Document Detail


Quantifying bone marrow edema in the rheumatoid cervical spine using magnetic resonance imaging.
MedLine Citation:
PMID:  20551094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Ravi Suppiah; Anthony Doyle; Raylynne Rai; Nicola Dalbeth; Maria Lobo; Jürgen Braun; Fiona M McQueen
Related Documents :
16226634 - Pathological cervical fracture after spinal manipulation in a pregnant patient.
8727144 - Quantitative three-dimensional anatomy of the subaxial cervical spine: implication for ...
17114854 - Ataxia and deafness in a young male: an unusual aetiology.
11342744 - Echosight patton coaxial catheter-guided hysteroscopy.
2349014 - Morphological diagnosis of congenital and acquired heart disease by magnetic resonance ...
19512854 - Magnetic resonance imaging in the evaluation of acute stroke.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-15
Journal Detail:
Title:  The Journal of rheumatology     Volume:  37     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-02     Completed Date:  2010-11-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1626-32     Citation Subset:  IM    
Affiliation:
Department of Rheumatology and Department of Radiology, Auckland District Health Board, Auckland, United Kingdom. ravi.suppiah@gmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Arthritis, Rheumatoid / 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


Previous Document:  Spontaneous thrombosis of congenital extrahepatic portosystemic shunt (Abernethy malformation) simul...
Next Document:  Elevated cerebral blood flow and volume in systemic lupus measured by dynamic susceptibility contras...