Yoshikazu Nakashima1, Mami Tamai1, Junko Kita1, Toru Michitsuji1, Toshimasa Shimizu1, Shoichi Fukui1, Masataka Umeda1, Ayako Nishino1, Takahisa Suzuki1, Yoshiro Horai1, Akitomo Okada1, Takayuki Nishimura1, Tomohiro Koga1, Shin-Ya Kawashiri1, Naoki Iwamoto1, Kunihiro Ichinose1, Yasuko Hirai1, Kazuhiko Arima1, Satoshi Yamasaki1, Hideki Nakamura1, Tomoki Origuchi1, Shoichiro Takao1, Masataka Uetani1, Kiyoshi Aoyagi1, Katsumi Eguchi1, Atsushi Kawakami1. 1. From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD,
Abstract
OBJECTIVE: To clarify whether magnetic resonance imaging (MRI) bone edema predicts the development of rapid radiographic progression (RRP) in the Nagasaki University Early Arthritis Cohort of patients with early-stage rheumatoid arthritis (RA). METHODS: Patients with early-stage RA (n = 76) were enrolled and underwent 1.5-T MRI of both wrists and finger joints. Synovitis, bone edema, and bone erosion were evaluated using the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring (RAMRIS). RRP was defined as an annual increment > 3 at 1 year by the Genant-modified Sharp score of plain radiographs. A multivariate logistic regression analysis was performed to establish the risk factors for RRP. RESULTS: Median disease duration at enrollment was 3 months. RRP was found in 12 of the 76 patients at 1 year. A univariate analysis revealed that matrix metalloprotease-3, RAMRIS bone edema score, and RAMRIS bone erosion score were associated with RRP. Multivariate logistic regression analyses demonstrated that the RAMRIS bone edema score at enrollment (5-point increase, OR 2.18, 95% CI 1.32-3.59, p = 0.002) was the only independent predictor of the development of RRP at 1 year. A receiver-operating characteristic analysis identified the best cutoff value for RAMRIS bone edema score as 5. RRP was significantly rare among the patients with a RAMRIS bone edema score < 5 at enrollment (2 from 50 patients). CONCLUSION: Our findings suggest that MRI bone edema is closely associated with the development of RRP in patients with early-stage RA. Physicians should carefully control the disease activity when MRI bone edema is observed in patients with early RA.
OBJECTIVE: To clarify whether magnetic resonance imaging (MRI) bone edema predicts the development of rapid radiographic progression (RRP) in the Nagasaki University Early Arthritis Cohort of patients with early-stage rheumatoid arthritis (RA). METHODS:Patients with early-stage RA (n = 76) were enrolled and underwent 1.5-T MRI of both wrists and finger joints. Synovitis, bone edema, and bone erosion were evaluated using the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring (RAMRIS). RRP was defined as an annual increment > 3 at 1 year by the Genant-modified Sharp score of plain radiographs. A multivariate logistic regression analysis was performed to establish the risk factors for RRP. RESULTS: Median disease duration at enrollment was 3 months. RRP was found in 12 of the 76 patients at 1 year. A univariate analysis revealed that matrix metalloprotease-3, RAMRIS bone edema score, and RAMRIS bone erosion score were associated with RRP. Multivariate logistic regression analyses demonstrated that the RAMRIS bone edema score at enrollment (5-point increase, OR 2.18, 95% CI 1.32-3.59, p = 0.002) was the only independent predictor of the development of RRP at 1 year. A receiver-operating characteristic analysis identified the best cutoff value for RAMRIS bone edema score as 5. RRP was significantly rare among the patients with a RAMRIS bone edema score < 5 at enrollment (2 from 50 patients). CONCLUSION: Our findings suggest that MRI bone edema is closely associated with the development of RRP in patients with early-stage RA. Physicians should carefully control the disease activity when MRI bone edema is observed in patients with early RA.
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Keywords:
BONE EDEMA; EARLY-STAGE RHEUMATOID ARTHRITIS; MAGNETIC RESONANCE IMAGING; RAPID RADIOGRAPHIC PROGRESSION
Authors: Edit Végh; János Gaál; Pál Géher; Edina Gömöri; Attila Kovács; László Kovács; Katalin Nagy; Edit Feketéné Posta; László Tamási; Edit Tóth; Eszter Varga; Andrea Domján; Zoltán Szekanecz; Gabriella Szűcs Journal: BMC Musculoskelet Disord Date: 2021-04-02 Impact factor: 2.362