Early prediction of rheumatoid arthritis by serological variables and magnetic resonance imaging of the wrists and finger joints: results from prospective clinical examination

Tamai, Mami; Kawakami, Atsushi; Uetani, Masataka; Sugiyama, Takao; Rashid, H.; Tanaka, Fumiko; Fujikawa, Keita; Aramaki, Toshiyuki; Nakamura, Hideki; Iwanaga, Naoki; Izumi, Yuichi; Arima, Kei; Aratake, Kouichiro; Kamachi, Makoto; Huang, Mingguo; Origuchi, Tomoki; Ida, Hiroaki; Aoyagi, Kiyoshi; Eguchi, Katsumi

doi:10.1136/ard.2005.043075

Cited by 50 publications

(49 citation statements)

References 3 publications

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“…As shown in Fig. 2, MRI study on the hands clearly detected bilateral findings of synovitis, bone marrow edema in the ossa metacarpi, and bone erosions in the carpal bones, leading to the diagnosis of early-stage RA by rheumatologists and radiologists [7,8]. As shown in Fig.…”

Section: Case Presentationmentioning

confidence: 88%

Manifestation of Rheumatoid Arthritis after Transsphenoidal Surgery in a Patient with Acromegaly

et al. 2006

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Abstract. Acromegalic arthropathy is one of the most frequent manifestations occurring in acromegaly patients. In contrast, rheumatoid arthritis (RA) is a rare clinical complication in acromegaly patients. Here, we report a 70-year-old Japanese woman with acromegaly, who complained of bilateral finger stiffness and polyarthralgia two months after transsphenoidal surgery of a growth hormone (GH)-secreting pituitary adenoma. Postoperative levels of serum GH and insulin-like growth factor-1 (IGF-1) were markedly decreased without any secretory deficiency of other anterior pituitary hormones. Hand X-ray did not show typical RA changes; however, erosive changes in carpal bones were clearly detected by magnetic resonance imaging with gadolinium enhancement. Based on the levels of serological markers in the patient following surgery including C-reactive protein, rheumatoid factor and matrix metalloproteinase-3, anti-rheumatic therapy was subsequently commenced. Regardless of the levels of GH and IGF-1, acromegaly patients frequently complain about joint-related symptoms even after remission. Therefore, careful observation of bone erosive changes and immunological activity in acromegaly patients is required when joint-related symptoms persist.

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Section: Case Presentationmentioning

confidence: 88%

Manifestation of Rheumatoid Arthritis after Transsphenoidal Surgery in a Patient with Acromegaly

et al. 2006

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“…Their disease status was formally confirmed by a Japan College of Rheumatology-certified rheumatologist in our department, and a diagnosis of RA was made based on the 1987 criteria of the American College of Rheumatology for RA (4). Baseline clinical manifestations and variables included sex, age, localization of tender and/or swollen joints, morning stiffness, C-reactive protein level (measured by latex turbidimetric immunosorbent assay; Daiichi Pure Chemicals), IgM rheumatoid factor (IgM-RF) positivity (measured by latex-enhanced immunonephelometric assay, cutoff value 14 IU/ml; Dade Behring), positive status for anti-cyclic citrullinated peptide (anti-CCP) antibodies (measured by enzyme-linked immunosorbent assay, cutoff value 4.5 units/ml; DIASTAT Anti-CCP, Axis-Shield), HLA-DRB1 genotyping, and MRI of both the wrist and finger joints, as previously described (5)(6)(7)(8). All of the variables were examined on the same day, as previously reported (5)(6)(7)(8).…”

Section: Methodsmentioning

confidence: 99%

“…All of the MRI studies were performed within 2 weeks after entry. The images were evaluated for bone edema, bone erosion, and synovitis in 15 sites in each finger and wrist: the distal radioulnar joint, the radiocarpal joint, the midcarpal joint, the first carpometacarpal joint, the second through fifth carpometacarpal joints (together), the first through fifth metacarpophalangeal (MCP) joints, and the first through fifth proximal interphalangeal (PIP) joints separately (a total of 30 sites in both hands), as we previously reported (5)(6)(7)(8). The presence of synovitis, bone edema, and bone erosion was evaluated according to the methods described by Lassere et al (9) and Conaghan et al (10) and by two experienced radiologists (MU and ST), and decisions were reached by consensus as we previously described (5-8).…”

Section: Methodsmentioning

confidence: 99%

Comparative study of the detection of joint injury in early‐stage rheumatoid arthritis by magnetic resonance imaging of the wrist and finger joints and physical examination

Tamai¹,

Kawakami²,

Iwamoto³

et al. 2011

Arthritis Care & Research

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Objective. To verify whether magnetic resonance imaging (MRI)-proven joint injury is sensitive as compared with joint injury determined by physical examination. Methods. MRI of the wrist and finger joints of both hands was examined in 51 early-stage rheumatoid arthritis (RA) patients by both plain and gadolinium diethylenetriaminepentaacetic acid-enhanced MRI. Synovitis, bone edema, and bone erosion (the latter two included as bone lesions at the wrist joints); metacarpophalangeal joints; and proximal interphalangeal joints were considered as MRI-proven joint injury. Japan College of Rheumatology-certified rheumatologists had given a physical examination just before the MRI study. The presence of tender and/or swollen joints in the same fields as MRI was considered as joint injury on physical examination. The association of MRI-proven joint injury with physical examination-proven joint injury was examined. Results. A total of 1,110 sites were available to be examined. MRI-proven joint injury was found in 521 sites, whereas the other 589 sites were normal. Physical examination-proven joint injury was found in 305 sites, which was significantly low as compared with MRI-proven joint injury (P ‫؍‬ 1.1 ؋ 10 ؊12 versus MRI). Joint injury on physical examination was not found in 81.5% of the sites where MRI findings were normal. Furthermore, an association of the severity of MRI-proven joint injury with that of joint injury on physical examination was clearly demonstrated (P ‫؍‬ 1.6 ؋ 10 ؊15 , r s ‫؍‬ 0.469). Conclusion. Our present data suggest that MRI is not only sensitive but accurately reflects the joint injury in patients with early-stage RA.

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“…All variables were examined on the same day, as we recently reported [13][14][15][16][17]. Each patient provided a signed consent form to participate in the study, which was approved by the Institutional Review Board of Nagasaki University.…”

Section: Patientsmentioning

confidence: 99%

Delayed treatment with tumor necrosis factor inhibitors in incomplete responders to synthetic disease-modifying anti-rheumatic drugs shows an excellent effect in patients with very early rheumatoid arthritis with poor prognosis factors

et al. 2011

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We aimed to investigate whether delayed treatment with tumor necrosis factor (TNF) inhibitors in incomplete responders to synthetic disease-modifying anti-rheumatic drugs (DMARDs) was effective among patients with very early rheumatoid arthritis (RA) with poor prognosis factors. We examined 22 patients with very early RA who were positive for anti-cyclic citrullinated peptide antibodies or IgM-rheumatoid factor. The mean disease duration at entry was 14.1 weeks. A treat-to-target strategy, aiming at simplified disease activity index (SDAI) remission, was initiated with synthetic DMARDs. SDAI remission was not achieved in 9 of the 22 patients with synthetic DMARDs alone, and TNF inhibitors were added in these patients. SDAI values in these 9 patients were further examined for the following 6 months. The TNF inhibitors (infliximab 8, etanercept 1) were added at a mean interval of 34.1 weeks after the initiation of synthetic DMARDs. SDAI remission was achieved in 4 of the 9 patients (44.4%) at 3 months and in 8 of the 9 patients (88.9%) at 6 months after the introduction of the TNF inhibitors. Radiographic damage had not progressed in these patients. Delayed treatment with TNF inhibitors is effective and tolerable for patients with very early RA with poor prognosis factors.

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Early prediction of rheumatoid arthritis by serological variables and magnetic resonance imaging of the wrists and finger joints: results from prospective clinical examination

Cited by 50 publications

References 3 publications

Manifestation of Rheumatoid Arthritis after Transsphenoidal Surgery in a Patient with Acromegaly

Manifestation of Rheumatoid Arthritis after Transsphenoidal Surgery in a Patient with Acromegaly

Comparative study of the detection of joint injury in early‐stage rheumatoid arthritis by magnetic resonance imaging of the wrist and finger joints and physical examination

Delayed treatment with tumor necrosis factor inhibitors in incomplete responders to synthetic disease-modifying anti-rheumatic drugs shows an excellent effect in patients with very early rheumatoid arthritis with poor prognosis factors

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