Intra-individual assessment of inflammatory severity and cartilage composition of finger joints in rheumatoid arthritis

• Published in: Skeletal radiology Vol. 44; no. 4; pp. 513 - 518
• Main Authors: Schleich, C., Müller-Lutz, A., Sewerin, P., Ostendorf, B., Buchbender, C., Schneider, M., Antoch, G., Miese, F.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2015; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Arthritis; Arthritis, Rheumatoid - pathology; Cartilage - pathology; Contrast Media; Female; Finger Joint - pathology; Gadolinium DTPA; Humans; Image Enhancement; Imaging; Inflammation; Inflammation - pathology; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Nuclear Medicine; Orthopedics; Pathology; Radiology; Rheumatoid factor; Scientific Article; Severity of Illness Index; Young Adult; Inflammation; MRI; dGEMRIC; Rheumatoid arthritis
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-014-2045-9

Objective To intra-individually assess the association of inflammation severity and cartilage composition measured by RAMRIS synovitis sub-score and delayed gadolinium-enhanced magnetic resonance imaging of the cartilage (dGEMRIC) of metacarpophalangeal (MCP) joints in patients with rheumatoid arthritis (RA). Methods Forty-three patients with RA according to ACR/EULAR classification criteria (age 52.9 ± 14.5 years, range, 18–77 years) were included in this study. All study participants received 3-T MRI scans of the metacarpophalangeal joints of the second and third finger (MCP 2 and 3). The severity of synovitis was scored according to the RAMRIS synovitis sub-score by two readers in consensus. In the cases with identical synovitis sub-scores, two radiologists decided in consensus on the joint with more severe synovitis. Cartilage composition was assessed with dGEMRIC. To test the association of inflammation severity and cartilage damage and in order to eliminate inter-patient confounders, each patient’s MCP 2 and 3 were dichotomized into the joint with more severe synovitis versus the joint with less severe synovitis for a paired Wilcoxon test of dGEMRIC value. Results There was a significant difference of dGEMRIC value (median of difference: 47.12, CI [16.6; 62.76]) between the dichotomized MCPs ( p  = 0.0001). There was a significant correlation between dGEMRIC value and RAMRIS synovitis grading of the joint with more severe synovitis ( r  = 0.5; p < 0.05) and the joint with less severe synovitis ( r  = 0.33; p < 0.05). Conclusions Our data concur with the concept that synovitis severity is associated with cartilage damage. The local inflammatory status on a joint level correlated significantly with the extent of cartilage degradation in biochemical MRI.