Can Magnetic Resonance Imaging Differentiate Undifferentiated Arthritis Based on Knee Imaging?

Emad, Yasser; Ragab, Yasser; Shaarawy, Ahmed; Abou‐Zeid, A. A.; Saad, Ahmed; Fawzy, Magdy; Jokhdar, Hani; Rasker, Johannes J.

doi:10.3899/jrheum.081320

Cited by 25 publications

(18 citation statements)

References 29 publications

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“…This finding was confirmed by our group 5 . We compared enhanced MRI findings of the knee joints in 3 groups of patients, undifferentiated arthritis (UA; n = 25), established RA (n = 15), and SpA (n = 15), and found that enthesitis was a common feature on MRI in the SpA group, was totally absent in the group of patients with RA, and was observed in 3 patients in the UA group.…”

supporting

confidence: 81%

“…Bone was assessed for marrow signal intensity abnormalities and focal erosions. Maximal synovium thickness was measured in the suprapatellar pouch on sagittal T1-weighted Gd-enhanced images, as in our earlier studies 4,5 . Special emphasis was given to the following entheseal sites and they were carefully evaluated for abnormalities: the quadriceps tendon insertion and the proximal and distal patellar tendon.…”

Section: Severitymentioning

confidence: 99%

“…These findings suggest an explanation for the localization of disease to skeletal sites that are subject to repeated mechanical stress 2 . There appear to be 2 patterns of inflammation: the "rheumatoid arthritis" (RA) phenotype, where synovial involvement is the primary target of inflammation, and the "SpA" pattern, where enthesitis comes first, followed by synovitis 1,3,4,5 .…”

mentioning

confidence: 99%

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Knee Enthesitis and Synovitis on Magnetic Resonance Imaging in Patients with Psoriasis without Arthritic Symptoms

et al. 2012

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ABSTRACT. Objective. This case-control study was designed to evaluate magnetic resonance imaging (MRI) findings of knee joints in patients with psoriasis without clinical peripheral or axial joint involvement, and to correlate MRI findings with disease and demographic variables. Methods. In total 48 patients with psoriasis and no clinical evidence of synovitis or enthesitis in any peripheral or axial joints were enrolled. A random sample of 20 healthy subjects without knee or other joint complaints and matched for age and sex served as controls. All patients and controls underwent enhanced MRI studies of both knee joints, and MRI findings were compared. Results. Among 48 patients (96 knees), a total of 90 entheseal lesions were detected, with no enthesitis in 2 cases (6.3%). Signs of continuing inflammation bilaterally were frequently found: soft tissue edema (STE; n = 52), bone marrow edema (BME; n = 20), perientheseal BME (n = 3), cartilaginous erosions (n = 42), and bone erosions (n = 27). In controls, 2 (10%) subjects had BME and another 5 (25%) showed cartilaginous erosions. None showed evidence of enthesitis. Significant correlations were observed between the number of entheseal lesions of both knees vs STE (present vs absent; r = 0.314, p = 0.030) and STE (number of lesions; r = 0.351, p = 0.014). Enthesitis (unilateral vs bilateral) was significantly and positively correlated with STE (r = 0.304, p = 0.036), cartilaginous erosions (r = 0.304, p = 0.036), and villous projections (r = 0.347, p = 0.016). Conclusion. Subclinical synovitis and enthesitis are frequently found in the knee joint of patients with psoriasis. These may be an early sign of psoriatic

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confidence: 81%

Section: Severitymentioning

confidence: 99%

mentioning

confidence: 99%

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Knee Enthesitis and Synovitis on Magnetic Resonance Imaging in Patients with Psoriasis without Arthritic Symptoms

et al. 2012

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“…Moreover, the absence of psoriatic skin lesions does not always exclude the diagnosis of PsA, especially in the absence of other important features of the disease (e.g., finger nail dystrophy, seronegativity for RF, distal interphalangeal joint involvement, oligoarthritis, asymmetry, and dactylitis) [10].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictive value of anti-cyclic citrullinated protein antibodies for future development of rheumatoid arthritis in early undifferentiated arthritis

et al. 2010

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The aim of this study is to evaluate the prevalence and predictive value of anti-cyclic citrullinated protein (CCP) antibodies as a diagnostic marker for future development of rheumatoid arthritis (RA) in a cohort of patients presenting with undifferentiated arthritis (UA). The study comprised 69 patients (22 males and 47 females) presenting with UA, and 66 healthy subjects as control group. For all patients the following parameters were assessed: swollen joint count (SJC), tender joint count (TJC), and duration of morning stiffness in minutes. Baseline laboratory investigations included erythrocyte sedimentation rate (ESR) first hour, C-reactive protein (CRP), complete blood count, complete liver and kidney function tests, urine analysis, anti-nuclear antibodies, rheumatoid factor (RF), and anti-CCP antibodies. Positive correlations were observed between anti-CCP versus SJC, TJC (p = 0.001), duration of morning stiffness (p = 0.04), ESR first hour, and bone erosive changes (p = 0.001). Anti-CCP showed sensitivity of 57%, specificity of 37.9%, positive predictive value of 65.1%, and negative predictive value of 39.3%. Sensitivity and positive predictive values of anti-CCP are close to those observed for RF. In patients presenting with UA, anti-CCP antibodies may allow prediction of RA, thereby allowing early individualized therapeutic decisions.

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“…Interpretation of these data is complicated by the fact that these studies used different approaches (MRI, ultrasound, Power Doppler ultrasound) and enthesitis scores. This results in wide variability of findings with, for example, a reported frequency of enthesitis ranging from no enthesitis at all6 8 to 60% in RA 4. To avoid potential biases, we based our approach on the study by McGonagle et al ,2 focusing on the same patient groups and using globally the same MRI parameters.…”

Section: Discussionmentioning

confidence: 99%

Peripheral joint inflammation in early onset spondyloarthritis is not specifically related to enthesitis

et al. 2013

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Can Magnetic Resonance Imaging Differentiate Undifferentiated Arthritis Based on Knee Imaging?

Cited by 25 publications

References 29 publications

Knee Enthesitis and Synovitis on Magnetic Resonance Imaging in Patients with Psoriasis without Arthritic Symptoms

Knee Enthesitis and Synovitis on Magnetic Resonance Imaging in Patients with Psoriasis without Arthritic Symptoms

Prevalence and predictive value of anti-cyclic citrullinated protein antibodies for future development of rheumatoid arthritis in early undifferentiated arthritis

Peripheral joint inflammation in early onset spondyloarthritis is not specifically related to enthesitis

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