Imaging the spine in arthritis—a pictorial review

Jurik, Anne Grethe

doi:10.1007/s13244-010-0061-4

Cited by 48 publications

(27 citation statements)

References 34 publications

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“…Later in the development of the disease, the inflammatory infiltrate is reduced and excessive tissue formation ensues, intervertebral disc degeneration and destruction and ectopic mature and hypertrophic chondrocytes that expanded between adjacent vertebrae in the caudal area of the axial skeleton. This ectopic new bone formation led to vertebral fusion, as revealed by CT imaging analysis, resembling imaging findings detected in human patients of ankylosing spondylitis (26)(27)(28).…”

Section: Discussionsupporting

confidence: 71%

Ectopic bone formation and systemic bone loss in a transmembrane TNF-driven model of human spondyloarthritis

Christodoulou-Vafeiadou¹,

Geka²,

Ntari³

et al. 2020

Preprint

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Background The transmembrane-TNF transgenic mouse, TgA86, has been shown to develop spontaneously peripheral arthritis with signs of axial involvement. To assess similarity to human spondyloarthritis we performed detailed characterization of the axial, peripheral and comorbid pathologies of this model. MethodsTgA86 bone pathologies were assessed at different ages using CT imaging of the spine, tail vertebrae and hind limbs and characterized in detail by histopathological and immunohistochemical analysis. Cardiac function was examined by echocardiography and electrocardiography and bone structural parameters by µCT analysis. The response of TgA86 mice to either early or late anti-TNF treatment was evaluated clinically, histopathologically and by µCT analysis. ResultsTgA86 mice developed with 100% penetrance spontaneous axial and peripheral pathology which progressed with time and manifested as reduced body weight and body length, kyphosis, tail bendings as well as swollen and distorted hind joints. Whole body CT analysis at advanced ages revealed bone erosions of sacral and caudal vertebrae as well as of sacroiliac joints and hind limps, and also, new ectopic bone formation and eventually vertebral fusion. The pathology of these mice highly resembled that of SpA patients, as it evolved through an early inflammatory phase, evident as enthesitis and synovitis in the affected joints, characterized by mesenchymal cell accumulation and neutrophilic infiltration. Subsequently, regression of inflammation was accompanied by ectopic bone formation, leading to ankylosis. In addition, both systemic bone loss and comorbid heart valve pathology were evident. Importantly, early anti-TNF treatment, similar to clinical treatment protocols, significantly reduced the inflammatory phase of both the axial and peripheral pathology of TgA86 mice. Conclusions The TgA86 mice develop a spontaneous peripheral and axial biphasic pathology accompanied by comorbid heart valvular dysfunction and osteoporosis, overall faithfully reproducing the progression of pathognomonic features of human spondyloarthritis. Therefore, the TgA86 mouse represents a valuable model for deciphering the pathogenic mechanisms of spondyloarthritis and for assessing the efficacy of human therapeutics targeting different phases of the disease.

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Section: Discussionsupporting

confidence: 71%

Ectopic bone formation and systemic bone loss in a transmembrane TNF-driven model of human spondyloarthritis

Christodoulou-Vafeiadou¹,

Geka²,

Ntari³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Later in the development of the disease, the in ammatory in ltrate is reduced and excessive tissue formation ensues, intervertebral disc degeneration and destruction and ectopic mature and hypertrophic chondrocytes that expanded between adjacent vertebrae in the caudal area of the axial skeleton. This ectopic new bone formation led to vertebral fusion, as revealed by CT imaging analysis, resembling imaging ndings detected in human patients with ankylosing spondylitis (29)(30)(31). Interestingly, severe in ammation was never found simultaneously with severe excessive tissue formation within the same joint supporting sequential, rather than parallel progression of these disease features.…”

Section: Discussionsupporting

confidence: 62%

Ectopic bone formation and systemic bone loss in a transmembrane TNF-driven model of human spondyloarthritis

-Vafeiadou

Geka

Ntari

et al. 2020

Preprint

View full text Add to dashboard Cite

Background The transmembrane-TNF transgenic mouse, TgA86, has been shown to develop spontaneously peripheral arthritis with signs of axial involvement. To assess similarity to human spondyloarthritis we performed detailed characterization of the axial, peripheral and comorbid pathologies of this model.Methods TgA86 bone pathologies were assessed at different ages using CT imaging of the spine, tail vertebrae and hind limbs and characterized in detail by histopathological and immunohistochemical analysis. Cardiac function was examined by echocardiography and electrocardiography and bone structural parameters by µCT analysis. The response of TgA86 mice to either early or late anti-TNF treatment was evaluated clinically, histopathologically and by µCT analysis. Results TgA86 mice developed with 100% penetrance spontaneous axial and peripheral pathology which progressed with time and manifested as reduced body weight and body length, kyphosis, tail bendings as well as swollen and distorted hind joints. Whole body CT analysis at advanced ages revealed bone erosions of sacral and caudal vertebrae as well as of sacroiliac joints and hind limps, and also, new ectopic bone formation and eventually vertebral fusion. The pathology of these mice highly resembled that of SpA patients, as it evolved through an early inflammatory phase, evident as enthesitis and synovitis in the affected joints, characterized by mesenchymal cell accumulation and neutrophilic infiltration. Subsequently, regression of inflammation was accompanied by ectopic bone formation, leading to ankylosis. In addition, both systemic bone loss and comorbid heart valve pathology were evident. Importantly, early anti-TNF treatment, similar to clinical treatment protocols, significantly reduced the inflammatory phase of both the axial and peripheral pathology of TgA86 mice. Conclusions The TgA86 mice develop a spontaneous peripheral and axial biphasic pathology accompanied by comorbid heart valvular dysfunction and osteoporosis, overall faithfully reproducing the progression of pathognomonic features of human spondyloarthritis. Therefore, the TgA86 mouse represents a valuable model for deciphering the role of transmembrane TNF in the pathogenic mechanisms of spondyloarthritis and for assessing the efficacy of human therapeutics targeting different phases of the disease.

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“…Jurik proposed a reasonable approach to image the cervical spine in patients with RA. 89 The use of radiographs, with a dedicated open-mouth view to assess the morphology of the dens, and with lateral flexion views to assess atlantoaxial instability, is of significant importance for monitoring the patient or to decide whether further evaluation with MRI and/or CT is required. Clinical symptoms comprise weakness, spasticity, or other signs of myelopathy or vertebrobasilar insufficiency.…”

Section: Clinically Based Decision For the Choice Of Imaging Modalitymentioning

confidence: 99%

Magnetic Resonance Imaging of Rheumatoid Arthritis: Peripheral Joints and Spine

Reijnierse

Helm-Mil

Eshed

et al. 2018

Semin Musculoskelet Radiol

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Both the fields of rheumatology and radiology are changing rapidly. Effective medication has become available for rheumatoid arthritis (RA) and transformed it from a progressive disabling disease into a chronic disease. Indications for magnetic resonance imaging (MRI) have changed accordingly, shifting toward early detection. There is also an overall increased clinical demand for high-end imaging. Together with improvement of MRI units and sequences, MRI protocols are adapted based on clinical indications. This article addresses (1) the clinical background and present role of MRI in early disease detection, (2) RA involvement of peripheral joints, (3) RA involvement of the spine, and (4) state-of-the-art RA MRI protocols. The key toward cost-effective MRI examination in RA is communication between radiologist and rheumatologist as well as awareness and knowledge of the basics and advancements in both fields.

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Imaging the spine in arthritis—a pictorial review

Cited by 48 publications

References 34 publications

Ectopic bone formation and systemic bone loss in a transmembrane TNF-driven model of human spondyloarthritis

Ectopic bone formation and systemic bone loss in a transmembrane TNF-driven model of human spondyloarthritis

Ectopic bone formation and systemic bone loss in a transmembrane TNF-driven model of human spondyloarthritis

Magnetic Resonance Imaging of Rheumatoid Arthritis: Peripheral Joints and Spine

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