RESEARCH - Can MRI differentiate undifferentiated arthritis based on knee imaging?

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J Rheumatol September 2009 36(9):1963-1970;

doi:10.3899/jrheum.081320

Can Magnetic Resonance Imaging Differentiate Undifferentiated

Arthritis Based on Knee Imaging?

From the Departments of Rheumatology and Rehabilitation, Radiology,

Public Health, and Internal Medicine, Faculty of Medicine, Cairo

University, Cairo, Egypt; and University Twente, Enschede, The

Netherlands.

Y. Emad, MD, Department of Rheumatology and Rehabilitation, Cairo

University, Dr. Erfan and Bagedo General Hospital, Jeddah, Saudi

Arabia; Y. Ragab, MD, Department of Radiology, Cairo University, Dr.

Erfan and Bagedo General Hospital; A. Shaarawy, Department of

Ophthalmology, Cairo University, Dr. Erfan and Bagedo General

Hospital; A. Abou-Zeid, MD, Department of Public Health, Cairo

University; A. Saad, MD; M. Fawzy, MD, Department of Internal

Medicine, Cairo University, Dr. Erfan and Bagedo General Hospital; H.

Jokhdar, PhD, Department of Community Medicine and Pilgrims Health

Care, Makkah, Dr. Erfan and Bagedo General Hospital, Jeddah, Saudi

Arabia; J.J. Rasker, MD, University Twente.

Abstract

Objective. To compare findings as observed on enhanced magnetic

resonance imaging (MRI) of the knee joints, in

oligoarticular-undifferentiated arthritis (UA) in those with

established rheumatoid arthritis (RA) and spondyloarthropathy (SpA).

Methods. A total of 55 patients with knee arthritis were consecutively

recruited for the study, including 25 with undifferentiated

oligoarthritis of the knee joint(s), 15 fulfilling the American

College of Rheumatology criteria for RA and 15 with SpA. Laboratory

investigations included erythrocyte sedimentation rate, C-reactive

protein, complete blood count, aspartate aminotransferase, alanine

aminotransferase, serum creatinine, and urine analysis. In all

patients in the UA and in the RA group, rheumatoid factor and

anti-CCP2 antibody (ELISA) were tested. All patients underwent

enhanced MRI of the more symptomatic knee. All groups were compared in

terms of demographics, laboratory investigations, and MRI findings.

Results. Synovial thickness differed significantly in the RA group

compared to UA and SpA groups (p < 0.001). The RA group showed a

higher rate of bony and cartilaginous erosions and bone marrow edema

compared to UA and SpA groups (p < 0.001). Enthesitis was found in all

patients in the SpA group (100%) and differed from RA and UA groups (p

< 0.001).

Conclusion. Patients with RA showed more destructive changes in terms

of synovial thickening, bone marrow edema, cartilaginous and bone

erosions compared to UA and SpA groups. Enthesitis is a common feature

on MRI in SpA, while absent in the RA and UA groups. This latter

finding may have important clinical implications for classification

purposes, and can help to determine the evolving pattern of patients

with UA of the knee joint.

http://jrheum.org/content/36/9/1963.abstract

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If you subscribe to the Journal of Rhem. can you post this abstract, you hae to

purchase it, to read it:

Immune responses following administration of influenza and pneumococcal

vaccines...

L Kaine, Alan J Kivitz, Birbara, and Y Luo

J Rheumatol February 2007 34(2):272-279

Abstract Full Text (PDF) Full text (external)