Significant improvement in MRI-proven bone edema is associated with protection from structural damage in very early RA patients managed using the tight control approach

Abstract Objective To identify the value of magnetic resonance imaging (MRI)-proven bone edema in patients with very early rheumatoid arthritis (RA). Methods All of the 13 patients included in the study were positive at entry for MRI-proven bone edema of the wrist and finger joints and anti-cyclic c...

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Bibliographic Details
Published in:Modern rheumatology 2013-03, Vol.23 (2), p.254-259
Main Authors: Kita, Junko, Tamai, Mami, Arima, Kazuhiko, Kawashiri, Shin-ya, Horai, Yoshiro, Iwamoto, Naoki, Okada, Akitomo, Koga, Tomohiro, Nakashima, Yoshikazu, Suzuki, Takahisa, Yamasaki, Satoshi, Nakamura, Hideki, Origuchi, Tomoki, Ida, Hiroaki, Aoyagi, Kiyoshi, Uetani, Masataka, Eguchi, Katsumi, Kawakami, Atsushi
Format: Article
Language:English
Subjects:
Adult
Aged
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - complications
Arthritis, Rheumatoid - drug therapy
Arthritis, Rheumatoid - pathology
Bone Diseases - diagnostic imaging
Bone Diseases - etiology
Bone Diseases - pathology
Correlation analysis
Disease Progression
Edema - diagnostic imaging
Edema - etiology
Edema - pathology
Female
Finger Joint - diagnostic imaging
Finger Joint - pathology
Humans
Magnetic Resonance Imaging
Male
Methotrexate - therapeutic use
Middle Aged
MRI
NMR
Nuclear magnetic resonance
Peptides
Radiographic progression
Radiography
RAMRIS bone edema score
Rheumatoid arthritis
Rheumatology
SDAI
Sulfasalazine - therapeutic use
Tacrolimus - therapeutic use
Treatment Outcome
Very early RA
Wrist Joint - diagnostic imaging
Wrist Joint - pathology
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Summary:Abstract Objective To identify the value of magnetic resonance imaging (MRI)-proven bone edema in patients with very early rheumatoid arthritis (RA). Methods All of the 13 patients included in the study were positive at entry for MRI-proven bone edema of the wrist and finger joints and anti-cyclic citrullinated peptide antibodies or IgM-rheumatoid factor. A tight control approach was applied for 12 months. Plain MRI and radiographs of both wrist and finger joints were examined every 6 months. MRI was scored by the RA MRI scoring (RAMRIS) technique and plain radiographs were scored using the Genant-modified Sharp score. Variables that were correlated with plain radiographic changes at 12 months were examined. Results Simplified disease activity index (SDAI) remission was achieved in 7 patients, and a significant reduction in the RAMRIS bone edema score, which declined to < 33 % as compared with the baseline, was achieved in 8 out of 13 patients. Four patients showed plain radiographic progression while 9 patients did not. Significant reductions in the RAMRIS bone edema score (p = 0.007) and the time-integrated SDAI (p = 0.031) were the variables involved in plain radiographic progression. Conclusions Improvement in bone edema may be associated with protection against structural damage in very early RA patients managed using the tight control approach.
ISSN:1439-7595
1439-7609
DOI:10.3109/s10165-012-0646-5