material and structures like cartilage, tendons, ligaments, effusions, pannus, cortical bone and marrow offers essential advantages for diagnosis, differential diagnosis, follow-up control and detection of local complications in rheumatics radiology. The review article discusses the achievements of MRI for detection of early signs of rheumatoid arthritis and the current indications for MRI examination for early diagnosis. (Orig./AJ) [Deutsch] Die Magnetresonanztomographie (MRT) ist ein bedeutender Fortschritt in der Diagnostik von Erkrankungen des muskuloskelettalen Systems. Die Darstellung von Gelenkstrukturen einschliesslich Knorpel, Sehnen, Baendern, Erguessen, Pannus, kortikalem Knochen und Mark ist in der Diagnostik, Differentialdiagnostik, Verlaufsbeurteilung und der Aufdeckung von lokalen Komplikationen in der Rheumaradiologie von erheblichem Vorteil. In der Uebersicht werden die Fruehveraenderungen der rheumatoiden Arthritis in der MRT-Bildgebung und die heute aktuellen Indiakationen fuer den Einsatz der MRT in der Fruehdiagnostik diskutiert. (Orig./AJ)

HIF-2α-induced chemokines stimulate motility of fibroblast-like synoviocytes and chondrocytes into the cartilage-pannus interface in experimental rheumatoid arthritis mouse models.

Science.gov (United States)

Huh, Yun Hyun; Lee, Gyuseok; Lee, Keun-Bae; Koh, Jeong-Tae; Chun, Jang-Soo; Ryu, Je-Hwang

2015-10-29

Pannus formation and resulting cartilage destruction during rheumatoid arthritis (RA) depends on the migration of synoviocytes to cartilage tissue. Here, we focused on the role of hypoxia-inducible factor (HIF)-2α-induced chemokines by chondrocytes in the regulation of fibroblast-like synoviocyte (FLS) migration into the cartilage-pannus interface and cartilage erosion. Collagen-induced arthritis (CIA), K/BxN serum transfer, and tumor necrosis factor-α transgenic mice were used as experimental RA models. Expression patterns of HIF-2α and chemokines were determined via immunostaining, Western blotting and RT-PCR. FLS motility was evaluated using transwell migration and invasion assays. The specific role of HIF-2α was determined via local deletion of HIF-2α in joint tissues or using conditional knockout (KO) mice. Cartilage destruction, synovitis and pannus formation were assessed via histological analysis. HIF-2α and various chemokines were markedly upregulated in degenerating cartilage and pannus of RA joints. HIF-2α induced chemokine expression by chondrocytes in both primary culture and cartilage tissue. HIF-2α -induced chemokines by chondrocytes regulated the migration and invasion of FLS. Local deletion of HIF-2α in joint tissues inhibited pannus formation adjacent to cartilage tissue and cartilage destruction caused by K/BxN serum transfer. Furthermore, conditional knockout of HIF-2α in cartilage blocked pannus formation in adjacent cartilage but not bone tissue, along with inhibition of cartilage erosion caused by K/BxN serum transfer. Our findings suggest that chemokines induced by IL-1β or HIF-2α in chondrocytes regulate pannus expansion by stimulating FLS migration and invasion, leading to cartilage erosion during RA pathogenesis.

Gender Peculiarities of Rheumatoid Arthritis Course

Directory of Open Access Journals (Sweden)

G.A. Gonchar

2013-04-01

Full Text Available Rheumatoid arthritis in women differs by more clinical course of pathologic process, and injury of certain joints depends on patient’s gender (changes of sacroiliac joints, development of tendovaginitis, intraarticular Hoffa bodies are more often being detected in men, whereas in women — proximal interphalangeal joints of fingers and toes, supramaxillary and knee joints. There is sexual dimorphism of the integral extraarticular (systemic manifestations of rheumatoid arthritis, is this case more frequent damage of lungs and peripheral nervous system is attributable to men, and Sjogren syndrome and changes in central nervous system are observed only in women’s group. Indicators of bone metabolism change in blood serum of patients with rheumatoid arthritis, besides patients with osteoporosis have the commonality and gender differences in concentrations of osteoassociated hormones and chemical elements.

Lymphatic endothelial cells efferent to inflamed joints produce iNOS and inhibit lymphatic vessel contraction and drainage in TNF-induced arthritis in mice.

Science.gov (United States)

Liang, Qianqian; Ju, Yawen; Chen, Yan; Wang, Wensheng; Li, Jinlong; Zhang, Li; Xu, Hao; Wood, Ronald W; Schwarz, Edward M; Boyce, Brendan F; Wang, Yongjun; Xing, Lianping

2016-03-12

In this study, we sought to determine the cellular source of inducible nitric oxide synthase (iNOS) induced in lymphatic endothelial cells (LECs) in response to tumor necrosis factor (TNF), the effects of iNOS on lymphatic smooth muscle cell (LSMC) function and on the development of arthritis in TNF-transgenic (TNF-Tg) mice, and whether iNOS inhibitors improve lymphatic function and reduce joint destruction in inflammatory erosive arthritis. We used quantitative polymerase chain reactions, immunohistochemistry, histology, and near-infrared imaging to examine (1) iNOS expression in podoplanin + LECs and lymphatic vessels from wild-type (WT) and TNF-Tg mice, (2) iNOS induction by TNF in WT LECs, (3) the effects of iNOS inhibitors on expression of functional muscle genes in LSMCs, and (4) the effects of iNOS inhibitors on lymphatic vessel contraction and drainage, as well as the severity of arthritis, in TNF-Tg mice. LECs from TNF-Tg mice had eight fold higher iNOS messenger RNA levels than WT cells, and iNOS expression was confirmed immunohistochemically in podoplanin + LECs in lymphatic vessels from inflamed joints. TNF (0.1 ng/ml) increased iNOS levels 40-fold in LECs. LSMCs cocultured with LECs pretreated with TNF had reduced expression of functional muscle genes. This reduction was prevented by ferulic acid, which blocked nitric oxide production. Local injection of L-N(6)-(1-iminoethyl)lysine 5-tetrazole-amide into inflamed paws of TNF-Tg mice resulted in recovery of lymphatic vessel contractions and drainage. Treatment of TNF-Tg mice with ferulic acid reduced synovial inflammation as well as cartilage and bone erosion, and it also restored lymphatic contraction and drainage. iNOS is produced primarily by LECs in lymphatic vessel efferent from inflamed joints of TNF-Tg mice in response to TNF and inhibits LSMC contraction and lymph drainage. Ferulic acid represents a potential new therapy to restore lymphatic function and thus improve inflammatory

TREATMENT FOR GASTROESOPHAGEAL REFLUX DISEASE AMONG CHILDREN, SUFFERING FROM JUVENILE ARTHRITIS

Directory of Open Access Journals (Sweden)

T.M. Bzarova

2007-01-01

Full Text Available The article presents the evaluation results of esomeprazol efficacy in the complex therapy for gastroesophageal reflux disease among 152 children aged between 3 and 18, suffering from juvenile arthritis. The treatment scheme used in treatment induced the remission of gastro esophageal reflux disease among 45% of patients, conduced to considerable decrease of the esophagus affect intensity among 53% of patients, epithelized erosions of the mucous coat of esophagus among 30 of 32 children. The medication did not cause any clinically significant side responses among the cured children (even younger ones and may be applied to treat gastro esophageal reflux disease among the patients, suffering from juvenile arthritis.Key words: gastroesophageal reflux disease, children, treatment, reflux, esomeprazol, esophagitis, juvenile rheumatoid arthritis.

Aiming for a shorter rheumatoid arthritis MRI protocol: can contrast-enhanced MRI replace T2 for the detection of bone marrow oedema?

Energy Technology Data Exchange (ETDEWEB)

Stomp, Wouter; Bloem, Johan L.; Reijnierse, Monique [Leiden University Medical Center, Department of Radiology, P.O. Box 9600, Leiden (Netherlands); Krabben, Annemarie; Heijde, Desiree van der; Huizinga, Tom W.J.; Helm-van Mil, Annette H.M. van der [Leiden University Medical Center, Department of Rheumatology, P.O. Box 9600, Leiden (Netherlands)

2014-10-15

To determine whether T1 post-gadolinium chelate images (T1Gd) can replace T2-weighted images (T2) for evaluating bone marrow oedema (BME), thereby allowing a shorter magnetic resonance imaging (MRI) protocol in rheumatoid arthritis (RA). In 179 early arthritis patients and 43 advanced RA patients, wrist and metacarpophalangeal joints were examined on a 1.5-T extremity MRI system with a standard protocol (coronal T1, T2 fat-saturated and coronal and axial T1 fat-saturated after Gd). BME was scored according to OMERACT RAMRIS by two observers with and without T2 images available. Agreement was assessed using intraclass correlation coefficients (ICCs) for semi-quantitative scores and test characteristics with T2 images as reference. Agreement between scores based on T2 and T1Gd images was excellent ICC (0.80-0.99). At bone level, sensitivity and specificity of BME on T1Gd compared to T2 were high for both patient groups and both readers (all ≥80 %). T1Gd and T2 images are equally suitable for evaluating BME. Because contrast is usually administered to assess (teno)synovitis, a short MRI protocol of T1 and T1Gd is sufficient in RA. (orig.)

Aiming for a shorter rheumatoid arthritis MRI protocol: can contrast-enhanced MRI replace T2 for the detection of bone marrow oedema?

International Nuclear Information System (INIS)

Stomp, Wouter; Bloem, Johan L.; Reijnierse, Monique; Krabben, Annemarie; Heijde, Desiree van der; Huizinga, Tom W.J.; Helm-van Mil, Annette H.M. van der

2014-01-01

To determine whether T1 post-gadolinium chelate images (T1Gd) can replace T2-weighted images (T2) for evaluating bone marrow oedema (BME), thereby allowing a shorter magnetic resonance imaging (MRI) protocol in rheumatoid arthritis (RA). In 179 early arthritis patients and 43 advanced RA patients, wrist and metacarpophalangeal joints were examined on a 1.5-T extremity MRI system with a standard protocol (coronal T1, T2 fat-saturated and coronal and axial T1 fat-saturated after Gd). BME was scored according to OMERACT RAMRIS by two observers with and without T2 images available. Agreement was assessed using intraclass correlation coefficients (ICCs) for semi-quantitative scores and test characteristics with T2 images as reference. Agreement between scores based on T2 and T1Gd images was excellent ICC (0.80-0.99). At bone level, sensitivity and specificity of BME on T1Gd compared to T2 were high for both patient groups and both readers (all ≥80 %). T1Gd and T2 images are equally suitable for evaluating BME. Because contrast is usually administered to assess (teno)synovitis, a short MRI protocol of T1 and T1Gd is sufficient in RA. (orig.)

Synovial DKK1 expression is regulated by local glucocorticoid metabolism in inflammatory arthritis.

Science.gov (United States)

Hardy, Rowan; Juarez, Maria; Naylor, Amy; Tu, Jinwen; Rabbitt, Elizabeth H; Filer, Andrew; Stewart, Paul M; Buckley, Christopher D; Raza, Karim; Cooper, Mark S

2012-10-18

Inflammatory arthritis is associated with increased bone resorption and suppressed bone formation. The Wnt antagonist dickkopf-1 (DKK1) is secreted by synovial fibroblasts in response to inflammation and this protein has been proposed to be a master regulator of bone remodelling in inflammatory arthritis. Local glucocorticoid production is also significantly increased during joint inflammation. Therefore, we investigated how locally derived glucocorticoids and inflammatory cytokines regulate DKK1 synthesis in synovial fibroblasts during inflammatory arthritis. We examined expression and regulation of DKK1 in primary cultures of human synovial fibroblasts isolated from patients with inflammatory arthritis. The effect of TNFα, IL-1β and glucocorticoids on DKK1 mRNA and protein expression was examined by real-time PCR and ELISA. The ability of inflammatory cytokine-induced expression of the glucocorticoid-activating enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11β-HSD1) to sensitise fibroblasts to endogenous glucocorticoids was explored. Global expression of Wnt signalling and target genes in response to TNFα and glucocorticoids was assessed using a custom array. DKK1 expression in human synovial fibroblasts was directly regulated by glucocorticoids but not proinflammatory cytokines. Glucocorticoids, but not TNFα, regulated expression of multiple Wnt agonists and antagonists in favour of inhibition of Wnt signalling. However, TNFα and IL-1β indirectly stimulated DKK1 production through increased expression of 11β-HSD1. These results demonstrate that in rheumatoid arthritis synovial fibroblasts, DKK1 expression is directly regulated by glucocorticoids rather than TNFα. Consequently, the links between synovial inflammation, altered Wnt signalling and bone remodelling are not direct but are dependent on local activation of endogenous glucocorticoids.

BODY COMPOSITION AND BONE MINERAL DENSITY IN WOMEN WITH RHEUMATOID ARTHRITIS

Directory of Open Access Journals (Sweden)

S. E. Myasoedova

2016-01-01

Full Text Available Objective: to establish specific features of body composition, skeletal muscle changes and bone mineral density (BMD in middle-aged and elderly female patients with rheumatoid arthritis (RA as compared to female subjects without RA.Materials and methods. The study included 86 female patients with RA aged 59.06 ± 7.52 years and 81 female subjects without RA aged 57.4 ± 5.3 years. Body composition and BMD in spine and femur was assessed using Lunar Prodidgy device (General Electric. Sarcopenia was defined as lean mass index (LMI of < 5.64 kg/m2 .Results. We have detected statistically significant decrease in fat, muscle and femoral BMD in female patients with RA as compared to their non-RA counterparts. Sarcopenia in the form of osteopenic sarcopenia and osteosarcopenia obesity was detected in 13.95 % RA patients vs 4.94 % non-RA subjects based on LMI findings. Both groups had high prevalence of osteopenia obesity.Conclusions. Assessment of the body composition by radiographic densitometry in female RA patients with osteopenia or osteoporosis may be used to detect sarcopenia and its phenotypes in order to inform prognosis and adjust the management plan.

Evaluation of anti-IL-6 monoclonal antibody therapy using murine type II collagen-induced arthritis

Directory of Open Access Journals (Sweden)

Shealy David

2009-04-01

Full Text Available Abstract Interleukin-6 is a multifunctional cytokine that is critical for T/B-cell differentiation and maturation, immunoglobulin secretion, acute-phase protein production, and macrophage/monocyte functions. Extensive research into the biology of IL-6 has implicated IL-6 in the pathophysiology and pathogenesis of RA. An anti-murine IL-6 mAb that neutralizes mouse IL-6 activities was tested in animal model of collagen-induced arthritis. Prophylactic treatment with anti-IL-6 mAb significantly reduced the incidence and severity of arthritis compared to control mAb treated mice. The mitogenic response of B and T cells isolated from the lymph nodes of anti-IL-6 treated mice was significantly reduced compared to cells isolated from control mAb treated mice. The overall histopathology score for paws from the anti-IL-6 treated mice was significantly reduced when compared to paws from mice treated with control mAb, including both inflammatory (synovitis and pannus and erosive (erosions and architecture parameters. Reduced loss of cartilage matrix components was also observed in the anti-IL-6 treated mice. Collectively, these data suggest that IL-6 plays a major role in the pathophysiology of rheumatoid arthritis, and thus support the potential benefit of anti-IL-6 mAb treatment in rheumatoid arthritis patients.

Metacarpal sign

Directory of Open Access Journals (Sweden)

Barbara Nieradko-Iwanicka

2018-02-01

Full Text Available Background Archibald's sign, or metacarpal sign is defined as shortening of the IV and V metacarpal bones, is a rare phenomenon found in the Turner syndrome, homocystinuria and in Albright's osteodystrophy. Objectives The aim of the article was to show a rare case of metacarpal sign with atypical shortening of the III and IV metacarpal bones not connected with gonadal dysgenesia, genetic disorders nor osteodystrophy. Material and methods Case report of a 60-year-old female patient. Results Artchibald's metacarpal sign in the described case was accompanied by erosive arthritis in the left lower extremity. No features of genetic disorders nor gonadal disgenesia were found in the patient. Undifferentiated seronegative asymmetric erosive arthritis developed in the patient. The level of parathormon was within the normal range. No signs of tumor were seen in bone scintigraphy. Conclusions Archibald's metacarpal sign may be present in patients without genetic disorders.

Changes in synovial membrane and joint effusion volumes after intraarticular methylprednisolone. Quantitative assessment of inflammatory and destructive changes in arthritis by MRI

DEFF Research Database (Denmark)

Østergaard, Mikkel; Stoltenberg, M; Gideon, P

1996-01-01

OBJECTIVE: To evaluate synovial membrane volumes, effusion volumes, and cartilage and bone erosion scores determined by magnetic resonance imaging (MRI) as markers of disease activity and severity in arthritis. METHODS: Gadolinium-DTPA enhanced MRI of 18 arthritic knees was performed before and 1......, 7, 30 and 180 days after intraarticular methylprednisolone injection until clinical relapse. Intraobserver, interobserver, and inter-MRI variations were determined from 2 successive MRI of another 6 knees. RESULTS: In all knees synovial membrane and effusion volumes decreased within the first...... posttreatment week (median decrease 49 and 65%, respectively), and remained low during remission. Synovial volumes, but not effusion volumes, increased to pretreatment levels in case of clinical relapse, indicating that synovial volumes were most important to the clinical appearance. The intraobserver...

The utility of bone scans in rheumatology

International Nuclear Information System (INIS)

Duncan, I.; Dorai-Raj, A.; Khoo, K.; Tymans, K.; Brook, A.

1997-01-01

Full text: Introduction: Bone scans are the commonest diagnostic imaging services requested by Australian rheumatologists. Medicare figures suggest that an average rheumatologist orders about $50 000 (AUS) of bone scans annually. Aims: To ascertain the reasons why rheumatologists request bone scans and how it affects their patient management. Methods: A two-part prospective survey was administered before and after every bone scan ordered by four rheumatologists over a six-month period in 1996. Results: A total of 136 bone scans were requested (66.2% whole body; 33.8% regional; 6% SPECT). The primary indications for scanning were (1) to confirm a clinical diagnosis (38%); (2) to exclude a diagnosis (34%); (3) to localize site of pain (17%); and (4) to assist in management (6%). The common diseases that rheumatologists were attempting to confirm/exclude with bone scanning were inflammatory arthritis, malignancy, and fracture. However, the commonest provisional and final diagnosis was soft tissue rheumatism (18%) followed by inflammatory arthritis (15%) and osteoarthritis (11%). In 24% of patients with a provisional diagnosis of soft tissue rheumatism the diagnosis was changed by the bone scan. The scan was successful in excluding a diagnosis in 88 per cent where this was the primary indication for the test. It was successful in confirming a diagnosis in 79 per cent where this was the primary indication. In 32 per cent the bone scan altered the clinical diagnosis and in 43 per cent it altered management. The bone scan result prevented further investigations in 60 per cent. Conclusions: The commonest pre-scan and post-scan diagnosis is soft tissue rheumatism. Rheumatologists predominantly request bone scanning to confirm or exclude their clinical suspicion of inflammatory arthritis, malignancy, and fracture. Bone scans were successful in achieving these objectives in at least 79 per cent of cases

Calcifying tendinitis of the rotator cuff with cortical bone erosion

Energy Technology Data Exchange (ETDEWEB)

Chan, Roxanne; Kim, David H.; Millett, Peter J. [Harvard Medical School, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Weissman, Barbara N. [Harvard Medical School, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Department of Radiology, Musculoskeletal Division, Boston (United States)

2004-10-01

Calcifying tendinitis occurs most commonly in the rotator cuff tendons, particularly involving the supraspinatus tendon insertion, and is often asymptomatic. Cortical erosion secondary to calcifying tendinitis has been reported in multiple locations, including in the rotator cuff tendons. We present a pathologically proven case of symptomatic calcifying tendinitis involving the infraspinatus tendon with cortical erosion with correlative radiographic, CT, and MR findings. The importance of considering this diagnosis when evaluating lytic lesions of the humerus and the imaging differential diagnosis of calcifying tendinitis and cortical erosion are discussed. (orig.)

Calcifying tendinitis of the rotator cuff with cortical bone erosion

International Nuclear Information System (INIS)

Chan, Roxanne; Kim, David H.; Millett, Peter J.; Weissman, Barbara N.

2004-01-01

Calcifying tendinitis occurs most commonly in the rotator cuff tendons, particularly involving the supraspinatus tendon insertion, and is often asymptomatic. Cortical erosion secondary to calcifying tendinitis has been reported in multiple locations, including in the rotator cuff tendons. We present a pathologically proven case of symptomatic calcifying tendinitis involving the infraspinatus tendon with cortical erosion with correlative radiographic, CT, and MR findings. The importance of considering this diagnosis when evaluating lytic lesions of the humerus and the imaging differential diagnosis of calcifying tendinitis and cortical erosion are discussed. (orig.)

MRI quantification of rheumatoid arthritis: current knowledge and future perspectives

DEFF Research Database (Denmark)

Boesen, Mikael; Østergaard, Mikkel; Cimmino, Marco A

2009-01-01

for detecting and quantifying joint damage in RA. However, radiographs only show late disease manifestations as joint space narrowing and bone erosions, whereas it cannot detect synovitis and bone marrow oedema, i.e., inflammation in the synovium or the bone, which may be visualized by magnetic resonance...

Management of osteoporosis in rheumatoid arthritis patients

NARCIS (Netherlands)

Hoes, J.N.; Bultink, I.E.; Lems, W.F.

2015-01-01

Introduction: In rheumatoid arthritis (RA) patients, the risk of both vertebral and non-vertebral fractures is roughly doubled, which is for an important part caused by inflammation-mediated amplification of bone loss and by immobilization. New treatments have become available in the last two

The interleukin-20 receptor axis in early rheumatoid arthritis: novel links between disease-associated autoantibodies and radiographic progression

DEFF Research Database (Denmark)

Kragstrup, Tue Wenzel; Greisen, Stinne Ravn; Nielsen, Morten Aagaard

2016-01-01

BACKGROUND: Rheumatoid arthritis (RA) is often characterized by the presence of rheumatoid factor, anti-citrullinated protein antibodies, and bone erosions. Current therapies can compromise immunity, leading to risk of infection. The interleukin-20 receptor (IL-20R) axis comprising IL-19, IL-20...... the production of the IL-20R cytokines by monocytes/macrophages. Increased baseline plasma concentrations of IL-20 and IL-24 were associated with Sharp-van der Heijde score progression after 24 months (Spearman's rho = 0.19 and 0.26, both P ... by osteoclast precursors and in multinucleated osteoclasts. IL-20 and IL-24 increased the secretion of monocyte chemoattractant protein 1 by these cells. CONCLUSIONS: This study suggests that IL-20 and IL-24 link RA-associated autoantibodies with radiographic progression via the IL-22R1. Modulation of this axis...

Comparing the effects of tofacitinib, methotrexate and the combination, on bone marrow oedema, synovitis and bone erosion in methotrexate-naive, early active rheumatoid arthritis: results of an exploratory randomised MRI study incorporating semiquantitative and quantitative techniques.

Science.gov (United States)

Conaghan, Philip G; Østergaard, Mikkel; Bowes, Michael A; Wu, Chunying; Fuerst, Thomas; van der Heijde, Désirée; Irazoque-Palazuelos, Fedra; Soto-Raices, Oscar; Hrycaj, Pawel; Xie, Zhiyong; Zhang, Richard; Wyman, Bradley T; Bradley, John D; Soma, Koshika; Wilkinson, Bethanie

2016-06-01

To explore the effects of tofacitinib-an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA)-with or without methotrexate (MTX), on MRI endpoints in MTX-naive adult patients with early active RA and synovitis in an index wrist or hand. In this exploratory, phase 2, randomised, double-blind, parallel-group study, patients received tofacitinib 10 mg twice daily + MTX, tofacitinib 10 mg twice daily + placebo (tofacitinib monotherapy), or MTX + placebo (MTX monotherapy), for 1 year. MRI endpoints (Outcome Measures in Rheumatology Clinical Trials RA MRI score (RAMRIS), quantitative RAMRIS (RAMRIQ) and dynamic contrast-enhanced (DCE) MRI) were assessed using a mixed-effect model for repeated measures. Treatment differences with ptofacitinib + MTX and -1.74 (-2.72 to -0.76) for tofacitinib monotherapy (both ptofacitinib + MTX and -0.52 (-1.46 to 0.41) for tofacitinib monotherapy (both p>0.05 vs MTX monotherapy). Treatment differences in RAMRIQ synovitis were statistically significant at month 3, consistent with DCE MRI findings. Less deterioration of RAMRIS and RAMRIQ erosive damage was seen at months 6 and 12 in both tofacitinib groups versus MTX monotherapy. These results provide consistent evidence using three different MRI technologies that tofacitinib treatment leads to early reduction of inflammation and inhibits progression of structural damage. NCT01164579. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

DEFF Research Database (Denmark)

Østergaard, Mikkel; Emery, Paul; Conaghan, Philip G

2011-01-01

To evaluate the effects of golimumab on inflammation/structural damage detected by magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA).......To evaluate the effects of golimumab on inflammation/structural damage detected by magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA)....

Glucocorticoid receptor gene polymorphism and juvenile idiopathic arthritis

Directory of Open Access Journals (Sweden)

Scheplyagina Larisa A

2011-01-01

Full Text Available Abstract Background The glucocorticoid receptor gene (NR3C1 has been suggested as a candidate gene affecting juvenile idiopathic arthritis (JIA course and prognosis. The purpose of this study is to investigate the glucocorticoid receptor gene BclI polymorphism (rs41423247 in JIA patients, the gene's role in susceptibility to juvenile idiopathic arthritis, and its associations with JIA activity, course and bone mineralization. Methods One hundred twenty-two Caucasian children with JIA and 143 healthy ethnically matched controls were studied. We checked markers of clinical and laboratory activity: morning stiffness, Ritchie Articular Index (RAI, swollen joint count (SJC, tender joint count (TJC, physician's visual analog scale (VAS, hemoglobin level (Hb, leukocyte count (L, platelet count (Pl, Westergren erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, albumin, DAS and DAS28. Bone mineralization was measured by dual-energy X-ray absorptiometry (DXA of lumbar spine L1-L4. Assessments of bone metabolism included osteocalcin, C-terminal telopeptide (CTT, parathyroid hormone (PTH, total and ionized calcium, inorganic phosphate and total alkaline phosphatase (TAP. BclI polymorphism was genotyped by polymerase chain reaction restriction fragment length polymorphism. Results No association was observed between glucocorticoid receptor gene polymorphism and the presence or absence of JIA. In girls with JIA, the presence of the G allele was associated with an unfavorable arthritis course, a younger age of onset of arthritis (p = 0.0017, and higher inflammatory activity. The higher inflammatory activity was demonstrated by the following: increased time of morning stiffness (p = 0.02, VAS (p = 0.014, RAI (p = 0.048, DAS (p = 0.035, DAS28 (p = 0.05, Pl (p = 0.003, L (p = 0.046, CRP (p = 0.01. In addition, these patients had bone metabolism disturbances as follows: decreased BA (p = 0.0001, BMC (p = 0.00007, BMD (0.005 and Z score (p = 0.002; and

Papular xanthomas and erosive arthritis in a 3 year old girl, is this a new MRH variant?

Directory of Open Access Journals (Sweden)

Groh Brandt

2009-10-01

Full Text Available Abstract Xanthomatous skin lesions and arthritis in children are not a common association. We present the case of a 3 year old girl who presented with xanthomatous lesions in the periungual region of both hands, around the nares and on her forehead, associated with significant arthritis that was clinically compatible with multicentric reticulohistiocytosis. However, pathology of the xanthomatous lesions was more suggestive of papular xanthoma, a disease that is not associated with arthritis. Based on her presentation and the negative lipid workup, she was treated for presumed multicentric reticulohistiocytosis. Multiple treatment strategies were utilized, with improvement on a combination of infliximab, methotrexate, and prednisone. We review the different diagnoses that should be considered in children with xanthomas and arthritis as well as the different pharmacologic therapies used in children with multicentric reticulohistiocytosis.

A radiographic classification system in juvenile rheumatoid arthritis applied to the knee

International Nuclear Information System (INIS)

Dale, K.; Paus, A.C.; Laires, K.

1994-01-01

A new radiographic grading system for evaluation of juvenile rheumatoid arthritis (JRA) for the knee is presented. The classification is based on known arthritic criteria in childhood. Joints with erosion are given a higher score than growth disturbances alone. Signs of osteoarthrosis including joint space narrowing were excluded from the classification. The femorotibial and patello-femoral joints are assessed together. Verbal definitions are used for the classification, but, regarding the erosions, standard reference films are used. The intra- and inter-observer variations of the method were low. (P < 0.01) (orig.)

Radiographic changes in the condyle of the temporomandibular joint in psoriatic arthritis

International Nuclear Information System (INIS)

Koenoenen, M.; Helsinki Univ.

1987-01-01

One hundred and ten patients with psoriatic arthritis (PA) and 100 matched control patients were examined by using orthopantomography to discover radiographic changes in the condyle of the temporomandibular joint (TMJ). 31% of the PA patients and 13% of the control patients had radiographic changes in the condyle of the TMJ. The most common radiographic finding in PA patients was unilateral erosion of the condyle. Of the radiographic changes in the PA group, cortical erosions correlated negatively with age, whereas osteophytes correlated positively with the duration of PA. (orig.)

Survey of bone pain in patients of infectious section of Labafinejad hospital using radioisotope scanning

International Nuclear Information System (INIS)

Ibrahimie, Farhad

1996-01-01

Skeletal scintigraphy is the first or second most frequently performed imaging procedure in most nuclear medicine departments. The uses of bone scan in orthopedic practice are multiple. Bone scans are often used to localize disease, to identify areas of focal increased physiological activity, and to evaluate pain. Bone scans are particularly useful in depicting and localizing small tumors. Bone scans may clarify the significance of radiographic abnormalities. When pain is poorly localized, a bone scan helps focus attention, particularly when it precisely corresponds to the questionable radiographic lesion. In order to do a survey about role of bone scan for the detection and localizing bone pain, a retrospective study was done about 37 patient who from 1373 to 1374 were admitted to the infectious department of Martyr Labafinejad having bone pain. The results of our studies showed that most common case of bone pain of this patients was due to brucellosis (brucella arthritis) with 19%, and other causes were cellulits with 13.15% osteomyelitis and D.J.D with 11%, septic arthritis, bone metastasis, bone abscesses, discopathy, infectious spondylitis, lymphoma, D.V.T. and reactive traumatic arthritis with 2.7%

Magnetic resonance imaging, radiography, and scintigraphy of the finger joints: one year follow up of patients with early arthritis

Science.gov (United States)

Klarlund, M; Ostergaard, M; Jensen, K; Madsen, J; Skjodt, H; Lorenzen, I; the, T

2000-01-01

OBJECTIVES—To evaluate synovial membrane hypertrophy, tenosynovitis, and erosion development of the 2nd to 5th metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints by magnetic resonance imaging in a group of patients with rheumatoid arthritis (RA) or suspected RA followed up for one year. Additionally, to compare the results with radiography, bone scintigraphy, and clinical findings.
PATIENTS AND METHODS—Fifty five patients were examined at baseline, of whom 34 were followed up for one year. Twenty one patients already fulfilled the American College of Rheumatology (ACR) criteria for RA at baseline, five fulfilled the criteria only after one year's follow up, whereas eight maintained the original diagnosis of early unclassified polyarthritis. The following MRI variables were assessed at baseline and one year: synovial membrane hypertrophy score, number of erosions, and tenosynovitis score.
RESULTS—MRI detected progression of erosions earlier and more often than did radiography of the same joints; at baseline the MRI to radiography ratio was 28:4. Erosions were exclusively found in patients with RA at baseline or fulfilling the ACR criteria at one year. At one year follow up, scores of MR synovial membrane hypertrophy, tenosynovitis, and scintigraphic tracer accumulation had not changed significantly from baseline; in contrast, swollen and tender joint counts had declined significantly (pthe changes seen over time in clinically assessed swollen and tender joint counts. Although joint disease activity may be assessed as quiescent by conventional clinical methods, a more detailed evaluation by MRI may show that a pathological condition is still present within the synovium.

 PMID:10873961

RESULTS OF AN OPEN CLINICAL STUDY OF THE EFFICACY OF LEFLUNOMIDE IN RHEUMATOID ARTHRITIS

Directory of Open Access Journals (Sweden)

I M Marusenko

2009-06-01

Conclusion. The new basic drug leflunomide is as effective as the gold standard methotrexate, at the same time it allows clinical improvement to be more rapidly achieved. Leflunomide also slows down the rate of progression of erosive arthritis and it is well tolerated.

Bone scintigraphy in psoriasis

Energy Technology Data Exchange (ETDEWEB)

Hahn, K.; Thiers, G.; Eissner, D.; Holzmann, H.

1980-08-01

Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones.

The negative bone effects of the disease and of chronic corticosteroid treatment in premenopausal women affected by rheumatoid arthritis

Directory of Open Access Journals (Sweden)

A. Fassio

2016-09-01

Full Text Available Osteoporosis is a well-known extra-articular complication in rheumatoid arthritis (RA. The chronic corticosteroid treatment, the functional impairment associated with RA and the disease itself appear to be the most relevant determinants. Most of the previous studies involved postmenopausal women, in whom the estrogenic deficiency might amplify the negative effect towards bone of both RA and corticosteroid therapy. We decided to evaluate bone health in a cohort of premenopausal RA patients. The study population includes 47 premenopausal women attending our outpatient clinic for RA and twice as many healthy age-matched control women selected from the hospital personnel. The bone density at the spine and femoral neck were significantly lower in patients with RA as compared with controls. When spine bone mineral density (BMD values were adjusted for the cumulative glucocorticoid (GC dose alone and for the cumulative GC dose plus body mass index (BMI the mean differences between two groups decreased but they remained statistically significant. We found no difference when the spine BMD was adjusted for cumulative GC dose, BMI and health assessment questionnaire. The difference in femoral neck BMD remained statistically significant also after all the same adjustments. In conclusion, our study shows that a BMD deficiency is frequent also in premenopausal women affected by RA, especially at femoral site and that the main determinants of this bone loss are not only the disease-related weight loss, corticosteroid therapy and functional impairment, but also the systemic effects of the disease itself.

Differential diagnosis between chronic otitis media with and without cholesteatoma by temporal bone CT: focus on bone change and mass effect

International Nuclear Information System (INIS)

Jung, Cheol Kyu; Park, Dong Woo; Seong, Jin Yong; Lee, Kak Soo; Park Choong Ki; Lee, Seung Ro; Hahm, Chang Kok

2000-01-01

In order to determine specific differences, we compared the temporal bone CT findings of chronic otitis media (COM) with and without cholesteatoma, focusing on bone change. Between 1997 and 1998, 82 patients (84 cases) underwent temporal bone CT and were shown to have COM, with or without cholesteatoma after mastoidectomy and tympanoplasty. There were 36 cases of COM with cholesteatoma (26 patients, M:F =3D 11:15; age range, 16-61 (mean, 36,2) years), and 58 cases without chlesteatoma (56 patients, M:F =3D 25:31, age range, 15-61 (mean, 36.2) years). The findings of temporal bone CT were analysed at the point of bony changes including erosion and medial displacement of ossicles (malleus, incus, and stapes), erosion or destruction of the scutum, tegmen, facial canal, and lateral semicircular canal, and ballooning of the tympanic cavity and mastoid antrum. In addition, the soft tissue changes seen on temporal bone CT were analyzed at the site of lateral bulging of soft tissue in Prussak's space, perforation of the pars flaccida, tympanic membrane retraction, and tympanosclerosis. We retrospectively compared the findings of temporal bone CT with the surgical findings, and to assess statistical significance, the Chi-square test was used. Bone erosion or destruction was seen in 36.2% of COM cases without cholesteatoma, and in 96.2% of cases with cholesteatoma. Comparing COM with and without cholesteatoma, the erosion of ossicles including the malleus (81%, 24%), incus (88%, 14%), stapes (58%, 10%), scutum (88%, 10%), facial canal (8%, 0%), and lateral semicircular canal (8%, 0%), was more common in COM with cholesteatoma (p-value less than 0.05), with the exception of erosion of the tegmen (8%, 3%). Other bony changes including medial displacement of ossicles (27%, 3%), ballooning of tympanic cavity and mastoid antrum (96%, 16%), and the soft tissue changes including lateral bulging of soft tissue in Prussak's space (58%, 14%) and perforation of the pars flaccida (35

Differential diagnosis between chronic otitis media with and without cholesteatoma by temporal bone CT: focus on bone change and mass effect

Energy Technology Data Exchange (ETDEWEB)

Jung, Cheol Kyu; Park, Dong Woo; Seong, Jin Yong; Lee, Kak Soo; Park Choong Ki; Lee, Seung Ro; Hahm, Chang Kok [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

2000-01-01

In order to determine specific differences, we compared the temporal bone CT findings of chronic otitis media (COM) with and without cholesteatoma, focusing on bone change. Between 1997 and 1998, 82 patients (84 cases) underwent temporal bone CT and were shown to have COM, with or without cholesteatoma after mastoidectomy and tympanoplasty. There were 36 cases of COM with cholesteatoma (26 patients, M:F =3D 11:15; age range, 16-61 (mean, 36,2) years), and 58 cases without chlesteatoma (56 patients, M:F =3D 25:31, age range, 15-61 (mean, 36.2) years). The findings of temporal bone CT were analysed at the point of bony changes including erosion and medial displacement of ossicles (malleus, incus, and stapes), erosion or destruction of the scutum, tegmen, facial canal, and lateral semicircular canal, and ballooning of the tympanic cavity and mastoid antrum. In addition, the soft tissue changes seen on temporal bone CT were analyzed at the site of lateral bulging of soft tissue in Prussak's space, perforation of the pars flaccida, tympanic membrane retraction, and tympanosclerosis. We retrospectively compared the findings of temporal bone CT with the surgical findings, and to assess statistical significance, the Chi-square test was used. Bone erosion or destruction was seen in 36.2% of COM cases without cholesteatoma, and in 96.2% of cases with cholesteatoma. Comparing COM with and without cholesteatoma, the erosion of ossicles including the malleus (81%, 24%), incus (88%, 14%), stapes (58%, 10%), scutum (88%, 10%), facial canal (8%, 0%), and lateral semicircular canal (8%, 0%), was more common in COM with cholesteatoma (p-value less than 0.05), with the exception of erosion of the tegmen (8%, 3%). Other bony changes including medial displacement of ossicles (27%, 3%), ballooning of tympanic cavity and mastoid antrum (96%, 16%), and the soft tissue changes including lateral bulging of soft tissue in Prussak's space (58%, 14%) and perforation of the pars

Rheumatoid arthritis: identifying and characterising polymorphisms using rat models

Science.gov (United States)

2016-01-01

ABSTRACT Rheumatoid arthritis is a chronic inflammatory joint disorder characterised by erosive inflammation of the articular cartilage and by destruction of the synovial joints. It is regulated by both genetic and environmental factors, and, currently, there is no preventative treatment or cure for this disease. Genome-wide association studies have identified ∼100 new loci associated with rheumatoid arthritis, in addition to the already known locus within the major histocompatibility complex II region. However, together, these loci account for only a modest fraction of the genetic variance associated with this disease and very little is known about the pathogenic roles of most of the risk loci identified. Here, we discuss how rat models of rheumatoid arthritis are being used to detect quantitative trait loci that regulate different arthritic traits by genetic linkage analysis and to positionally clone the underlying causative genes using congenic strains. By isolating specific loci on a fixed genetic background, congenic strains overcome the challenges of genetic heterogeneity and environmental interactions associated with human studies. Most importantly, congenic strains allow functional experimental studies be performed to investigate the pathological consequences of natural genetic polymorphisms, as illustrated by the discovery of several major disease genes that contribute to arthritis in rats. We discuss how these advances have provided new biological insights into arthritis in humans. PMID:27736747

The joint in psoriatic arthritis.

Science.gov (United States)

Mortezavi, Mahta; Thiele, Ralph; Ritchlin, Christopher

2015-01-01

Psoriatic arthritis (PsA), a chronic inflammatory joint disease associated with psoriasis, is notable for diversity in disease presentation, course and response to treatment. Equally varied are the types of musculoskeletal involvement which include peripheral and axial joint disease, dactylitis and enthesitis. In this review, we focus on the psoriatic joint and discuss pathways that underlie synovial, cartilage and bone inflammation and highlight key histopathologic features. The pivotal inflammatory mechanisms and pathobiology of PsA parallel findings in other forms of spondyloarthritis but are distinct from disease pathways described in rheumatoid synovitis and bone disease. The diagnosis of PsA from both a clinical and imaging perspective is also discussed.

Dactylitis in psoriatic arthritis: clinical features, diagnosis, immunopathogenesis, and treatment

Directory of Open Access Journals (Sweden)

T. V. Korotaeva

2018-01-01

Full Text Available When dactylitis is detected in a patient with psoriatic arthritis (PsA, it is necessary to use active treatment as soon as possible, since in the absence of therapy the disease progresses to joint erosion and  functional disorders. The paper considers the clinical signs and  diagnosis of PsA and notes the importance of differential diagnosis in this sign with other joint inflammatory diseases. It points to the  necessity of elaborating common approaches to an objective  assessment of the severity of dactylitis. Its immunopathogenesis and main treatment areas, including the use of biological agents (BAs,  are detailed. There are data of clinical trials that have evaluated the  efficiency of treatment for dactylitis and established that in most  cases, the use of BAs considerably reduce not only the severity of its clinical signs, but also concomitant bone marrow edema. It is noted  that the development of new pathogenetic treatments targeting a number of currently established biologically active molecules that  play an important role in the pathogenesis of dactylitis will enhance  the efficiency of treatment in patients with PsA.

Dynamic contrast-enhanced magnetic resonance imaging of articular and extraarticular synovial structures of the hands in patients with psoriatic arthritis

DEFF Research Database (Denmark)

Cimmino, Marco Amedeo; Barbieri, Francesca; Boesen, Mikael

2012-01-01

Dynamic, contrast-enhanced magnetic resonance imaging (DCE-MRI), the quantification of enhancement within the synovial membrane and bone by extracting curves using fast T1-weighted sequences during intravenous administration of contrast agent, evaluates synovitis and bone marrow edema in psoriati...... arthritis (PsA). In this pilot study, we looked at possible differences between joint synovitis and tenosynovitis in PsA as compared with rheumatoid arthritis (RA)....

Automatic MPST-cut for segmentation of carpal bones from MR volumes.

Science.gov (United States)

Gemme, Laura; Nardotto, Sonia; Dellepiane, Silvana G

2017-08-01

In the context of rheumatic diseases, several studies suggest that Magnetic Resonance Imaging (MRI) allows the detection of the three main signs of Rheumatoid Arthritis (RA) at higher sensitivities than available through conventional radiology. The rapid, accurate segmentation of bones is an essential preliminary step for quantitative diagnosis, erosion evaluation, and multi-temporal data fusion. In the present paper, a new, semi-automatic, 3D graph-based segmentation method to extract carpal bone data is proposed. The method is unsupervised, does not employ any a priori model or knowledge, and is adaptive to the individual variability of the acquired data. After selecting one source point inside the Region of Interest (ROI), a segmentation process is initiated, which consists of two automatic stages: a cost-labeling phase and a graph-cutting phase. The algorithm finds optimal paths based on a new cost function by creating a Minimum Path Spanning Tree (MPST). To extract the region, a cut of the obtained tree is necessary. A new criterion of the MPST-cut based on compactness shape factor was conceived and developed. The proposed approach is applied to a large database of 96 T1-weighted MR bone volumes. Performance quality is evaluated by comparing the results with gold-standard bone volumes manually defined by rheumatologists through the computation of metrics extracted from the confusion matrix. Furthermore, comparisons with the existing literature are carried out. The results show that this method is efficient and provides satisfactory performance for bone segmentation on low-field MR volumes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Bone X-Ray (Radiography)

Medline Plus

Full Text Available ... and fracture reductions. look for injury, infection, arthritis , abnormal bone growths and bony changes seen in metabolic ... to current x-ray images for diagnosis and disease management. top of page How is the procedure ...

Bone X-Ray (Radiography)

Medline Plus

Full Text Available ... as spine repair/fusion, joint replacement and fracture reductions. look for injury, infection, arthritis , abnormal bone growths ... the individual patient's condition. Ultrasound imaging, which uses sound waves instead of ionizing radiation to create diagnostic ...

Bone X-Ray (Radiography)

Medline Plus

Full Text Available ... injury, infection, arthritis , abnormal bone growths and bony changes seen in metabolic conditions. assist in the detection ... examination may also be necessary so that any change in a known abnormality can be monitored over ...

Frequency of inflammatory-like MR imaging findings in asymptomatic fingers of healthy volunteers

International Nuclear Information System (INIS)

Agten, Christoph A.; Rosskopf, Andrea B.; Jonczy, Maciej; Pfirrmann, Christian W.A.; Buck, Florian M.; Brunner, Florian

2018-01-01

To describe the frequency of inflammatory-like findings on MR imaging in asymptomatic volunteers and compare them with patients with known rheumatoid arthritis and psoriatic arthritis. MR images of fingers in 42 asymptomatic volunteers and 33 patients with rheumatoid/psoriatic arthritis were analyzed. The Outcome Measures in Rheumatology Clinical Trials (OMERACT) Rheumatoid/Psoriatic Arthritis MRI Scoring System (RAMRIS/PsAMRIS) and tenosynovitis scoring system were used to assess: bone marrow edema (BME), erosions, tendon sheath fluid/tenosynovitis, joint effusion, and soft-tissue edema. Findings and scores were compared between volunteers and patients. Inter-reader agreement was calculated (intraclass correlation coefficients, ICC). In volunteers, tendon sheath fluid was very common in at least one location (42/42 volunteers for reader 1, 34/42 volunteers for reader 2). BME, erosions, joint effusion, and soft-tissue edema were absent (except one BME in the 3rd proximal phalanx for reader 1). Tendon sheath fluid scores in volunteers and tenosynovitis scores in patients were high (reader 1, 7.17 and 5.39; reader 2, 2.31 and 5.45). Overall, inter-reader agreement was substantial (ICC = 0.696-0.844), except for tendon sheath fluid (ICC = 0.258). Fluid in the finger flexor tendon sheaths may be a normal finding and without gadolinium administration should not be interpreted as tenosynovitis. Bone marrow edema, erosions, joint effusion, and soft-tissue edema in the fingers most likely reflect pathology if present. (orig.)

Frequency of inflammatory-like MR imaging findings in asymptomatic fingers of healthy volunteers

Energy Technology Data Exchange (ETDEWEB)

Agten, Christoph A.; Rosskopf, Andrea B.; Jonczy, Maciej; Pfirrmann, Christian W.A.; Buck, Florian M. [University Hospital Balgrist, Radiology, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland); Brunner, Florian [University of Zurich, Faculty of Medicine, Zurich (Switzerland); University Hospital Balgrist, Department of Physical Medicine and Rheumatology, Zurich (Switzerland)

2018-02-15

To describe the frequency of inflammatory-like findings on MR imaging in asymptomatic volunteers and compare them with patients with known rheumatoid arthritis and psoriatic arthritis. MR images of fingers in 42 asymptomatic volunteers and 33 patients with rheumatoid/psoriatic arthritis were analyzed. The Outcome Measures in Rheumatology Clinical Trials (OMERACT) Rheumatoid/Psoriatic Arthritis MRI Scoring System (RAMRIS/PsAMRIS) and tenosynovitis scoring system were used to assess: bone marrow edema (BME), erosions, tendon sheath fluid/tenosynovitis, joint effusion, and soft-tissue edema. Findings and scores were compared between volunteers and patients. Inter-reader agreement was calculated (intraclass correlation coefficients, ICC). In volunteers, tendon sheath fluid was very common in at least one location (42/42 volunteers for reader 1, 34/42 volunteers for reader 2). BME, erosions, joint effusion, and soft-tissue edema were absent (except one BME in the 3rd proximal phalanx for reader 1). Tendon sheath fluid scores in volunteers and tenosynovitis scores in patients were high (reader 1, 7.17 and 5.39; reader 2, 2.31 and 5.45). Overall, inter-reader agreement was substantial (ICC = 0.696-0.844), except for tendon sheath fluid (ICC = 0.258). Fluid in the finger flexor tendon sheaths may be a normal finding and without gadolinium administration should not be interpreted as tenosynovitis. Bone marrow edema, erosions, joint effusion, and soft-tissue edema in the fingers most likely reflect pathology if present. (orig.)

MRI features of Lyme arthritis of the hips

International Nuclear Information System (INIS)

Amini, Behrang; Geller, Matthew D.; Mathew, Manesh; Gerard, Perry

2007-01-01

Diagnosing Lyme arthritis without a history of travel to endemic regions or erythema migrans can be a challenge. Radiographic and ultrasonographic findings are nonspecific for the diagnosis of Lyme arthritis. We present the MRI features of Lyme disease of the hip in a 4-year-old boy who presented with hip pain and was found to have Lyme disease by Western blot. Our findings include bilateral hip effusions and synovial enhancement, normal bone marrow signal intensity without enhancement, minimal adjacent muscular and soft-tissue edema, and bilateral inguinal lymph nodes measuring up to 1 cm. (orig.)

MRI features of Lyme arthritis of the hips

Energy Technology Data Exchange (ETDEWEB)

Amini, Behrang [Maimonides Medical Center, Department of Surgery, Brooklyn, NY (United States); Geller, Matthew D. [New York College of Osteopathic Medicine, Old Westbury, NY (United States); Mathew, Manesh; Gerard, Perry [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States)

2007-11-15

Diagnosing Lyme arthritis without a history of travel to endemic regions or erythema migrans can be a challenge. Radiographic and ultrasonographic findings are nonspecific for the diagnosis of Lyme arthritis. We present the MRI features of Lyme disease of the hip in a 4-year-old boy who presented with hip pain and was found to have Lyme disease by Western blot. Our findings include bilateral hip effusions and synovial enhancement, normal bone marrow signal intensity without enhancement, minimal adjacent muscular and soft-tissue edema, and bilateral inguinal lymph nodes measuring up to 1 cm. (orig.)

Correlation of Periodontal Disease With Inflammatory Arthritis in the Time Before Modern Medical Intervention.

Science.gov (United States)

Rothschild, Bruce

2017-03-01

Controversy exists regarding possible correlation of periodontal disease with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Confounding factors may relate to stringency of inflammatory disease diagnosis and the effect of therapeutic intervention for RA on periodontal disease. These factors are investigated in this study. Forty-five individuals with documented RA (n = 15), spondyloarthropathy (n = 15), and calcium pyrophosphate deposition disease (CPPD) (n = 15), from the Hamann-Todd collection of human skeletons compiled from 1912 to 1938, and 15 individuals contemporarily incorporated in the collection were examined for tooth loss, cavity occurrence, average and maximum lingual and buccal depth of space between tooth and bone, periosteal reaction, serpentine bone resorption, abscess formation, and root penetration of the bone surface and analyzed by analysis of variance. Tooth loss was common, but actual number of teeth lost, cavity occurrence, average and maximum lingual and buccal depth of space between tooth and bone, periosteal reaction, serpentine grooving surrounding teeth (considered a sign of inflammation), abscess formation, and root exposure (penetration of bone surface) were indistinguishable among controls and individuals with RA, spondyloarthropathy, and CPPD. Although many factors can affect periodontal disease, presence of inflammatory arthritis does not appear to be one of them. The implication is that dental disease was common in the general population and not necessarily associated with arthritis, at least before the advent of modern rheumatologic medications. As specific diagnosis did not affect prevalence, perhaps current prevalence controversy may relate to current intervention, a subject for further study.

Psoriatic arthritis: an update.

Science.gov (United States)

López-Ferrer, A; Laiz-Alonso, A

2014-12-01

Advances in our understanding of the pathogenesis of psoriatic arthritis and clinical aspects of the disease justify the present review. Studies have identified common inflammatory pathways related to the innate immune response, such as the IL-12/IL-23 axis, along with numerous genes that affect susceptibility to both diseases and influence phenotypic development. Interest has grown in biomarkers that can be used for early diagnosis or prognosis or to predict joint destruction and the response to treatment. Recent reports describe important differences between the effects of disease-modifying antirheumatic drugs and biologics on the process of new bone formation. Other issues that have been discussed include the need for reliable screening methods, particularly for early detection of oligoarticular arthritis, and for protocols to guide referral to specialists, especially in newly created multidisciplinary practices. Copyright © 2013 Elsevier España, S.L.U. y AEDV. All rights reserved.

Intravenous delivery of HIV-based lentiviral vectors preferentially transduces F4/80+ and Ly-6C+ cells in spleen, important target cells in autoimmune arthritis.

Directory of Open Access Journals (Sweden)

Ben T van den Brand

Full Text Available Antigen presenting cells (APCs play an important role in arthritis and APC specific gene therapeutic targeting will enable intracellular modulation of cell activity. Viral mediated overexpression is a potent approach to achieve adequate transgene expression levels and lentivirus (LV is useful for sustained expression in target cells. Therefore, we studied the feasibility of lentiviral mediated targeting of APCs in experimental arthritis. Third generation VSV-G pseudotyped self-inactivating (SIN-LV were injected intravenously and spleen cells were analyzed with flow cytometry for green fluorescent protein (GFP transgene expression and cell surface markers. Collagen-induced arthritis (CIA was induced by immunization with bovine collagen type II in complete Freund's adjuvant. Effect on inflammation was monitored macroscopically and T-cell subsets in spleen were analyzed by flow cytometry. Synovium from arthritic knee joints were analyzed for proinflammatory cytokine expression. Lentiviruses injected via the tail vein preferentially infected the spleen and transduction peaks at day 10. A dose escalating study showed that 8% of all spleen cells were targeted and further analysis showed that predominantly Ly6C+ and F4/80+ cells in spleen were targeted by the LV. To study the feasibility of blocking TAK1-dependent pathways by this approach, a catalytically inactive mutant of TAK1 (TAK1-K63W was overexpressed during CIA. LV-TAK1-K63W significantly reduced incidence and arthritis severity macroscopically. Further histological analysis showed a significant decrease in bone erosion in LV-TAK1-K63W treated animals. Moreover, systemic Th17 levels were decreased by LV-TAK1-K63W treatment in addition to diminished IL-6 and KC production in inflamed synovium. In conclusion, systemically delivered LV efficiently targets monocytes and macrophages in spleen that are involved in autoimmune arthritis. Moreover, this study confirms efficacy of TAK1 targeting in

Bone scintigraphy in psoriasis

International Nuclear Information System (INIS)

Hahn, K.; Thiers, G.; Eissner, D.; Holzmann, H.; Frankfurt Univ.

1980-01-01

Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones. (orig.) [de

Express-diagnostics of rheumatoid arthritis and osteoarthrosis

Directory of Open Access Journals (Sweden)

Zoltan M. Sigal

2017-09-01

Full Text Available Introduction: Diseases of bones and joints have the third greatest impact on the health of the world population. Rheumatoid arthritis and osteoarthritis are uppermost inflammatory diseases of the joints. The aim of the study is the assessment of the ultrasonography and transillumination pulsooptometry of the knee joint as the diagnostic tools for rheumatoid arthritis and osteoarthrosis. Materials and Methods: 2 266 people (29 % – rheumatoid arthritis, 62 % – osteoarthritis, 9 % – healthy, aged 19–75 years took part in the study. The ultrasonography and transillumination pulsooptometry were conducted. Measurements of hemodynamics and optical density were performed using the device and method of Z. M. Sigal (2007. Results. Various indicators were established, for example, the volume of synovial fluid in the suprapatellar bag for rheumatoid arthritis and osteoarthritis. Optical density for rheumatoid arthritis is three times less than for osteoarthritis. There are significant differences in the amplitude of pulse oscillations in rheumatoid arthritis and osteoarthritis. Results: Various indicators were established, for example, the volume of synovial fluid in the suprapatellar bag for rheumatoid arthritis and osteoarthritis. Optical density for rheumatoid arthritis is three times less than for osteoarthritis. There are significant differences in the amplitude of pulse oscillations in rheumatoid arthritis and osteoarthritis. Discussion and Conclusions: The volume of synovial fluid in the suprapatellar bag of the knee joint with rheumatoid arthritis is higher than in osteoarthritis and normal: 55.8 cm3 and above and 3,29 cm3, 1,85 cm3 and below, respectively. With osteoarthritis and normal amount of synovial fluid did not differ significantly. The optical density in the suprapatellar bag of the knee joint for rheumatoid arthritis was 0.56 ± 0.2, the amplitude of pulse oscillations was 13.45 ± 3.62 mm. In osteoarthritis, these values were 1

Bone X-Ray (Radiography)

Medline Plus

Full Text Available ... x-rays. top of page What does the equipment look like? The equipment typically used for bone x-rays consists of ... and joint abnormalities, such as arthritis. X-ray equipment is relatively inexpensive and widely available in emergency ...

Photoacoustic and ultrasound dual-modality imaging for inflammatory arthritis

Science.gov (United States)

Xu, Guan; Chamberland, David; Girish, Gandikota; Wang, Xueding

2014-03-01

Arthritis is a leading cause of disability, affecting 46 million of the population in the U.S. Rendering new optical contrast in articular tissues at high spatial and temporal resolution, emerging photoacoustic imaging (PAI) combined with more established ultrasound (US) imaging technologies provides unique opportunities for diagnosis and treatment monitoring of inflammatory arthritis. In addition to capturing peripheral bone and soft tissue images, PAI has the capability to quantify hemodynamic properties including regional blood oxygenation and blood volume, both abnormal in synovial tissues affected by arthritis. Therefore, PAI, especially when performed together with US, should be of considerable help for further understanding the pathophysiology of arthritis as well as assisting in therapeutic decisions, including assessing the efficacy of new pharmacological therapies. In this paper, we will review our recent work on the development of PAI for application to the diagnostic imaging and therapeutic monitoring of inflammatory arthritis. We will present the imaging results from a home-built imaging system and another one based on a commercial US. The performance of PAI in evaluating pharmacological therapy on animal model of arthritis will be shown. Moreover, our resent work on PAI and US dual-modality imaging of human peripheral joints in vivo will also be presented.

[The temporomandibular joint in juvenile idiopathic arthritis: what radiologists need to look for on magnetic resonance imaging].

Science.gov (United States)

De La Hoz Polo, M; Navallas, M

2014-01-01

The term "juvenile idiopathic arthritis" (JIA) encompasses a group of arthritis of unknown cause with onset before the age of 16 years that last for at least 6 weeks. The prevalence of temporomandibular joint involvement in published series ranges from 17% to 87%. Temporomandibular joint involvement is difficult to detect clinically, so imaging plays a key role in diagnosis and monitoring treatment. MRI is the technique of choice for the study of arthritis of the temporomandibular joint because it is the most sensitive technique for detecting acute synovitis and bone edema. Power Doppler ultrasonography can also detect active synovitis by showing the hypervascularization of the inflamed synovial membrane, but it cannot identify bone edema. This article describes the MRI technique for evaluating the temporomandibular joint in patients with juvenile idiopathic arthritis, defines the parameters to look for, and illustrates the main findings. Copyright © 2013 SERAM. Published by Elsevier Espana. All rights reserved.

Denosumab for bone diseases: translating bone biology into targeted therapy.

Science.gov (United States)

Tsourdi, Elena; Rachner, Tilman D; Rauner, Martina; Hamann, Christine; Hofbauer, Lorenz C

2011-12-01

Signalling of receptor activator of nuclear factor-κB (RANK) ligand (RANKL) through RANK is a critical pathway to regulate the differentiation and activity of osteoclasts and, hence, a master regulator of bone resorption. Increased RANKL activity has been demonstrated in diseases characterised by excessive bone loss such as osteoporosis, rheumatoid arthritis and osteolytic bone metastases. The development and approval of denosumab, a fully MAB against RANKL, has heralded a new era in the treatment of bone diseases by providing a potent, targeted and reversible inhibitor of bone resorption. This article summarises the molecular and cellular biology of the RANKL/RANK system and critically reviews preclinical and clinical studies that have established denosumab as a promising novel therapy for metabolic and malignant bone diseases. We will discuss the potential indications for denosumab along with a critical review of safety and analyse its potential within the concert of established therapies.

Reducing glucocorticoid dosage improves serum osteocalcin in patients with rheumatoid arthritis-results from the TOMORROW study.

Science.gov (United States)

Tada, M; Inui, K; Sugioka, Y; Mamoto, K; Okano, T; Koike, T; Nakamura, H

2016-02-01

Decreasing the daily dose of glucocorticoids improved bone metabolic marker levels in patients with rheumatoid arthritis. However, changes in disease activity did not influence bone metabolism. Bone metabolism might thus remain uncontrolled even if disease activity is under good control. Decreasing glucocorticoid dosage appears important for improving bone metabolism. Patients with rheumatoid arthritis (RA) develop osteoporosis more frequently than healthy individuals. Bone resorption is increased and bone formation is inhibited in patients with RA, and glucocorticoid negatively affects bone metabolism. We aimed to investigate factors influencing bone metabolic markers in patients with RA. We started the 10-year prospective cohort Total Management of Risk Factors in Rheumatoid Arthritis Patients to Lower Morbidity and Mortality (TOMORROW) study in 2010. We compared changes in urinary cross-linked N-telopeptide of type I collagen (uNTx) and serum osteocalcin (OC), as markers of bone resorption and formation, respectively, in 202 RA patients and age- and sex-matched volunteers between 2010 and 2011. We also investigated factors influencing ΔuNTx and ΔOC in the RA group using multivariate analysis. Values of ΔuNTx were significantly lower in patients with RA than in healthy controls (-0.51 vs. 7.41 nmol bone collagen equivalents (BCE)/mmol creatinine (Cr); p = 0.0013), whereas ΔOC values were significantly higher in RA patients (0.94 vs. 0.37 ng/ml; p = 0.0065). Changes in prednisolone dosage correlated negatively with ΔOC (β = -0.229, p = 0.001), whereas changes in disease activity score, bisphosphonate therapy, and period of biologics therapy did not correlate significantly with ΔOC. No significant correlation was seen between ΔuNTx and change in prednisolone dosage. Decreased glucocorticoid dosage improved bone metabolic markers in RA, but disease activity, bisphosphonate therapy, and period of biologics therapy did not influence

Effect of intraarticular osmic acid on synovial membrane volume and inflammation, determined by magnetic resonance imaging

DEFF Research Database (Denmark)

Østergaard, Mikkel; Stoltenberg, M; Gideon, P

1995-01-01

The changes in MR-determined synovial membrane volume, early synovial enhancement, and cartilage and bone erosions after osmic acid knee synovectomy were studied. Gadolinium-DTPA enhanced magnetic resonance imaging (MRI) of 18 knees with persistent arthritis was performed before and 1 month after...

Time course of bone mineral density changes during 4-year rituximab therapy in postmenopausal women with rheumatoid arthritis

Directory of Open Access Journals (Sweden)

T. A. Raskina

2015-01-01

Full Text Available Objective: to estimate the time course of bone mineral density (BMD changes during 4-year rituximab (RTM therapy in postmenopausal women with rheumatoid arthritis (RA.Subjects and methods. Seventy-nine postmenopausal women with a valid diagnosis of RA were followed up. According to the basic therapy option, all the patients were allocated into two groups: 1 44 patients who received combination therapy with RTM and methotrexate (MT; 2 35 patients who had MT monotherapy. BMD was estimated by dual-energy X-ray absorptiometry using an Excell XR-46 stationary dualenergy X-ray bone densitometer (Norland, USA.Results. There was a statistically significant increase in femoral neck BMD and T score as compared to the baseline values in the RTM group after 3 years of follow-up. The MT monotherapy group showed no statistically significant densitometric changes in the femoral neck. The similar positive BMD changes were observed 4 years following RTM and MT therapy.Conclusion. Following 2 therapy cycles, femoral neck BMD parameters were noted to be stabilized in the patients with RA. After 3 therapy cycles, there was a positive densitometric change that remained by the fourth therapy cycle.

Factors associated with sustained remission in patients with rheumatoid arthritis.

Science.gov (United States)

Martire, María Victoria; Marino Claverie, Lucila; Duarte, Vanesa; Secco, Anastasia; Mammani, Marta

2015-01-01

To find out the factors that are associated with sustained remission measured by DAS28 and boolean ACR EULAR 2011 criteria at the time of diagnosis of rheumatoid arthritis. Medical records of patients with rheumatoid arthritis in sustained remission according to DAS28 were reviewed. They were compared with patients who did not achieved values of DAS28<2.6 in any visit during the first 3 years after diagnosis. We also evaluated if patients achieved the boolean ACR/EULAR criteria. Variables analyzed: sex, age, smoking, comorbidities, rheumatoid factor, anti-CCP, ESR, CRP, erosions, HAQ, DAS28, extra-articular manifestations, time to initiation of treatment, involvement of large joints, number of tender joints, number of swollen joints, pharmacological treatment. Forty five patients that achieved sustained remission were compared with 44 controls. The variables present at diagnosis that significantly were associated with remission by DAS28 were: lower values of DAS28, HAQ, ESR, NTJ, NSJ, negative CRP, absence of erosions, male sex and absence of involvement of large joints. Only 24.71% achieved the boolean criteria. The variables associated with sustained remission by these criteria were: lower values of DAS28, HAQ, ESR, number of tender joints and number of swollen joints, negative CRP and absence of erosions. The factors associated with sustained remission were the lower baseline disease activity, the low degree of functional disability and lower joint involvement. We consider it important to recognize these factors to optimize treatment. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Rheumatoid arthritis: Radiological changes in the cervical spine

International Nuclear Information System (INIS)

Al-Boukai, Ahmad A.; Al-Arfaj, Abdurahman S.

2003-01-01

Objective was to describe the radiographic cervical spine changes in rheumatoid arthritis patients.Forty-nine patients (37 females and 12 males ) diagnosed with rheumatoid arthritis at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between June 1998 and December 2000, were studied for their radiographic cervical spine changes . Their mean age at disease onset was 41.4 + 13.4 years (range of 18-73)and mean duration of disease was 9.1+-6.28 years (range of 2-34). Their demographic data including rheumatoid factor status was obtained. Standard conventional radiographs cervical spine were obtained to study the cervical spine changes. Cervical radiographic changes were found in 34 patients (27 females and 7 males) 10 had subluxation (7 with atlanto-axial subluxation,2 with sub-axial subluxation,and one with lateral subluxation ). No vertical impaction was seen. Erosion of odontoid process was seen in one patient .All were rheumatoid seropositive Cervical spine changes in patients with rheumatoid arthritis are common, in particular subluxation in the upper cervical spine. Our study showed somewhat lesser prevalence of these changes. These were clinically correlated with disease duration, female sex, and rheumatoid factor, but were not clinically significant. (author)

Temporomandibular joint involvement in rheumatoid arthritis patients: association between clinical and tomographic data

OpenAIRE

Cordeiro, Patrícia C. F; Guimaraes, Josemar P; de Souza, Viviane A; Dias, Isabela M; Silva, Jesca N. N; Devito, Karina L; Bonato, Leticia L

2016-01-01

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation and synovial hyperplasia, which usually affects multiple joints. The temporomandibular joint (TMJ) becomes susceptible to the development of changes resulting from RA. The aim of this study was to evaluate the presence of TMD and degenerative bone changes in TMJ in patients diagnosed with RA (rheumatoid arthritis). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) questio...

Extra-virgin olive oil and its phenolic extract prevent inflammatory response and joint damage in murine experimental arthritis

International Nuclear Information System (INIS)

Rosillo, M.A.; Sanchez-Hidalgo, M.; AlarcOn-de-la-Lastra, C.

2016-01-01

The consumption of EVOO in Mediterranean countries has shown beneficial effects. A wide range of evidence indicates that the phenolic compounds present in EVOO are endowed with anti-inflammatory properties. In this work, we evaluated the effects of dietary EVOO and treatment with its phenolic extract (PE) in a model of RA, the collagen-induced arthritis (CIA) in mice. On day 0, DBA-1/J mice were immunized with bovine collagen type II (CII). On day 21, the mice received a booster injection. We have demonstrated that EVOO and its PE decreases joint edema, cell migration, cartilage degradation and bone erosion. Our data indicate that dietary EVOO and PE treatment inhibit JNK, p38 and signal transducer and STAT-3. In addition, both EVOO and PE decrease NF-κB translocation leading to the down-regulation of the arthritic process. These results support the interest of natural diet components in the development of therapeutic products for arthritic conditions. [es

Extra-virgin olive oil and its phenolic extract prevent inflammatory response and joint damage in murine experimental arthritis

Directory of Open Access Journals (Sweden)

M. A. Rosillo

2016-12-01

Full Text Available The consumption of EVOO in Mediterranean countries has shown beneficial effects. A wide range of evidence indicates that the phenolic compounds present in EVOO are endowed with anti-inflammatory properties. In this work, we evaluated the effects of dietary EVOO and treatment with its phenolic extract (PE in a model of RA, the collagen-induced arthritis (CIA in mice. On day 0, DBA-1/J mice were immunized with bovine collagen type II (CII. On day 21, the mice received a booster injection. We have demonstrated that EVOO and its PE decreases joint edema, cell migration, cartilage degradation and bone erosion. Our data indicate that dietary EVOO and PE treatment inhibit JNK, p38 and signal transducer and STAT-3. In addition, both EVOO and PE decrease NF-κB translocation leading to the down-regulation of the arthritic process. These results support the interest of natural diet components in the development of therapeutic products for arthritic conditions.

Validation of the OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) for the Hand and Foot in a Randomized Placebo-controlled Trial.

Science.gov (United States)

Glinatsi, Daniel; Bird, Paul; Gandjbakhch, Frederique; Mease, Philip J; Bøyesen, Pernille; Peterfy, Charles G; Conaghan, Philip G; Østergaard, Mikkel

2015-12-01

To assess changes following treatment and the reliability and responsiveness to change of the Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) in a randomized controlled trial. Forty patients with PsA randomized to either placebo or abatacept (ABA) had MRI of either 1 hand (n = 20) or 1 foot (n = 20) at baseline and after 6 months. Images were scored blindly twice by 3 independent readers according to the PsAMRIS (for synovitis, tenosynovitis, periarticular inflammation, bone edema, bone erosion, and bone proliferation). Inflammatory features improved numerically but statistically nonsignificantly in the ABA group but not the placebo group. Baseline intrareader intraclass correlation coefficients (ICC) were good (≥ 0.50) to very good (≥ 0.80) for all features in both hand and foot. Baseline interreader ICC were good (ICC 0.72-0.96) for all features, except periarticular inflammation and bone proliferation in the hand and tenosynovitis in the foot (ICC 0.25-0.44). Intrareader and interreader ICC for change scores varied. Guyatt's responsiveness index (GRI) was high for inflammatory features in the hand and metatarsophalangeal joints (GRI -0.67 to -3.13; bone edema not calculable). Minimal change and low prevalence resulted in low ICC and GRI for bone damage. PsAMRIS showed overall good intrareader agreement in the hand and foot, and inflammatory feature scores were responsive to change, suggesting that PsAMRIS may be a valid tool for MRI assessment of hands and feet in PsA clinical trials.

Erosion and erosion-corrosion

International Nuclear Information System (INIS)

Isomoto, Yoshinori

2008-01-01

It is very difficult to interpret the technical term of erosion-corrosion' which is sometimes encountered in piping systems of power plants, because of complicated mechanisms and several confusing definitions of erosion-corrosion phenomena. 'FAC (flow accelerated corrosion)' is recently introduced as wall thinning of materials in power plant systems, as a representative of 'erosion-corrosion'. FAC is, however, not necessarily well understood and compared with erosion-corrosion. This paper describes firstly the origin, definition and fundamental understandings of erosion and erosion-corrosion, in order to reconsider and reconfirm the phenomena of erosion, erosion-corrosion and FAC. Next, typical mapping of erosion, corrosion, erosion-corrosion and FAC are introduced in flow velocity and environmental corrosiveness axes. The concept of damage rate in erosion-corrosion is finally discussed, connecting dissolution rate, mass transfer of metal ions in a metal oxide film and film growth. (author)

Rheumatoid arthritis clinical features and management strategies at an urban tertiary facility in Pakistan.

Science.gov (United States)

Rais, Rehan; Saeed, Mohammad; Haider, Rimsha; Jassani, Zahra; Riaz, Amir; Perveen, Tahira

2014-12-01

To determine the presentation patterns, biologically vulnerable patient groups and treatment strategies of rheumatoid arthritis. The retrospective study was conducted at the Rheumatology Clinic of Liaquat National Hospital and Medical College, Karachi, and comprised data of rheumatology patients who presented between September 2006 and September 2012. After screening all the files, rheumatoid arthritis cases were identified. Data collection was done using a questionnaire that included patient demographics, co-morbidities, clinical manifestations and drug therapy. SPSS 13 was used for statistical analysis. Of the 2300 files screened, 500(21.7%) related to patients of rheumatoid arthritis. The mean age at presentation of these 500 patients was 41±15 years. There were 367(73.4%) women and they presented at an earlier age compared to men (p<0.024). Erosions were present in 198(40%) patients on X-rays and 22(4.4%) had joint deformities. Seropositive rheumatoid arthritis was associated with higher erythrocyte sedimentation rate levels (p<0.014), but did not differ from seronegative rheumatoid arthritis in terms of Disease Activity Score-28 levels (p<0.21). The skewed gender distribution was likely an effect of rheumatoid arthritis biology rather than due to issues of healthcare accessibility. Seronegative RA is likely to present late though it is as destructive as the seropositive disease.

MRI features of tuberculosis of peripheral joints

Energy Technology Data Exchange (ETDEWEB)

Sawlani, V.; Chandra, T.; Mishra, R.N.; Aggarwal, A.; Jain, U.K.; Gujral, R.B. E-mail: gujralrb@sgpgi.ac.in

2003-10-01

The aim of this article is to present the magnetic resonance imaging (MRI) features of peripheral tubercular arthritis. The clinical presentation of peripheral tubercular arthritis is variable and simulates other chronic inflammatory arthritic disorders. MRI is a highly sensitive technique which demonstrates fine anatomical details and identifies the early changes of arthritis, which are not visible on radiographs. The MRI features of tubercular arthritis include synovitis, effusion, central and peripheral erosions, active and chronic pannus, abscess, bone chips and hypo-intense synovium. These imaging features in an appropriate clinical setting may help in the diagnosis of tubercular arthritis. Early diagnosis and treatment can effectively eliminate the long-term morbidity of joints affected by tuberculosis.

MRI features of tuberculosis of peripheral joints

International Nuclear Information System (INIS)

Sawlani, V.; Chandra, T.; Mishra, R.N.; Aggarwal, A.; Jain, U.K.; Gujral, R.B.

2003-01-01

The aim of this article is to present the magnetic resonance imaging (MRI) features of peripheral tubercular arthritis. The clinical presentation of peripheral tubercular arthritis is variable and simulates other chronic inflammatory arthritic disorders. MRI is a highly sensitive technique which demonstrates fine anatomical details and identifies the early changes of arthritis, which are not visible on radiographs. The MRI features of tubercular arthritis include synovitis, effusion, central and peripheral erosions, active and chronic pannus, abscess, bone chips and hypo-intense synovium. These imaging features in an appropriate clinical setting may help in the diagnosis of tubercular arthritis. Early diagnosis and treatment can effectively eliminate the long-term morbidity of joints affected by tuberculosis

Body composition in children with juvenile idiopathic arthritis: effect ...

African Journals Online (AJOL)

Introduction: the aim of this study was to evaluate the relationship between macronutrient intake, body composition (lean body mass and fat mass) and bone mineral content in Moroccan children with juvenile idiopathic arthritis (JIA). Methods: a cross-sectional study, conducted between May 2010 and June 2011, covering ...

Megakaryocytes compensate for Kit insufficiency in murine arthritis.

Science.gov (United States)

Cunin, Pierre; Penke, Loka R; Thon, Jonathan N; Monach, Paul A; Jones, Tatiana; Chang, Margaret H; Chen, Mary M; Melki, Imene; Lacroix, Steve; Iwakura, Yoichiro; Ware, Jerry; Gurish, Michael F; Italiano, Joseph E; Boilard, Eric; Nigrovic, Peter A

2017-05-01

The growth factor receptor Kit is involved in hematopoietic and nonhematopoietic development. Mice bearing Kit defects lack mast cells; however, strains bearing different Kit alleles exhibit diverse phenotypes. Herein, we investigated factors underlying differential sensitivity to IgG-mediated arthritis in 2 mast cell-deficient murine lines: KitWsh/Wsh, which develops robust arthritis, and KitW/Wv, which does not. Reciprocal bone marrow transplantation between KitW/Wv and KitWsh/Wsh mice revealed that arthritis resistance reflects a hematopoietic defect in addition to mast cell deficiency. In KitW/Wv mice, restoration of susceptibility to IgG-mediated arthritis was neutrophil independent but required IL-1 and the platelet/megakaryocyte markers NF-E2 and glycoprotein VI. In KitW/Wv mice, platelets were present in numbers similar to those in WT animals and functionally intact, and transfer of WT platelets did not restore arthritis susceptibility. These data implicated a platelet-independent role for the megakaryocyte, a Kit-dependent lineage that is selectively deficient in KitW/Wv mice. Megakaryocytes secreted IL-1 directly and as a component of circulating microparticles, which activated synovial fibroblasts in an IL-1-dependent manner. Transfer of WT but not IL-1-deficient megakaryocytes restored arthritis susceptibility to KitW/Wv mice. These findings identify functional redundancy among Kit-dependent hematopoietic lineages and establish an unanticipated capacity of megakaryocytes to mediate IL-1-driven systemic inflammatory disease.

Oral administration of curcumin suppresses production of matrix metalloproteinase (MMP)-1 and MMP-3 to ameliorate collagen-induced arthritis: inhibition of the PKCdelta/JNK/c-Jun pathway.

Science.gov (United States)

Mun, Se Hwan; Kim, Hyuk Soon; Kim, Jie Wan; Ko, Na Young; Kim, Do Kyun; Lee, Beob Yi; Kim, Bokyung; Won, Hyung Sik; Shin, Hwa-Sup; Han, Jeung-Whan; Lee, Hoi Young; Kim, Young Mi; Choi, Wahn Soo

2009-09-01

We investigated whether oral administration of curcumin suppressed type II collagen-induced arthritis (CIA) in mice and its effect and mechanism on matrix metalloproteinase (MMP)-1 and MMP-3 production in CIA mice, RA fibroblast-like synoviocytes (FLS), and chondrocytes. CIA in mice was suppressed by oral administration of curcumin in a dose-dependent manner. Macroscopic observations were confirmed by histological examinations. Histological changes including infiltration of immune cells, synovial hyperplasia, cartilage destruction, and bone erosion in the hind paw sections were extensively suppressed by curcumin. The histological scores were consistent with clinical arthritis indexes. Production of MMP-1 and MMP-3 were inhibited by curcumin in CIA hind paw sections and tumor necrosis factor (TNF)-alpha-stimulated FLS and chondrocytes in a dose-dependent manner. As for the mechanism, curcumin inhibited activating phosphorylation of protein kinase Cdelta (PKCdelta) in CIA, FLS, and chondrocytes. Curcumin also suppressed the JNK and c-Jun activation in those cells. This study suggests that the suppression of MMP-1 and MMP-3 production by curcumin in CIA is mediated through the inhibition of PKCdelta and the JNK/c-Jun signaling pathway.

 Adiponectin in early and chronic rheumatoid arthritis and osteoarthritis

DEFF Research Database (Denmark)

Laurberg, Trine Bay

  Dato 31. januar 2006Title Adiponectin in early and chronic rheumatoid arthritis and osteoarthritisAuthors:Trine Bay Laurberg,Torkell Ellingsen,Jan Frystyk,Ib Hansen,Anette Jørgensen,Ulrik Tarp,Merete Lund Hetland,Kim Hørslev-Petersen,Nete Hornung,Jørgen Hjelm Poulsen,Allan Flyvbjerg,Kristian St......  Dato 31. januar 2006Title Adiponectin in early and chronic rheumatoid arthritis and osteoarthritisAuthors:Trine Bay Laurberg,Torkell Ellingsen,Jan Frystyk,Ib Hansen,Anette Jørgensen,Ulrik Tarp,Merete Lund Hetland,Kim Hørslev-Petersen,Nete Hornung,Jørgen Hjelm Poulsen,Allan Flyvbjerg......,Kristian Stengaard-PedersenBackground: Rheumatoid arthritis (RA) is a systemic, chronic, autoimmune disease, which affects the joints with inflammation leading to destruction of cartilage and bone. Osteoarthritis (OA) is a degenerative joint disease characterised by low level of chronic inflammation, slow...

Magnetic resonance imaging for early diagnosis of rheumatoid arthritis

International Nuclear Information System (INIS)

Uhl, M.; Allmann, K.H.; Hauer, M.P.; Laubenberger, J.; Kempis, J. v.; Langer, M.

1997-01-01

Nuclear magnetic resonance tomography (MRI) represents essential progress in the diagnostic means for evaluation of lesions of the muskuloskeletal system. The imaging of bone joints including material and structures like cartilage, tendons, ligaments, effusions, pannus, cortical bone and marrow offers essential advantages for diagnosis, differential diagnosis, follow-up control and detection of local complications in rheumatics radiology. The review article discusses the achievements of MRI for detection of early signs of rheumatoid arthritis and the current indications for MRI examination for early diagnosis. (Orig./AJ) [de

Erosive arthritis in a patient with pycnodysostosis: An experiment of nature

NARCIS (Netherlands)

Ainola, M.; Valleala, H.; Nykänen, P.; Risteli, J.; Hanemaaijer, R.; Konttinen, Y.T.

2008-01-01

Objective. The excellent poster painter Henri de Toulouse-Lautrec is the most famous patient with cathepsin K-deficient pycnodysostosis. Cathepsin K is believed to play a major role in osteoclast-driven bone resorption. In this study we explored the role of cathepsin K in bone resorption in a

Deduction of Novel Genes Potentially Involved in Osteoblasts of Rheumatoid Arthritis Using Next-Generation Sequencing and Bioinformatic Approaches

Directory of Open Access Journals (Sweden)

Yi-Jen Chen

2017-11-01

Full Text Available The role of osteoblasts in peri-articular bone loss and bone erosion in rheumatoid arthritis (RA has gained much attention, and microRNAs are hypothesized to play critical roles in the regulation of osteoblast function in RA. The aim of this study is to explore novel microRNAs differentially expressed in RA osteoblasts and to identify genes potentially involved in the dysregulated bone homeostasis in RA. RNAs were extracted from cultured normal and RA osteoblasts for sequencing. Using the next generation sequencing and bioinformatics approaches, we identified 35 differentially expressed microRNAs and 13 differentially expressed genes with potential microRNA–mRNA interactions in RA osteoblasts. The 13 candidate genes were involved mainly in cell–matrix adhesion, as classified by the Gene Ontology. Two genes of interest identified from RA osteoblasts, A-kinase anchoring protein 12 (AKAP12 and leucin rich repeat containing 15 (LRRC15, were found to express more consistently in the related RA synovial tissue arrays in the Gene Expression Omnibus database, with the predicted interactions with miR-183-5p and miR-146a-5p, respectively. The Ingenuity Pathway Analysis identified AKAP12 as one of the genes involved in protein kinase A signaling and the function of chemotaxis, interconnecting with molecules related to neovascularization. The findings indicate new candidate genes as the potential indicators in evaluating therapies targeting chemotaxis and neovascularization to control joint destruction in RA.

Large-scale linkage analysis of 1302 affected relative pairs with rheumatoid arthritis

Science.gov (United States)

Hamshere, Marian L; Segurado, Ricardo; Moskvina, Valentina; Nikolov, Ivan; Glaser, Beate; Holmans, Peter A

2007-01-01

Rheumatoid arthritis is the most common systematic autoimmune disease and its etiology is believed to have both strong genetic and environmental components. We demonstrate the utility of including genetic and clinical phenotypes as covariates within a linkage analysis framework to search for rheumatoid arthritis susceptibility loci. The raw genotypes of 1302 affected relative pairs were combined from four large family-based samples (North American Rheumatoid Arthritis Consortium, United Kingdom, European Consortium on Rheumatoid Arthritis Families, and Canada). The familiality of the clinical phenotypes was assessed. The affected relative pairs were subjected to autosomal multipoint affected relative-pair linkage analysis. Covariates were included in the linkage analysis to take account of heterogeneity within the sample. Evidence of familiality was observed with age at onset (p << 0.001) and rheumatoid factor (RF) IgM (p << 0.001), but not definite erosions (p = 0.21). Genome-wide significant evidence for linkage was observed on chromosome 6. Genome-wide suggestive evidence for linkage was observed on chromosomes 13 and 20 when conditioning on age at onset, chromosome 15 conditional on gender, and chromosome 19 conditional on RF IgM after allowing for multiple testing of covariates. PMID:18466440

Detailed Joint Region Analysis of the 7-Joint Ultrasound Score: Evaluation of an Arthritis Patient Cohort over One Year

Directory of Open Access Journals (Sweden)

S. Ohrndorf

2013-01-01

Full Text Available Objective. The main objective of this study was to evaluate the 7-joint ultrasound (US7 score by detailed joint region analysis of an arthritis patient cohort. Methods. The US7 score examines the clinically most affected wrist, MCP and PIP II, III, MTP II, and V joints for synovitis, tenosynovitis/paratenonitis, and erosions. Forty-five patients with rheumatoid arthritis (RA (84.4% and spondyloarthritis with polyarticular peripheral arthritis (PsA 13.3%; AS 2.2% with a median disease duration of 6.5 yrs (range 7.5 mths–47.6 yrs were included and examined at baseline and 3, 6, and 12 months after starting or changing therapy (DMARD/biologic. In this study, detailed US7 score joint region analysis was firstly performed. Results. The joint region analysis performed at baseline disclosed synovitis in 95.6% of affected wrists in the dorsal aspect by greyscale (GS US where Grade 2 (moderate was most often (48.9% detected. Palmar wrist regions presented Grade 1 (minor capsule elevation in 40% and Grade 2 (moderate synovitis in 37.8%. Tenosynovitis of the extensor carpi ulnaris (ECU tendon was found in 40%, with PD activity in 6.6%. Most of the erosions in MCP II were detected in the radial (68.9%, followed by the dorsal (48.9% and palmar (44.4% aspects. In MTP V, erosions were seen in 75.6% from lateral. Conclusions. Synovitis in GSUS was more often detected in the wrist in the dorsal than in the palmar aspect. ECU tendon involvement was frequent. Most erosions were found in the lateral scan of MTP V and the medial (radial scan of MCP II.

Rheumatoid arthritis affecting temporomandibular joint

Directory of Open Access Journals (Sweden)

Amandeep Sodhi

2015-01-01

Full Text Available Rheumatoid arthritis (RA is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT in diagnosing the bony changes in the early phase of the disease.

[Rheumatoid arthritis among mapuche aborigines. A 16 years experience in the IX Region of the Chile].

Science.gov (United States)

Kaliski, S; Bustos, L; Artigas, C; Alarcón, C; Vega, M A; Cárdenas, C

2001-03-01

Mapuche, Chilean natives, represent approximately 9.8% of Chilean population and in the IX region of the country, they account for 18.4% of population over 15 years old. They preserve some socio-cultural characteristics that make them different to the rest of the population. To describe the epidemiological characteristics rheumatoid arthritis among Mapuche natives. Retrospective review of patients of Mapuche origin with rheumatoid arthritis, seen at Temuco Hospital between 1980 and 1996. Among 308 cases gathered, only 106 (93 women, aged 55 +/- 10 years old) complied with 1987 American College of Rheumatology (ACR) criteria for rheumatoid arthritis. The disease began between 29 and 52 years old in 73% of patients and the mean delay in diagnosis was 4.4 years. At diagnosis, 99% had symmetric poliarthritis, 28.3% had either fatigue, fever or weight loss, and 46.9% were in class III or in class IV of ACR-1991. Fifty three percent of patients developed Sicca syndrome, 36% developed nodules, 23% developed Raynaud phenomenon, 11% developed pulmonary involvement, 7% developed vasculitis, 5% developed neurological manifestations and 19% developed ophthalmologic involvement. Rheumatoid factor was positive in 78% and 73% had erosions. HLA DR4 was (+) in 60% of 30 patients. Thirty percent required 3 or more disease modifying drugs and prednisone over 10 mg/day. There was no correlation between functional capacity and several other features of the disease. Mapuche rheumatoid arthritis patients are detected late and have a poor functional capacity at the time of diagnosis. They also have a higher proportion of extraarticular manifestations, more erosions and require more aggressive treatments.

Intractable Diseases Treated with Intra-Bone Marrow-Bone Marrow Transplantation

Directory of Open Access Journals (Sweden)

Ming eLi

2014-09-01

Full Text Available Bone marrow transplantation (BMT is used to treat hematological disorders, autoimmune diseases and lymphoid cancers. Intra bone marrow-BMT (IBM-BMT has been proven to be a powerful strategy for allogeneic BMT due to the rapid hematopoietic recovery and the complete restoration of T cell functions. IBM-BMT not only replaces hematopoietic stem cells but also mesenchymal stem cells (MSMCs. MSMCs are multi-potent stem cells that can be isolated from bone marrow, umbilical cord blood, and adipose tissue. MSMCs play an important role in the support of hematopoiesis, and modify and influence the innate and adaptive immune systems. MSMCs also differentiate into mesodermal, endodermal and ectodermal lineage cells to repair tissues. This review aims to summarize the functions of bone marrow-derived- MSMCs, and the treatment of intractable diseases such as rheumatoid arthritis and malignant tumors with IBM-BMT.

Breast-cancer-associated metastasis is significantly increased in a model of autoimmune arthritis.

Science.gov (United States)

Das Roy, Lopamudra; Pathangey, Latha B; Tinder, Teresa L; Schettini, Jorge L; Gruber, Helen E; Mukherjee, Pinku

2009-01-01

Sites of chronic inflammation are often associated with the establishment and growth of various malignancies including breast cancer. A common inflammatory condition in humans is autoimmune arthritis (AA) that causes inflammation and deformity of the joints. Other systemic effects associated with arthritis include increased cellular infiltration and inflammation of the lungs. Several studies have reported statistically significant risk ratios between AA and breast cancer. Despite this knowledge, available for a decade, it has never been questioned if the site of chronic inflammation linked to AA creates a milieu that attracts tumor cells to home and grow in the inflamed bones and lungs which are frequent sites of breast cancer metastasis. To determine if chronic inflammation induced by autoimmune arthritis contributes to increased breast cancer-associated metastasis, we generated mammary gland tumors in SKG mice that were genetically prone to develop AA. Two breast cancer cell lines, one highly metastatic (4T1) and the other non-metastatic (TUBO) were used to generate the tumors in the mammary fat pad. Lung and bone metastasis and the associated inflammatory milieu were evaluated in the arthritic versus the non-arthritic mice. We report a three-fold increase in lung metastasis and a significant increase in the incidence of bone metastasis in the pro-arthritic and arthritic mice compared to non-arthritic control mice. We also report that the metastatic breast cancer cells augment the severity of arthritis resulting in a vicious cycle that increases both bone destruction and metastasis. Enhanced neutrophilic and granulocytic infiltration in lungs and bone of the pro-arthritic and arthritic mice and subsequent increase in circulating levels of proinflammatory cytokines, such as macrophage colony stimulating factor (M-CSF), interleukin-17 (IL-17), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), and tumor necrosis factor-alpha (TNF-alpha) may contribute

Breast cancer-associated metastasis is significantly increased in a model of autoimmune arthritis

Science.gov (United States)

Das Roy, Lopamudra; Pathangey, Latha B; Tinder, Teresa L; Schettini, Jorge L; Gruber, Helen E; Mukherjee, Pinku

2009-01-01

Introduction Sites of chronic inflammation are often associated with the establishment and growth of various malignancies including breast cancer. A common inflammatory condition in humans is autoimmune arthritis (AA) that causes inflammation and deformity of the joints. Other systemic effects associated with arthritis include increased cellular infiltration and inflammation of the lungs. Several studies have reported statistically significant risk ratios between AA and breast cancer. Despite this knowledge, available for a decade, it has never been questioned if the site of chronic inflammation linked to AA creates a milieu that attracts tumor cells to home and grow in the inflamed bones and lungs which are frequent sites of breast cancer metastasis. Methods To determine if chronic inflammation induced by autoimmune arthritis contributes to increased breast cancer-associated metastasis, we generated mammary gland tumors in SKG mice that were genetically prone to develop AA. Two breast cancer cell lines, one highly metastatic (4T1) and the other non-metastatic (TUBO) were used to generate the tumors in the mammary fat pad. Lung and bone metastasis and the associated inflammatory milieu were evaluated in the arthritic versus the non-arthritic mice. Results We report a three-fold increase in lung metastasis and a significant increase in the incidence of bone metastasis in the pro-arthritic and arthritic mice compared to non-arthritic control mice. We also report that the metastatic breast cancer cells augment the severity of arthritis resulting in a vicious cycle that increases both bone destruction and metastasis. Enhanced neutrophilic and granulocytic infiltration in lungs and bone of the pro-arthritic and arthritic mice and subsequent increase in circulating levels of proinflammatory cytokines, such as macrophage colony stimulating factor (M-CSF), interleukin-17 (IL-17), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), and tumor necrosis factor

How early should psoriatic arthritis be treated with a TNF-blocker?

LENUS (Irish Health Repository)

Harty, Leonard

2012-02-01

PURPOSE OF REVIEW: Psoriatic arthritis (PsA) is the second most commonly identified inflammatory arthropathy in early arthritis clinics. It is a complex multisystem disease involving the skin and joints, but may also present with inflammation of the spine - spondylitis, digits - dactylitis, eyes - uveitis and ligamentous insertions - enthesitis. The skin manifestations may be mild or patchy and often precede the joint inflammation. Joint erosions, however, may occur within the first 2 years in up to half of PsA patients and an erosion rate of 11% per annum has been reported suggesting it is not a benign disease as it was once regarded. RECENT FINDINGS: Therapy with mild anti-inflammatories is only beneficial in very mild or localized disease. In cases of more widespread joint involvement systemic therapy with disease-modifying antirheumatic drugs (DMARDs) such as methotrexate may be required and in the case of extra-articular or spinal disease, in which DMARDs have failed to show efficacy, biologic therapy may be highly effective. SUMMARY: The question of how early treatment should be instituted should be decided in a specialist rheumatology referral centre following appropriate assessment. Optimal therapy with combination DMARD and biologics may result in remission rates of up to 60%.

The Impact of Low-Dose Disease-modifying Anti-rheumatics Drugs (DMARDs) on Bone Mineral Density of Premenopausal Women in Early Rheumatoid Arthritis.

Science.gov (United States)

Rexhepi, Sylejman; Rexhepi, Mjellma; Sahatçiu-Meka, Vjollca; Mahmutaj, Vigan; Boshnjaku, Shkumbin

2016-04-01

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by symmetrical polyarthritis and multisystemic involvement. The aim of this study was to assess the impact of low dose of methotrexate on bone mineral density (BMD) in patients with early rheumatoid arthritis (RA). This paper follows a retrospective study, which involves 60 female patients with early onset RA diagnosed according to the American Rheumatism Association Criteria (ACR/EULAR 2010). The patients were divided into two groups group I was composed of thirty patients treated with dose of 7.5 mg/weekly methotrexate (MTX), while group II included thirty patients treated with dose of 2 g/daily sulfasalazine (SSZ). The Disease Activity was measured by a combination of Erythrocyte Sedimentation Rate (ESR) and Disease Activity Score (DAS-28). Bone mineral density of the lumbar spine (L2-4), and femoral neck, was measured by dual energy X-ray absorptiometry (DEXA) (Stratos 800). Laboratory findings included: In this study, we found no negative effect on BMD in RA patients treated with low dose MTX in comparison to patients treated with SSZ. There was not observed significant difference in BMD of the lumbar spine, femur neck or trochanter, of MTX and SSZ patients in the pretreatment phase, nor after 12 months of treatment. No significant change in the biochemical parameters of the both groups. Based on the results of our study, low dose of methotrexate has no negative effect on BMD in premenopausal RA patients. We believe that these results might provide new insights and that further longitudinal studies with larger groups of premenopausal RA patients are required.

Patterns of radiographic damage to cervical spine in polyarticular juvenile idiopathic arthritis patients presenting to tertiary care hospital in pakistan

International Nuclear Information System (INIS)

Khyzer, E.; Aftab, T.

2015-01-01

Objective: To see the radiographic cervical spine damage in polyarticular juvenile idiopathic arthritis (PJIA) coming to a tertiary care hospital in Islamabad, Pakistan. Study Design: Cross-sectional descriptive study. Place and Duration of Study: The study was conducted in department of Rheumatology at Pakistan Institute of Medical Sciences from Jun 2013 to Dec 2013. Subjects and Methods: A total of 50 patients of PJIA coming to Rheumatology Outpatient Department were recruited in the study after informed consent. Radiographs of cervical spine were performed for each patient in antero-posterior, lateral with flexion and extension and open-mouth views. Radiographs were reviewed for the following eatures: loss of cervical lordosis, odontoid process erosion, anterior atlantoaxial subluxation, C1-C2 arthritis, atlantoaxial impaction, inflammation of disc, apophyseal joint arthritis, anterior ankylosis, apophyseal joint ankylosis, anterior and posterior subaxial subluxation and growth disturbances. Data was analysed using SPSS version 18. Results: Out of the total 50 patients, 28 (56%) were females while 22 (44%) were males. The mean duration of pJIA was 5.54 +- 3.28 years. Radiological cervical spine involvement was seen in 52% patients. The most common structural lesions were anterior atlantoaxial subluxation (30%), C1-C2 arthritis (22%) erosion of the odontoid process (18%), and apophyseal joint arthritis (16%). Loss of cervical lordosis was found in 7(14%) patients. There was no growth disturbances observed in vertebra. Conclusion: Cervical spine involvement is common in patients of PJIA. It is mostly asymptomatic, so routine cervical spine radiographs in all patients suffering from PJIA is recommended. (author)

Stromal cells and osteoclasts are responsible for exacerbated collagen-induced arthritis in interferon-beta-deficient mice

DEFF Research Database (Denmark)

Treschow, Alexandra P; Teige, Ingrid; Nandakumar, Kutty S

2005-01-01

OBJECTIVE: Clinical trials using interferon-beta (IFNbeta) in the treatment of rheumatoid arthritis have shown conflicting results. We undertook this study to understand the mechanisms of IFNbeta in arthritis at a physiologic level. METHODS: Collagen-induced arthritis (CIA) was induced in IFNbeta....... Differences in osteoclast maturation were determined in situ by histology of arthritic and naive paws and by in vitro maturation studies of naive bone marrow cells. The importance of IFNbeta-producing fibroblasts was determined by transferring fibroblasts into mice at the time of CIA immunization. RESULTS...

Arthritis - resources

Science.gov (United States)

Resources - arthritis ... The following organizations provide more information on arthritis : American Academy of Orthopaedic Surgeons -- orthoinfo.aaos.org/menus/arthritis.cfm Arthritis Foundation -- www.arthritis.org Centers for Disease Control and Prevention -- www. ...

Can we see enough? A comparative study of film-screen vs digital radiographs in small lesions in rheumatoid arthritis

International Nuclear Information System (INIS)

Jagt, E.J. van der; Hofman, S.; Kraft, B.M.; Leeuwen, M.A. van

2000-01-01

The aim of this study was to evaluate the performance of digital radiography in the detection of early very small erosions and joint space narrowing in the hands and feet in rheumatoid arthritis. Fifty-three sets of film-screen and digital radiographs of the same hands and feet with very small and sometimes questionable lesions (possible erosions and cysts) were scored independently two times by four investigators. The percentage of lesions found in exactly the same position for each investigator was calculated. Intra-observer agreement between first and second reading in film-screen radiography was 64-76 % (mean 67 %), and in digital radiographs 60-71 % (mean 64 %). Agreement between film-screen and digital radiographs ranged from 54 to 64 % (mean 58 %) in the first reading and from 56 to 66 % (mean 62 %) in the second reading. Overall agreement between both techniques between first and second reading ranged between 62 and 73 % (mean 65 %). Digital radiography of the hands and feet can be used in patients suspected of rheumatoid arthritis and in follow-up of those patients, because small and early erosions can be seen equally well with the digital technique as compared with the conventional film-screen technique. (orig.)

Roles of PAD4 and NETosis in Experimental Atherosclerosis and Arterial Injury: Implications for Superficial Erosion.

Science.gov (United States)

Franck, Grégory; Mawson, Thomas L; Folco, Eduardo J; Molinaro, Roberto; Ruvkun, Victoria; Engelbertsen, Daniel; Liu, Xin; Tesmenitsky, Yevgenia; Shvartz, Eugenia; Sukhova, Galina K; Michel, Jean-Baptiste; Nicoletti, Antonino; Lichtman, Andrew; Wagner, Denisa; Croce, Kevin J; Libby, Peter

2018-06-22

Neutrophils likely contribute to the thrombotic complications of human atheromata. In particular, neutrophil extracellular traps (NETs) could exacerbate local inflammation and amplify and propagate arterial intimal injury and thrombosis. PAD4 (peptidyl arginine deiminase 4) participates in NET formation, but an understanding of this enzyme's role in atherothrombosis remains scant. This study tested the hypothesis that PAD4 and NETs influence experimental atherogenesis and in processes implicated in superficial erosion, a form of plaque complication we previously associated with NETs. Bone marrow chimeric Ldlr deficient mice reconstituted with either wild-type or PAD4-deficient cells underwent studies that assessed atheroma formation or procedures designed to probe mechanisms related to superficial erosion. PAD4 deficiency neither retarded fatty streak formation nor reduced plaque size or inflammation in bone marrow chimeric mice that consumed an atherogenic diet. In contrast, either a PAD4 deficiency in bone marrow-derived cells or administration of DNaseI to disrupt NETs decreased the extent of arterial intimal injury in mice with arterial lesions tailored to recapitulate characteristics of human atheroma complicated by erosion. These results indicate that PAD4 from bone marrow-derived cells and NETs do not influence chronic experimental atherogenesis, but participate causally in acute thrombotic complications of intimal lesions that recapitulate features of superficial erosion. © 2018 American Heart Association, Inc.

Therapeutic effect of cortistatin on experimental arthritis by downregulating inflammatory and Th1 responses.

Science.gov (United States)

Gonzalez-Rey, Elena; Chorny, Alejo; Del Moral, Raimundo G; Varela, Nieves; Delgado, Mario

2007-05-01

Rheumatoid arthritis is a chronic autoimmune disease of unknown aetiology characterised by chronic inflammation in the joints and subsequent destruction of the cartilage and bone. To propose a new strategy for the treatment of arthritis based on the administration of cortistatin, a newly discovered neuropeptide with anti-inflammatory actions. DBA/1J mice with collagen-induced arthritis were treated with cortistatin after the onset of disease, and the clinical score and joint histopathology were evaluated. Inflammatory response was determined by measuring the levels of various inflammatory mediators (cytokines and chemokines) in joints and serum. T helper cell type 1 (Th1)-mediated autoreactive response was evaluated by determining the proliferative response and cytokine profile of draining lymph node cells stimulated with collagen and by assaying the content of serum autoantibodies. Cortistatin treatment significantly reduced the severity of established collagen-induced arthritis, completely abrogating joint swelling and destruction of cartilage and bone. The therapeutic effect of cortistatin was associated with a striking reduction in the two deleterious components of the disease-that is, the Th1-driven autoimmune and inflammatory responses. Cortistatin downregulated the production of various inflammatory cytokines and chemokines, decreased the antigen-specific Th1-cell expansion, and induced the production of regulatory cytokines, such as interleukin 10 and transforming growth factor beta1. Cortistatin exerted its effects on synovial cells through both somatostatin and ghrelin receptors, showing a higher effect than both peptides protecting against experimental arthritis. This work provides a powerful rationale for the assessment of the efficacy of cortistatin as a novel therapeutic approach to the treatment of rheumatoid arthritis.

Two Kampo Medicines, Jidabokuippo and Hachimijiogan Alleviate Sprains, Bruises and Arthritis

Directory of Open Access Journals (Sweden)

Yasuyo Hijikata

2007-01-01

Full Text Available In traditional Chinese medicine theory (TCM, the affected parts of sprains, bruises and arthritis are considered to be under certain conditions of TCM concept. We administered two Kampo medicines with synergistic effects to promote quick recovery from these conditions. Jidabokuippo (Zhidapuyifang in Chinese, which means ‘decoction for contusions’ is expected to remove these conditions. Hachimijiogan (Baweidihuangwan in Chinese, which translates as ‘eight-ingredient pill with Rehmannia’ is expected to restore presumed minute bone injury and regulates bone metabolism by changing such conditions based on TCM theory. We administered the two prescriptions to 10 patients (age range: 40–85 years; 1 male, 9 females suffering from bruises, sprains, arthritis and spinal compression fracture without changing their routine intake of other drugs. Patients reported on changes in the pain of affected body parts by using the visual analog scale (VAS before and after administration of Kampo medicine. In almost all cases, recovery began promptly after administration and the pain disappeared within ∼2 weeks. Large doses for a short time brought about much quicker recovery than small doses. Administration of a combination of two Kampo medicines, Jidabokuippo and Hachimijiogan, quickly resolved the pain of bruises, sprains, arthritis and one spinal compression fracture.

Are rheumatoid arthritis patients discernible from other early arthritis patients using 1.5T extremity magnetic resonance imaging? a large cross-sectional study.

Science.gov (United States)

Stomp, Wouter; Krabben, Annemarie; van der Heijde, Désirée; Huizinga, Tom W J; Bloem, Johan L; van der Helm-van Mil, Annette H M; Reijnierse, Monique

2014-08-01

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. 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). 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 arthritis patients.

Radiographic temporomandibular joint abnormality in adults with micrognathia and juvenile rheumatoid arthritis

Energy Technology Data Exchange (ETDEWEB)

Larheim, T.A.; Haanaes, H.R.; Dale, K. (Oslo Univ. (Norway))

1981-01-01

Radiographic findings of the upper and lower jaw bone of 20 adult patients with micrognathia, bird face, and juvenile rheumatoid arthritis are reported. In all patients a symmetrically underdeveloped mandible with the chin posteriorly positioned was found at cephalometry. Arthritic lesion of the temporomandibular joint, mostly symmetric, with limitation of movement and secondary arthrosis, was observed in all patients. Complete absence of the mandibular head was frequent (75%). The fossa was generally flat, probably due to growth disturbance of the tubercle. Abnormal anterior position of the mandibular head occurred in almost half of the patients. The degree of mandibular growth disturbance seemed to be correlated to the severity of the arthritis, indicating the arthritis to be a causal mechanism of micrognathia.

EFFECT OF INFLIXIMAB ON DYNAMICS OF FUNCTIONAL CLASS AND RADIOLOGICAL SIGN OF BONE AND CARTILAGINOUS TISSUES ALTERATION OF JOINTS IN PATIENTS WITH DIFFERENT TYPES OF JUVENILE ARTHRITIS

Directory of Open Access Journals (Sweden)

E.I. Alexeeva

2008-01-01

Full Text Available An objective of this trial was evaluation of effect of treatment with blocker of tumor necrosis factor infliximab on dynamics of functional class and radiological changes of bone and cartilaginous tissue of joints in children with different clinical types of juvenile arthritis (JA. Infliximab was used according to standard scheme on 0, 2, 6 and then every 8 week by intravenous infusion. Mean single dose of infliximab was 6,8 ± 2,3 mg/kg. All children were treated with immunosuppressive agents (ciclosporin in 6% of patients, methotrexate in 60%, ciclosporin combined with methotrexate — 20%, ciclosporin with leflunomide — 5%, leflunomide with methotreate — 4% combined with anti cytokine treatment. 7 children were treated with oral glucocorticoids in mean dose 0,37 mg/kg daily. disorders in joint function and structural changes of joints of different severity (radiological sign were discovered in all patients before starting of treatment with infliximab. Duration of observation was 6 week — 2 years. Authors made a conclusion that treatment with infliximab prevents progressing of bone and cartilaginous destruction in all types of AJ, not depending on intensity of its clinical activity. This medication provides for full functional recovery of joints and elimination of features of disablement in patients with good clinical activity.Key words: children, juvenile arthritis, infliximab, treatment.

MRI-assessed therapeutic effects of locally administered PLGA nanoparticles loaded with anti-inflammatory siRNA in a murine arthritis model

NARCIS (Netherlands)

te Boekhorst, B.C.; Jensen, L.B.; Colombo, S.; Varkouhi, A.K.; Schiffelers, R.M.; Lammers, Twan Gerardus Gertudis Maria; Storm, Gerrit; Nielsen, H.M.; Strijkers, G.J.; Foged, C.; Nicolay, K.

2012-01-01

Abstract Rheumatoid arthritis is characterized by systemic inflammation of synovial joints leading to erosion and cartilage destruction. Although efficacious anti-tumor necrosis factor α (TNF-α) biologic therapies exist, there is an unmet medical need for safe and more efficient treatment regimens

Film-screen vs. digital radiography in rheumatoid arthritis of the hand. An ROC analysis

International Nuclear Information System (INIS)

Jonsson, A.; Borg, A.; Hannesson, P.; Herrlin, K.; Jonsson, K.; Sloth, M.; Pettersson, H.

1994-01-01

In a prospective investigation the diagnostic accuracy of filmscreen and digital radiography in rheumatoid arthritis of hands was compared. Seventy hands of 36 patients with established rheumatoid arthritis were included in the study. Each of 11 joints in every hand was evaluated regarding the following radiologic parameters: soft tissue swelling, joint space narrowing, erosions and periarticular osteopenia. The digital images were obtained with storage phosphor image plates and evaluated in 2 forms; as digital hard-copy on film and on a monitor of an interactive workstation. The digital images had a resolution of either 3.33 or 5.0 lp/mm. ROC curves were constructed and comparing the area under the curves no significant difference was found between the 3 different imaging forms in either resolution group for soft tissue swelling, joint space narrowing and erosions. The film-screen image evaluation of periarticular osteopenia was significantly better than the digital hard-copy one in the 3.33 lp/mm resolution group, but no significant difference was found in the 5.0 lp/mm group. These results support the view that currently available digital systems are capable of adequate diagnostic performance. (orig.)

Dendrobium moniliforme Exerts Inhibitory Effects on Both Receptor Activator of Nuclear Factor Kappa-B Ligand-Mediated Osteoclast Differentiation in Vitro and Lipopolysaccharide-Induced Bone Erosion in Vivo.

Science.gov (United States)

Baek, Jong Min; Kim, Ju-Young; Ahn, Sung-Jun; Cheon, Yoon-Hee; Yang, Miyoung; Oh, Jaemin; Choi, Min Kyu

2016-03-01

Dendrobium moniliforme (DM) is a well-known plant-derived extract that is widely used in Oriental medicine. DM and its chemical constituents have been reported to have a variety of pharmacological effects, including anti-oxidative, anti-inflammatory, and anti-tumor activities; however, no reports discuss the beneficial effects of DM on bone diseases such as osteoporosis. Thus, we investigated the relationship between DM and osteoclasts, cells that function in bone resorption. We found that DM significantly reduced receptor activator of nuclear factor kappa-B ligand (RANKL)-induced tartrate-resistant acid phosphatase (TRAP)-positive osteoclast formation; DM directly induced the down-regulation of c-Fos and nuclear factor of activated T cells c1 (NFATc1) without affecting other RANKL-dependent transduction pathways. In the later stages of osteoclast maturation, DM negatively regulated the organization of filamentous actin (F-actin), resulting in impaired bone-resorbing activity by the mature osteoclasts. In addition, micro-computed tomography (μ-CT) analysis of the murine model revealed that DM had a beneficial effect on lipopolysaccharide (LPS)-mediated bone erosion. Histological analysis showed that DM attenuated the degradation of trabecular bone matrix and formation of TRAP-positive osteoclasts in bone tissues. These results suggest that DM is a potential candidate for the treatment of metabolic bone disorders such as osteoporosis.

Genetic Control of Lyme Arthritis by Borrelia burgdorferi Arthritis-Associated Locus 1 Is Dependent on Localized Differential Production of IFN-β and Requires Upregulation of Myostatin.

Science.gov (United States)

Paquette, Jackie K; Ma, Ying; Fisher, Colleen; Li, Jinze; Lee, Sang Beum; Zachary, James F; Kim, Yong Soo; Teuscher, Cory; Weis, Janis J

2017-11-15

Previously, using a forward genetic approach, we identified differential expression of type I IFN as a positional candidate for an expression quantitative trait locus underlying Borrelia burgdorferi arthritis-associated locus 1 ( Bbaa1 ). In this study, we show that mAb blockade revealed a unique role for IFN-β in Lyme arthritis development in B6.C3- Bbaa1 mice. Genetic control of IFN-β expression was also identified in bone marrow-derived macrophages stimulated with B. burgdorferi , and it was responsible for feed-forward amplification of IFN-stimulated genes. Reciprocal radiation chimeras between B6.C3- Bbaa1 and C57BL/6 mice revealed that arthritis is initiated by radiation-sensitive cells, but orchestrated by radiation-resistant components of joint tissue. Advanced congenic lines were developed to reduce the physical size of the Bbaa1 interval, and confirmed the contribution of type I IFN genes to Lyme arthritis. RNA sequencing of resident CD45 - joint cells from advanced interval-specific recombinant congenic lines identified myostatin as uniquely upregulated in association with Bbaa1 arthritis development, and myostatin expression was linked to IFN-β production. Inhibition of myostatin in vivo suppressed Lyme arthritis in the reduced interval Bbaa1 congenic mice, formally implicating myostatin as a novel downstream mediator of the joint-specific inflammatory response to B. burgdorferi . Copyright © 2017 by The American Association of Immunologists, Inc.

CHANGES OF BONE MINERAL DENSITY DURING FOUR-YEAR RITUXIMAB AND METHOTREXATE THERAPY IN POSTMENOPAUSAL WOMEN WITH RHEUMATOID ARTHRITIS

Directory of Open Access Journals (Sweden)

T. A. Raskina

2016-01-01

Full Text Available Objective: to estimate the changes of bone mineral density (BMD  at the femoral neck and lumbar spine during fouryear combination  therapy with rituximab (RTM  and methotrexate (MT in postmenopausal women with rheumatoid arthritis (RA.Subjects and methods. 79 postmenopausal women with a documented diagnosis of RA were followed up. They were divided into two groups according to the basic treatment:  1 44 patients received combination  therapy with RTM and MT; 2 36 patients had MT monotherapy. BMD was assessed by dual-energy X-ray absorptiometry using an Excell XR-46 stationary dual-energy X-ray bone densitometer  (Norland, USA once per year (over 48 months.Results and discussion. The group of patients receiving RTM and MT achieved a statistically significant increase in femoral neck BMD after 36 months of therapy. Statistically significant changes in femoral neck BMD were not revealed in the patients who had MT monotherapy. Lumbar spine BMD was decreased during MT monotherapy, but it remained stable in the RTM + MT group throughout  the 48-month follow-up.Conclusion. Thirty-six-month combination  treatment with RTM and MT provides positive changes in femoral neck BMD, which persists within 48 months after treatment initiation.  Lumbar spine BMD remained stable in the patients receiving RTM and MT.

Immunomodulation of Autoimmune Arthritis by Herbal CAM

Directory of Open Access Journals (Sweden)

Shivaprasad H. Venkatesha

2011-01-01

Full Text Available Rheumatoid arthritis (RA is a debilitating autoimmune disease of global prevalence. The disease is characterized by synovial inflammation leading to cartilage and bone damage. Most of the conventional drugs used for the treatment of RA have severe adverse reactions and are quite expensive. Over the years, increasing proportion of patients with RA and other immune disorders are resorting to complementary and alternative medicine (CAM for their health needs. Natural plant products comprise one of the most popular CAM for inflammatory and immune disorders. These herbal CAM belong to diverse traditional systems of medicine, including traditional Chinese medicine, Kampo, and Ayurvedic medicine. In this paper, we have outlined the major immunological pathways involved in the induction and regulation of autoimmune arthritis and described various herbal CAM that can effectively modulate these immune pathways. Most of the information about the mechanisms of action of herbal products in the experimental models of RA is relevant to arthritis patients as well. The study of immunological pathways coupled with the emerging application of genomics and proteomics in CAM research is likely to provide novel insights into the mechanisms of action of different CAM modalities.

Psoriatic arthritis

International Nuclear Information System (INIS)

Sankowski, Artur Jacek; Łebkowska, Urszula Maria; Ćwikła, Jarosław; Walecka, Irena; Walecki, Jerzy

2013-01-01

Psoriatic arthritis (PsA) is a chronic inflammatory joint disease which develops in patients with psoriasis. It is characteristic that the rheumatoid factor in serum is absent. Etiology of the disease is still unclear but a number of genetic associations have been identified. Inheritance of the disease is multilevel and the role of environmental factors is emphasized. Immunology of PsA is also complex. Inflammation is caused by immunological reactions leading to release of kinins. Destructive changes in bones usually appear after a few months from the onset of clinical symptoms. Typically PsA involves joints of the axial skeleton with an asymmetrical pattern. The spectrum of symptoms include inflammatory changes in attachments of articular capsules, tendons, and ligaments to bone surface. The disease can have divers clinical course but usually manifests as oligoarthritis. Imaging plays an important role in the diagnosis of PsA. Classical radiography has been used for this purpose for over a hundred years. It allows to identify late stages of the disease, when bone tissue is affected. In the last 20 years many new imaging modalities, such as ultrasonography (US), computed tomography (CT) and magnetic resonance (MR), have been developed and became important diagnostic tools for evaluation of rheumatoid diseases. They enable the assessment and monitoring of early inflammatory changes. As a result, patients have earlier access to modern treatment and thus formation of destructive changes in joints can be markedly delayed or even avoided

X-ray diagnosis of mutilating arthritis in patients with psoriatic arthritis Smirnov A.V.

Directory of Open Access Journals (Sweden)

A.V. Smirnov

2014-01-01

Full Text Available The typical X-ray symptoms of psoriatic arthritis (PsA in joints of hands and distal sections of feet (asymmetric lesions; isolated lesion of distal interphalangeal joints (DIJ of hands with no changes in other small joints of hands; axial lesion of three joints in a single finger; transverse lesion of joints of the hand at the same level; destruction of distal phalanges; narrowing of the distal epiphysis of hand finger phalanges and metacarpal bones; cup-shaped deformity of the proximal portion of hand finger phalanges and narrowing of distal epiphysis; osseous ankyloses; multiple osteolytic lesions and destruction of bone epiphysis and joint deformities; inflammatory changes in the sacroiliac joints; and typical degenerative changes in the spine are described. It is especially important to know X-ray manifestations of PsA when there are no typical cutaneous manifestations of psoriasis. 

Repeated administration of mazindol reduces spontaneous pain-related behaviors without modifying bone density and microarchitecture in a mouse model of complete Freund’s adjuvant-induced knee arthritis

Directory of Open Access Journals (Sweden)

Robledo-González LE

2017-07-01

Full Text Available LE Robledo-González,1 A Martínez-Martínez,1 VM Vargas-Muñoz,1 RI Acosta-González,2 R Plancarte-Sánchez,3 M Anaya-Reyes,4 C Fernández del Valle-Laisequilla,5 JG Reyes-García,6 JM Jiménez-Andrade1 1Laboratorio de Farmacología, 2Departamento de Análisis Clínicos, Unidad Académica Multidisciplinaria Reynosa-Aztlán, UAT, Reynosa, Tamaulipas, Mexico; 3Departamento de Anestesiología, Terapia Intensiva y Clínica del Dolor, Instituto Nacional de Cancerología, Mexico City, Mexico; 4Investigación Clínica y Farmacovigilancia, 5Investigación Clínica y Farmacovigilancia, Productos Medix, S.A. de C.V., Mexico City, Mexico; 6Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico Background: The role of dopaminergic system in the development of rheumatoid arthritis-related pain, a major symptom in this disease, has not been explored. Therefore, the antinociceptive effect of mazindol, a dopamine uptake inhibitor, was evaluated in a model of complete Freund’s adjuvant (CFA-induced arthritis. Furthermore, as studies have shown that the dopaminergic system regulates bone metabolism, the effect of mazindol on bone mass and microarchitecture was determined.Methods: Adult ICR male mice received intra-articular injections of either CFA or saline into the right knee joint every week. Spontaneous pain-like behaviors (flinching and guarding and locomotor activity were assessed at day 26 post-first CFA, following which, a single intraperitoneally (i.p. administered dose of mazindol was given (1, 3 and 10 mg/kg. Then, the antinociceptive effect of a repeated administration of 3 mg/kg mazindol (daily, i.p.; day 15–day 26 was evaluated. Additionally, at day 26, the participation of D1-like, D2-like or opioid receptors in the antinociceptive effect of mazindol was evaluated. The effect of mazindol on bone density and microarchitecture was evaluated by micro

Psoriatic arthritis

International Nuclear Information System (INIS)

Gerber, L.H.; Espinoza, L.R.

1985-01-01

This book contains 11 chapters. Some of the titles are: The history and epidemiologic definition of psoriatic arthritis as a distinct entity; Psoriatic arthritis: Further epidemiologic and genetic considerations; The radiologic features of psoriatic arthritis; and Laboratory findings and pathology of psoriatic arthritis

Juvenile Arthritis

Science.gov (United States)

Juvenile arthritis (JA) is arthritis that happens in children. It causes joint swelling, pain, stiffness, and loss of motion. It can affect any joint, but ... of JA that children get is juvenile idiopathic arthritis. There are several other forms of arthritis affecting ...

Study the Influence of Arthritis on Breast Cancer-Associated Bone Metastasis

Science.gov (United States)

2008-10-01

Arthritis Lopamudra Das Roy, Latha B. Pathangey, Teresa L. Tinder , and Pinku Mukherjee* Department of Biology, University of North Carolina at... relationship to angiogenic factors in multiple myeloma. European Journal of Internal Medicine. 17:412–416. 40. K. Leitzel, Ettenberg.S, Walsh.R, Abraham.J

Dynamic automated synovial imaging (DASI) for differential diagnosis of rheumatoid arthritis

Science.gov (United States)

Grisan, E.; Raffeiner, B.; Coran, A.; Rizzo, G.; Ciprian, L.; Stramare, R.

2014-03-01

Inflammatory rheumatic diseases are leading causes of disability and constitute a frequent medical disorder, leading to inability to work, high comorbidity and increased mortality. The gold-standard for diagnosing and differentiating arthritis is based on patient conditions and radiographic findings, as joint erosions or decalcification. However, early signs of arthritis are joint effusion, hypervascularization and synovial hypertrophy. In particular, vascularization has been shown to correlate with arthritis' destructive behavior, more than clinical assessment. Contrast Enhanced Ultrasound (CEUS) examination of the small joints is emerging as a sensitive tool for assessing vascularization and disease activity. The evaluation of perfusion pattern rely on subjective semiquantitative scales, that are able to capture the macroscopic degree of vascularization, but are unable to detect the subtler differences in kinetics perfusion parameters that might lead to a deeper understanding of disease progression and a better management of patients. We show that after a kinetic analysis of contrast agent appearance, providing the quantitative features characterizing the perfusion pattern of the joint, it is possible to accurately discriminate RA from PSA by building a random forest classifier on the computed features. We compare its accuracy with the assessment performed by expert radiologist blinded of the diagnosis.

Iside effects of salicylates (ACK, corticosteroids and imunomodulators on the gastroduodenal mucosa - medication used in rheumatoid arthritis treatment

Directory of Open Access Journals (Sweden)

Popović M.

2015-01-01

Full Text Available The aim is to determine pathological -ulcero-erosive changes in the gastroduodenal mucosa (erosions, ulcers, ulcers, ulcer complications, subepithelial hemorrhage, etc. resulting from the adverse effects of salicylates /ACK/ corticosteroid, imunoodulatora which was prescribed in the treatment of rheumatoid arthritis (RA. The test was performed on 50 patients diagnosed with RA who were on the two-year continuous therapy. When respondents were done gastroscopy and pathological macroscopic changes resulting from the gastroduodenal mucosa as a result of adverse effects of administered drugs verified. After two years of preparations ACK controlled therapy, corticosteroids, imunomodula- sector on mucosa gastroduodenal erosions were found in 81.5% of patients, gastric ulcer in 33%, duodenal ulcer with 18.5% of patients and bleeding in 44.4%.

Radiographic study of bone changes on TMJ arthrosis

International Nuclear Information System (INIS)

You, Dong Soo

1982-01-01

The author analyzed the morphologic changes of bone structures from 1256 radiographs of 314 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral projection and orthopantomography. The interrelations of the bone changes and clinical symptoms were examined. Also, the positional relationships of condylar head, articular fossa and articular eminence in the mouth open and closed state were observed in the patients with bone changes. The results were as follows; 1. The most frequent bone change in the TMJ arthrosis was eburnation of cortical bone (35.64%) of total cases. Then came bone surface erosion and localized radiolucency (26.18%), marginal proliferation (9.7%) and flattening of articular surface (9.58%) in that order. 2. The most frequent site of bone change was articular eminence (41.70%). The came condylar head (21.09%) and articular fossa (20.73%) in that order. 3. In the patients with bone changes, their clinical symptoms were pain (51.55%), clicking sound during mandibular movement (37.71%) and limited mandibular movement (10.73%). In the patients complaining pain, their radiographs showed eburnation of cortical bone (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening in the (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening of articular surface (10.68%). 4. The condylar positional changes in the TMJ arthrosis patients with bone changes were as follows: in the mouth closed state, there were the widening of joint space in 624 cases (50.00%), the narrowing of joint space in 543 cases (43.47%) and bone on bone relationships in 82 cases (6.57%). In the mouth open state, there were forward positioning of the condyle in 332 cases (28.55%), limitation of movement in 332 cases (28.55%), bone on bone relationships in 248 cases (21.31%) and downward positioning of condyle in 217 cases (18.66%). Bone on bone relationships in 248 cases (21.32%) and downward positioning of

Radiographic study of bone changes on TMJ arthrosis

Energy Technology Data Exchange (ETDEWEB)

You, Dong Soo [Dept. of Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1982-11-15

The author analyzed the morphologic changes of bone structures from 1256 radiographs of 314 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral projection and orthopantomography. The interrelations of the bone changes and clinical symptoms were examined. Also, the positional relationships of condylar head, articular fossa and articular eminence in the mouth open and closed state were observed in the patients with bone changes. The results were as follows; 1. The most frequent bone change in the TMJ arthrosis was eburnation of cortical bone (35.64%) of total cases. Then came bone surface erosion and localized radiolucency (26.18%), marginal proliferation (9.7%) and flattening of articular surface (9.58%) in that order. 2. The most frequent site of bone change was articular eminence (41.70%). The came condylar head (21.09%) and articular fossa (20.73%) in that order. 3. In the patients with bone changes, their clinical symptoms were pain (51.55%), clicking sound during mandibular movement (37.71%) and limited mandibular movement (10.73%). In the patients complaining pain, their radiographs showed eburnation of cortical bone (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening in the (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening of articular surface (10.68%). 4. The condylar positional changes in the TMJ arthrosis patients with bone changes were as follows: in the mouth closed state, there were the widening of joint space in 624 cases (50.00%), the narrowing of joint space in 543 cases (43.47%) and bone on bone relationships in 82 cases (6.57%). In the mouth open state, there were forward positioning of the condyle in 332 cases (28.55%), limitation of movement in 332 cases (28.55%), bone on bone relationships in 248 cases (21.31%) and downward positioning of condyle in 217 cases (18.66%). Bone on bone relationships in 248 cases (21.32%) and downward positioning of

Observer differences in detecting erosions in radiographs of rheumatoid arthritis. A comparison of posteranterior, Norgaard and Brewerton views

Energy Technology Data Exchange (ETDEWEB)

Mews, M.M.A.; Pui, M.; Cockshott, W.P.; Buchanan, W.W. (McMaster Univ., Hamilton, Ontario (Canada))

1983-04-01

This study shows no significant advantage of Brewerton or Norgaard radiographs in detection of erosions at metacarpophalangeal joints in patients with polyarthritis over the conventional posteroanterior view. The observer agreement for detection of exact number of erosions/pair of hands is uniformly low. Therefore, erosion index cannot be reliably used in epidemiologic surveys or therapeutic trials as an outcome measure unless steps are taken to improve the observer agreement.

Bone loss in unclassified polyarthritis and early rheumatoid arthritis is better detected by digital x ray radiogrammetry than dual x ray absorptiometry: relationship with disease activity and radiographic outcome

DEFF Research Database (Denmark)

Jensen, T; Klarlund, Mette; Hansen, M

2004-01-01

OBJECTIVE: To compare changes in regional bone mineral density (BMD) of the metacarpal joints measured by dual x ray absorptiometry (DXA) and digital x ray radiogrammetry (DXR) in relation to disease activity and radiographic outcome in a two year follow up study of patients with early RA...... polyarthritis. The patients with RA were divided into groups according to mean disease activity, average glucocorticoid dose, and MRI and x ray detected bone erosions in the hands. Clinical and biochemical measurements were made every month and an x ray examination of the hands and BMD of the metacarpal joints...

Chronological study for solitary bone metastasis in the sternum from breast cancer with bone scintigraphy

International Nuclear Information System (INIS)

Miyoshi, Hidenao; Otsuka, Nobuaki; Sone, Teruki; Nagai, Kiyohisa; Tamada, Tsutomu; Mimura, Hiroaki; Yanagimoto, Shinichi; Tomomitsu, Tatsushi; Fukunaga, Masao

1999-01-01

Since breast cancer is frequently associated with bone metastasis, bone scintigraphies have been performed to determine pre-operative staging and to survey postoperative bone metastasis. The sternum, in particular, is a site at which is difficult to differentiate between benign bone disease and bone metastasis, because of varied uptake and wide individual variations. In this study, chronological bone images were scintigraphied in six cases with solitary sternal metastasis and three cases with benign bone disease including two fracture cases and one arthritis case. On bone scintigrams in which solitary sternal metastasis appeared, increased uptake was found in five cases, and photon deficiency was observed in one case. During follow-up scintigraphies, abnormal accumulations, such as hot spots and cold lesions, increased in the bone metastasis while abnormal uptake disappeared or was unchanged in the benign bone disease cases. On CT, four cases showed osteolytic change, and one exhibited osteosclerotic change. These findings indicate that sternal metastasis usually shows osteolytic change, even if a hot lesion is recognized on bone scintigraphy. In solitary sternal metastasis, for which early diagnosis is difficult, both an integrated diagnosis using other imaging techniques and chronological bone scintigraphy are important. (author)

Candida Arthritis: Analysis of 112 Pediatric and Adult Cases

Science.gov (United States)

Gamaletsou, Maria N.; Rammaert, Blandine; Bueno, Marimelle A.; Sipsas, Nikolaos V.; Moriyama, Brad; Kontoyiannis, Dimitrios P.; Roilides, Emmanuel; Zeller, Valerie; Taj-Aldeen, Saad J.; Miller, Andy O.; Petraitiene, Ruta; Lortholary, Olivier; Walsh, Thomas J.

2016-01-01

Background. Candida arthritis is a debilitating form of deeply invasive candidiasis. However, its epidemiology, clinical manifestations, management, and outcome are not well understood. Methods. Cases of Candida arthritis were reviewed from 1967 through 2014. Variables included Candida spp in joint and/or adjacent bone, underlying conditions, clinical manifestations, inflammatory biomarkers, diagnostic imaging, management, and outcome. Results. Among 112 evaluable cases, 62% were males and 36% were pediatric. Median age was 40 years (range, Candida albicans constituted 63%, Candida tropicalis 14%, and Candida parapsilosis 11%. Most cases (66%) arose de novo, whereas 34% emerged during antifungal therapy. Osteolysis occurred in 42%, joint-effusion in 31%, and soft tissue extension in 21%. Amphotericin and fluconazole were the most commonly used agents. Surgical interventions included debridement in 25%, irrigation 10%, and drainage 12%. Complete or partial response was achieved in 96% and relapse in 16%. Conclusion. Candida arthritis mainly emerges as a de novo infection in usually non-immunosuppressed patients with hips and knees being most commonly infected. Localizing symptoms are frequent, and the most common etiologic agents are C albicans, C tropicalis, and C parapsilosis. Management of Candida arthritis remains challenging with a clear risk of relapse, despite antifungal therapy. PMID:26858961

US Evaluation of Juvenile Idiopathic Arthritis and Osteoarticular Infection.

Science.gov (United States)

Nguyen, Jie C; Lee, Kenneth S; Thapa, Mahesh M; Rosas, Humberto G

2017-01-01

Juvenile idiopathic arthritis (JIA) and osteoarticular infection can cause nonspecific articular and periarticular complaints in children. Although contrast material-enhanced magnetic resonance imaging is the reference standard imaging modality, musculoskeletal ultrasonography (US) is emerging as an important adjunct imaging modality that can provide valuable information relatively quickly without use of radiation or the need for sedation. However, diagnostic accuracy requires a systemic approach, familiarity with various US techniques, and an understanding of maturation-related changes. Specifically, the use of dynamic, Doppler, and/or multifocal US assessments can help confirm sites of disease, monitor therapy response, and guide interventions. In patients with JIA, ongoing synovial inflammation can lead to articular and periarticular changes, including synovitis, tenosynovitis, cartilage damage, bone changes, and enthesopathy. Although these findings can manifest in adult patients with rheumatoid arthritis, important differences and pitfalls exist because of the unique changes associated with an immature and maturing skeleton. In patients who are clinically suspected of having osteoarticular infection, the inability of US to evaluate the bone marrow decreases its sensitivity. Therefore, the US findings should be interpreted with caution because juxtacortical inflammation is suggestive, but neither sensitive nor specific, for underlying osteomyelitis. Similarly, the absence of a joint effusion makes septic arthritis extremely unlikely but not impossible. US findings of JIA and osteoarticular infection often overlap. Although certain clinical scenarios, laboratory findings, and imaging appearances can favor one diagnosis over the other, fluid analysis may still be required for definitive diagnosis and optimal treatment. US is the preferred modality for fluid aspiration and administering intra-articular corticosteroid therapy. © RSNA, 2017.

Use of bisphosphonate might be important to improve bone mineral density in patients with rheumatoid arthritis even under tight control: the TOMORROW study.

Science.gov (United States)

Tada, Masahiro; Inui, Kentaro; Sugioka, Yuko; Mamoto, Kenji; Okano, Tadashi; Anno, Shohei; Koike, Tatsuya

2017-06-01

Although patients with rheumatoid arthritis (RA) are prone to osteoporosis, tight control of disease activity might have a positive effect on bone metabolism. We aimed to determine whether bisphosphonate use is still important to improve bone mineral density (BMD) in RA patients whose disease activity was tightly controlled and the dose of glucocorticoid was reduced. This study was a sub-analysis of the 10-year prospective cohort TOtal Management Of Risk factors in Rheumatoid arthritis patients to lOWer morbidity and mortality: the TOMORROW which started from 2010. We compared BMD between 192 patients with RA and age- and sex-matched volunteers between 2010 and 2013 using dual-energy X-ray absorptiometry (DXA) in whole body mode. We then determined ratios of changes in BMD (%ΔBMD) to assess factors influencing increases in BMD among the patients using multivariate logistic regression analysis. The BMD was significantly lower in the patients than in the controls at all sites surveyed during 2010 and 2013. The %ΔBMD of the total spine was significantly higher among the patients treated with, than without bisphosphonate (6.2 vs. 1.8%, P = 0.0001). Multivariate logistic regression analysis revealed that use of bisphosphonate was a significant factor contributing to BMD increase (odds ratio 2.13; 95% confidence interval, 1.03-4.38, P = 0.041). Meanwhile, use of biologic agents, reducing glucocorticoid dose, and control of disease activity were not significant factors for gain of BMD. The BMD was lower among patients with RA than non-RA controls. Use of bisphosphonate significantly increased the BMD of the spine in patients over a period of 3 years and was important for maintaining the BMD among patients with RA under the control of inflammation and disease activity.

Arthritis in Children

Science.gov (United States)

... Issues Listen Español Text Size Email Print Share Arthritis Page Content Article Body Arthritis is an inflammation ... with antibiotics, even if arthritis develops. Juvenile Idiopathic Arthritis (JIA) Juvenile idiopathic arthritis (JIA) has previously been ...

Loss of lean body mass affects low bone mineral density in patients with rheumatoid arthritis - results from the TOMORROW study.

Science.gov (United States)

Okano, Tadashi; Inui, Kentaro; Tada, Masahiro; Sugioka, Yuko; Mamoto, Kenji; Wakitani, Shigeyuki; Koike, Tatsuya; Nakamura, Hiroaki

2017-11-01

Osteoporosis is one of the complications for patients with rheumatoid arthritis (RA). Rheumatoid cachexia, the loss of lean body mass, is another. However, the relationship between decreased lean body mass and reduced bone mineral density (BMD) in patients with RA has not been well studied. This study included 413 participants, comprising 208 patients with RA and 205 age- and sex-matched healthy volunteers. Clinical data, BMD, bone metabolic markers (BMM) and body composition, such as lean body mass and percent fat, were collected. Risk factors for osteoporosis in patients with RA including the relationship BMD and body composition were analyzed. Patients with RA showed low BMD and high BMM compared with controls. Moreover, lean body mass was lower and percent fat was higher in patients with RA. Lean body mass correlated positively and percent fat negatively with BMD. Lean body mass was a positive and disease duration was a negative independent factor for BMD in multivariate statistical analysis. BMD and lean body mass were significantly lower in patients with RA compared to healthy controls. Lean body mass correlated positively with BMD and decreased lean body mass and disease duration affected low BMD in patients with RA. [UMIN Clinical Trials Registry, http://www.umin.ac.jp/ctr/ , UMIN000003876].

Bone scintigraphy in drug addiction

Energy Technology Data Exchange (ETDEWEB)

Lopez-Majano, V.; Miskew, D.; Sansi, P.

1981-01-01

In 22 drug addicts, the clinical diagnosis of osteomyelitis and/or septic arthritis was suspected because of symptoms of sepsis and pain in various locations. All patients underwent bone scintigraphy with 17-20 mCi of /sup 99/sup(m)Tc labeling either pyrophosphate or methylene diphosphonate. Whole body and spot scans located the area of disease in most patients. This permitted biopsy of the affected area when the pathogen recurs. One of the two patients whose scintigrams were normal was on adequate treatment before the bone scintigram and the other was on oxacillin. Radiographs of the affected areas were normal, which indicates bone scintigraphy should be preferred to radiography in the early diagnosis of osseous infections.

Bone scintigraphy in drug addiction

International Nuclear Information System (INIS)

Lopez-Majano, V.; Miskew, D.; Sansi, P.

1981-01-01

In 22 drug addicts, the clinical diagnosis of osteomyelitis and/or septic arthritis was suspected because of symptoms of sepsis and pain in various locations. All patients underwent bone scintigraphy with 17-20 mCi of 99 sup(m)Tc labeling either pyrophosphate or methylene diphosphonate. Whole body and spot scans located the area of disease in most patients. This permitted biopsy of the affected area when the pathogen recurs. One of the two patients whose scintigrams were normal was on adequate treatment before the bone scintigram and the other was on oxacillin. Radiographs of the affected areas were normal, which indicates bone scintigraphy should be preferred to radiography in the early diagnosis of osseous infections. (orig.) [de

Rapidly Destructive Inflammatory Arthritis of the Hip

Directory of Open Access Journals (Sweden)

Jenny Shu

2014-01-01

Full Text Available Rapidly destructive coxarthrosis (RDC is a rare syndrome that involves aggressive hip joint destruction within 6–12 months of symptom onset with no single diagnostic laboratory, pathological, or radiographic finding. We report an original case of RDC as an initial presentation of seronegative rheumatoid arthritis (RA in a 57-year-old Caucasian woman presenting with 6 months of progressive right groin pain and no preceding trauma or chronic steroid use. Over 5 months, she was unable to ambulate and plain films showed complete resorption of the right femoral head and erosion of the acetabulum. There were inflammatory features seen on computed tomography (CT and magnetic resonance imaging (MRI. She required a right total hip arthroplasty, but arthritis in other joints showed improvement with triple disease modifying antirheumatic drugs (DMARD therapy and almost complete remission with the addition of adalimumab. We contrast our case of RDC as an initial presentation of RA to 8 RDC case reports of patients with established RA. Furthermore, this case highlights the importance of obtaining serial imaging to evaluate a patient with persistent hip symptoms and rapid functional deterioration.

Neurologic dysfunction in patients with rheumatoid arthritis of the cervical spine. Predictive value of clinical, radiographic and MR imaging parameters

Energy Technology Data Exchange (ETDEWEB)

Reijnierse, M.; Kroon, H.M.; Holscher, H.C.; Bloem, J.L. [Dept. of Radiology, University Hospital Leiden (Netherlands); Dijkmans, B.A.C.; Breedveld, F.C. [Dept. of Rheumatology, University Hospital Leiden (Netherlands); Hansen, B. [Dept. of Medical Statistics, University Hospital Leiden (Netherlands); Pope, T.L. [Dept. of Diagnostic Radiology, Univ. of South Carolina (United States)

2001-03-01

The aim of this study was to evaluate if subjective symptoms, radiographic and especially MR parameters of cervical spine involvement, can predict neurologic dysfunction in patients with severe rheumatoid arthritis (RA). Sequential radiographs, MR imaging, and neurologic examination were performed yearly in 46 consecutive RA patients with symptoms indicative of cervical spine involvement. Radiographic parameters were erosions of the dens or intervertebral joints, disc-space narrowing, horizontal and vertical atlantoaxial subluxation, subluxations below C2, and the diameter of the spinal canal. The MR features evaluated were presence of dens and atlas erosion, brainstem compression, subarachnoid space encroachment, pannus around the dens, abnormal fat body caudal to the clivus, cervicomedullary angle, and distance of the dens to the line of McRae. Muscle weakness was associated with a tenfold increased risk of neurologic dysfunction. Radiographic parameters were not associated. On MR images atlas erosion and a decreased distance of the dens to the line of McRae showed a fivefold increased risk of neurologic dysfunction. Subarachnoid space encroachment was associated with a 12-fold increased risk. Rheumatoid arthritis patients with muscle weakness and subarachnoid space encroachment of the entire cervical spine have a highly increased risk of developing neurologic dysfunction. (orig.)

Neurologic dysfunction in patients with rheumatoid arthritis of the cervical spine. Predictive value of clinical, radiographic and MR imaging parameters

International Nuclear Information System (INIS)

Reijnierse, M.; Kroon, H.M.; Holscher, H.C.; Bloem, J.L.; Dijkmans, B.A.C.; Breedveld, F.C.; Hansen, B.; Pope, T.L.

2001-01-01

The aim of this study was to evaluate if subjective symptoms, radiographic and especially MR parameters of cervical spine involvement, can predict neurologic dysfunction in patients with severe rheumatoid arthritis (RA). Sequential radiographs, MR imaging, and neurologic examination were performed yearly in 46 consecutive RA patients with symptoms indicative of cervical spine involvement. Radiographic parameters were erosions of the dens or intervertebral joints, disc-space narrowing, horizontal and vertical atlantoaxial subluxation, subluxations below C2, and the diameter of the spinal canal. The MR features evaluated were presence of dens and atlas erosion, brainstem compression, subarachnoid space encroachment, pannus around the dens, abnormal fat body caudal to the clivus, cervicomedullary angle, and distance of the dens to the line of McRae. Muscle weakness was associated with a tenfold increased risk of neurologic dysfunction. Radiographic parameters were not associated. On MR images atlas erosion and a decreased distance of the dens to the line of McRae showed a fivefold increased risk of neurologic dysfunction. Subarachnoid space encroachment was associated with a 12-fold increased risk. Rheumatoid arthritis patients with muscle weakness and subarachnoid space encroachment of the entire cervical spine have a highly increased risk of developing neurologic dysfunction. (orig.)

Pannus invasion and cartilage degradation in rheumatoid arthritis: involvement of MMP-3 and interleukin-1beta.

Science.gov (United States)

Ainola, M M; Mandelin, J A; Liljeström, M P; Li, T F; Hukkanen, M V J; Konttinen, Y T

2005-01-01

Synovial inflammation in rheumatoid arthritis (RA) leads to pannus tissue invasion and destruction of cartilage/bone matrix by proteinases. Our intention was to analyze some of the key matrix metalloproteinases (MMPs) in pannus tissue overlying evolving cartilage erosions in RA. Frozen tissue samples of pannus and synovium from advanced RA and synovium from osteoarthritic patients were used for immunohistochemical, western blotting and quantitative reverse transcriptase polymerase chain reaction (RT-PCR) analysis of MMP-1, -3, -13 and -14. Synovial fibroblast cultures, stimulated with tumour necrosis factor alpha (TNF-alpha) and interleukin-1 beta (IL-1beta), were analyzed with enzyme-linked immunosorbent assays (ELISA) and quantitative RT-PCR. MMP-3 was highly expressed in pannus tissue compared with significantly lower expression levels of MMP-1, -13 and -14. In fibroblast cultures IL-1beta was a potent stimulus for MMP-3, whereas TNF-alpha was more potent for MMP-1. This is the first study to demonstrate quantitatively in real time that MMP-3 mRNA expression is clearly higher in advanced RA pannus tissue compared to parallel RA or osteoarthritic synovium. MMP-3 mRNA levels were also clearly overexpressed in RA pannus compared to MMP-1, -13 and -14. Advanced RA has previously been found to overexpress IL-1beta. The high expression of MMP-3 in pannus and IL-1beta, mediated stimulation of MMP-3 suggest that MMP-3 plays a significant role in the progression of erosions through the proteoglycan-rich cartilage matrix.

Bone scintigraphy in two cases of chronic brucellosis

International Nuclear Information System (INIS)

Kujat, C.; Neidl, K.; Mueller-Leisse, C.; Berg, D.

1989-01-01

As shown in the case reports, bone scintigraphy plays an important part considering the diagnosis of chronic brucellosis, an infectious disease which occurs rarely in Germany. To establish the diagnosis knowledge of symptoms and signs of the disease is necessary. Chronic brucellosis may occur in each organ, ionvolving especially bones and joints. The disease may manifest as spondilytis (especially of the lumbar spine) or arthritis of large joints, sacroiliacal joints or costotransverse joints. Chronic brucellosis has to be considered if a bone scan reveals a typical pattern even without a typical history. (orig.) [de

Principles on the use of imaging studies in the diagnosis and management of juvenile idiopathic arthritis

Directory of Open Access Journals (Sweden)

N. T. Vatutin

2015-01-01

Full Text Available The paper presents the basic principles on the use of imaging studies in the diagnosis and management of juvenile idiopathic arthritis (JIA, which have been elaborated by the European League Against Rheumatism (EULAR jointly with the Pediatric Rheumatology European Society (PreS. These principles will render certain assistance to practitioners in diagnosing and treating patients with JIA. Undoubtedly, there have been no answers to many questions so far. This primarily applies to the necessity of understanding the standards for the possibility to interpret the pathological process, to harmonize the respective MRI protocols, to identify bone marrow edema, erosions, and synovitis, and to determine the suitability of these or those examinations in order to reveal changes in individual joints. There are considerable conceptual differences in approaches to diagnostic techniques in adults and children. The EULAR-PReS experts assume that some studies may be impracticable or economically inaccessible and this may hinder their introduction into clinical practice. However, most techniques, including ultrasonography, are quite affordable. The practical application of these techniques certainly requires a high professionalism of specialists in functional diagnosis and other instrumental studies.

Gonococcal arthritis

Science.gov (United States)

Disseminated gonococcal infection (DGI); Disseminated gonococcemia; Septic arthritis - gonococcal arthritis ... Gonococcal arthritis is an infection of a joint. It occurs in people who have gonorrhea , which is caused by ...

Exposure to Candida albicans polarizes a T-cell driven arthritis model towards Th17 responses, resulting in a more destructive arthritis.

Science.gov (United States)

Marijnissen, Renoud J; Koenders, Marije I; van de Veerdonk, Frank L; Dulos, John; Netea, Mihai G; Boots, Annemieke M H; Joosten, Leo A B; van den Berg, Wim B

2012-01-01

Fungal components have been shown very effective in generating Th17 responses. We investigated whether exposure to a minute amount of C. albicans in the arthritic joint altered the local cytokine environment, leading to enhanced Th17 expansion and resulting in a more destructive arthritis. Chronic SCW arthritis was induced by repeated injection with Streptococcus pyogenes (SCW) cell wall fragments into the knee joint of C57Bl/6 mice, alone or in combination with the yeast of C. albicans or Zymosan A. During the chronic phase of the arthritis, the cytokine levels, mRNA expression and histopathological analysis of the joints were performed. To investigate the phenotype of the IL-17 producing T-cells, synovial cells were isolated and analyzed by flowcytometry. Intra-articular injection of either Zymosan A or C. albicans on top of the SCW injection both resulted in enhanced joint swelling and inflammation compared to the normal SCW group. However, only the addition of C. albicans during SCW arthritis resulted in severe chondrocyte death and enhanced destruction of cartilage and bone. Additionally, exposure to C. albicans led to increased IL-17 in the arthritic joint, which was accompanied by an increased synovial mRNA expression of T-bet and RORγT. Moreover, the C. albicans-injected mice had significantly more Th17 cells in the synovium, of which a large population also produced IFN-γ. This study clearly shows that minute amounts of fungal components, like C. albicans, are very potent in interfering with the local cytokine environment in an arthritic joint, thereby polarizing arthritis towards a more destructive phenotype.

Gene therapy in animal models of rheumatoid arthritis: are we ready for the patients?

NARCIS (Netherlands)

Loo, F.A.J. van de; Smeets, R.L.L.; Berg, W.B. van den

2004-01-01

Rheumatoid arthritis (RA) is a chronic inflammatory disease of the synovial joints, with progressive destruction of cartilage and bone. Anti-tumour necrosis factor-alpha therapies (e.g. soluble tumour necrosis factor receptors) ameliorate disease in 60-70% of patients with RA. However, the need for

Psoriatic arthritis

International Nuclear Information System (INIS)

Espinoza, L.R.

1985-01-01

In the past 10 years, a number of well-controlled surveys of psoriatic patients selective for the presence of arthritis have been conducted. A Canadian group reported that of 100 patients admitted to the hospital for treatment of psoriasis, 32 had clinical or radiologic evidence of psoriatic arthritis, and 17 had both types of evidence. Eighty patients with radiologic evidence of spinal or sacroiliac involvement were asymptomatic, and seven had clinical evidence of peripheral arthritis but without radiologic evidence. The authors concluded that psoriatic arthritis is a common event in patients with severe psoriasis and that it is associated with more extensive skin disease than is found in patients without arthritis. The information gathered from these epidemiologic studies coupled with clinical, radiologic, and serologic characteristics have provided the basis for the current belief that psoriatic arthritis is indeed a distinct entity

The aryl hydrocarbon receptor suppresses osteoblast proliferation and differentiation through the activation of the ERK signaling pathway

Energy Technology Data Exchange (ETDEWEB)

Yu, Haitao; Du, Yuxuan; Zhang, Xulong; Sun, Ying; Li, Shentao; Dou, Yunpeng [Department of Immunology, School of Basic Medical Sciences, Capital Medical University, No. 10 Xitoutiao, You An Men, Beijing 100069 (China); Li, Zhanguo [Department of Rheumatology and Immunology, Clinical Immunology Center, Peking University People' s Hospital, No. 11 Xizhimen South Street, Beijing 100044 (China); Yuan, Huihui, E-mail: huihui_yuan@163.com [Department of Immunology, School of Basic Medical Sciences, Capital Medical University, No. 10 Xitoutiao, You An Men, Beijing 100069 (China); Zhao, Wenming, E-mail: zhao-wenming@163.com [Department of Immunology, School of Basic Medical Sciences, Capital Medical University, No. 10 Xitoutiao, You An Men, Beijing 100069 (China)

2014-11-01

Ahr activation is known to be associated with synovitis and exacerbated rheumatoid arthritis (RA), but its contributions to bone loss have not been completely elucidated. Osteoblast proliferation and differentiation are abnormal at the erosion site in RA. Here, we reported that the expression of Ahr was increased in the hind paws' bone upon collagen-induced arthritis (CIA) in mice, and the levels of Ahr were negatively correlated with bone mineral density (BMD). In addition, immunofluorescent staining showed that the high expression of Ahr was mainly localized in osteoblasts from the CIA mice compared to normal controls. Moreover, the luciferase intensity of Ahr in the nucleus increased by 12.5% in CIA osteoblasts compared to that in normal controls. In addition, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) activation of the Ahr inhibited pre-osteoblast MC3T3-E1 cellular proliferation and differentiation in a dose-dependent manner. Interestingly, the levels of alkaline phosphatase (ALP) mRNA expression in the osteoblasts of CIA mice were reduced compared to normal controls. In contrast, decreased ALP expression by activated Ahr was completely reversed after pretreatment with an Ahr inhibitor (CH-223191) in MC3T3-E1 cell lines and primary osteoblasts on day 5. Our data further showed that activation of Ahr promoted the phosphorylation of ERK after 5 days. Moreover, Ahr-dependent activation of the ERK signaling pathway decreased the levels of proliferation cells and inhibited ALP activity in MC3T3-E1 cells. These results demonstrated that the high expression of Ahr may suppress osteoblast proliferation and differentiation through activation of the ERK signaling pathway, further enabling bone erosion in CIA mice. - Highlights: • The upregulation of Ahr was localized in osteoblasts of CIA mice. • The overexpression of Ahr suppressed osteoblast development. • The Ahr activated ERK signaling pathway to exacerbate bone erosion.

Role of CTA1R7K-COL-DD as a novel therapeutic mucosal tolerance-inducing vector for treatment of collagen-induced arthritis.

Science.gov (United States)

Hasselberg, Annemarie; Schön, Karin; Tarkowski, Andrej; Lycke, Nils

2009-06-01

To determine whether a cholera toxin-derived, novel immunomodulating fusion protein, CTA1R7K-COL-DD, carrying the class II major histocompatibility complex H-2q-restricted type II collagen peptide aa 259-274, can induce therapeutic tolerance and prevent collagen-induced arthritis (CIA) when administered intranasally in DBA/1 mice, and to assess whether ADP-ribosylation at the mucosal membranes exerts a regulatory function such that the outcome of tolerance or immune enhancement can be controlled. DBA/1 mice with CIA were treated intranasally with CTA1R7K-COL-DD. The therapeutic effect was monitored for 46 days after the onset of disease. Clinical scoring of disease, histologic examination of inflammation, and bone erosion were assessed, and cytokine levels were determined in the serum or supernatants from splenocytes stimulated with recall antigen. The protective effect of CTA1R7K-COL-DD resulted in roughly 60% of the mice having no clinical signs or histologic evidence of disease after treatment, and those with CIA had significantly milder disease with less bone erosion. The protective status was associated with lower serum titers of IgG1, IgG2a, IgG2b, and IgG3 anticollagen and a substantial decrease in the production of interleukin-6 (IL-6), IL-17, and interferon-gamma, while levels of IL-10 were markedly up-regulated both in the serum and at the T cell level. The enzymatically inactive mutant fusion protein CTA1R7K-COL-DD provided substantial therapeutic protection against CIA following intranasal administration. The mechanism behind the effect appears to be mediated by peptide-specific regulatory T cells induced by mucosal exposure to the peptide containing CTA1R7K-COL-DD vector. In addition, ADP-ribosylation at the mucosal membranes acts as a key regulator controlling mucosal tolerance or immunity.

Nyctanthes arbor-tristis Ameliorated FCA-Induced Experimental Arthritis: A Comparative Study among Different Extracts

Science.gov (United States)

Uroos, Maliha; Sattar, Shumaila; Umer, Nigarish; Sharif, Ahsan

2017-01-01

Nyctanthes arbor-tristis (NAT) is commonly used traditionally for the treatment of rheumatism and inflammatory diseases. Current study evaluates the antiarthritic potential of NAT using Freund's adjuvant-induced arthritic rat model. Treatments with methanolic, ethyl acetate, and n-hexane extracts were continued for consecutive 20 days. Macroscopic arthritic scoring and water displacement plethysmometry were used to evaluate arthritic development. Hematological and biochemical parameters were investigated and ankle joints were processed for histopathological evaluation. Qualitative phytochemical analysis and GC-MS analysis were conducted for identification of constituents. NAT extracts suppressed arthritic scoring, paw edema, infiltration of inflammatory cells, pannus formation, and bone erosion. The plant extracts ameliorated total leukocytes and platelet counts and nearly normalized red blood cells (RBC) counts and hemoglobin (Hb) content. The extracts were found safe in terms of hepatotoxicity and nephrotoxicity as determined by aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and urea levels. Comparative analysis showed that ethyl acetate extract produced the highest inhibition of paw edema. The major constituents found in ethyl acetate extract can be classified into three major classes, that is, terpenes, terpenoids, fatty acids, and iridoid glycosides. Current study showed that Nyctanthes arbor-tristis ameliorated experimental rheumatoid arthritis and ethyl acetate extract possessed the highest inhibitory activity. PMID:28676830

Effects of the use of growth hormone in children and adolescents with juvenile idiopathic arthritis: a systematic review

Directory of Open Access Journals (Sweden)

Renan Bazuco Frittoli

Full Text Available Abstract Introduction: Children with juvenile idiopathic arthritis (JIA often have impaired growth and short stature. There is evidence that the therapeutic use of growth hormone (GH is useful and safe in these patients. Objective: To analyze the effects of GH use in patients with JIA. Method: A systematic review of the literature over the last 18 years in Medline and Embase databases. The criteria were analyzed independently by the researchers. We used the following keywords: "growth hormone", "arthritis, juvenile", "arthritis, rheumatoid", "child" and "adolescent". Results: Among the 192 identified articles, 20 corresponded to the inclusion criteria. Seventeen longitudinal studies and 3 case reports were found. Most studies analyzed observed increased growth, muscle mass and bone mass using GH. Adverse effects observed were glucose intolerance, diabetes, bone deformities, osteonecrosis, reactivation of the disease and low final height. Conclusion: The majority of studies reported positive effects after the therapeutic use of GH, but some variability in response to treatment was observed. The combination of growth hormone with other drugs seems to be a good option.

Periarticular and generalised bone loss in patients with early rheumatoid arthritis

DEFF Research Database (Denmark)

Jensen, T W; Hansen, M S; Hørslev-Petersen, Kim

2013-01-01

)). PATIENTS AND METHODS: A hundred and sixty patients with early, active rheumatoid arthritis (RA) received methotrexate, intra-articular betamethasone and ciclosporin /placebo-ciclosporin. Patients with Z-score ≤0 also started alendronate 10 mg/day. BMD of the hand (digital x-ray radiogrammetry (DXR...... in hand, lumbar spine and femoral neck was negatively associated with the dose of intra-articular betamethasone (p...

Runoff erosion

OpenAIRE

Evelpidou, Niki (Ed.); Cordier, Stephane (Ed.); Merino, Agustin (Ed.); Figueiredo, Tomás de (Ed.); Centeri, Csaba (Ed.)

2013-01-01

Table of Contents PART I – THEORY OF RUNOFF EROSION CHAPTER 1 - RUNOFF EROSION – THE MECHANISMS CHAPTER 2 - LARGE SCALE APPROACHES OF RUNOFF EROSION CHAPTER 3 - MEASURING PRESENT RUNOFF EROSION CHAPTER 4 - MODELLING RUNOFF EROSION CHAPTER 5 - RUNOFF EROSION AND HUMAN SOCIETIES: THE INFLUENCE OF LAND USE AND MANAGEMENT PRACTICES ON SOIL EROSION PART II - CASE STUDIES CASE STUDIES – INTRODUCTION: RUNOFF EROSION IN MEDITERRANEAN AREA CASE STUDY 1: Soil Erosion Risk...

Reactive Arthritis

Directory of Open Access Journals (Sweden)

Eren Erken

2013-06-01

Full Text Available Reactive arthritis is an acute, sterile, non-suppurative and inflammatory arthropaty which has occured as a result of an infectious processes, mostly after gastrointestinal and genitourinary tract infections. Reiter syndrome is a frequent type of reactive arthritis. Both reactive arthritis and Reiter syndrome belong to the group of seronegative spondyloarthropathies, associated with HLA-B27 positivity and characterized by ongoing inflammation after an infectious episode. The classical triad of Reiter syndrome is defined as arthritis, conjuctivitis and urethritis and is seen only in one third of patients with Reiter syndrome. Recently, seronegative asymmetric arthritis and typical extraarticular involvement are thought to be adequate for the diagnosis. However, there is no established criteria for the diagnosis of reactive arthritis and the number of randomized and controlled studies about the therapy is not enough. [Archives Medical Review Journal 2013; 22(3.000: 283-299

Arthritis Foundation

Science.gov (United States)

... Vision Leadership News Partners & Sponsors Careers Code of Ethics Financials Annual Report Contact Us Privacy Policy Terms & Conditions Donate Press Store Blog Community Local Offices Kids Get Arthritis Too Español Arthritis Today Social Media Newsletters Sign Up for E-Newsletters Arthritis Foundation ...

EFFICACY AND SAFETY OF ALENDRONIC ACID IN PATIENTS WITH JUVENILE RHEUMATOID ARTHRITIS AND OSTEOPOROSIS

Directory of Open Access Journals (Sweden)

A.O. Lisitsin

2010-01-01

Full Text Available Search for and practical application of new medications to treat of osteoporosis is one of the critical issues in pediatric rheumatology. The article reviews the efficacy and safety of alendronic acid in 64 subjects with juvenile rheumatoid arthritis and systemic osteoporosis. It is demonstrated that alendronate-based therapy in weekly 1 mg/kg doses over 12 months facilitated reliably increased bonedensity, decreased intensity of pain syndrome, and lowered C-terminal telopeptide serum concentration, which indicates improved bone metabolism processes.Key words: juvenile rheumatoid arthritis, osteoporosis, children, treatment, bisphosphonates, alendronic acid. (Pediatric Pharmacology. – 2010; 7(1:48-54

Radiological manifestations of rheumatoid arthritis; Die radiologische Manifestation der rheumatoiden Arthritis

Energy Technology Data Exchange (ETDEWEB)

Kapp, H.J. [Zentrum fuer Rheumatologie, Schlangenbad (Germany). Abt. Radiologie

1997-06-01

Rheumatoid arthritis preferrably becomes manifest at the synovial joints of the limbs, especially at the small joints of the hands and feet, at bursae and synovial sheathes. The pathologic lesions are less frequently found at cartilaginous joints or entheses. The lesions very often are symmetrically distributed and are characterized by the following: 1. A periarticular, spindle-shaped opacity with a density similar to soft-tissue, induced by an inflammatory hypertrophy of the synovia, a serosynovitis, or an edematous impregnation of the periarticular tissue. 2. A juxta-articular osteoporosis, most probably caused by a neighbouring synovialitis accompanied by hyperemia. 3. A diffuse joint cavity narrowing due to a destruction of the articular cartilage by the pannus, a fibrovascular resorptive tissue. 4. Central as well as marginal erosions, caused by destruction of ossous material by the pannus. 5. Subchondral signal cysts, likewise unduced by the pannus. (Orig./AJ) [Deutsch] Die rheumatoide Arthritis manifestiert sich bevorzugt an den synovialen Gelenken der Extremitaeten, insbesondere an den kleinen Gelenken der Haende und Fuesse, an Bursae und an Sehnenscheiden. Seltener finden sich pathologische Veraenderungen an kartilaginaeren Gelenken und an Enthesen. Die Gelenkveraenderungen an Haenden und Fuessen sind oft symmetrisch verteilt und durch folgende Veraenderungen gepraegt: 1. Einer partikulaeren, spindelfoermigen weichteildichten Verschattung, hervorgerufen durch eine entsuendliche Hypertrophie der Synovia, einen Gelenkerguss und einer oedematoesen Durchtraenkung des perartikulaeren Gewebes. 2. Einer gelenknahen Osteoporose, deren Ursache die benachbarte Synovialitis mit Hyperaemie sein duerfte. 3. Einer diffusen Gelenkspaltverschmaelerung des Gelenkknorpels durch den Pannus, einem fibrovaskulaeren Resorptivgewebe. 4. Durch zentrale und marginale Erosionen, die als Folge einer Zerstoerung des Knochens durch den Pannus hervorgerufen werden. 5. Durch

Radiographic study of bone deformans on charged condylar head position in TMJ arthrosis

International Nuclear Information System (INIS)

You, Dong Soo

1983-01-01

The author analyzed the morphologic changes of bone structure from 848 radiographics (424 joints) of 212 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral transcranial projection and ortho pantomography. The interrelation of the bone changes and condylar head positions the results were as follows: 1. In the 212 patients with TMJ arthrosis, 210 patients (99.05%) show the condylar positional changes. Among them, 187 patients (89.05%) show the bone changes. 2. In TMJ arthrosis patients with bone changes, 108 patients (57.75%) show both the condylar positional changes and bone changes. 66 patients show the condylar positional changes bilaterally and bone changes unilaterally. On the other hand, 11 patients (5.88%) show the condylar positional changes unilaterally and bone change bilaterally. 3. The bone changes in the TMJ arthrosis patients with the condylar positional changes were as follows: There were the flattening of articular surface in 103 cases (26.55%) the erosion in 99 cases (25.52%), and the erosion in 88 cases (22.68%). There were not much differences among the three types of bone changes. And the deformity in 70 cases (18.04%), the sclerosis in 22 cases (5.67%), the marginal proliferation in 6 cases (1.55%) were seen. 4. The regions of bone changes in TMJ arthrosis patients with condylar positional changes were as follows: They occurred at the condyle head (51.04%), the articular eminence (39.20%) and the articular fossa (9.60%) in that order. The condylar positional changes and bone changes according to the regions were as follows: a) In the bone changes at the condylar head, the flattening (34.63%) was a most frequent finding and the deformity (27.63%) the erosion (34.63%) in the order. In the condylar positional changes, the downward positioning of condyle (41.44%) was a most frequent finding in the mouth closed state and the restricted movement within the articular fossa (35.46%) in the mouth open state. b) In

Radiographic study of bone deformans on charged condylar head position in TMJ arthrosis

Energy Technology Data Exchange (ETDEWEB)

You, Dong Soo [Department of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1983-11-15

The author analyzed the morphologic changes of bone structure from 848 radiographics (424 joints) of 212 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral transcranial projection and ortho pantomography. The interrelation of the bone changes and condylar head positions the results were as follows: 1. In the 212 patients with TMJ arthrosis, 210 patients (99.05%) show the condylar positional changes. Among them, 187 patients (89.05%) show the bone changes. 2. In TMJ arthrosis patients with bone changes, 108 patients (57.75%) show both the condylar positional changes and bone changes. 66 patients show the condylar positional changes bilaterally and bone changes unilaterally. On the other hand, 11 patients (5.88%) show the condylar positional changes unilaterally and bone change bilaterally. 3. The bone changes in the TMJ arthrosis patients with the condylar positional changes were as follows: There were the flattening of articular surface in 103 cases (26.55%) the erosion in 99 cases (25.52%), and the erosion in 88 cases (22.68%). There were not much differences among the three types of bone changes. And the deformity in 70 cases (18.04%), the sclerosis in 22 cases (5.67%), the marginal proliferation in 6 cases (1.55%) were seen. 4. The regions of bone changes in TMJ arthrosis patients with condylar positional changes were as follows: They occurred at the condyle head (51.04%), the articular eminence (39.20%) and the articular fossa (9.60%) in that order. The condylar positional changes and bone changes according to the regions were as follows: a) In the bone changes at the condylar head, the flattening (34.63%) was a most frequent finding and the deformity (27.63%) the erosion (34.63%) in the order. In the condylar positional changes, the downward positioning of condyle (41.44%) was a most frequent finding in the mouth closed state and the restricted movement within the articular fossa (35.46%) in the mouth open state. b) In

Musculoskeletal ultrasound imaging of the plantar forefoot in patients with rheumatoid arthritis: inter-observer agreement between a podiatrist and a radiologist

Directory of Open Access Journals (Sweden)

Bowen Catherine J

2008-07-01

Full Text Available Abstract Background The use of musculoskeletal ultrasound (MSUS in the diagnosis and management of foot and ankle musculoskeletal pathology is increasing. Due to the wide use of MSUS and the depth and breadth of training required new proposals advocate tailored learning of the technique to discrete fields of practice. The aims of the study were to evaluate the inter-observer agreement between a MSUS radiologist and a podiatrist, who had completed basic skills training in MSUS, in the MSUS assessment of the forefoot of patients with Rheumatoid Arthritis. Methods A consecutive sample of thirty-two patients with rheumatoid arthritis was assessed for presence of synovitis, erosions and bursitis within the forefoot using MSUS. All MSUS assessments were performed independently on the same day by a podiatrist and one of two Consultant Radiologists experienced in MSUS. Results Moderate agreement on image acquisition and interpretation was achieved for bursitis (kappa 0.522; p Conclusion This study demonstrated good inter-observer agreement between a podiatrist and radiologist on MSUS assessment of the forefoot, particularly for bursitis and erosions, in patients with rheumatoid arthritis. There is scope to further evaluate and consider the role of podiatrists in the MSUS imaging of the foot following appropriate training and also in the development of reliable protocols for MSUS assessment of the foot.

Frequency and spectrum of abnormalities in the bone marrow of the wrist: MR imaging findings

International Nuclear Information System (INIS)

Alam, F.; Schweitzer, M.E.; Malat, J.; Hussain, S.M.; Rijksuniversiteit Leiden

1999-01-01

Objective. To describe the frequency of marrow abnormalities on wrist MR imaging and the MR findings of these various abnormalities.Design and patients. Five hundred and nineteen patients were studied at 1.5 T. Two observers recorded the presence and location of avascular necrosis, occult fractures and arthritic edema [focal osteoarthritis, ulnolunate abutment, rheumatoid arthritis, septic arthritis, gouty arthritis and scapholunate advanced collapse (SLAC)].Results and conclusion. One hundred and eighty-seven (36%) patients demonstrated marrow abnormalities in the wrist, of which 101 were diagnosed as arthritis [64 (34%) as focal osteoarthritis, 17 (9%) as ulnolunate abutment, 15 (8%) as rheumatoid arthritis, 2 as septic arthritis, 2 as SLAC, and 1 as gouty arthritis]. Seventy-two patients had occult fractures and in 27 patients avascular necrosis was seen. MR imaging can reveal various abnormalities in bone marrow of the wrist when findings on radiography are normal or equivocal. (orig.)

Bone mineral content measurement by bone mineral analyzer

International Nuclear Information System (INIS)

Yamamoto, Itsuo; Dokoh, Shigeharu; Fukunaga, Masao; Torizuka, Kanji; Kosaka, Tadako.

1976-01-01

With a bone mineral analyzer (Studsvik Bone Scanner 7102), bone mineral content (BMC) was validated using various concentrations of standard CaCO 3 . Seventy-five normal subjects, nineteen patients with rheumathoid arthritis (RA) and twenty-two patients with abnormal thyroid function were investigated by this method. Some inherent problems concerning the present measurements were also discussed. Reproducibility of BMC in sixteen normal subjects during a four months interval was +-4% on the mid-shaft of the radius and +-5% on the distal head of the radius, respectively. Although correlation of the single energy method and the dual energy method with the bone scanner was high (r=0.970), the single energy method was probably underestimated due to the fat layer. BMC in normal subjects was highest in 30th and 40th decades for both males and females, and gradually decreased with aging. Males had higher BMC and BMC/bone width than did females. All of the stage 1 group of RA patients, according to roentgenographic staging, revealed normal BMC, but most of stage 2 and 3 groups had abnormally low BMC, suggesting that progression of the disease may be an important factor in BMC values. The BMC of hyperthyroid patients was low, whereas that of euthyroid patients was normal. Serial measurements of BMC in a hyperparathyroid patient and a hyperthyroid patient revealed distinct recurrence of BMC after treatment. (Evans, J.)

Suppressive effects of QFGJS, a preparation from an anti-arthritic herbal formula, on rat experimental adjuvant-induced arthritis

International Nuclear Information System (INIS)

Cai Xiong; Zhou Hua; Wong Yuenfan; Xie Ying; Liu Zhong Qiu; Jiang Zhhong; Bian Zhaoxiang; Xu Hongxi; Liu Liang

2005-01-01

To analyze the anti-arthritic effects of QFGJS (a pharmaceutical preparation from herbs) on rheumatoid arthritis, adjuvant-induced arthritis (AIA) was established in male SD rats, and two administration protocols, i.e., oral treatment with different doses of QFGJS on the day of arthritis induction or on the day when visible clinical signs of arthritis occurred, were initiated and continued until day 30. Treatments with QFGJS using both administration protocols significantly suppressed the incidence and severity of arthritis in a dose-dependent manner, showing dramatic reduction of paw swelling and ESR throughout the disease progression of AIA. Radiological and histopathological examinations showed markedly decreased tissue and bone destruction of ankle joints in the QFGJS-treated rats. The serum levels of TNF-α, IL-1β, and IL-6 were significantly decreased in the QFGJS-treated rats. QFGJS demonstrates pronounced anti-arthritic effects on AIA, indicating that this herbal preparation would be a potent candidate as a novel botanical drug for further investigation

Radiographic Severity of Rheumatoid Arthritis in African-Americans: Results from the CLEAR Registry

Science.gov (United States)

Bridges, S. Louis; Causey, Zenoria L.; Burgos, Paula I.; Huynh, B. Quynh N.; Hughes, Laura B.; Danila, Maria I.; van Everdingen, Amalia; Ledbetter, Stephanie; Conn, Doyt L.; Tamhane, Ashutosh; Westfall, Andrew O.; Jonas, Beth L.; Callahan, Leigh F.; Smith, Edwin A.; Brasington, Richard; Moreland, Larry W.; Alarcón, Graciela S.; van der Heijde, Désirée M.

2010-01-01

Objective To describe radiographic changes in African-Americans with rheumatoid arthritis (RA) from the CLEAR (Consortium for the Longitudinal Evaluation of African-Americans with Early Rheumatoid Arthritis) Registry, a multicenter observational study. Methods Self-declared African-American patients, were enrolled in CLEAR I, a longitudinal cohort of early RA (disease duration <2 years) from 2000 to 2005; or in CLEAR II, a cross-sectional cohort (any disease duration), from 2006 to the present. Demographic and clinical data were obtained, and sets of hand/wrist and foot radiographs were scored using the modified Sharp/van der Heijde scoring system. Results A total of 357 and 418 patients, respectively, have been enrolled into CLEAR I and CLEAR II. We report here an interim analysis of radiographic severity in these patients. For the CLEAR I cohort, 294 patients had a mean radiographic score of 2.89 at the baseline visit; 32.0% showed either erosions (25.9%) or joint space narrowing (JSN) (19.4%). At the 36-month visit the mean score was 5.65; 44.2% had erosions, 41.5% JSN and 55.4% had either. Among those patients without radiographic damage at baseline, 18.9% had progressed at the 36-month visit, compared to 57.1% of those with baseline damage (p<0.0001). For the CLEAR II cohort, 167 patients with RA of any duration, 65.3% exhibited joint erosions, 65.3% JSN and 74.8% exhibited either. The mean radiographic score was 33.42. Conclusion This is the largest radiographic study of African American RA patients. Damage occurs early in the disease and is associated with radiographic progression at 3 years of disease duration. The CLEAR Registry will provide a valuable resource for future analyses of genetic, clinical, and environmental factors associated with radiographic severity of RA in African-Americans. PMID:20461784

Radiosynovectomy in the treatment of arthritis

International Nuclear Information System (INIS)

Liepe, Knut

2005-01-01

Full text: Radiosynovectomy is a useful therapeutic option that involves radiopharmaceutical injections into joints, especially to treat rheumatoid arthritis. The indications included different kinds of arthritis, such as rheumatoid arthritis, psoriatic arthritis, Bechterew's disease, hemophiliac arthritis, osteoarthritis, but also patients with joint prosthesis and synovial effusion. There are three commercial available radiopharmaceuticals for the treatment: yttrium-90 for the knee (185 to 250 MBq), rhenium-186 for larger joints (shoulder and hip with 111 MBq; elbow, wrist, ankle joint with can also rederbium-169 for smaller joints (acromioclavicular joint with 37 MBq, thumb base and MTP I with 30 MBq, MCP and MTP II-V with 22 MBq, PIP with 18.5 MBq, and DIP with 15 MBq, respectively). Decisive for the treatment is a positive sign for arthritis in the two-phase bone scan with 99mTc-HMDP (high uptake in the blood pool phase). Only for radiosynovecotmy in the knee an ultrasound with an evidence of effusion is sufficient. Side effects by the treatment are rare, such as temporary radiation or crystal synovitis, tissue necrosis (extra articular fraction or intra-articular), joint infection (1 of 35,000 joints) or effects due to the immobilisation (thrombosis, pulmonary embolism (immobilization of the knee), lymphoedema or loss of motion. In the treatment of the knee a prophylaxis with heparin is necessary to protect the patients for a pulmonary embolism. The clinical outcome is depending from the primary disease and the stage of arthrosis. Kresnik at al reported in 2190 treated joints an overall response rate of 73 ± 17%. A higher response rate was observed in patients with early stage of arthrosis (73 ± 12%) to patients with advance stage (52 ± 24%). The best results had patients with hemophiliac arthritis (91 ± 4%). In our hospital were treated up to 10.000 joints with a mean response rate of 70-80%. There was a higher response rate in larger joints with 81 ± 5

Microbiology and management of joint and bone infections due to anaerobic bacteria.

Science.gov (United States)

Brook, Itzhak

2008-03-01

To describes the microbiology, diagnosis, and management of septic arthritis and osteomyelitis due to anaerobic bacteria. The predominant anaerobes in arthritis are anaerobic Gram-negative bacilli (AGNB) including the Bacteroides fragilis group, Fusobacterium spp., Peptostreptococcus spp., and Propionibacterium acnes. Infection with P. acnes is associated with a prosthetic joint, previous surgery, and trauma. B. fragilis group is associated with distant infection, Clostridium spp. with trauma, and Fusobacterium spp. with oropharyngeal infection. Most cases of anaerobic arthritis, in contrast to anaerobic osteomyelitis, involved a single isolate, and most cases are secondary to hematogenous spread. The predominant anaerobes in osteomyelitis are Bacteroides, Peptostreptococcus, Fusobacterium, and Clostridium spp. as well as P. acnes. Conditions predisposing to bone infections are vascular disease, bites, contiguous infection, peripheral neuropathy, hematogenous spread, and trauma. Pigmented Prevotella and Porphyromonas spp. are mostly isolated in skull and bite infections, members of the B. fragilis group in hand and feet infections, and Fusobacterium spp. in skull, bite, and hematogenous long bone infections. Many patients with osteomyelitis due to anaerobic bacteria have evidence of an anaerobic infection elsewhere in the body that is the source of the organisms involved in the osteomyelitis. Treatment of arthritis and osteomyelitis involving anaerobic bacteria includes symptomatic therapy, immobilization in some cases, adequate drainage of purulent material, and antibiotic therapy effective against these organisms. Anaerobic bacteria can cause septic arthritis and osteomyelitis. Correct diagnosis and appropriate therapy are important contributor to successful outcome.

Diagnostic imaging of psoriatic arthritis. Part I: etiopathogenesis, classifications and radiographic features

Directory of Open Access Journals (Sweden)

Iwona Sudoł-Szopińska

2016-03-01

Full Text Available Psoriatic arthritis is one of the spondyloarthritis. It is a disease of clinical heterogenicity, which may affect peripheral joints, as well as axial spine, with presence of inflammatory lesions in soft tissue, in a form of dactylitis and enthesopathy. Plain radiography remains the basic imaging modality for PsA diagnosis, although early inflammatory changes affecting soft tissue and bone marrow cannot be detected with its use, or the image is indistinctive. Typical radiographic features of PsA occur in an advanced disease, mainly within the synovial joints, but also in fibrocartilaginous joints, such as sacroiliac joints, and additionally in entheses of tendons and ligaments. Moll and Wright classified PsA into 5 subtypes: asymmetric oligoarthritis, symmetric polyarthritis, arthritis mutilans, distal interphalangeal arthritis of the hands and feet and spinal column involvement. In this part of the paper we discuss radiographic features of the disease. The next one will address magnetic resonance imaging and ultrasonography.

The safety of interleukin-1 receptor antagonist (anakinra in the treatment of rheumatoid arthritis

Directory of Open Access Journals (Sweden)

L. Riente

2011-09-01

Full Text Available The safety profile of interleukin-1 receptor antagonist (anakinra has been studied with randomised, placebo-controlled trials involving 2932 patients affected by rheumatoid arthritis. The most frequently reported adverse events were represented by injection site reactions (71% and headache (13.6%. No statistically significant difference in the incidence of infections was observed among the patients treated with the interleukin-1 receptor antagonist and the patients receiving placebo. In particular, the incidence of serious infections was 1,8% in rheumatoid arthritis patients on anakinra therapy and 0,7% in patients on placebo. The reported serious infections consisted of pneumonia, cellulitis, bone and joint infections, bursitis. No case of opportunistic infections or tubercolosis was observed. The results of clinical studies suggest that anakinra is a new well-tolerated drug for the treatment of patients affected by rheumatoid arthritis.

Requirement of the inducible nitric oxide synthase pathway for IL-1-induced osteoclastic bone resorption

OpenAIRE

van't Hof, R. J.; Armour, K. J.; Smith, L. M.; Armour, K. E.; Wei, X. Q.; Liew, F. Y.; Ralston, S. H.

2000-01-01

Nitric oxide has been suggested to be involved in the regulation of bone turnover, especially in pathological conditions characterized by release of bone-resorbing cytokines. The cytokine IL-1 is thought to act as a mediator of periarticular bone loss and tissue damage in inflammatory diseases such as rheumatoid arthritis. IL-1 is a potent stimulator of both osteoclastic bone resorption and expression of inducible nitric oxide synthase (iNOS) in bone cells and other cell types. In this study,...

Carpal pseudoerosions: a plain X-ray interpretation pitfall

Energy Technology Data Exchange (ETDEWEB)

Wawer, Richard [Univ. Catholique de Lille (France). Service d' Imagerie Medicale; Budzik, Jean Francois [Univ. Catholique de Lille (France). Service d' Imagerie Medicale; Univ. Nord de France, Boulogne sur Mer (France). Unite de Recherche EA 4490, Physiopathologie des Maladies Osseuses Inflammatoires; Demondion, Xavier [Univ. Lille 2 (France). Service d' Imagerie Musculosquelettique; CHRU Lille (France). Lab. d' Anatomie; Forzy, Gerard [Univ. Catholique de Lille, Lomme (France). Lab. de Biologie; Cotten, Anne [Univ. Lille 2 (France). Service d' Imagerie Musculosquelettique; Univ. Nord de France, Boulogne sur Mer (France). Unite de Recherche EA 4490, Physiopathologie des Maladies Osseuses Inflammatoires

2014-10-15

To examine in detail images of pseudoerosion of the wrist and hand on plain radiographs. The study was conducted with 28 cadaver wrists. During a single imaging session three techniques - plain radiography, tomosynthesis, and computed tomography - were used to visualize the wrist and hand specimens. For each technique, 20 radio-ulno-carpo-metacarpal sites known to present bone erosions in rheumatoid arthritis were analyzed by two radiologists using a standard system to score the cortical bone: normal, pseudoerosion, true erosion, or other pathology. Cohen's concordance analysis was performed to determine inter-observer and intra-observer (for the senior radiologist) agreement by site and by technique. Serial sections of two cadaver specimens were examined to determine the anatomical correlation of the pseudoerosions. On the plain radiographs, the radiologists scored many images as pseudoerosion (7.3 %), particularly in the distal ulnar portion of the capitate, the distal radial portion of the hamate, the proximal ulnar portion of the base of the third metacarpal, the proximal radial portion of the base of the fourth metacarpal, the distal ulnar portion of the hamate, and the proximal portion of the base of the fifth metacarpal. The computed tomography scan revealed that none of these doubtful images corresponded to true erosions. The anatomical correlation study showed that these images could probably be attributed to ligament insertions, thinner lamina, and enhanced cortical bone transparency. Knowledge of the anatomical carpal localizations where pseudoerosions commonly occur is a necessary prerequisite for analysis of plain radiographs performed to diagnose or monitor rheumatoid arthritis. (orig.)

Collagen induced arthritis increases secondary metastasis in MMTV-PyV MT mouse model of mammary cancer