| Quantifying bone marrow edema in the rheumatoid cervical spine using magnetic resonance imaging. | |
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MedLine Citation:
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PMID: 20551094 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the reliability and feasibility of a new magnetic resonance imaging (MRI) score to quantify bone marrow edema (BME), synovitis, and erosions in the cervical spine of patients with rheumatoid arthritis (RA); and to investigate the correlations among neck pain, clinical markers of RA disease activity, and MRI features of disease activity in the cervical spine. METHODS: Thirty patients with RA (50% with neck pain) and a Disease Activity Score 28-joint count > 3.2 had an MRI scan of their cervical spine. STIR, VIBE, and T1-weighted postcontrast sequences were used to quantify BME. MRI scans were scored for total BME, synovitis, and erosions using a new scoring method developed by the authors and assessed for reliability and feasibility. Associations between neck pain and clinical markers of disease activity were investigated. RESULTS: BME was present in 14/30 patients; 9/14 (64%) had atlantoaxial BME, 10/14 (71%) had subaxial BME, and 5/14 (36%) had both. Interobserver reliability for total cervical BME score was moderate [intraclass correlation coefficient (ICC) = 0.51]. ICC improved to 0.67 if only the vertebral bodies and dens were considered. There was no correlation between neck pain or clinical measures of RA disease activity and the presence of any MRI features including BME, synovitis, or erosions. CONCLUSION: Current RA disease activity scores do not identify activity in the cervical spine. An MRI score that quantifies BME, synovitis, and erosions in the cervical spine may provide useful information regarding inflammation and damage. This could alert clinicians to the presence of significant pathology and influence management. |
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Authors:
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Ravi Suppiah; Anthony Doyle; Raylynne Rai; Nicola Dalbeth; Maria Lobo; Jürgen Braun; Fiona M McQueen |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-06-15 |
Journal Detail:
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Title: The Journal of rheumatology Volume: 37 ISSN: 0315-162X ISO Abbreviation: J. Rheumatol. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-02 Completed Date: 2010-11-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7501984 Medline TA: J Rheumatol Country: Canada |
Other Details:
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Languages: eng Pagination: 1626-32 Citation Subset: IM |
Affiliation:
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Department of Rheumatology and Department of Radiology, Auckland District Health Board, Auckland, United Kingdom. ravi.suppiah@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arthritis, Rheumatoid
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complications,
pathology*,
physiopathology Bone Marrow / pathology* Bone Marrow Diseases / diagnosis*, etiology Cervical Vertebrae / pathology* Edema / diagnosis*, etiology Female Health Status Humans Joints / pathology, physiopathology Magnetic Resonance Imaging Male Middle Aged Neck Pain / etiology, pathology, physiopathology Prospective Studies Reproducibility of Results Severity of Illness Index Synovitis / etiology, pathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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