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Comparison of in-office magnetic resonance imaging versus conventional radiography in detecting changes in erosions after one year of infliximab therapy in patients with rheumatoid arthritis

  • ORIGINAL ARTICLE
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Modern Rheumatology

Abstract

The objective of this study was to compare standard hand radiographs with in-office 0.2 T magnetic resonance imaging (MRI) in monitoring response to therapy in patients with rheumatoid arthritis (RA) who were receiving infliximab, to evaluate the frequency and location of erosions, and to determine if there were differences in outcome based on disease duration at baseline. Patients who satisfied the American College of Rheumatology criteria for RA and were receiving infliximab therapy were evaluated with a baseline and 1-year follow-up MRI. Magnetic resonance images were interpreted by two blinded, board-certified radiologists. Bone erosions were identified as well-defined defects extending through the cortical margin. The mean age of the 48 patients was 58.5 years. The median infliximab dosage was 4 mg/kg. Baseline data showed that 41 patients had abnormal MRIs. The mean time between the baseline and follow-up MRI examinations was 10.5 months. Follow-up MRI revealed regression in 11 patients. Thirty-one patients had both MRIs and radiographs. Magnetic resonance imaging was approximately twice as sensitive as radiography in detecting erosions at baseline. In-office MRI was useful in monitoring disease response after the initiation of infliximab treatment. Magnetic resonance imaging is potentially a very valuable diagnostic tool and prognostic indicator for use in patients with RA.

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References

  1. E Lindqvist K Jonsson T Saxne K Eberhardt (2003) ArticleTitleCourse of radiographic damage over 10 years in a cohort with early rheumatoid arthritis Ann Rheum Dis 62 611–6 Occurrence Handle12810421 Occurrence Handle10.1136/ard.62.7.611 Occurrence Handle1:STN:280:DC%2BD3s3ot1Ggtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  2. E Toussirot D Wendling (2004) ArticleTitleThe use of TNF-alpha blocking agents in rheumatoid arthritis: an overview Expert Opin Pharmacother 5 581–94 Occurrence Handle15013927 Occurrence Handle1:CAS:528:DC%2BD2cXhslGitb4%3D Occurrence Handle10.1517/14656566.5.3.581

    Article  PubMed  CAS  Google Scholar 

  3. FC Breedveld P Emery E Keystone K Patel DE Furst JR Kalden et al. (2004) ArticleTitleInfliximab in active early rheumatoid arthritis Ann Rheum Dis 63 149–55 Occurrence Handle14722203 Occurrence Handle10.1136/ard.2003.013961 Occurrence Handle1:CAS:528:DC%2BD2cXhsVGnsLY%3D

    Article  PubMed  CAS  Google Scholar 

  4. FC Breedveld C Han M Bala D van der Heijde D Baker AF Kavanaugh et al. (2005) ArticleTitleAssociation between baseline radiographic damage and improvement in physical function after treatment of patients with rheumatoid arthritis Ann Rheum Dis 64 52–5 Occurrence Handle15286005 Occurrence Handle10.1136/ard.2003.017160 Occurrence Handle1:STN:280:DC%2BD2cnjtV2luw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  5. PE Lipsky DM van der Heijde EW St Clair DE Furst FC Breedveld JR Kalden et al. (2000) ArticleTitleInfliximab and methotrexate in the treatment of rheumatoid arthritis N Engl J Med 343 1594–602 Occurrence Handle11096166 Occurrence Handle10.1056/NEJM200011303432202 Occurrence Handle1:CAS:528:DC%2BD3cXovVeltLk%3D

    Article  PubMed  CAS  Google Scholar 

  6. R Maini EW St Clair F Breedveld D Furst J Kalden M Weisman et al. (1999) ArticleTitleInfliximab (chimeric anti-tumour necrosis factor alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial Lancet 354 1932–9 Occurrence Handle10622295 Occurrence Handle10.1016/S0140-6736(99)05246-0 Occurrence Handle1:CAS:528:DC%2BD3cXit1Oquw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  7. V Devauchelle-Pensec A Saraux S Alapetite D Colin P Le Goff (2002) ArticleTitleDiagnostic value of radiographs of the hands and feet in early rheumatoid arthritis Joint Bone Spine 69 434–41 Occurrence Handle12477226 Occurrence Handle10.1016/S1297-319X(02)00427-X

    Article  PubMed  Google Scholar 

  8. DL Scott (2004) ArticleTitleRadiological progression in established rheumatoid arthritis J Rheumatol Suppl 69 55–65 Occurrence Handle15053455

    PubMed  Google Scholar 

  9. V Strand JT Sharp (2003) ArticleTitleRadiographic data from recent randomized controlled trials in rheumatoi d arthritis: what have we learned? Arthritis Rheum 48 21–34 Occurrence Handle12528100 Occurrence Handle10.1002/art.10683

    Article  PubMed  Google Scholar 

  10. JV Crues FG Shellock S Dardashti TW James OM Troum (2004) ArticleTitleIdentification of wrist and metacarpophalangeal joint erosions using a portable magnetic resonance imaging system compared to conventional radiographs J Rheumatol 31 676–85 Occurrence Handle15088291

    PubMed  Google Scholar 

  11. D Foley-Nolan JP Stack M Ryan U Redmond C Barry J Ennis et al. (1991) ArticleTitleMagnetic resonance imaging in the assessment of rheumatoid arthritis–a comparison with plain film radiographs Br J Rheumatol 30 101–6 Occurrence Handle2012935 Occurrence Handle10.1093/rheumatology/30.2.101 Occurrence Handle1:STN:280:DyaK3M7ptFarsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  12. JL Hoving R Buchbinder S Hall G Lawler P Coombs S McNealy et al. (2004) ArticleTitleA comparison of magnetic resonance imaging, sonography, and radiography of the hand in patients with early rheumatoid arthritis J Rheumatol 31 663–75 Occurrence Handle15088290

    PubMed  Google Scholar 

  13. C Jorgensen C Cyteval JM Anaya MP Baron JL Lamarque J Sany (1993) ArticleTitleSensitivity of magnetic resonance imaging of the wrist in very early rheumatoid arthritis Clin Exp Rheumatol 11 163–8 Occurrence Handle8508558 Occurrence Handle1:STN:280:DyaK3s3osVOlsw%3D%3D

    PubMed  CAS  Google Scholar 

  14. FC Arnett SM Edworthy DA Bloch DJ McShane JF Fries NS Cooper et al. (1988) ArticleTitleThe American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis Arthritis Rheum 31 315–24 Occurrence Handle3358796 Occurrence Handle10.1002/art.1780310302 Occurrence Handle1:STN:280:DyaL1c7pt1Ohsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  15. CG Peterfy (2004) ArticleTitleIs there a role for extremity magnetic resonance imaging in routine clinical management of rheumatoid arthritis? J Rheumatol 31 640–4 Occurrence Handle15088286

    PubMed  Google Scholar 

  16. A Guermazi B Taouli JA Lynch CG Peterfy (2004) ArticleTitleImaging of bone erosion in rheumatoid arthritis Semin Musculoskelet Radiol 8 269–85 Occurrence Handle15643569 Occurrence Handle10.1055/s-2004-861575

    Article  PubMed  Google Scholar 

  17. FM McQueen (2000) ArticleTitleMagnetic resonance imaging in early inflammatory arthritis: what is its role? Rheumatology (Oxford) 39 700–6 Occurrence Handle10.1093/rheumatology/39.7.700 Occurrence Handle1:STN:280:DC%2BD3cvot1WitA%3D%3D

    Article  CAS  Google Scholar 

  18. M Ostergaard A Duer U Moller B Ejbjerg (2004) ArticleTitleMagnetic resonance imaging of peripheral joints in rheumatic diseases Best Pract Res Clin Rheumatol 18 861–79 Occurrence Handle15501187 Occurrence Handle10.1016/j.berh.2004.06.001

    Article  PubMed  Google Scholar 

  19. BJ Ejbjerg E Narvestad S Jacobsen HS Thomsen M Ostergaard (2005) ArticleTitleOptimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints: comparison with conventional high field MRI and radiography Ann Rheum Dis 64 1280–7 Occurrence Handle15650012 Occurrence Handle10.1136/ard.2004.029850 Occurrence Handle1:STN:280:DC%2BD2MvjtFKitA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  20. RN Maini FC Breedveld JR Kalden JS Smolen D Davis JD Macfarlane et al. (1998) ArticleTitleTherapeutic efficacy of multiple intravenous infusions of anti-tumor necrosis factor alpha monoclonal antibody combined with low-dose weekly methotrexate in rheumatoid arthritis Arthritis Rheum 41 1552–63 Occurrence Handle9751087 Occurrence Handle10.1002/1529-0131(199809)41:9<1552::AID-ART5>3.0.CO;2-W Occurrence Handle1:CAS:528:DyaK1cXmsVChtbg%3D

    Article  PubMed  CAS  Google Scholar 

  21. RN Maini FC Breedveld JR Kalden JS Smolen D Furst MH Weisman et al. (2004) ArticleTitleSustained improvement over two years in physical function, structural damage, and signs and symptoms among patients with rheumatoid arthritis treated with infliximab and methotrexate Arthritis Rheum 50 1051–65 Occurrence Handle15077287 Occurrence Handle10.1002/art.20159 Occurrence Handle1:CAS:528:DC%2BD2cXjslGqsrk%3D

    Article  PubMed  CAS  Google Scholar 

  22. MA Quinn PG Conaghan PJ O'Connor Z Karim A Greenstein A Brown et al. (2005) ArticleTitleVery early treatment with infliximab in addition to methotrexate in early, poor-prognosis rheumatoid arthritis reduces magnetic resonance imaging evidence of synovitis and damage, with sustained benefit after infliximab withdrawal: results from a twelve-month randomized, double-blind, placebo-controlled trial Arthritis Rheum 52 27–35 Occurrence Handle15641102 Occurrence Handle10.1002/art.20712 Occurrence Handle1:CAS:528:DC%2BD2MXht1KisLY%3D

    Article  PubMed  CAS  Google Scholar 

  23. MI Argyropoulou A Glatzouni PV Voulgari VG Xydis SN Nikas SC Efremidis et al. (2005) ArticleTitleMagnetic resonance imaging quantification of hand synovitis in patients with rheumatoid arthritis treated with infliximab Joint Bone Spine 72 557–61 Occurrence Handle16376805 Occurrence Handle10.1016/j.jbspin.2004.08.014

    Article  PubMed  Google Scholar 

  24. CG Peterfy (2001) ArticleTitleMagnetic resonance imaging of rheumatoid arthritis: the evolution of clinical applications through clinical trials Semin Arthritis Rheum 30 375–96 Occurrence Handle11404821 Occurrence Handle10.1053/sarh.2001.22497 Occurrence Handle1:STN:280:DC%2BD3Mzjs1yntg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  25. B Ejbjerg E Narvestad E Rostrup M Szkudlarek S Jacobsen HS Thomsen et al. (2004) ArticleTitleMagnetic resonance imaging of wrist and finger joints in healthy subjects occasionally shows changes resembling erosions and synovitis as seen in rheumatoid arthritis Arthritis Rheum 50 1097–106 Occurrence Handle15077291 Occurrence Handle10.1002/art.20135

    Article  PubMed  Google Scholar 

  26. D McGonagle W Gibbon P O'Connor D Blythe R Wakefield M Green et al. (1999) ArticleTitleA preliminary study of ultrasound aspiration of bone erosion in early rheumatoid arthritis Rheumatology (Oxford) 38 329–31 Occurrence Handle10.1093/rheumatology/38.4.329 Occurrence Handle1:STN:280:DyaK1MzgsFSmtw%3D%3D

    Article  CAS  Google Scholar 

  27. B Ostendorf R Peters P Dann A Becker A Scherer F Wedekind et al. (2001) ArticleTitleMagnetic resonance imaging and miniarthroscopy of metacarpophalangeal joints: sensitive detection of morphologic changes in rheumatoid arthritis Arthritis Rheum 44 2492–502 Occurrence Handle11710705 Occurrence Handle10.1002/1529-0131(200111)44:11<2492::AID-ART429>3.0.CO;2-X Occurrence Handle1:STN:280:DC%2BD3MnmsFekug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  28. FM McQueen N Benton J Crabbe E Robinson S Yeoman L McLean et al. (2001) ArticleTitleWhat is the fate of erosions in early rheumatoid arthritis? Tracking individual lesions using x rays and magnetic resonance imaging over the first two years of disease Ann Rheum Dis 60 859–68 Occurrence Handle11502613 Occurrence Handle1:STN:280:DC%2BD3Mvls1Ojug%3D%3D

    PubMed  CAS  Google Scholar 

  29. NB Gaylis S Needell (2006) ArticleTitleComparison of two different in-office 0.2T magnetic resonance imaging systems and standard radiographs in an outpatient rheumatoid arthritis patient population Ann Rheum Dis 65 IssueIDSuppl II 628

    Google Scholar 

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Correspondence to Norman B. Gaylis.

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Gaylis, N., Needell, S. & Rudensky, D. Comparison of in-office magnetic resonance imaging versus conventional radiography in detecting changes in erosions after one year of infliximab therapy in patients with rheumatoid arthritis. Mod Rheumatol 17, 273–278 (2007). https://doi.org/10.1007/s10165-007-0591-x

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  • DOI: https://doi.org/10.1007/s10165-007-0591-x

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