Rh of CPP2, but not T50, is independently associated with VC in patients with CKD Stages 4-5.

The hip has multiple anatomic variants that can mimic abnormalities at hip MRI. The labrum has several anatomic variants that can be confused with true labral tears.

OBJECTIVESThe mechanisms that trigger flare in rheumatoid arthritis (RA) are unknown. In murine arthritis models, dysfunctional lymph node (LN) drainage is associated with joint flare. To examine if LN alterations are associated with RA flare, we analyzed the change in LN volume via contrast-enhanced magnetic resonance imaging (CE-MRI) in patients with active joint flare at baseline and 16 weeks after certolizumab pegol (CZP) therapy. We also assessed the changes in popliteal or epitrochlear LN volumes versus the Rheumatoid and Arthritis Outcome Score (RAOS) (knee), or the Michigan Hand Questionnaire (MHQ; wrist/hand), and Disease Activity Score 28 (DAS28), at baseline and 16 weeks.RESULTSTotal LN volume in 7 of 10 patients with measurable LN on CE-MRI significantly decreased 16 weeks after CZP therapy (mean decrease 37%; P = 0.0019). Improvement in knee pain measured by the RAOS (P = 0.03) inversely correlated with a decrease in total popliteal LN volume (R2 = 0.94). All patients demonstrated significant improvement in DAS28 (mean decrease 1.48; P = 0.0002). For flare in the hand, significant improvement in activities of daily living (ADL) as measured by the MHQ was observed (left hand mean improvement 20%; P = 0.02; right hand mean improvement 37%; P = 0.03).CONCLUSIONRA patients with the smallest change in LN volume during anti-tumor necrosis factor (anti-TNF) therapy experienced the greatest pain relief in symptomatic knee joints. Moreover, the remarkably linear inverse correlation between LN volume and joint pain observed in this small clinical pilot provides initial evidence to support the concept that dynamic changes in draining LN volume are a biomarker of clinical response to therapy in RA.

The hip has multiple anatomic variants that may mimic disease on hip MRI. Like labral variants, nonlabral variants can be confused for true abnormalities.

Background We observed cases of extensive osteolysis of the femoral head following acetabular fractures even though the original fracture did not involve the femoral head or neck. This observation has been called massive osteolysis of the femoral head (MOFH). Purpose To evaluate the clinical and imaging features of MOFH to gain a better understanding of its patho-etiology. Material and Methods We retrospectively collected cases of acetabular fractures seen over a period of 10 years and evaluated the clinical features and imaging characteristics. The findings were compared with the features of other complications such as osteonecrosis, rapidly progressive osteoarthritis, or post-traumatic osteolysis. Results Fifteen patients (M:F ratio 9:6; mean age, 61.6 years) out of 244 had MOFH (prevalence: 6.1%). Motor vehicle collision and falls were the most common mechanisms of injury. The time interval for developing MOFH was in the range of 1-18 months after the initial injury. Patterns of femoral head osteolysis varied from eccentric (12 cases) to transcervical (3 cases). Four cases of eccentric osteolysis developed high-degree of osteolysis. MOFH was observed near the surgical hardware in 6/15 cases. One biopsy specimen did not reveal typical features of osteoarthritis or avascular necrosis. Conclusion MOFH appears to be a distinct entity from avascular necrosis or rapidly progressive osteoarthritis. It is suggested that MOFH is a variant of post-traumatic osteolysis that is evident in a subset of patients.