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Bone Edema Determined by Magnetic Resonance Imaging Reflects Severe Disease Status in Patients with Early-Stage Rheumatoid Arthritis
MAMI TAMAI, ATSUSHI KAWAKAMI, MASATAKA UETANI, SHOICHIRO TAKAO, FUMIKO TANAKA, KEITA FUJIKAWA, TOSHIYUKI ARAMAKI, HIDEKI NAKAMURA, NOZOMI IWANAGA, YASUMORI IZUMI, KAZUHIKO ARIMA, KOUICHIRO ARATAKE, MAKOTO KAMACHI, MINGGUO HUANG, TOMOKI ORIGUCHI, HIROAKI IDA, KIYOSHI AOYAGI, and KATSUMI EGUCHI
ABSTRACT. Methods. We simultaneously examined serologic variables, MRI of wrist sites and finger joints of both hands, clinical disease activity score (DAS), and HLA-DR typing at entry in 80 patients with early-stage RA. Results. The number of bones scored as positive for bone edema correlated with the number of sites scored as positive for MRI synovitis and MRI bone erosion, rate of enhancement (E-rate), and serum C-reactive protein (CRP), matrix metalloproteinase 3 (MMP-3), and interleukin 6 (IL-6). Findings for MRI synovitis and MRI bone erosion, E-rate, CRP, MMP-3, IL-6, seropositivity, and titer of anti-cyclic citrullinated peptide antibody (anti-CCP antibody), DAS28-CRP and HLA-DRB1*0405 allele carriership, were significantly higher in the positive versus the negative bone edema group. Conclusion. Bone edema based on our scoring system may reflect severe disease status in patients with early-stage RA. However, its clinical value at entry in prognostication of RA should be examined through prospective clinical followup studies. (First Release Oct 1 2007; J Rheumatol 2007;34:2154-7) Key Indexing Terms:
EARLY-STAGE RHEUMATOID ARTHRITIS
From the First Department of Internal Medicine; Department of Radiology and Radiation Research; Department of Public Health, Graduate School of Biomedical Sciences; and Nagasaki University School of Health Sciences, Nagasaki University, Nagasaki, Japan. Supported by a grant from The Ministry of Health, Labour and Welfare, Japan. M. Tamai, MD, PhD; A. Kawakami, MD, PhD, First Department of Internal Medicine; M. Uetani, MD, PhD; S. Takao, MD, Department of Radiology and Radiation Research; F. Tanaka, MD, PhD; K. Fujikawa, MD; T. Aramaki, MD; H. Nakamura, MD, PhD; N. Iwanaga, MD, PhD; Y. Izumi, MD, PhD; K. Arima, MD, PhD; K. Aratake, MD, PhD; M. Kamachi, MD, PhD; M. Huang, MD, PhD, First Department of Internal Medicine; T. Origuchi, MD, PhD, Nagasaki University School of Health Sciences; H. Ida, MD, PhD, First Department of Internal Medicine; K. Aoyagi, MD, PhD, Department of Public Health, Graduate School of Biomedical Sciences; K. Eguchi, MD, PhD, First Department of Internal Medicine. Address reprint requests to Prof. K. Eguchi, First Department of Internal Medicine, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. E-mail: eguchi@net.nagasaki-u.ac.jp Accepted for publication June 29, 2007. |
