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Use of magnetic resonance imaging in detecting subclinical synovitis in rheumatoid arthritis and correlation of imaging findings with interleukin-18 levels.
- Source :
-
International journal of rheumatic diseases [Int J Rheum Dis] 2016 Aug; Vol. 19 (8), pp. 790-8. Date of Electronic Publication: 2014 Aug 15. - Publication Year :
- 2016
-
Abstract
- Aim: We studied the usefulness of magnetic resonance imaging (MRI) in detecting subclinical inflammation in patients with asymptomatic RA and tested the hypothesis of interleukin (IL)-18 as a marker of disease activity.<br />Methods: Thirteen RA patients with Disease Activity Score of 28 joints (DAS28) < 2.6 were evaluated. The patients underwent clinical evaluation, laboratory tests and MRI assessment. Imaging of bilateral hands and wrists was performed using validated acquisition and scoring techniques. Serum IL-18 levels were concurrently measured.<br />Results: MRI assessments showed that 92.3% and 76.9% of patients had synovitis and bone marrow edema, respectively, despite being in clinical remission. Eight out of 12 patients (66.7%) had erosions on MRI which were not visualised on plain radiographs. Of all the 182 joints studied for synovitis on MRI, only one had clinical evidence of joint swelling. Comparison of the total sum scores of synovitis between the right and left hand and wrist joints of individual patients showed a significant difference between the two sides. Measurements of IL-18 indicated that a large proportion (54%) of the patients had undetectable or very low levels of the cytokine.<br />Conclusion: MRI is more sensitive in detecting erosions compared with X-rays, and is superior in its ability to detect subclinical inflammation in RA patients. Despite being in clinical remission, a large majority of patients had imaging-detected synovitis and bone marrow edema. Our study highlights the usefulness of MRI for the accurate evaluation of disease activity. In the utility of MRI, it may be important to assess bilateral hands and wrists, instead of limiting to the dominant side.<br /> (© 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.)
- Subjects :
- Adult
Aged
Arthritis, Rheumatoid therapy
Asymptomatic Diseases
Biomarkers blood
Bone Marrow Diseases blood
Bone Marrow Diseases diagnostic imaging
Cross-Sectional Studies
Edema blood
Edema diagnostic imaging
Enzyme-Linked Immunosorbent Assay
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Prognosis
Remission Induction
Reproducibility of Results
Severity of Illness Index
Singapore
Synovitis therapy
Arthritis, Rheumatoid blood
Arthritis, Rheumatoid diagnostic imaging
Inflammation Mediators blood
Interleukin-18 blood
Magnetic Resonance Imaging
Synovial Membrane diagnostic imaging
Synovitis blood
Synovitis diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1756-185X
- Volume :
- 19
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- International journal of rheumatic diseases
- Publication Type :
- Academic Journal
- Accession number :
- 25123522
- Full Text :
- https://doi.org/10.1111/1756-185X.12448