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Giulini M, Brinks R, Vordenbäumen S, Acar H, Richter JG, Baraliakos X, Ostendorf B, Schneider M, Sander O, Sewerin P. High Frequency of Osteophytes Detected by High-Resolution Ultrasound at the Finger Joints of Asymptomatic Factory Workers. J Pers Med 2023; 13:1343. [PMID: 37763111 PMCID: PMC10532985 DOI: 10.3390/jpm13091343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Hand Osteoarthritis (HOA) is a frequently occurring musculoskeletal disease that impacts health. Diagnostic criteria often incorporate osteophytes documented through imaging procedures. Radiographic imaging is considered the gold standard; however, more sensitive and safer methods like ultrasound imaging are becoming increasingly important. We conducted a population-based cross-sectional study to examine the prevalence, grade, and pattern of osteophytes using high-resolution ultrasound investigation. Factory workers were recruited on-site for the study. Each participant had 26 finger joints examined using ultrasonography to grade the occurrence of osteophytes on a semi-quantitative scale ranging from 0-3, where higher scores indicate larger osteophytes. A total of 427 participants (mean age 53.5 years, range 20-79 years) were included, resulting in 11,000 joints scored. At least one osteophyte was found in 4546 out of 11,000 (41.3%) joints or in 426 out of 427 (99.8%) participants, but only 5.0% (553) of the joints showed grade 2 or 3 osteophytes. The total osteophyte sum score increased by 0.18 per year as age increased (p < 0.001). The distal interphalangeal joints were the most commonly affected, with 61%, followed by the proximal interphalangeal joints with 48%, carpometacarpal joint 1 with 39%, and metacarpophalangeal joints with 16%. There was no observed impact of gender or workload. In conclusion, ultrasound imaging proves to be a practical screening tool for osteophytes and HOA. Grade 1 osteophytes are often detected in the working population through ultrasound assessments and their incidence increases with age. The occurrence of grade 2 or 3 osteophytes is less frequent and indicates the clinical presence of HOA. Subsequent evaluations are imperative to ascertain the predictive significance of early osteophytes.
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Affiliation(s)
- Mario Giulini
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Ralph Brinks
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Stefan Vordenbäumen
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Hasan Acar
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Jutta G. Richter
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Claudiusstrasse 45, 44649 Herne, Germany
| | - Benedikt Ostendorf
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Matthias Schneider
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Oliver Sander
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Philipp Sewerin
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Claudiusstrasse 45, 44649 Herne, Germany
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Lautwein A, Ostendorf B, Vordenbäumen S, Liedmann A, Brinks R, Giulini M, Ohrndorf S, Backhaus M, Acar H, Sander O, Richter JG, Schneider M, Sewerin P. Musculoskeletal ultrasound as a screening-tool for rheumatoid arthritis: results of the "Rheuma-Truck" screening and awareness initiative. Adv Rheumatol 2022; 62:1. [PMID: 34983698 DOI: 10.1186/s42358-021-00233-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/20/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To evaluate musculoskeletal ultrasound (MSUS) as a screening tool for rheumatoid arthritis (RA) and osteoarthritis (OA) patients in a rheumatology-screening program. PATIENTS AND METHODS To raise awareness for rheumatic diseases, a mobile rheumatology office was deployed in different cities of Germany ("Rheuma-Truck"). Standardized questionnaire assessment, testing for rheumatoid factor and citrullinated peptide antibodies and medical student driven MSUS of the clinically dominant hand/foot including wrist, MCP-II, -III, -V, PIP-II, -III, MTP-II and -V were offered free of charge to the population. In case of suspicious results, a rheumatologist was consulted. RESULTS In MSUS, 192 of 560 selected volunteers (aged 18-89, mean 52.7 years; 72.9% female) had suspicious findings including synovitis or erosions primarily affecting the MTP-II (11.8%), dorsal wrist (8.9%), and MCP-II (7%). 354 of the 560 volunteers further visited a rheumatologist of whom 76 were diagnosed with RA. According to the 'US7 Score', a sum scores ≥ 5 was significantly predictive for RA (odds ratio (OR) 5.06; confidence interval (CI) 0.83-35.32). 313 volunteers displayed signs of OA including osteophytes, while MCP-II (36.2%), MCP-III (14.8%), and the wrist (10.5%) were mostly affected. Diagnosis of RA was favoured over OA if the wrist (OR 4.2; CI 1.28-13.95), MTP-II (OR 1.62; CI 1.0-2.6), and MCP-V (OR 2.0; CI 1.0-3.8) were involved. CONCLUSION Medical student driven MSUS by the 'US7 Score' can facilitate diagnosis of RA in rheumatology-screening programs due to the level of the score and the affected joints. A high rate of unknown OA signs was detected by MSUS. A mobile rheumatology office displays an opportunity to screen patients for RA and OA.
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Affiliation(s)
- Alexander Lautwein
- Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf Medical Faculty, Moorenstrasse 5, 40225, Duesseldorf, Germany
| | - Benedikt Ostendorf
- Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf Medical Faculty, Moorenstrasse 5, 40225, Duesseldorf, Germany
| | - Stefan Vordenbäumen
- Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf Medical Faculty, Moorenstrasse 5, 40225, Duesseldorf, Germany
| | - Aiko Liedmann
- Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf Medical Faculty, Moorenstrasse 5, 40225, Duesseldorf, Germany
| | - Ralph Brinks
- Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf Medical Faculty, Moorenstrasse 5, 40225, Duesseldorf, Germany
| | - Mario Giulini
- Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf Medical Faculty, Moorenstrasse 5, 40225, Duesseldorf, Germany
| | - Sarah Ohrndorf
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Marina Backhaus
- Department of Internal Medicine, Rheumatology and Clinical Immunology, Academic Hospital of the Charité Berlin, Park-Klinik Weissensee Berlin, Berlin, Germany
| | - Hasan Acar
- Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf Medical Faculty, Moorenstrasse 5, 40225, Duesseldorf, Germany
| | - Oliver Sander
- Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf Medical Faculty, Moorenstrasse 5, 40225, Duesseldorf, Germany
| | - Jutta G Richter
- Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf Medical Faculty, Moorenstrasse 5, 40225, Duesseldorf, Germany
| | - Matthias Schneider
- Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf Medical Faculty, Moorenstrasse 5, 40225, Duesseldorf, Germany
| | - Philipp Sewerin
- Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf Medical Faculty, Moorenstrasse 5, 40225, Duesseldorf, Germany.
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Hartung W, Sewerin P, Ostendorf B. [Erratum to: Sports and exercise therapy in inflammatory rheumatic diseases]. Z Rheumatol 2021; 80:755. [PMID: 34581875 DOI: 10.1007/s00393-021-01094-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Wolfgang Hartung
- Asklepios Klinik Bad Abbach, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Deutschland.
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Abstract
Physical therapy has always been a pillar of the treatment of inflammatory rheumatic diseases in addition to targeted drug treatment; nevertheless, it is only established in the treatment guidelines for a few diseases. Within the last two decades the discovery of myokines has uncovered the physiological correlations of the anti-inflammatory effect of physical activity. For rheumatoid arthritis and spondylarthritis, several randomized controlled trials provide sufficient evidence to make well-founded recommendations. For connective tissue diseases (CTD) the data situation is clearly sparser but nevertheless shows that the positive effects of physical activity prevail. In the following article the authors present the most important clinical studies on sport and inflammatory rheumatic diseases and from these derive possible therapeutic recommendations.
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Affiliation(s)
- Wolfgang Hartung
- Asklepios Klinik Bad Abbach, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Deutschland.
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Abrar DB, Schleich C, Müller-Lutz A, Frenken M, Radke KL, Vordenbäumen S, Schneider M, Ostendorf B, Sewerin P. Cartilage Degradation in Psoriatic Arthritis Is Associated With Increased Synovial Perfusion as Detected by Magnetic Resonance Imaging. Front Med (Lausanne) 2020; 7:539870. [PMID: 33102496 PMCID: PMC7546830 DOI: 10.3389/fmed.2020.539870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/21/2020] [Indexed: 01/27/2023] Open
Abstract
Objective: Even though cartilage loss is a known feature of psoriatic arthritis (PsA), research is sparse on its role in the pathogenesis of PsA and its potential use for disease detection and monitoring. Using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and dynamic contrast-enhanced MRI (DCE MRI), research has shown that early cartilage loss is strongly associated with synovial inflammation in rheumatoid arthritis (RA). The aim of this study was to determine if acute inflammation is associated with early cartilage loss in small finger joints of patients with PsA. Methods: Metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints of 17 patients with active PsA were evaluated by high-resolution 3 Tesla dGEMRIC and DCE MRI using a dedicated 16-channel hand coil. Semi-quantitative and quantitative perfusion parameters were calculated. Images were analyzed by two independent raters for dGEMRIC indices, PsA MRI scores (PsAMRIS), total cartilage thickness (TCT), and joint space width (JSW). Results: We found significant negative correlations between perfusion parameters (except Kep) and dGEMRIC indices, with the highest value at the MCP joints (KTrans: τ = −0.54, p = 0.01; Kep: τ = −0.02, p = 0.90; IAUC: τ = −0.51, p = 0.015; Initial Slope: τ = −0.54, p = 0.01; Peak: τ = −0.67, p = 0.002). Heterogeneous correlations were detected between perfusion parameters and both, total PsAMRIS and PsAMRIS synovitis sub-scores. No significant correlation was seen between any perfusion parameter and JSW and/or TCT. Conclusion: As examined by DCE MRI and dGEMRIC, there is a potential association between early cartilage loss and acute synovial inflammation in small finger joints of PsA patients.
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Affiliation(s)
- Daniel B Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Düsseldorf, Germany
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Düsseldorf, Germany
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Düsseldorf, Germany
| | - Miriam Frenken
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Düsseldorf, Germany
| | - K Ludger Radke
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Düsseldorf, Germany
| | - Stefan Vordenbäumen
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Matthias Schneider
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Benedikt Ostendorf
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Philipp Sewerin
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Sewerin P, Abrar D, Müller-Lutz A, Frenken M, Radke KL, Vordenbäumen S, Schneider M, Ostendorf B, Schleich C. FRI0361 CARTILAGE DEGRADATION IN PSORIATIC ARTHRITIS IS ASSOCIATED WITH INCREASED SYNOVIAL PERFUSION AS DETECTED BY MAGNETIC RESONANCE IMAGING. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Even though cartilage loss is a known feature of psoriatic arthritis (PsA), research is sparse on its role in the pathogenesis of PsA and its potential use for disease detection and monitoring. Using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and dynamic contrast-enhanced MRI (DCE MRI), research has shown that early cartilage loss is strongly associated with synovial inflammation in rheumatoid arthritis (RA). The aim of this study was to determine if acute inflammation is associated with early cartilage loss in small finger joints of patients with PsA.Objectives:Is local perfusion in PsA patients measured by dynamic MRI associated to local cartilage loss?Methods:Metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints of 17 patients with active PsA were evaluated by high-resolution 3 Tesla dGEMRIC and DCE MRI using a dedicated 16-channel hand coil. Semi-quantitative and quantitative perfusion parameters were calculated. Images were analyzed by two independent raters for dGEMRIC indices, PsA MRI scores (PsAMRIS), total cartilage thickness (TCT), and joint space width (JSW).Results:We found significant negative correlations between perfusion parameters (except Kep) and dGEMRIC indices, with the highest value at the MCP joints (KTrans: τ = -0.54, p = 0.01; Kep: τ= -0.02, p = 0.90; IAUC: τ = -0.51, p = 0.015; Initial Slope: τ = -0.54, p = 0.01; Peak: τ = -0.67, p = 0.002). Heterogeneous correlations were detected between perfusion parameters and both, total PsAMRIS and PsAMRIS synovitis sub-scores. No significant correlation was seen between any perfusion parameter and JSW and/or TCT.Conclusion:As examined by DCE MRI and dGEMRIC, there is a significant association between early cartilage loss and acute synovial inflammation in small finger joints of PsA patients.Figure 1.dGEMRIC maps (third digit) and perfusion maps (peak parameter) of MCP, PIP, and DIP joints in 26-year-old male (A and B) and a 59-year-old female (C and D) with PsA. Lower dGEMRIC values are illustrated in D, indicating more proteoglycan loss than in A. Higher peak values are depicted in C, indicating a higher severity of synovitis than in B. Peak parameter is illustrated in mM/l per second, dGEMRIC indices in ms.Disclosure of Interests:Philipp Sewerin Grant/research support from: AbbVie Deutschland GmbH & Co. KGBristol-Myers Squibb Celgene GmbHLilly Deutschland GmbHNovartis Pharma GmbH Pfizer Deutschland GmbHRheumazentrum Rhein-Ruhr, Consultant of: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Speakers bureau: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Daniel Abrar: None declared, Anja Müller-Lutz: None declared, Miriam Frenken: None declared, Karl Ludger Radke: None declared, Stefan Vordenbäumen: None declared, Matthias Schneider Grant/research support from: GSK, UCB, Abbvie, Consultant of: Abbvie, Alexion, Astra Zeneca, BMS, Boehringer Ingelheim, Gilead, Lilly, Sanofi, UCB, Speakers bureau: Abbvie, Astra Zeneca, BMS, Chugai, GSK, Lilly, Pfizer, Sanofi, Benedikt Ostendorf: None declared, Christoph Schleich: None declared
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Sewerin P, Abrar D, Lautwein A, Vordenbäumen S, Brinks R, Goertz C, Frenken M, Schneider M, Ostendorf B, Schleich C. AB0226 USING 3 TESLA MRI WITH A HIGH-RESOLUTION 16-CHANNEL HAND COIL TO DIFFERENTIATE BETWEEN RHEUMATOID AND PSORIATIC ARTHRITIS: A PILOT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The differentiation between rheumatoid arthritis (RA) and psoriatic arthritis (PsA) is sometimes a challenge for rheumatologists in daily clinical practice. Imaging techniques such as MRI could be a helpful tool for this purpose.Objectives:To examine the value of 3 Tesla (T) magnetic resonance imaging (MRI) with a high-resolution 16-channel hand coil for the differentiation between RA and PsA.Methods:A total of 17 patients with active PsA and 27 patients with active RA were evaluated by 3T MRI. Images were analyzed by three readers according to the outcome measures for RA clinical trials (OMERACT) and RA and PsA MRI scores for the presence and intensity of the following MRI features: synovitis, flexor tenosynovitis, bone edema, bone erosion, periarticular inflammation, bone proliferation, and joint space narrowing. A receiver operating characteristics (ROC) curve was established for a calculated prediction model comprising age, gender, and the imaging features ‘periarticular inflammation’ and ‘erosion’ of the metacarpophalangeal (MCP) joint of the 5th finger.Results:PsA could be differentiated from RA by extracapsular inflammatory changes (PsAMRIS sub-score ‘periarticular inflammation’), with a minimal odds ratio (OR) for the outcome ‘not RA’ of 0.06 (p< 0.01) at all MCP joints. The calculated ROC curve had an area under the curve (AUC) of 98.1%.Conclusion:3T MRI showed a strong association of extracapsular inflammatory changes with PsA at the MCP joint level, and consequently allowed differentiation between PsA and RA.Figure 1.Receiver operating characteristics (ROC) curve with different thresholds for the calculated prediction model for the outcome RA. Area under the curve (AUC) = 98.1%.Figure 2.51-year-old female patient with PsA. MR images show flexor tenosynovitis (FS), synovitis (Syn), and periarticular inflammation (PI). A. Sagittal PD fat-saturation of D5. PI at the volar and dorsal aspects at the MCP, PIP, and DIP levels. FS at the PIP and DIP joint levels. Black asterisks indicate PI. Black arrow points to FS. B. Coronal STIR with bone edema (BE) at the proximal portion of PIP3 and 5 accompanied by PI at PIP3 and MCP, PIP and DIP5. Asterisks indicate BE. Arrowheads point to PI. C. Transversal T2 fat-saturation with FS and PI at MCP5. Arrowhead indicates FS, arrow points to volar PI. D. Transversal T1 fat-saturation following iv contrast, with FS and PI at MCP5. Arrowhead indicates FS, arrows points to volar PI.Disclosure of Interests:Philipp Sewerin Grant/research support from: AbbVie Deutschland GmbH & Co. KGBristol-Myers Squibb Celgene GmbHLilly Deutschland GmbHNovartis Pharma GmbH Pfizer Deutschland GmbHRheumazentrum Rhein-Ruhr, Consultant of: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Speakers bureau: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Daniel Abrar: None declared, Alexander Lautwein: None declared, Stefan Vordenbäumen: None declared, Ralph Brinks: None declared, Christine Goertz: None declared, Miriam Frenken: None declared, Matthias Schneider Grant/research support from: GSK, UCB, Abbvie, Consultant of: Abbvie, Alexion, Astra Zeneca, BMS, Boehringer Ingelheim, Gilead, Lilly, Sanofi, UCB, Speakers bureau: Abbvie, Astra Zeneca, BMS, Chugai, GSK, Lilly, Pfizer, Sanofi, Benedikt Ostendorf: None declared, Christoph Schleich: None declared
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Sewerin P, Abrar D, Frenken M, Schneider M, Ostendorf B, Schleich C. THU0476 GLYCOSAMINOGLYCAN REMODELLING OF LUMBAR INTERVERTEBRAL DISCS IN ELITE ROWERS THROUGHOUT THEIR ANNUAL TRAINING CYCLE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:To assess the glycosaminoglycan (GAG) content of lumbar intervertebral discs (IVD) in elite rowers (ER) at different stages of their annual training cycle and compared to healthy volunteers (HV) using GAG chemical exchange saturation transfer (gagCEST).Objectives:Does GAG content of IVDs differs between ER in different stages of the training cycle from HV?Methods:205 lumbar IVD of 21 ER (23 ±3 years, 9 female, 11 male) and 25 HV (27 ±2 years, 13 female, 12 male) were prospectively examined with 3T magnetic resonance imaging (MRI). Standard T2 weighted (T2w) sequences were used for morphological grading according to the Pfirrmann classification. GAG content of the nucleus pulposus (NP) and annulus fibrosus was determined with gagCEST in non-degenerated discs according to Pfirrmann. ER were examined during the peak of their competition preparation (T0) and 6 months later during the peak of their post-competition recovery period (T1).Results:At T0 we found significantly higher gagCEST values in ER (A) compared to HV (C) (NP: 4.26 ±2.37% vs. 3.38 ±1.72%, p<0.05; confidence interval (CI) 0.32%/1.44%; AF: 2.75 ±1.7% vs.1.961 ±1.23%, p<0.01; CI 0.4%/1.2%). At T1 gagCEST values in ER (B) decreased and illustrated no significant difference compared to HV (C) (NP: 3.55 ± 2.31%, p = 0.531, CI 0.038%/0.73%; AF: 2.31 ±1.57%, p = 0.073, CI 0.03%/0.74%).Conclusion:Compared to HV lumbar IVD of ER show significantly higher gagCEST values during the peak of their competition preparation and similar values during the recovery period, indicating a GAG remodelling effect by training.Figure 1.Comparison of gagCEST values of lumbar IVD between ER (A, T0; B, T1) and HV.Disclosure of Interests: :Philipp Sewerin Grant/research support from: AbbVie Deutschland GmbH & Co. KGBristol-Myers Squibb Celgene GmbHLilly Deutschland GmbHNovartis Pharma GmbH Pfizer Deutschland GmbHRheumazentrum Rhein-Ruhr, Consultant of: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Speakers bureau: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Daniel Abrar: None declared, Miriam Frenken: None declared, Matthias Schneider Grant/research support from: GSK, UCB, Abbvie, Consultant of: Abbvie, Alexion, Astra Zeneca, BMS, Boehringer Ingelheim, Gilead, Lilly, Sanofi, UCB, Speakers bureau: Abbvie, Astra Zeneca, BMS, Chugai, GSK, Lilly, Pfizer, Sanofi, Benedikt Ostendorf: None declared, Christoph Schleich: None declared
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Sewerin P, Abrar D, Nebelung S, Frenken M, Ulrich T, Radke KL, Antoch G, Vordenbäumen S, Brinks R, Schneider M, Ostendorf B, Schleich C. OP0182 PROTEOGLYCAN LOSS IN ARTICULAR CARTILAGE IS ASSOCIATED WITH JOINT INFLAMMATION SEVERITY IN PSORIATIC ARTHRITIS – A COMPOSITIONAL MAGNETIC RESONANCE IMAGING STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Even though cartilage loss is a known feature of psoriatic arthritis (PsA), little is known about its role in the pathogenesis of PsA. Using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) as a non-invasive marker of the tissue’s proteoglycan content, such early (i.e. pre-morphological) changes have been associated with inflammation in rheumatoid arthritis (RA). Yet, this association has not been studied before in PsA.Objectives:Is the severity of local joint inflammation associated to local proteoglycan loss in PsA patients?Methods:Metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints of 17 patients with active PsA were evaluated by high-resolution clinical standard morphological and dGEMRIC sequences using a 3T MRI scanner (Magnetom Skyra, Siemens) and a dedicated 16-channel hand coil. Images were analyzed by two independent raters for dGEMRIC indices, PsA MRI scores (PsAMRIS) and total cartilage thickness (TCT). Kendall-Tau correlation coefficients (τ) were calculated.Results:We found significant negative correlations between dGEMRIC indices and total PsAMRIS (τ = -0.5, p= 0.012), synovitis (τ = -0.56, p= 0.006), flexor tenosynovitis (τ = -0.4, p= 0.049), and periarticular inflammation (τ = -0.72, p< 0.001). Significant positive correlations were found between TCT and dGEMRIC indices in all joint levels (τ = 0.43, p<0.001). No significant correlations were determined between dGEMRIC indices and bone erosion, bone edema or bone proliferation.Conclusion:In PsA, proteoglycan loss as assessed by dGEMRIC is associated with periarticular inflammation, synovitis, and flexor tenosynovitis, but not with bone erosion or proliferation, thereby highlighting the need for effective anti-inflammatory treatment regimes. Beyond morphology, advanced MRI techniques may be used to assess cartilage composition in PsA and to identify early changes in cartilage as an imaging biomarker with potential application in detection and monitoring of PsA.Figure 1Right hand of a 26-year-old male with psoriatic arthritis Coronal STIR image (A) of digits 1-5, transversal fat-saturated (fs) T2-weighted image of digits 2-4 (B) and the corresponding transversal fs contrast-enhanced T1-weighted image (C) at the distal portion of the proximal phalanges. Horizontal white bar in (A) indicates level of transversal slices (B) & (C). Sagittal fs Proton Density-weighted image of the third digit (D). A: Increased signal at the collateral ligaments and synovitis of the proximal interphalangeal (PIP) joint of the third digit (white arrow). Periarticular inflammation around the PIP joint and the body of the proximal phalanx of the third digit (arrowhead). B & C: Extensive flexor tenosynovitis (asterix) and periarticular inflammation in the subcutaneous tissues (arrowhead) alongside thickened flexor tendon pulleys (arrow). D & E: Representative sagittal T1-weighted images of the MCP, PIP and DIP joint of the 3rd digit. Following iv contrast administration and appropriate delay of 40 min, A gives the morphological T1 map, while B gives the corresponding parameter map with dGEMRIC values [ms] overlaid. Note the significant decrease in dGEMRIC indices of the PIP joint as compared to the MCP joint.Disclosure of Interests:Philipp Sewerin Grant/research support from: AbbVie Deutschland GmbH & Co. KGBristol-Myers Squibb Celgene GmbHLilly Deutschland GmbHNovartis Pharma GmbH Pfizer Deutschland GmbHRheumazentrum Rhein-Ruhr, Consultant of: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Speakers bureau: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Daniel Abrar: None declared, Sven Nebelung: None declared, Miriam Frenken: None declared, Tim Ulrich: None declared, Karl Ludger Radke: None declared, Gerald Antoch: None declared, Stefan Vordenbäumen: None declared, Ralph Brinks: None declared, Matthias Schneider Grant/research support from: GSK, UCB, Abbvie, Consultant of: Abbvie, Alexion, Astra Zeneca, BMS, Boehringer Ingelheim, Gilead, Lilly, Sanofi, UCB, Speakers bureau: Abbvie, Astra Zeneca, BMS, Chugai, GSK, Lilly, Pfizer, Sanofi, Benedikt Ostendorf: None declared, Christoph Schleich: None declared
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Sewerin P, Abrar D, Frenken M, Baraliakos X, Schneider M, Ostendorf B, Schleich C. AB0722 LOSS OF GLYCOSAMINOGLYCANS OF LUMBAR INTERVERTEBRAL DISCS IN PATIENTS WITH ANKYLOSING SPONDYLITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:To evaluate the glycosaminoglycan (GAG) content of lumbar intervertebral discs (IVD) in patients with ankylosing spondylitis (AS) using GAG chemical exchange saturation transfer (gagCEST).Objectives:Does local GAG content in non-degenerative IVDs measured by gagCEST MRI differs between AS patients and HC?Methods:195 lumbar IVD of 15 patients with AS (mean age 50 ±10 years) and 25 healthy control patients (HC) were prospectively examined with 3 T magnetic resonance imaging (MRI). MRI protocol contained morphological T2 weighted (T2w) images to grade IVD according to the Pfirrmann classification and biochemical imaging with gagCEST to calculate a region of interest (ROI) of the nucleus pulposus (NP) and annulus fibrosus (AF). Prior to statistical testing of gagCEST effects in patients and HC, IVD were classified according to Pfirrmann.Results:Significantly lower gagCEST values of NP and AF were found in non-degenerative IVD (Pfirrmann 1 and 2) of AS patients compared to HC (NP: 1.88 % ±1.21% vs. 3.38 % ±1.71%; p<0.01; confidence interval (CI): 0.89%/2.11%. AF: 1.11 % ± 1.07 % vs. 1.96 %± 1.23 %; p<0.01; CI 0.39%/1.3%).Conclusion:GagCEST analysis of morphologically non-degenerative IVDs in T2w images showed significantly lower GAG values in patients with AS in the NP and AF compared to HC. Our results potentially allow for the detection of GAG loss prior to morphological degeneration.Figure 1.Comparison of morphological T2 weighted (T2w) images to grade IVD according to the Pfirrmann classification and biochemical imaging with gagCEST between HC (A and C) and AS patients (B and D) showing significant lower GAG levels in AS patients.Disclosure of Interests:Philipp Sewerin Grant/research support from: AbbVie Deutschland GmbH & Co. KGBristol-Myers Squibb Celgene GmbHLilly Deutschland GmbHNovartis Pharma GmbH Pfizer Deutschland GmbHRheumazentrum Rhein-Ruhr, Consultant of: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Speakers bureau: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Daniel Abrar: None declared, Miriam Frenken: None declared, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Matthias Schneider Grant/research support from: GSK, UCB, Abbvie, Consultant of: Abbvie, Alexion, Astra Zeneca, BMS, Boehringer Ingelheim, Gilead, Lilly, Sanofi, UCB, Speakers bureau: Abbvie, Astra Zeneca, BMS, Chugai, GSK, Lilly, Pfizer, Sanofi, Benedikt Ostendorf: None declared, Christoph Schleich: None declared
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Abrar DB, Schleich C, Nebelung S, Frenken M, Ullrich T, Radke KL, Antoch G, Vordenbäumen S, Brinks R, Schneider M, Ostendorf B, Sewerin P. Proteoglycan loss in the articular cartilage is associated with severity of joint inflammation in psoriatic arthritis-a compositional magnetic resonance imaging study. Arthritis Res Ther 2020; 22:124. [PMID: 32471515 PMCID: PMC7257142 DOI: 10.1186/s13075-020-02219-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/14/2020] [Indexed: 12/27/2022] Open
Abstract
Background Even though cartilage loss is a known feature of psoriatic arthritis (PsA), little is known about its role in the pathogenesis of PsA. Using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) as a non-invasive marker of the tissue’s proteoglycan content, such early (i.e., pre-morphological) changes have been associated with inflammation in rheumatoid arthritis (RA). Yet, this association has not been studied before in PsA. Methods The metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints of 17 patients with active PsA were evaluated by high-resolution clinical standard morphological and dGEMRIC sequences using a 3T MRI scanner (Magnetom Skyra, Siemens) and a dedicated 16-channel hand coil. Images were analyzed by two independent raters for dGEMRIC indices, PsA MRI scores (PsAMRIS), and total cartilage thickness (TCT). Kendall tau correlation coefficients (τ) were calculated. Results We found significant negative correlations between dGEMRIC indices and total PsAMRIS (τ = − 0.5, p = 0.012), synovitis (τ = − 0.56, p = 0.006), flexor tenosynovitis (τ = − 0.4, p = 0.049), and periarticular inflammation (τ = − 0.72, p < 0.001). Significant positive correlations were found between TCT and dGEMRIC indices at all joint levels (τ = 0.43, p < 0.001). No significant correlations were determined between dGEMRIC indices and bone erosion, bone edema, or bone proliferation. Conclusion In PsA, proteoglycan loss as assessed by dGEMRIC is associated with periarticular inflammation, synovitis, and flexor tenosynovitis, but not with bone erosion or proliferation. Thereby, these findings contribute to in vivo concepts of the disease’s pathophysiology. Beyond morphology, advanced MRI techniques may be used to assess cartilage composition in PsA and to identify early changes in the cartilage as an imaging biomarker with potential application in detection, monitoring, and prediction of outcomes of PsA. Trial registration 2014123117, December 2014.
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Affiliation(s)
- Daniel B Abrar
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225, Düsseldorf, Germany.
| | - Christoph Schleich
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225, Düsseldorf, Germany
| | - Sven Nebelung
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225, Düsseldorf, Germany
| | - Miriam Frenken
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225, Düsseldorf, Germany
| | - Tim Ullrich
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225, Düsseldorf, Germany
| | - Karl Ludger Radke
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225, Düsseldorf, Germany
| | - Gerald Antoch
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225, Düsseldorf, Germany
| | - Stefan Vordenbäumen
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Ralph Brinks
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Matthias Schneider
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Benedikt Ostendorf
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Philipp Sewerin
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
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Abrar DB, Schleich C, Nebelung S, Frenken M, Radke KL, Vordenbäumen S, Brinks R, Schneider M, Ostendorf B, McGonagle D, Sewerin P. High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis. Arthritis Res Ther 2020; 22:40. [PMID: 32122392 PMCID: PMC7052970 DOI: 10.1186/s13075-020-2135-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 02/20/2020] [Indexed: 02/08/2023] Open
Abstract
Background To evaluate the value of 3 Tesla (T) magnetic resonance imaging (MRI) changes of flexor tendon pulleys for the differentiation of psoriatic (PsA) and rheumatoid arthritis (RA), using a novel 16-channel high-resolution hand coil. Methods Seventeen patients with active PsA, 20 patients with active RA, and 16 healthy controls (HC) underwent high-resolution 3 T MRI using the dedicated 16-channel hand coil. Images were analyzed by three independent readers for the degree of inflammatory changes, thickness of flexor tendon pulleys, and comparison to the outcome measures for RA clinical trials (OMERACT) PsA MRI score (PsAMRIS) and to its sub-scores. For correlation analyses, Spearman rho correlation was calculated. Results Flexor tendon pulleys were thicker in PsA than in RA patients (mean difference 0.16 mm, p < 0.001) and HC (mean difference 0.2 mm, p < 0.001) and showed a higher degree of associated inflammatory changes (mean difference from RA 4.7, p = 0.048; mean difference from HC 14.65, p < 0.001). Additionally, there was a strong correlation of accessory pulley inflammation and PsAMRIS and its acute-inflammatory sub-scores, flexor tenosynovitis, synovitis, and periarticular inflammation (for the second digit synovitis ρ = 0.72, flexor tenosynovitis ρ = 0.7, overall PsAMRIS ρ = 0.72, p < 0.01). Similar robust correlations were evident in digits 3–5. Weaker correlations were evident in RA (synovitis ρ = 0.49, flexor tenosynovitis ρ = 0.49, periarticular inflammation ρ = 0.4). Conclusion The assessment of MRI changes of flexor tendon pulleys is potentially beneficial for disease detection in PsA, as well as for its distinction from RA and HC. Trial registration 2014123117, December 2014.
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Affiliation(s)
- Daniel B Abrar
- Institute for Diagnostic and Interventional Radiology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Christoph Schleich
- Institute for Diagnostic and Interventional Radiology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Sven Nebelung
- Institute for Diagnostic and Interventional Radiology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Miriam Frenken
- Institute for Diagnostic and Interventional Radiology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Karl Ludger Radke
- Institute for Diagnostic and Interventional Radiology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Stefan Vordenbäumen
- Policlinic and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Ralph Brinks
- Policlinic and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Matthias Schneider
- Policlinic and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Benedikt Ostendorf
- Policlinic and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Dennis McGonagle
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust and The University of Leeds, Leeds, UK
| | - Philipp Sewerin
- Policlinic and Hiller Research Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
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Sander O, Korfmacher W, Ostendorf B, Schneider M. [Rheumatology in the mirror of media and advertising exemplified by the Rheumazentrum Rhein-Ruhr]. Z Rheumatol 2019; 77:300-308. [PMID: 29654390 DOI: 10.1007/s00393-018-0461-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- O Sander
- Poliklinik und Funktionsbereich für Rheumatologie & Hiller Forschungszentrum Rheumatologie, Universitätsklinikum Düsseldorf Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, Düsseldorf, Deutschland.
| | - W Korfmacher
- Fachbereiche Architektur und Design, Peter Behrens School of Arts, Hochschule Düsseldorf, Düsseldorf, Deutschland
| | - B Ostendorf
- Poliklinik und Funktionsbereich für Rheumatologie & Hiller Forschungszentrum Rheumatologie, Universitätsklinikum Düsseldorf Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, Düsseldorf, Deutschland
| | - M Schneider
- Poliklinik und Funktionsbereich für Rheumatologie & Hiller Forschungszentrum Rheumatologie, Universitätsklinikum Düsseldorf Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, Düsseldorf, Deutschland
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Sewerin P, Ostendorf B, Schleich C. [MRI diagnostics in inflammatory joint and spinal diseases: protocols and special sequences: when and for what?]. Z Rheumatol 2019; 77:538-548. [PMID: 29916005 DOI: 10.1007/s00393-018-0497-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Magnetic resonance imaging (MRI) is an important component in rheumatology for imaging diagnostics and therapy monitoring of inflammatory and non-inflammatory diseases of the spine and peripheral joints. The correct selection of suitable and practical MRI protocols and sequences represents a great challenge for physicians with respect to requesting and interpreting the indications for MRI investigations. This review article provides recommendations and suggestions for MRI investigation protocols for clinical utilization and practice. New sequences are evaluated and assessed in order to generate the best possible standardized and comparable examinations for rheumatology in the future and therefore optimize the quality of radiological interventions.
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Affiliation(s)
- P Sewerin
- Poliklinik, Funktionsbereich & Hiller Forschungszentrum für Rheumatologie, Universitätsklinikum, Heinrich-Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - B Ostendorf
- Poliklinik, Funktionsbereich & Hiller Forschungszentrum für Rheumatologie, Universitätsklinikum, Heinrich-Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - C Schleich
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Heinrich-Heine Universität Düsseldorf, Düsseldorf, Deutschland
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Pongratz G, Lowin T, Sewerin P, Zaucke F, Jenei-Lanzl Z, Pauly T, Ostendorf B, Schneider M. Tryptophan metabolism in rheumatoid arthritis is associated with rheumatoid factor and predicts joint pathology evaluated by the Rheumatoid Arthritis MRI Score (RAMRIS). Clin Exp Rheumatol 2019; 37:450-457. [PMID: 30557125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 07/23/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Tryptophan and its metabolites have been suggested to play a role in inflammatory processes. However, studies in rheumatoid arthritis (RA) are scarce, which prompted us to investigate two cohorts of RA patients to better understand the importance of tryptophan metabolism in this disease. METHODS Tryptophan and its metabolites were characterised by ELISA in a cross-sectional cohort 1 (81 RA, 55 OA) and a longitudinal cohort 2 (25 RA, 3 visits over 6 months) to investigate discriminatory power between diseases and predicitive value for radiologic outcome, respectively. Radiologic outcome was monitored by RA MRI Score (RAMRIS), including grading of synovitis, bone oedema and erosion, as well as delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) index assessing cartilage quality of the MCP II joint. RESULTS RA patients showed higher levels of serum serotonin (RA: 206.8 ng/ml ± 156.7; OA: 81.2 ng/ml ± 63.6) and estimated indoleamine (2,3)-dioxygenase (IDO) activity (kynurenine / tryptophan ratio; RA: 0.065±0.067; OA: 0.021±0.010). IDO activity showed similar, or better discriminatory power between RA and OA (AUC 0.914) than anti-CCP antibody level (AUC 0.922) and rheumatoid factor (RF, AUC 0.783), respectively. In cohort 2, regression analysis revealed a predictive value of baseline serotonin levels and IDO activity for changes in RAMRIS score and erosions at month six, respectively. CONCLUSIONS This study supports the hypothesis that tryptophan and its metabolites can be used as biomarkers predicting radiologic outcome and discriminate between RA and OA patients. Overall, our results strengthen the notion that tryptophan metabolism is closely linked to RA disease mechanisms.
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Affiliation(s)
- Georg Pongratz
- Department of Rheumatology and Hiller Research Centre for Rheumatology, University Hospital Düsseldorf, Germany.
| | - Torsten Lowin
- Department of Rheumatology and Hiller Research Centre for Rheumatology, University Hospital Düsseldorf, Germany
| | - Philipp Sewerin
- Department of Rheumatology and Hiller Research Centre for Rheumatology, University Hospital Düsseldorf, Germany
| | - Frank Zaucke
- Experimental Orthopaedics, Dept. of Orthopaedics Surgery Friedrichsheim, University Hospital Frankfurt, Germany
| | - Zsuzsa Jenei-Lanzl
- Experimental Orthopaedics, Dept. of Orthopaedics Surgery Friedrichsheim, University Hospital Frankfurt, Germany
| | - Thomas Pauly
- Department of Orthopaedics, River Rhein Centre for Rheumatology at St. Elisabeth Hospital, Meerbusch-Lank, Germany
| | - Benedikt Ostendorf
- Department of Rheumatology and Hiller Research Centre for Rheumatology, University Hospital Düsseldorf, Germany
| | - Matthias Schneider
- Department of Rheumatology and Hiller Research Centre for Rheumatology, University Hospital Düsseldorf, Germany
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Sewerin P, Schleich C, Brinks R, Müller-Lutz A, Fichter F, Eichner M, Schneider M, Ostendorf B, Vordenbäumen S. Assessing Associations of Synovial Perfusion, Cartilage Quality, and Outcome in Rheumatoid Arthritis Using Dynamic Contrast-enhanced Magnetic Resonance Imaging. J Rheumatol 2019; 47:15-19. [PMID: 30877219 DOI: 10.3899/jrheum.180832] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To assess associations of synovial perfusion, cartilage quality, and outcome in rheumatoid arthritis (RA). METHODS Synovial perfusion and cartilage quality were assessed by dynamic contrast-enhanced magnetic resonance imaging in metacarpophalangeal joints of 28 treatment-naive patients with RA at baseline and at 3 and 6 months after methotrexate. Analysis was by linear mixed modeling. RESULTS Synovial perfusion variables were associated with remission (p < 0.05) and cartilage quality (p < 0.004). Maximum synovial enhancement was associated to European League Against Rheumatism response (p < 0.05). Synovial perfusion improved in nonresponders over time (p < 0.05). CONCLUSION Synovial perfusion relates to remission, response, and cartilage quality in a cohort of therapy-naive patients with early RA.
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Affiliation(s)
- Philipp Sewerin
- From Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology, and Department of Diagnostic and Interventional Radiology, Düsseldorf, Germany. .,P. Sewerin, MD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; C. Schleich, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; R. Brinks, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; A. Müller-Lutz, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; F. Fichter, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Eichner, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Schneider, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; B. Ostendorf, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; S. Vordenbäumen, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology. P. Sewerin and C. Schleich contributed equally to this work.
| | - Christoph Schleich
- From Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology, and Department of Diagnostic and Interventional Radiology, Düsseldorf, Germany.,P. Sewerin, MD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; C. Schleich, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; R. Brinks, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; A. Müller-Lutz, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; F. Fichter, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Eichner, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Schneider, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; B. Ostendorf, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; S. Vordenbäumen, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology. P. Sewerin and C. Schleich contributed equally to this work
| | - Ralph Brinks
- From Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology, and Department of Diagnostic and Interventional Radiology, Düsseldorf, Germany.,P. Sewerin, MD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; C. Schleich, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; R. Brinks, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; A. Müller-Lutz, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; F. Fichter, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Eichner, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Schneider, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; B. Ostendorf, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; S. Vordenbäumen, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology. P. Sewerin and C. Schleich contributed equally to this work
| | - Anja Müller-Lutz
- From Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology, and Department of Diagnostic and Interventional Radiology, Düsseldorf, Germany.,P. Sewerin, MD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; C. Schleich, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; R. Brinks, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; A. Müller-Lutz, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; F. Fichter, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Eichner, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Schneider, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; B. Ostendorf, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; S. Vordenbäumen, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology. P. Sewerin and C. Schleich contributed equally to this work
| | - Florian Fichter
- From Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology, and Department of Diagnostic and Interventional Radiology, Düsseldorf, Germany.,P. Sewerin, MD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; C. Schleich, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; R. Brinks, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; A. Müller-Lutz, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; F. Fichter, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Eichner, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Schneider, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; B. Ostendorf, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; S. Vordenbäumen, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology. P. Sewerin and C. Schleich contributed equally to this work
| | - Markus Eichner
- From Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology, and Department of Diagnostic and Interventional Radiology, Düsseldorf, Germany.,P. Sewerin, MD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; C. Schleich, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; R. Brinks, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; A. Müller-Lutz, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; F. Fichter, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Eichner, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Schneider, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; B. Ostendorf, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; S. Vordenbäumen, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology. P. Sewerin and C. Schleich contributed equally to this work
| | - Matthias Schneider
- From Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology, and Department of Diagnostic and Interventional Radiology, Düsseldorf, Germany.,P. Sewerin, MD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; C. Schleich, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; R. Brinks, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; A. Müller-Lutz, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; F. Fichter, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Eichner, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Schneider, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; B. Ostendorf, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; S. Vordenbäumen, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology. P. Sewerin and C. Schleich contributed equally to this work
| | - Benedikt Ostendorf
- From Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology, and Department of Diagnostic and Interventional Radiology, Düsseldorf, Germany.,P. Sewerin, MD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; C. Schleich, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; R. Brinks, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; A. Müller-Lutz, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; F. Fichter, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Eichner, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Schneider, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; B. Ostendorf, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; S. Vordenbäumen, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology. P. Sewerin and C. Schleich contributed equally to this work
| | - Stefan Vordenbäumen
- From Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology, and Department of Diagnostic and Interventional Radiology, Düsseldorf, Germany.,P. Sewerin, MD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; C. Schleich, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; R. Brinks, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; A. Müller-Lutz, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; F. Fichter, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Eichner, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology; M. Schneider, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; B. Ostendorf, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology; S. Vordenbäumen, MD, PhD, Heinrich-Heine-University Düsseldorf, Medical Faculty, Department and Hiller-Research-Unit for Rheumatology. P. Sewerin and C. Schleich contributed equally to this work
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Sewerin P, Müller-Lutz A, Abrar DB, Odendahl S, Eichner M, Schneider M, Ostendorf B, Schleich C. Prevention of the progressive biochemical cartilage destruction under methotrexate therapy in early rheumatoid arthritis. Clin Exp Rheumatol 2019; 37:179-185. [PMID: 29998824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/24/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The aim of the study was to investigate biochemical cartilage composition under methotrexate (MTX) therapy and to intra-individually assess the impact of inflammation severity on cartilage composition by using dGEMRIC MRI in patients with early rheumatoid arthritis (eRA). METHODS dGEMRIC of MCP joints of the index and middle finger of 28 patients from the AthroMark cohort were examined prior to MTX-therapy as well as after 3 and 6 month. OMERACT RA MRI score and clinical parameters (CRP and DAS28) were registered at any time point. Each patient's second and third MCP joints were dichotomised into the joint with more severe synovitis versus the joint with less severe synovitis according to the RAMRIS synovitis subscore. RESULTS MCP joints with more severe synovitis ('bad joints') demonstrated significantly lower dGEMRIC values compared to MCP joints with less severe synovitis ('good joints') at time-points 0 and 3 months (p=0.002; p=0.019, respectively). After 6 months of MTX therapy no significant difference of dGEMRIC index was found between good and bad joint (p=0.086). CONCLUSIONS Under MTX therapy, biochemical cartilage integrity remains stable; no further cartilage destruction occurred if patients were treated early in the course of the disease. In addition, six months of MTX therapy triggered an alignment of dGEMRIC index of MCP joints with initially severe synovitis and less severe synovitis in an intra-individual assessment. This underlines the importance of an early treatment in eRA to reduce further cartilage damage of the inflamed joints.
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Affiliation(s)
- Philipp Sewerin
- Department and Hiller-Research Unit for Rheumatology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany
| | - Daniel Benjamin Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany
| | - Sina Odendahl
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany
| | - Markus Eichner
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany
| | - Matthias Schneider
- Department and Hiller-Research Unit for Rheumatology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany
| | - Benedikt Ostendorf
- Department and Hiller-Research Unit for Rheumatology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany
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Frenken M, Schleich C, Brinks R, Abrar DB, Goertz C, Schneider M, Ostendorf B, Sewerin P. The value of the simplified RAMRIS-5 in early RA patients under methotrexate therapy using high-field MRI. Arthritis Res Ther 2019; 21:21. [PMID: 30642376 PMCID: PMC6332674 DOI: 10.1186/s13075-018-1789-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 12/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the study was to evaluate a simplified version of the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) for five joints of the hand (RAMRIS-5) in patients with early rheumatoid arthritis (RA) before and after the initiation of methotrexate (MTX) therapy using high-resolution, 3-T magnetic resonance imaging (MRI). METHODS Twenty-eight patients with a seropositive, early RA (disease duration of less than 6 months (range 2-23 weeks)) according to 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria (mean age 56.8 years, range 39-74) were prospectively assessed with a baseline investigation including clinical assessment (disease activity score of 28 joints (DAS-28) and C-reactive protein (CRP)) and 3-T MRI of the clinically dominant hand. Follow-up visits were performed 3 and 6 months after initiation of a MTX therapy at baseline. MRI scans were analyzed in accordance with RAMRIS and the simplified RAMRIS-5. RESULTS DAS-28 and CRP decreased significantly after initiation of MTX therapy. Even though erosion scores increased over time, RAMRIS and RAMRIS-5 also decreased significantly after the start of therapy. There was a strong correlation between the total RAMRIS-5 and RAMRIS at baseline (r = 0.838; P <0.001) and follow-up (3 months: r = 0.876; P <0.001; 6 months: r = 0.897; P <0.001). In the short term (3-month follow-up), RAMRIS and RAMRIS-5 demonstrated similar ability to detect changes for all subgroups (bone edema, erosion, and synovitis). In the long-term comparison (6-month follow-up), RAMRIS-5 also showed similar effectiveness when detecting changes in bone edema and erosion compared with RAMRIS. Deviations occurred regarding only synovitis, where change was slightly higher in RAMRIS-5: SRM (RAMRIS) = 0.07 ± 0.14; SRM (RAMRIS-5) = 0.34 ± 0.06. CONCLUSIONS Three-Tesla MRI-based RAMRIS-5 is a simplified and resource-saving RAMRIS score which compares favorably with the RAMRIS when detecting changes in early RA. Even though there is a slight abbreviation between RAMRIS-5 and the original score regarding the change of synovitis, it may be used for diagnosis and therapy monitoring in follow-up evaluations.
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Affiliation(s)
- Miriam Frenken
- Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Christoph Schleich
- Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Ralph Brinks
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Daniel Benjamin Abrar
- Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Christine Goertz
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Matthias Schneider
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Benedikt Ostendorf
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Philipp Sewerin
- Department and Hiller Research Unit for Rheumatology, UKD, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
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Sewerin P, Schleich C, Vordenbäumen S, Ostendorf B. Update on imaging in rheumatic diseases: cartilage. Clin Exp Rheumatol 2018; 36 Suppl 114:139-144. [PMID: 30296981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 08/30/2018] [Indexed: 06/08/2023]
Abstract
In recent years, the role of articular cartilage for understanding pathogenesis as well as for clinical research has become increasingly important. Whereas previously cartilage could only be assessed invasively, various imaging procedures are available for its evaluation now. Although still widely used, conventional radiography bears significant limitations since it assesses cartilage indirectly by joint space width. Today, the cartilage thickness and structure can be reliably evaluated using ultrasound, although the molecular structure cannot be determined, yet. Besides ultrasound, MRI offers the possibility to image morphological changes with a very high resolution. In addition, the quality and composition of joint cartilage can already be measured due to a constant technical improvement and new MRI sequences such as dGEMRIC even in small joints (e.g. MCP or MTP joints). Despite the advantages of contrast agents for the detection of inflammation, its use is reevaluated today. Regarding that contrast agent-free imaging techniques for the assessment of joint cartilage are developed with great effort to depict its quality and changes over time. These novel MRI methods such as T2/T2*- and T1ρ-mapping, gagCEST, and sodium imaging provide promising quantitative imaging biomarkers that can detect early cartilage changes before morphological alterations occur. Hence, US and MRI will likely be of paramount importance in future clinical trials and clinical assessment of inflammatory and degenerative joint diseases not only for understanding pathogenesis but also for using its possible value in daily practice.
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Affiliation(s)
- Philipp Sewerin
- Department and Hiller-Research-Unit of Rheumatology, Heinrich-Heine-University Dusseldorf, Germany.
| | - Christoph Schleich
- Department of Diagnostic and Interventional, Radiology, Heinrich-Heine-University Dusseldorf, Germany
| | - Stefan Vordenbäumen
- Department and Hiller-Research-Unit of Rheumatology, Heinrich-Heine-University Dusseldorf, Germany
| | - Benedikt Ostendorf
- Department and Hiller-Research-Unit of Rheumatology, Heinrich-Heine-University Dusseldorf, Germany
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Ruthard J, Hermes G, Hartmann U, Sengle G, Pongratz G, Ostendorf B, Schneider M, Höllriegl S, Zaucke F, Wagener R, Streichert T, Klatt AR. Identification of antibodies against extracellular matrix proteins in human osteoarthritis. Biochem Biophys Res Commun 2018; 503:1273-1277. [PMID: 30001809 DOI: 10.1016/j.bbrc.2018.07.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 07/07/2018] [Indexed: 12/30/2022]
Abstract
We investigated the presence of autoantibodies against the extracellular matrix proteins thrombospondin-4 (TSP-4), cartilage oligomeric matrix protein (COMP), C-type lectin domain family 3 member A (CLEC3A), collagen II, collagen VI, matrilin-3, and fibrillin-2 in the serum of osteoarthritis (OA) patients. We compared those results with the presence of such antibodies in rheumatoid arthritis (RA) patients and in healthy donors (HD). Our study examines whether antibodies against extracellular proteins can be used as potential biomarkers to support the clinical diagnosis of OA. 10 OA, 10 RA patients and 10 HD were enrolled in this explorative cross-sectional study. SDS-PAGE and immunoblot were used to investigate the presence of antibodies against extracellular matrix proteins. The serum of 5/10 OA patients but 0/10 HD exhibited TSP-4 IgG isotype antibodies (P = 0.033). The serum of 8/10 OA patients but only 1/10 HD exhibited IgG isotype antibodies against TSP-4 or COMP (P = 0.005). The serum of 9/10 OA patients but only 1/10 HD exhibited IgG isotype antibodies against TSP-4, COMP or CLEC3A (P = 0.005). We found strong evidence for the presence of IgG isotype autoantibodies against the cartilage extracellular matrix proteins TSP-4, COMP and CLEC3A in OA. The detection of IgG isotype autoantibodies against TSP-4, COMP and CLEC3A may support the clinical diagnosis of OA. OA with autoantibodies against cartilage extracellular matrix proteins defines a new OA subgroup suggesting that patients with high concentrations of autoantibodies may benefit from an immune suppressive therapy.
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Affiliation(s)
- Johannes Ruthard
- Institute for Clinical Chemistry, Medical Faculty, University of Cologne, Kerpener Str. 62, 50924, Cologne, Germany
| | - Gabriele Hermes
- Institute for Clinical Chemistry, Medical Faculty, University of Cologne, Kerpener Str. 62, 50924, Cologne, Germany
| | - Ursula Hartmann
- Center for Biochemistry, Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 52, 50931, Cologne, Germany
| | - Gerhard Sengle
- Center for Biochemistry, Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 52, 50931, Cologne, Germany
| | - Georg Pongratz
- Institute for Rheumatology, Hiller Research Unit for Rheumatology, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Benedikt Ostendorf
- Institute for Rheumatology, Hiller Research Unit for Rheumatology, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Matthias Schneider
- Institute for Rheumatology, Hiller Research Unit for Rheumatology, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Stefan Höllriegl
- Sana-Dreifaltigkeitskrankenhaus, Aachener Str. 445, 50933, Cologne, Germany
| | - Frank Zaucke
- Dr Rolf M Schwiete Research Unit for Osteoarthritis, Orthopädische Universitätsklinik Friedrichsheim gGmbH, Marienburgstr. 2, 60528, Frankfurt am Main, Germany
| | - Raimund Wagener
- Center for Biochemistry, Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 52, 50931, Cologne, Germany
| | - Thomas Streichert
- Institute for Clinical Chemistry, Medical Faculty, University of Cologne, Kerpener Str. 62, 50924, Cologne, Germany
| | - Andreas R Klatt
- Institute for Clinical Chemistry, Medical Faculty, University of Cologne, Kerpener Str. 62, 50924, Cologne, Germany.
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Sewerin P, Le L, Vordenbäumen S, Schleich C, Sengewein R, Brinks R, Pongratz G, Bleck E, Lesch J, Mansmann U, Schneider M, Ostendorf B. Rheumatoid Arthritis Magnetic Resonance Imaging Score Predicts Therapy Response: Results of the German ArthroMark Cohort. J Rheumatol 2018; 45:753-759. [PMID: 29606664 DOI: 10.3899/jrheum.170797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Markers for treatment response in rheumatoid arthritis (RA) are lacking. The aim of the study was to assess the performance of the RA magnetic resonance imaging (MRI) scoring system (RAMRIS) in combination with serum biomarkers to predict response to methotrexate (MTX) treatment in therapy-naive patients with early RA by using high-field MRI. METHODS Twenty-eight patients with RA were prospectively assessed with baseline 3-T MRI of the clinical dominant hand, 3 and 6 months after MTX. The patients met the 2010 American College of Rheumatology/European League Against Rheumatism (EULAR) criteria [average age 56.8 yrs (range 39-74); positive for rheumatoid factor and/or anticyclic citrullinated peptide antibodies; disease duration < 6 mos (range 2-23 weeks)]. RAMRIS and serum biomarkers consisting of various experimental proteins including receptor activator of nuclear factor-κB ligand (RANKL) were obtained. Remission or treatment response was defined according to EULAR. To adjust for intrapersonal correlation, generalized linear mixed models were used. RESULTS Treatment response at 3 months was associated to low RAMRIS erosion subscores and low total RAMRIS scores (p = 0.019 and 0.03, respectively). Remission at 6 months was associated to low RANKL levels (p = 0.033). In multivariate analyses, response at 3 and 6 months was predicted more accurately with the inclusion of total RAMRIS score, RAMRIS synovitis subscore at the second metacarpophalangeal (MCP) joint, or a combination of the two (p value likelihood ratio test = 0.035, 0.035, and 0.041, respectively). Remission was more accurately predicted with inclusion of RANKL, with no significant predictive effect of MRI. CONCLUSION Baseline total RAMRIS can predict EULAR response. RAMRIS synovitis subscore at the second MCP joint and RANKL are associated with response and remission, respectively.
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Affiliation(s)
- Philipp Sewerin
- From the Department and Hiller-Research-Unit for Rheumatology, and the Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-University Düsseldorf; University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology, Düsseldorf; the Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany. .,P. Sewerin, MD, University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology; L. Le, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; S. Vordenbäumen, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; C. Schleich, MD, PhD, Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine-University Düsseldorf; R. Sengewein, MD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; R. Brinks, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; G. Pongratz, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; E. Bleck, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; J. Lesch, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; U. Mansmann, PhD, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; M. Schneider, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; B. Ostendorf, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf.
| | - Lien Le
- From the Department and Hiller-Research-Unit for Rheumatology, and the Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-University Düsseldorf; University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology, Düsseldorf; the Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany.,P. Sewerin, MD, University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology; L. Le, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; S. Vordenbäumen, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; C. Schleich, MD, PhD, Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine-University Düsseldorf; R. Sengewein, MD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; R. Brinks, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; G. Pongratz, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; E. Bleck, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; J. Lesch, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; U. Mansmann, PhD, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; M. Schneider, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; B. Ostendorf, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf
| | - Stefan Vordenbäumen
- From the Department and Hiller-Research-Unit for Rheumatology, and the Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-University Düsseldorf; University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology, Düsseldorf; the Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany.,P. Sewerin, MD, University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology; L. Le, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; S. Vordenbäumen, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; C. Schleich, MD, PhD, Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine-University Düsseldorf; R. Sengewein, MD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; R. Brinks, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; G. Pongratz, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; E. Bleck, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; J. Lesch, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; U. Mansmann, PhD, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; M. Schneider, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; B. Ostendorf, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf
| | - Christoph Schleich
- From the Department and Hiller-Research-Unit for Rheumatology, and the Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-University Düsseldorf; University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology, Düsseldorf; the Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany.,P. Sewerin, MD, University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology; L. Le, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; S. Vordenbäumen, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; C. Schleich, MD, PhD, Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine-University Düsseldorf; R. Sengewein, MD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; R. Brinks, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; G. Pongratz, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; E. Bleck, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; J. Lesch, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; U. Mansmann, PhD, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; M. Schneider, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; B. Ostendorf, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf
| | - Ruben Sengewein
- From the Department and Hiller-Research-Unit for Rheumatology, and the Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-University Düsseldorf; University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology, Düsseldorf; the Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany.,P. Sewerin, MD, University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology; L. Le, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; S. Vordenbäumen, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; C. Schleich, MD, PhD, Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine-University Düsseldorf; R. Sengewein, MD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; R. Brinks, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; G. Pongratz, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; E. Bleck, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; J. Lesch, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; U. Mansmann, PhD, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; M. Schneider, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; B. Ostendorf, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf
| | - Ralph Brinks
- From the Department and Hiller-Research-Unit for Rheumatology, and the Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-University Düsseldorf; University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology, Düsseldorf; the Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany.,P. Sewerin, MD, University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology; L. Le, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; S. Vordenbäumen, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; C. Schleich, MD, PhD, Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine-University Düsseldorf; R. Sengewein, MD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; R. Brinks, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; G. Pongratz, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; E. Bleck, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; J. Lesch, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; U. Mansmann, PhD, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; M. Schneider, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; B. Ostendorf, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf
| | - Georg Pongratz
- From the Department and Hiller-Research-Unit for Rheumatology, and the Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-University Düsseldorf; University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology, Düsseldorf; the Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany.,P. Sewerin, MD, University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology; L. Le, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; S. Vordenbäumen, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; C. Schleich, MD, PhD, Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine-University Düsseldorf; R. Sengewein, MD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; R. Brinks, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; G. Pongratz, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; E. Bleck, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; J. Lesch, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; U. Mansmann, PhD, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; M. Schneider, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; B. Ostendorf, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf
| | - Ellen Bleck
- From the Department and Hiller-Research-Unit for Rheumatology, and the Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-University Düsseldorf; University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology, Düsseldorf; the Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany.,P. Sewerin, MD, University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology; L. Le, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; S. Vordenbäumen, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; C. Schleich, MD, PhD, Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine-University Düsseldorf; R. Sengewein, MD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; R. Brinks, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; G. Pongratz, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; E. Bleck, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; J. Lesch, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; U. Mansmann, PhD, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; M. Schneider, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; B. Ostendorf, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf
| | - Juliane Lesch
- From the Department and Hiller-Research-Unit for Rheumatology, and the Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-University Düsseldorf; University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology, Düsseldorf; the Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany.,P. Sewerin, MD, University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology; L. Le, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; S. Vordenbäumen, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; C. Schleich, MD, PhD, Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine-University Düsseldorf; R. Sengewein, MD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; R. Brinks, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; G. Pongratz, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; E. Bleck, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; J. Lesch, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; U. Mansmann, PhD, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; M. Schneider, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; B. Ostendorf, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf
| | - Ulrich Mansmann
- From the Department and Hiller-Research-Unit for Rheumatology, and the Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-University Düsseldorf; University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology, Düsseldorf; the Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany.,P. Sewerin, MD, University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology; L. Le, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; S. Vordenbäumen, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; C. Schleich, MD, PhD, Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine-University Düsseldorf; R. Sengewein, MD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; R. Brinks, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; G. Pongratz, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; E. Bleck, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; J. Lesch, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; U. Mansmann, PhD, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; M. Schneider, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; B. Ostendorf, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf
| | - Matthias Schneider
- From the Department and Hiller-Research-Unit for Rheumatology, and the Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-University Düsseldorf; University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology, Düsseldorf; the Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany.,P. Sewerin, MD, University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology; L. Le, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; S. Vordenbäumen, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; C. Schleich, MD, PhD, Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine-University Düsseldorf; R. Sengewein, MD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; R. Brinks, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; G. Pongratz, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; E. Bleck, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; J. Lesch, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; U. Mansmann, PhD, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; M. Schneider, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; B. Ostendorf, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf
| | - Benedikt Ostendorf
- From the Department and Hiller-Research-Unit for Rheumatology, and the Institute of Diagnostic and Interventional Radiology, Universitätsklinikum Düsseldorf (UKD), Heinrich-Heine-University Düsseldorf; University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology, Düsseldorf; the Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany.,P. Sewerin, MD, University Düsseldorf, Medical Faculty, Department of Endocrinology, Diabetology and Rheumatology; L. Le, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; S. Vordenbäumen, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; C. Schleich, MD, PhD, Department for Diagnostic and Interventional Radiology, UKD, Heinrich-Heine-University Düsseldorf; R. Sengewein, MD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; R. Brinks, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; G. Pongratz, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; E. Bleck, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; J. Lesch, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; U. Mansmann, PhD, Institute for Medical Information Sciences, Biometry and Epidemiology, Ludwig Maximilian University; M. Schneider, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf; B. Ostendorf, MD, PhD, Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich-Heine-University Düsseldorf
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Abstract
Until now, most major medical advancements have been achieved through hypothesis-driven research within the scope of clinical trials. However, due to a multitude of variables, only a certain number of research questions could be addressed during a single study, thus rendering these studies expensive and time consuming. Big data acquisition enables a new data-based approach in which large volumes of data can be used to investigate all variables, thus opening new horizons. Due to universal digitalization of the data as well as ever-improving hard- and software solutions, imaging would appear to be predestined for such analyses. Several small studies have already demonstrated that automated analysis algorithms and artificial intelligence can identify pathologies with high precision. Such automated systems would also seem well suited for rheumatology imaging, since a method for individualized risk stratification has long been sought for these patients. However, despite all the promising options, the heterogeneity of the data and highly complex regulations covering data protection in Germany would still render a big data solution for imaging difficult today. Overcoming these boundaries is challenging, but the enormous potential advances in clinical management and science render pursuit of this goal worthwhile.
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Affiliation(s)
- Philipp Sewerin
- Heinrich-Heine-Universität Düsseldorf (HHU), Poliklinik, Funktionsbereich und Hiller-Forschungszentrum für Rheumatologie, Universitätskliniken Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
| | - Benedikt Ostendorf
- Heinrich-Heine-Universität Düsseldorf (HHU), Poliklinik, Funktionsbereich und Hiller-Forschungszentrum für Rheumatologie, Universitätskliniken Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland
| | - Axel J Hueber
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Medizinische Klinik 3 - Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Arnd Kleyer
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Medizinische Klinik 3 - Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
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23
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Sewerin P, Hoyer A, Schneider M, Ostendorf B, Brinks R. Inconsistency between Danish incidence and prevalence data about psoriatic arthritis (PsA). Ann Rheum Dis 2018; 78:e44. [PMID: 29295824 DOI: 10.1136/annrheumdis-2017-212817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 12/15/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Philipp Sewerin
- Department and Hiller Research Unit of Rheumatology, University Düsseldorf, Düsseldorf, Germany
| | - Annika Hoyer
- Institute for Biometry and Epidemiology, German Diabetes Center, Düsseldorf, Germany
| | - Matthias Schneider
- Department and Hiller Research Unit of Rheumatology, University Düsseldorf, Düsseldorf, Germany
| | - Benedikt Ostendorf
- Department and Hiller Research Unit of Rheumatology, University Düsseldorf, Düsseldorf, Germany
| | - Ralph Brinks
- Department and Hiller Research Unit of Rheumatology, University Düsseldorf, Düsseldorf, Germany
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24
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Sewerin P, Klein S, Brinks R, Hoyer A, Schleich C, Miese F, Blaschke S, Edelmann E, Gao I, Georgi J, Kellner H, Keyßer G, Lorenz HM, Müller-Ladner U, Pott HG, Schulze-Koops H, Walther M, Schmidt W, Schneider M, Ostendorf B. REMISSIONPLUS eine Initiative zur Integration moderner Bildgebung in die rheumatologische Versorgung Rückblick, Einblick, Ausblick: Auswertung der Niederfeld-MRT Daten. AKTUEL RHEUMATOL 2017. [DOI: 10.1055/s-0042-124184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ZusammenfassungBildgebende Verfahren nehmen heute bei der Diagnosestellung und Therapiekontrolle der Rheumatoiden Arthritis (RA) eine unverzichtbare Rolle ein. Die Initiative REMISSIONPLUS hat seit 2006 über 10 Jahre das Ziel verfolgt, moderne bildgebende Verfahren wie die Arthrosonografie und die Magnetresonanztomografie (MRT) in den klinischen Alltag des Rheumatologen zu implementieren. Neben Schulungen (über 3 000 Rheumatologen in über 200 Veranstaltungen) wurden zahlreiche Bildgebungs- Studien durchgeführt. Erstmals werden jetzt zusammenhängend alle Niederfeld-MRT Daten aus der Initiative vorgestellt. Die Ergebnisse dieser multizentrischen Studie zeigen, dass die Niederfeld-MRT für RA Patienten eine komfortable Untersuchungsmethode darstellt und für den Rheumatologen die Möglichkeit bietet, effektiv und sehr genau Therapieeffekte (DMARD, Biologika) zu kontrollieren. Die MRT-Daten korrelierten hierbei signifikant mit Klinik und Labor. Mit der Methode ist es ferner möglich bei RA-Patienten subklinische Arthritiszeichen zu detektieren, zum anderen konnte fortschreitende radiologische Progression (Erosivität), trotz klinischer Remission („silent progression") erkannt werden. Diese Ergebnisse sind konventionell radiologisch nicht zu gewinnen, sodass der Einsatz der MRT neue Einblicke in die Pathogenese und konsekutiv neue Informationen für das Management der RA liefert. Die Bewertung dieser Vorteile und der Benefit für den Patienten im klinischen Alltag muss in weiteren Studien untersucht und diskutiert werden.
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Affiliation(s)
- Philipp Sewerin
- Poliklinik, Funktionsbereich und Hiller-Forschungszentrum für Rheumatologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
| | - Sabine Klein
- Poliklinik, Funktionsbereich und Hiller-Forschungszentrum für Rheumatologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
| | - Ralph Brinks
- Poliklinik, Funktionsbereich und Hiller-Forschungszentrum für Rheumatologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
| | - Annika Hoyer
- Deutsches Diabetes Zentrum, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
| | - Christoph Schleich
- Institut für diagnostische und interventionelle Radiologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
| | - Falk Miese
- Institut für diagnostische und interventionelle Radiologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
| | | | | | - Ino Gao
- Rheumapraxis Heidelberg, Heidelberg
| | - Joachim Georgi
- Abteilung Innere Medizin/ Rheumatologie, Helios Ostseeklinik Damp, Damp
| | - Herbert Kellner
- Schwerpunktpraxis für Rheumatologie und Gastroenterologie, Ärztlicher Leiter der Abteilung Rheumatologie im Krankenhaus Neuwittelsbach, München
| | - Gernot Keyßer
- Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Halle, Halle/Saale
| | | | - Ulf Müller-Ladner
- Kerckhoff-Klinik, Abteilung für Rheumatologie und klinische Immunologie, Justus-Liebig-Universität Gießen, Bad Nauheim
| | - Hans-Georg Pott
- Schwerpunktpraxis für Rheumatologie, Physikalische Medizin und klinische Immunologie, Rheumatologikum Hannover, Hannover
| | - Hendrik Schulze-Koops
- Rheuma-Einheit, Medizinische Poliklinik, Universitätsklinikum München – Campus Innenstadt, München
| | - Marisa Walther
- Immanuel-Krankenhaus Rheumaklinik Berlin-Buch, Innere Medizin, Rheumatologie und Klinische Immunologie, Berlin
| | - Wolfgang Schmidt
- Immanuel-Krankenhaus Rheumaklinik Berlin-Buch, Innere Medizin, Rheumatologie und Klinische Immunologie, Berlin
| | - Matthias Schneider
- Poliklinik, Funktionsbereich und Hiller-Forschungszentrum für Rheumatologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
| | - Benedikt Ostendorf
- Poliklinik, Funktionsbereich und Hiller-Forschungszentrum für Rheumatologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
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Sewerin P, Vordenbaeumen S, Hoyer A, Brinks R, Buchbender C, Miese F, Schleich C, Klein S, Schneider M, Ostendorf B. Silent progression in patients with rheumatoid arthritis: is DAS28 remission an insufficient goal in RA? Results from the German Remission-plus cohort. BMC Musculoskelet Disord 2017; 18:163. [PMID: 28420375 PMCID: PMC5395882 DOI: 10.1186/s12891-017-1528-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 04/07/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Remission is arguably the ultimate therapeutic goal in rheumatoid arthritis (RA). Applying modern strategies, clinical remission can be achieved in a substantial number of patients with early RA (ERA). Even in those patients, the number and scope of erosions can increase. We, therefore, investigated the value of MRI for the detection of radiological progression in patients with DAS28 improvement and/or clinical remission of the German Remission-plus cohort. METHODS Data-sets of 80 RA patients (according to 2010 ACR/EULAR criteria) from the Remission-plus study cohort, who fulfilled the following criteria, were retrospectively analysed: availability of two consecutive MRI scans (low-field MRI, follow-up interval 1 year) of the clinically dominant hand and wrist, and the presence of DAS28 (CRP) scores at both time points, which was used to assess disease activity. RESULTS Seventy-one of the 80 investigated patients presented a numerical improvement of the DAS28 (CRP) after 12 months (DAS28(CRP) T0 average (Ø) 4.96, SD 1.2; DAS28 T4 (12 month) Ø 2.6, SD 1.0), 73% of them also improved in the RAMRIS-Score, while 24% demonstrated an increase despite DAS28 improvement and 3% showed equal values. 48% of patients who improved in the DAS28 reached EULAR remission. 41% of these patients had an increase in the RAMRIS Erosion-subscore after 12 months. When considering EULAR response criteria (non-response (n = 7), moderate response (n = 19), good response (n = 45)), an increase of erosions was found in 71.4% of non-responders, 52.6% of moderate responders, and 31.1% of good responders after 12 months, all compared to baseline. CONCLUSION Up to 40% of patients in this study demonstrated a progressive erosive disease detected by MRI despite DAS28 improvement or EULAR remission. Future studies are needed to determine the prognostic clinical impact of disease progression in MRI despite clinical remission, and to investigate if DAS28 remission may be an insufficient therapeutic goal and should be accompanied by MRI remission criteria.
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Affiliation(s)
- Philipp Sewerin
- Department of Rheumatology & Hiller Research Unit, University Hospital Düsseldorf, Moorenstreet 5, Duesseldorf, 40225, Germany.
| | - Stefan Vordenbaeumen
- Department of Rheumatology & Hiller Research Unit, University Hospital Düsseldorf, Moorenstreet 5, Duesseldorf, 40225, Germany
| | - Annika Hoyer
- German Diabetes Centre, Institute for Biometry and Epidemiology, Auf'm Hennekamp 65, Duesseldorf, 40225, Germany
| | - Ralph Brinks
- Department of Rheumatology & Hiller Research Unit, University Hospital Düsseldorf, Moorenstreet 5, Duesseldorf, 40225, Germany
| | - Christian Buchbender
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Moorenstreet 5, Duesseldorf, 40225, Germany
| | - Falk Miese
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Moorenstreet 5, Duesseldorf, 40225, Germany
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Moorenstreet 5, Duesseldorf, 40225, Germany
| | - Sabine Klein
- Department of Rheumatology & Hiller Research Unit, University Hospital Düsseldorf, Moorenstreet 5, Duesseldorf, 40225, Germany
| | - Matthias Schneider
- Department of Rheumatology & Hiller Research Unit, University Hospital Düsseldorf, Moorenstreet 5, Duesseldorf, 40225, Germany
| | - Benedikt Ostendorf
- Department of Rheumatology & Hiller Research Unit, University Hospital Düsseldorf, Moorenstreet 5, Duesseldorf, 40225, Germany
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Sewerin P, Vordenbaeumen S, Brinks R, Ostendorf B. Prospective MRI score to predict negative EULAR response in patients with rheumatoid arthritis (RA) before therapy-escalation to a biological therapy. Ann Rheum Dis 2017; 76:e44. [PMID: 28283516 DOI: 10.1136/annrheumdis-2017-211257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 02/04/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Philipp Sewerin
- Department of Policlinic of Rheumatology and Hiller Research Unit Rheumatology University Hospital (UKD), Duesseldorf, Germany
| | - Stefan Vordenbaeumen
- Department of Policlinic of Rheumatology and Hiller Research Unit Rheumatology University Hospital (UKD), Duesseldorf, Germany
| | - Ralph Brinks
- Department of Policlinic of Rheumatology and Hiller Research Unit Rheumatology University Hospital (UKD), Duesseldorf, Germany
| | - Benedikt Ostendorf
- Department of Policlinic of Rheumatology and Hiller Research Unit Rheumatology University Hospital (UKD), Duesseldorf, Germany
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Sewerin P, Schleich C, Ostendorf B. Magnetresonanztomografie peripherer Gelenke – up-date 2016. AKTUEL RHEUMATOL 2016. [DOI: 10.1055/s-0042-106080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungModerne und innovative bildgebende Verfahren spielen heute in der Rheumatologie eine zunehmend wichtige Rolle und werden dabei regelhaft bei Diagnosestellung und Therapiekontrolle eingesetzt. Neben der Sonografie, welche heute die rechte Hand des Rheumatologen darstellt, ist die Magnetresonanz-Tomografie (MRT), auch und gerade peripherer Gelenke, zunehmend in den wissenschaftlichen Fokus gerückt. Sie ist in der Lage hochsensitiv entzündliche artikuläre, periartikuläre und ossäre Veränderungen (wie die Synovialitis oder das Knochenmarködem) zu erkennen und dann darüber hinaus deutlich früher als bspw. das konventionelle Röntgen erosive Gelenkveränderungen ab zu bilden. Neben diesen Vorteilen ist es heute durch standardisierte Scoring-Systeme möglich MRT-Untersuchungen besser zu vergleichen, wobei hierfür erste vereinfachte Scores entwickelt und evaluiert wurden. Durch neue und innovative Sequenzen können frühzeitig Veränderungen des Knorpels erkannt werden. Dynamische MRT-Sequenzen versprechen eine noch genauere Darstellung lokaler Inflammation und sind neben hybriden bildgebenden Verfahren (z. B. PET-MRT oder SPECT-MRT) aktuell Gegenstand intensiver wissenschaftlicher Forschung.
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Affiliation(s)
- P. Sewerin
- Poliklinik, Funktionsbereich & Hiller-Forschungszentrum für Rheumatologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
| | - C. Schleich
- Institut für diagnostische und interventionelle Radiologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
| | - B. Ostendorf
- Poliklinik, Funktionsbereich & Hiller-Forschungszentrum für Rheumatologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
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Jian L, Scalley B, Xiao A, Nairn J, Spicer T, Somerford P, Ostendorf B, Weeramanthri T. Is Excess Heat Factor a Good Indicator for Assessing Heatwave Related Health Outcomes in Western Australia? Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv097.241] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Buchbender C, Ostendorf B, Ruhlmann V, Heusch P, Miese F, Beiderwellen K, Schneider M, Braun J, Antoch G, Baraliakos X. Hybrid 18F-labeled Fluoride Positron Emission Tomography/Magnetic Resonance (MR) Imaging of the Sacroiliac Joints and the Spine in Patients with Axial Spondyloarthritis: A Pilot Study Exploring the Link of MR Bone Pathologies and Increased Osteoblastic Activity. J Rheumatol 2015; 42:1631-7. [PMID: 26136491 DOI: 10.3899/jrheum.150250] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The biologically active molecule used in positron emission tomography (PET) for depiction of osteoblastic activity is 18F-labeled fluoride (18F-F). We examined whether inflammatory or chronic changes on magnetic resonance imaging (MRI) in the sacroiliac joints (SIJ) and the spines of patients with active ankylosing spondylitis (AS) are linked to osteoblastic activity, assessed by PET/MRI. METHODS Thirteen patients with AS (mean age 37.8 ± 11.4 yrs, Bath AS Disease Activity Index > 4, no anti-TNF treatment) underwent 3-Tesla whole-spine and SIJ PET/MRI. Two independent readers recorded pathologic changes related to vertebral (VQ) or SIJ quadrants (SQ). Final scores were based on reader agreement. RESULTS A total of 104 SQ and 1196 VQ were examined. In SIJ, bone marrow edema (BME) was seen in 44.2%, fat deposition (FD) in 42.3%, and 18F-F in 46.2% SQ. BME alone was associated with 18F-F in 78.6% and FD alone in only 7.7% SQ, while the combination BME/FD was associated with 18F-F in 72.2% SQ. Erosions, sclerosis, and ankylosis alone were rarely associated with 18F-F. In the spine, BME alone was seen in 9.9%, FD in 18.2%, and 18F-F in 5.4% VQ. BME alone was associated with 18F-F in 14.3% and FD alone in 8.7% VQ, while the combination BME/FD was associated with 18F-F in 40.6% VQ. CONCLUSION In this study of hybrid 18F-F PET/MRI of patients with active AS, we show that BME rather than chronic changes is associated with osteoblastic activity, while the combination of BME and FD showed the highest 18F-F uptake. The use of PET/MRI in prediction of future syndesmophyte formation in AS needs further exploration in prospective studies.
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Affiliation(s)
- Christian Buchbender
- From the Department of Diagnostic and Interventional Radiology, and Department of Rheumatology, Medical Faculty, University of Dusseldorf, Dusseldorf; Department of Nuclear Medicine, and Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen, Essen; Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany.C. Buchbender, MD, Department of Diagnostic and Interventional Radiology; B. Ostendorf, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; V. Ruhlmann, MD, Department of Nuclear Medicine, Medical Faculty, University of Duisburg-Essen; P. Heusch, MD; F. Miese, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; K. Beiderwellen, MD, Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen; M. Schneider, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; J. Braun, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum; G. Antoch, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; X. Baraliakos, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum
| | - Benedikt Ostendorf
- From the Department of Diagnostic and Interventional Radiology, and Department of Rheumatology, Medical Faculty, University of Dusseldorf, Dusseldorf; Department of Nuclear Medicine, and Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen, Essen; Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany.C. Buchbender, MD, Department of Diagnostic and Interventional Radiology; B. Ostendorf, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; V. Ruhlmann, MD, Department of Nuclear Medicine, Medical Faculty, University of Duisburg-Essen; P. Heusch, MD; F. Miese, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; K. Beiderwellen, MD, Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen; M. Schneider, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; J. Braun, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum; G. Antoch, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; X. Baraliakos, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum
| | - Verena Ruhlmann
- From the Department of Diagnostic and Interventional Radiology, and Department of Rheumatology, Medical Faculty, University of Dusseldorf, Dusseldorf; Department of Nuclear Medicine, and Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen, Essen; Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany.C. Buchbender, MD, Department of Diagnostic and Interventional Radiology; B. Ostendorf, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; V. Ruhlmann, MD, Department of Nuclear Medicine, Medical Faculty, University of Duisburg-Essen; P. Heusch, MD; F. Miese, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; K. Beiderwellen, MD, Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen; M. Schneider, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; J. Braun, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum; G. Antoch, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; X. Baraliakos, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum
| | - Philipp Heusch
- From the Department of Diagnostic and Interventional Radiology, and Department of Rheumatology, Medical Faculty, University of Dusseldorf, Dusseldorf; Department of Nuclear Medicine, and Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen, Essen; Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany.C. Buchbender, MD, Department of Diagnostic and Interventional Radiology; B. Ostendorf, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; V. Ruhlmann, MD, Department of Nuclear Medicine, Medical Faculty, University of Duisburg-Essen; P. Heusch, MD; F. Miese, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; K. Beiderwellen, MD, Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen; M. Schneider, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; J. Braun, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum; G. Antoch, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; X. Baraliakos, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum
| | - Falk Miese
- From the Department of Diagnostic and Interventional Radiology, and Department of Rheumatology, Medical Faculty, University of Dusseldorf, Dusseldorf; Department of Nuclear Medicine, and Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen, Essen; Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany.C. Buchbender, MD, Department of Diagnostic and Interventional Radiology; B. Ostendorf, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; V. Ruhlmann, MD, Department of Nuclear Medicine, Medical Faculty, University of Duisburg-Essen; P. Heusch, MD; F. Miese, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; K. Beiderwellen, MD, Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen; M. Schneider, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; J. Braun, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum; G. Antoch, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; X. Baraliakos, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum
| | - Karsten Beiderwellen
- From the Department of Diagnostic and Interventional Radiology, and Department of Rheumatology, Medical Faculty, University of Dusseldorf, Dusseldorf; Department of Nuclear Medicine, and Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen, Essen; Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany.C. Buchbender, MD, Department of Diagnostic and Interventional Radiology; B. Ostendorf, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; V. Ruhlmann, MD, Department of Nuclear Medicine, Medical Faculty, University of Duisburg-Essen; P. Heusch, MD; F. Miese, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; K. Beiderwellen, MD, Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen; M. Schneider, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; J. Braun, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum; G. Antoch, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; X. Baraliakos, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum
| | - Matthias Schneider
- From the Department of Diagnostic and Interventional Radiology, and Department of Rheumatology, Medical Faculty, University of Dusseldorf, Dusseldorf; Department of Nuclear Medicine, and Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen, Essen; Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany.C. Buchbender, MD, Department of Diagnostic and Interventional Radiology; B. Ostendorf, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; V. Ruhlmann, MD, Department of Nuclear Medicine, Medical Faculty, University of Duisburg-Essen; P. Heusch, MD; F. Miese, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; K. Beiderwellen, MD, Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen; M. Schneider, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; J. Braun, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum; G. Antoch, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; X. Baraliakos, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum
| | - Juergen Braun
- From the Department of Diagnostic and Interventional Radiology, and Department of Rheumatology, Medical Faculty, University of Dusseldorf, Dusseldorf; Department of Nuclear Medicine, and Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen, Essen; Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany.C. Buchbender, MD, Department of Diagnostic and Interventional Radiology; B. Ostendorf, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; V. Ruhlmann, MD, Department of Nuclear Medicine, Medical Faculty, University of Duisburg-Essen; P. Heusch, MD; F. Miese, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; K. Beiderwellen, MD, Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen; M. Schneider, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; J. Braun, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum; G. Antoch, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; X. Baraliakos, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum
| | - Gerald Antoch
- From the Department of Diagnostic and Interventional Radiology, and Department of Rheumatology, Medical Faculty, University of Dusseldorf, Dusseldorf; Department of Nuclear Medicine, and Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen, Essen; Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany.C. Buchbender, MD, Department of Diagnostic and Interventional Radiology; B. Ostendorf, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; V. Ruhlmann, MD, Department of Nuclear Medicine, Medical Faculty, University of Duisburg-Essen; P. Heusch, MD; F. Miese, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; K. Beiderwellen, MD, Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen; M. Schneider, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; J. Braun, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum; G. Antoch, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; X. Baraliakos, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum
| | - Xenofon Baraliakos
- From the Department of Diagnostic and Interventional Radiology, and Department of Rheumatology, Medical Faculty, University of Dusseldorf, Dusseldorf; Department of Nuclear Medicine, and Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen, Essen; Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany.C. Buchbender, MD, Department of Diagnostic and Interventional Radiology; B. Ostendorf, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; V. Ruhlmann, MD, Department of Nuclear Medicine, Medical Faculty, University of Duisburg-Essen; P. Heusch, MD; F. Miese, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; K. Beiderwellen, MD, Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University of Duisburg-Essen; M. Schneider, MD, Department of Rheumatology, Medical Faculty, University of Dusseldorf; J. Braun, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum; G. Antoch, MD, Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf; X. Baraliakos, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum.
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Sewerin P, Schleich C, Müller-Lutz A, Sengewein R, Antoch G, Brinks R, Miese F, Schneider M, Ostendorf B. AB1081 Glycosaminoglycan Chemical Exchange Saturation Transfer (Gagcest) of Lumbar Intervertebral Discs in Patients with Axial Spondyloarthritis: Leads Inflammation to Local Gag-Lost? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sewerin P, Brinks R, Schleich C, Miese F, Vordenbäumen S, Klein S, Antoch G, Schneider M, Ostendorf B. FRI0028 Gazing into the Crystal Ball? Prospective MRI Score to Predict Negative Eular-Response in Patients with Rheumatoid Arthritis (RA) Before Therapy-Escalation to a Biological Therapy. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lyle G, Bryan BA, Ostendorf B. Identifying the spatial and temporal variability of economic opportunity costs to promote the adoption of alternative land uses in grain growing agricultural areas: an Australian example. J Environ Manage 2015; 155:123-135. [PMID: 25836353 DOI: 10.1016/j.jenvman.2015.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 12/18/2014] [Accepted: 02/08/2015] [Indexed: 06/04/2023]
Abstract
Grain growers face many future challenges requiring them to adapt their land uses to changing economic, social and environmental conditions. To understand where to make on ground changes without significant negative financial repercussions, high resolution information on income generation over time is required. We propose a methodology which utilises high resolution yield data collected with precision agriculture (PA) technology, gross margin financial analysis and a temporal standardisation technique to highlight the spatial and temporal consistency of farm income. On three neighbouring farms in Western Australia, we found non-linear relationships between income and area. Spatio-temporal analysis on one farm over varying seasons found that between 37 and 49% (1082-1433ha) of cropping area consistently produced above the selected income thresholds and 43-32% (936-1257ha) regularly produced below selected thresholds. Around 20% of area showed inconsistent temporal variation in income generation. Income estimated from these areas represents the income forgone if a land use change is undertaken (the economic opportunity cost) and the average costs varied spatially from $190±114/ha to $560±108/ha depending on what scenario was chosen. The interaction over space and time showed the clustering of areas with similar values at a resolution where growers make input decisions. This new evidence suggests that farm area could be managed with two strategies: (a) one that maximises grain output using PA management in temporally stable areas which generate moderate to high income returns and (b) one that proposes land use change in low and inconsistent income returning areas where the financial returns from an alternative land use may be comparable. The adoption of these strategies can help growers meet the demand for agricultural output and offer income diversity and adaptive capacity to deal with the future challenges to agricultural production.
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Affiliation(s)
- G Lyle
- Landscape Science, School of Earth and Environmental Sciences, The University of Adelaide, PMB 1, Glen Osmond, SA, 5064, Australia.
| | - B A Bryan
- CSIRO Sustainable Ecosystems, PMB 2, Glen Osmond, SA, 5064, Australia
| | - B Ostendorf
- Landscape Science, School of Earth and Environmental Sciences, The University of Adelaide, PMB 1, Glen Osmond, SA, 5064, Australia
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Chehab G, Richter J, Sander O, Fischer-Betz R, Ostendorf B, Al-Neyadi T, Vordenbäumen S, Acar H, Brinks R, Schneider M. Validation and evaluation of the German version of the Systemic Lupus Activity Questionnaire (SLAQ). Clin Exp Rheumatol 2015; 33:354-359. [PMID: 25797042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 01/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Disease activity accounts for damage, overall mortality and co-morbidities in SLE and should frequently be assessed to adapt therapeutic patient management. The Systemic Lupus Activity Questionnaire (SLAQ) is a patient-reported instrument for the assessment of disease activity derived from the Systemic Lupus Erythematosus Activity Measure (SLAM) and was originally developed in English. Our aim was to validate the SLAQ in German and evaluate its use in a large cohort. METHODS We translated and adapted the SLAQ questionnaire in German. It was applied to SLE outpatients at a tertiary centre (n=328) and compared to the SLAMnolab and other SLE outcome parameters. Internal consistency, criterion validity, inter-rater and test-retest reliability as well as construct validity were examined. Correlation, Cronbach's alpha, Mann-Whitney U-test or the Kruskal-Wallis one-way analysis of variance test were ascertained where appropriate. Levels of statistical significance were defined at 5% (p<0.05). All reported p-values are two-tailed. RESULTS The German SLAQ showed a comparable strong correlation with the SLAMnolab (r=0.632, p<0.0001) as the original version of the SLAQ and presented a good to excellent internal consistency reliability (Cronbach's alpha=0.89). Accrued damage as well as low disease activity are factors possibly influencing the score. Amongst others, scores were higher in patients with more reported flares, lower self-reported overall health, lower functional status and higher daily doses of prednisolone. CONCLUSIONS Our German version of the SLAQ shows a comparable validity as the original SLAQ and is a promising instrument to survey disease activity in clinical routine as well as in clinical and epidemiological studies. Possible interacting factors need to be considered when applying.
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Affiliation(s)
- Gamal Chehab
- Policlinic of Rheumatology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Jutta Richter
- Policlinic of Rheumatology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Oliver Sander
- Policlinic of Rheumatology, Heinrich-Heine-University, Düsseldorf, Germany
| | | | - Benedikt Ostendorf
- Policlinic of Rheumatology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Tareq Al-Neyadi
- Policlinic of Rheumatology, Heinrich-Heine-University, Düsseldorf, Germany
| | | | - Hasan Acar
- Policlinic of Rheumatology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Ralph Brinks
- Policlinic of Rheumatology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Matthias Schneider
- Policlinic of Rheumatology, Heinrich-Heine-University, Düsseldorf, Germany
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Schleich C, Müller-Lutz A, Schmitt B, Aissa J, Sewerin P, Sengewein R, Ostendorf B, Antoch G, Miese F. Verringerung des Glykosaminoglykangehalts der Bandscheibe bei axialer Spondyloarthritis. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Schleich C, Müller-Lutz A, Aissa J, Sewerin P, Ostendorf B, Schneider M, Buchbender C, Antoch G, Miese F. Entzündungsaktivität und Knorpelqualität in Fingergelenken bei rheumatoider Arthritis. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Schleich C, Müller-Lutz A, Sewerin P, Ostendorf B, Buchbender C, Schneider M, Antoch G, Miese F. Intra-individual assessment of inflammatory severity and cartilage composition of finger joints in rheumatoid arthritis. Skeletal Radiol 2015; 44:513-8. [PMID: 25367672 DOI: 10.1007/s00256-014-2045-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 09/22/2014] [Accepted: 10/17/2014] [Indexed: 02/02/2023]
Abstract
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.
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Affiliation(s)
- C Schleich
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany
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Schleich C, Müller-Lutz A, Matuschke F, Sewerin P, Sengewein R, Schmitt B, Ostendorf B, Wittsack HJ, Stanke K, Antoch G, Miese F. Glycosaminoglycan chemical exchange saturation transfer of lumbar intervertebral discs in patients with spondyloarthritis. J Magn Reson Imaging 2015; 42:1057-63. [PMID: 25758361 DOI: 10.1002/jmri.24877] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 02/10/2015] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To assess glycosaminoglycan (GAG) content of lumbar intervertebral discs (IVD) in patients with spondyloarthritis (SpA) using glycosaminoglycan chemical exchange saturation transfer (gagCEST). MATERIALS AND METHODS Ninety lumbar intervertebral discs of nine patients with SpA and nine age-matched healthy controls (eight patients with ankylosing spondylitis; one patient with spondylitis related to inflammatory bowel disease; mean age: 44.1 ± 14.0 years; range: 27-72 years) were examined with a 3T magnetic resonance imaging (MRI) scanner in this prospective study. The MRI protocol included standard morphological, sagittal T2 -weighted (T2 w) images to assess Pfirrmann score of the five lumbar IVDs (L1 to S1) and biochemical imaging with gagCEST to calculate a region of interest analysis of nucleus pulposus (NP) and annulus fibrosus (AF). Prior to statistical testing of gagCEST effects (MTRasym values in percent) in patients and controls, IVDs were classified according to the Pfirrmann score. RESULTS Significantly lower gagCEST values of NP and AF were found in SpA patients compared with healthy volunteers (NP: 1.41% ± 0.41%, P = 0.001; 95% confidence interval, CI [0.600%-2.226%]; AF: 1.19% ± 0.32%, P < 0.001; CI [0.560%-1.822%]) by comparing the differences of the means. Pooled nondegenerative IVDs (Pfirrmann 1 and 2) had significantly lower gagCEST effects in patients suffering from SpA compared with healthy controls in NP (P < 0.001; CI [1.176%-2.337%]) and AF (P < 0.001; CI [0.858%-1.779%]). No significant difference of MTRasym values was found in degenerative IVDs between patients and controls in NP (P = 0.204; CI [-0.504%-2.170%]). CONCLUSION GagCEST analysis of morphologically nondegenerative IVDs (Pfirrmann score 1 and 2) in T2 w images demonstrated significantly lower GAG values in patients with spondyloarthritis in NP and AF, possibly representing a depletion of GAG in spondyloarthritis in the absence of morphologic degeneration.
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Affiliation(s)
- Christoph Schleich
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
| | - Anja Müller-Lutz
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
| | - Felix Matuschke
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
| | - Philipp Sewerin
- Univiversity Dusseldorf, Medical Faculty, Department of Rheumatology, Dusseldorf, Germany
| | - Ruben Sengewein
- Univiversity Dusseldorf, Medical Faculty, Department of Rheumatology, Dusseldorf, Germany
| | - Benjamin Schmitt
- Siemens Ltd. Australia, Healthcare Sector, Macquarie Park, NSW, Australia
| | - Benedikt Ostendorf
- Univiversity Dusseldorf, Medical Faculty, Department of Rheumatology, Dusseldorf, Germany
| | - Hans-Jörg Wittsack
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
| | - Karolin Stanke
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
| | - Gerald Antoch
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
| | - Falk Miese
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany
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Schleich C, Buchbender C, Sewerin P, Miese F, Aissa J, Brinks R, Schneider M, Antoch G, Ostendorf B. Evaluation of a simplified version of the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) comprising 5 joints (RAMRIS5). Clin Exp Rheumatol 2015; 33:209-215. [PMID: 25664925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 12/01/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES The objective of this study was to evaluate a simplified version of the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) reduced to five joints of the hand (RAMRIS5). METHODS 94 patients with rheumatoid arthritis (62 female; age 59±12 years, range 25-83 years; disease duration 60±90 months (median: 22 months, first quartile: 7 months, third quartile: 66 months) from the REMISSION PLUS study cohort who had complete files on C-reactive protein (CRP) levels and Disease Activity Score of 28 joints (DAS28) and complete MRI of the clinical dominant hand at baseline and after one year under anti-rheumatic therapy (follow-up time 12.5±1.1 months) in a dedicated extremity MRI scanner at 0.2T were included in this retrospective study. RESULTS There was a strong correlation between RAMRIS5 and the RAMRIS sum-score for all patients (r=0.87, p<0.001) at baseline and follow-up (r=0.87, p<0.001). Among the subscores there was a significant correlation between RAMRIS5 and RAMRIS-MCP (baseline: r=0.66, p<0.001; follow-up: r=0.74, p<0.001) as well as between RAMRIS5 and RAMRIS-wrist (baseline: r=0.72, p<0.001, follow-up: r=0.69, p<0.001) at baseline and follow-up. CONCLUSIONS RAMRIS5, a modified shorter RAMRIS score based on five joints of the hand is a viable tool for semi-quantitative assessment of joint damage in RA. This abbreviated score might reduce the time needed for image analysis in MRI-controlled studies in RA and might facilitate the use of MRI in studies on therapy response assessment in RA.
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Affiliation(s)
- Christoph Schleich
- Department of Diagnostic and Interventional Radiology, University of Dusseldorf, Medical Faculty, Dusseldorf, Germany
| | - Christian Buchbender
- Department of Diagnostic and Interventional Radiology, University of Dusseldorf, Medical Faculty, Dusseldorf, Germany
| | - Philipp Sewerin
- Department of Rheumatology, University of Dusseldorf, Medical Faculty, Dusseldorf, Germany
| | - Falk Miese
- Department of Diagnostic and Interventional Radiology, University of Dusseldorf, Medical Faculty, Dusseldorf, Germany
| | - Joel Aissa
- Department of Diagnostic and Interventional Radiology, University of Dusseldorf, Medical Faculty, Dusseldorf, Germany
| | - Ralph Brinks
- Institute of Biometry and Epidemiology, German Diabetes Centre, Dusseldorf, Germany
| | - Matthias Schneider
- Department of Rheumatology, University of Dusseldorf, Medical Faculty, Dusseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, University of Dusseldorf, Medical Faculty, Dusseldorf, Germany
| | - Benedikt Ostendorf
- Department of Rheumatology, University of Dusseldorf, Medical Faculty, Dusseldorf, Germany
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Vordenbäumen S, Schleich C, Lögters T, Sewerin P, Bleck E, Pauly T, Müller-Lutz A, Antoch G, Schneider M, Miese F, Ostendorf B. Dynamic contrast-enhanced magnetic resonance imaging of metacarpophalangeal joints reflects histological signs of synovitis in rheumatoid arthritis. Arthritis Res Ther 2014; 16:452. [PMID: 25270553 PMCID: PMC4201730 DOI: 10.1186/s13075-014-0452-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 09/04/2014] [Indexed: 12/29/2022] Open
Abstract
Introduction Synovial inflammation and joint destruction in rheumatoid arthritis (RA) may progress despite clinical remission. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is increasingly used to detect synovial inflammation in RA. Although small joints such as metacarpophalangeal (MCP) joints are mainly affected by RA, MRI findings have never been directly compared to histological synovitis in MCP synovial tissue. The objective of the current study was therefore to analyse if DCE-MRI relates to histological signs of synovitis small RA joints. Methods In 9 RA patients, DCE-MRI (3 Tesla, dynamic 2D T1 weighted turbo-flash sequence) of the hand was performed prior to arthroscopically-guided synovial biopsies from the second MCP of the imaged hand. Maximum enhancement (ME), rate of early enhancement, and maximum rate of enhancement were assessed in the MCP. Synovial biopsies were stained for determination of sublining CD68 and the Synovitis Score. Correlations between MRI and histological data were calculated according to Spearman. Results ME of the MCP significantly correlated to sublining CD68 staining (r = 0.750, P = 0.02), the Synovitis Score (r = 0.743, P = 0.02), and the subscores for lining layer hypertrophy (r = 0.789, P = 0.01) and cellular density (r = 0.842; P = 0.004). Conclusions Perfusion imaging of synovial tissue in RA finger joints employing DCE-MRI reflects histological synovial inflammation. According to our study, ME is the most closely associated parameter amongst the measures considered.
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Abstract
Modern imaging procedures play an import role in diagnostic and therapy-control in rheumatic diseases. Reasons are the continuous development, the evaluation and the implementation in local / international guidelines and classification criteria. According to new therapeutic goals and the aim of clinical and radiological remission the early diagnosis and sufficient therapy-control is unalterable. The ultrasound is today an inherent tool in the early diagnosis of joint- and vascular diseases and is used comprehensively in rheumatic diseases. Beside the highly sensitive detection of inflammation the MRI might depict bone erosions and bone marrow oedema, which is highly predictive for the development of erosions, clearly earlier than conventional x-rays. Due to its advantages the MRI is used frequently in the early diagnosis of spondyloarthritis (ASAS-guidelines). Moreover the capillary microscopy is - due to the rapid performance, the absence of radiation and the high sensitivity - applied in the early diagnosis and therapy-control of connective tissue diseases (e.g systemic sclerosis). New innovative imaging technics find increasing acceptance in the diagnostic algorithm in rheumatic disease. Hence the DECT can detect monosodium urate (MSU) crystals without the need of a joint puncture. Hybrid imaging technics like PET-CT / PET-MRI combine the high sensitivity of the PET and the accurate solution of the CT / MRI. These advantages lead to increasing importance in diagnostic imaging.
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Affiliation(s)
- P Sewerin
- Poliklinik für Rheumatologie, Medizinische Fakultät, Heinrich-Heine Universität Düsseldorf
| | - B Ostendorf
- Poliklinik für Rheumatologie, Medizinische Fakultät, Heinrich-Heine Universität Düsseldorf
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Baraliakos X, Buchbender C, Ostendorf B, Hartung V, Heusch P, Beiderweilen K, Schneider M, Antoch G, Braun J. OP0049 Conventional Magnetic Resonance Imaging (MR), Hybrid 18F-Fluoride Positron Emission Tomography MRI (18F-F- PET/MRI) and Computer Tomography of the Spine – A Detailed Description of Pathologic Signals in Patients with Active Ankylosing Spondylitis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.6089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sewerin P, Vordenbäumen S, Brinks R, Liedmann A, Ohrndorf S, Backhaus M, Sander O, Kümmel M, Schneider M, Ostendorf B. AB1004 Inter-Rater Reliability of the US-7 Score in A Population of Volunteers: is A Post-Hoc Analysis of Still Images Comparable to the Dynamic Analysis? Results from the “Rheuma-Truck” Cohort. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sewerin P, Vordenbäumen S, Brinks R, Liedmann A, Ohrndorf S, Backhaus M, Sander O, Kümmel M, Schneider M, Ostendorf B. AB1003 Is the Ultrasound Score Based on 7 Joints (US-7 SCORE) A Valid Screening Tool for Inflammatory Joint-Diseases in A Population of Volunteers? Results from the “Rheuma-Truck” Cohort. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Buchbender C, Baraliakos X, Ostendorf B, Heusch P, Hartung V, Beiderwellen K, Braun J, Antoch G. Hybride 18F-Fluorid Positronenemissionstomografie und Magnetresonanztomografie (18F-Fluorid-PET/MRT) der Wirbelsäule bei Patienten mit axialer Spondylarthritis – eine Pilotstudie. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Schleich C, Christian B, Nowak C, Kröpil P, Lanzman R, Wittsack HJ, Sewerin P, Aissa J, Schneider M, Ostendorf B, Scherer A, Antoch G, Miese F. Vergleich zwischen vermindertem Glykosaminoglykangehalt im Gelenkknorpel und Entzündungsaktivität der Synovia bei rheumatoider Arthritis. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sewerin P, Buchbender C, Vordenbäumen S, Scherer A, Miese F, Brinks R, Wittsack HJ, Klein S, Schneider M, Antoch G, Ostendorf B. Advantages of a combined rheumatoid arthritis magnetic resonance imaging score (RAMRIS) for hand and feet: does the RAMRIS of the hand alone underestimate disease activity and progression? BMC Musculoskelet Disord 2014; 15:104. [PMID: 24669889 PMCID: PMC3974414 DOI: 10.1186/1471-2474-15-104] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 03/21/2014] [Indexed: 12/03/2022] Open
Abstract
Background To evaluate a combined rheumatoid arthritis magnetic resonance imaging score (RAMRIS) for hand and foot (HaF-score) in rheumatoid arthritis (RA). Methods Magnetic resonance imaging (MRI, 0.2 Tesla) of the dominant hand and foot of 26 ACPA positive RA patients before and 6 months after initiation of methotrexate was obtained. RAMRIS of the hand was complemented by corresponding scoring of the foot (MTP I-V; HaF-score). Disease Activity Score 28 (DAS28) and a tender and swollen joint count (JC) of the joints scored in MRI were recorded. Changes in these scores (Δ) were assessed. Results ΔHaF-score correlated significantly with ΔDAS28 (r = 0.820, 95%-CI 0.633-0.916). Correlations to ΔDAS28 were best for changes in the synovitis subscore (0.648) and bone marrow edema (0.703). Correlations to ΔDAS28 were significantly better for of the ΔHaF-score than ΔRAMRIS (0.499, 0.139-0.743, p = 0.0368). All patients with at least moderate response (EULAR criteria, n = 11) had continuing disease activity on MRI, including five cases with new erosions, three of them at the feet. Improvements of the hand JC or foot JC were seen in 16 and 15 cases, respectively. However, MRI of the hand or feet improved in only 10 and 9 cases, respectively. No patient fulfilled SDAI remission criteria. Conclusions The HaF-score identifies patients with continuing disease activity despite clinical response that would have been missed by consideration of the traditional RAMRIS or the DAS28 alone. Response as opposed to remission may be an insufficient goal in RA as all patients showed continuing disease activity, especially at the feet.
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Affiliation(s)
- Philipp Sewerin
- Department of Rheumatology, Univ Duesseldorf, Medical Faculty, Moorenstrasse 5, Duesseldorf D-40225, Germany.
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Marshall VM, Lewis MM, Ostendorf B. Detecting new Buffel grass infestations in Australian arid lands: evaluation of methods using high-resolution multispectral imagery and aerial photography. Environ Monit Assess 2014; 186:1689-1703. [PMID: 24234223 PMCID: PMC3902193 DOI: 10.1007/s10661-013-3486-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 09/30/2013] [Indexed: 06/02/2023]
Abstract
We assess the feasibility of using airborne imagery for Buffel grass detection in Australian arid lands and evaluate four commonly used image classification techniques (visual estimate, manual digitisation, unsupervised classification and normalised difference vegetation index (NDVI) thresholding) for their suitability to this purpose. Colour digital aerial photography captured at approximately 5 cm of ground sample distance (GSD) and four-band (visible–near-infrared) multispectral imagery (25 cm GSD) were acquired (14 February 2012) across overlapping subsets of our study site. In the field, Buffel grass projected cover estimates were collected for quadrates (10 m diameter), which were subsequently used to evaluate the four image classification techniques. Buffel grass was found to be widespread throughout our study site; it was particularly prevalent in riparian land systems and alluvial plains. On hill slopes, Buffel grass was often present in depressions, valleys and crevices of rock outcrops, but the spread appeared to be dependent on soil type and vegetation communities. Visual cover estimates performed best (r 2 0.39), and pixel-based classifiers (unsupervised classification and NDVI thresholding) performed worst (r 2 0.21). Manual digitising consistently underrepresented Buffel grass cover compared with field- and image-based visual cover estimates; we did not find the labours of digitising rewarding. Our recommendation for regional documentation of new infestation of Buffel grass is to acquire ultra-high-resolution aerial photography and have a trained observer score cover against visual standards and use the scored sites to interpolate density across the region.
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Affiliation(s)
- V. M. Marshall
- School of Earth and Environmental Science, The University of Adelaide, Glen Osmond, South Australia Australia
| | - M. M. Lewis
- School of Earth and Environmental Science, The University of Adelaide, Glen Osmond, South Australia Australia
| | - B. Ostendorf
- School of Earth and Environmental Science, The University of Adelaide, Glen Osmond, South Australia Australia
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Vordenbäumen S, Sewerin P, Lögters T, Miese F, Schleich C, Bleck E, Philippski P, Schädel-Höpfner M, Pauly T, Schneider M, Ostendorf B. Inflammation and vascularisation markers of arthroscopically-guided finger joint synovial biospies reflect global disease activity in rheumatoid arthritis. Clin Exp Rheumatol 2014; 32:117-120. [PMID: 24387883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 10/09/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To analyse whether synovial markers of the clinically dominant metacarpophalangeal (MCP) joint reflect global disease activity measures in rheumatoid arthritis (RA). METHODS Arthroscopically-guided synovial biopsies from the dominant metacarpophalangeal (MCP) joint of 10 patients with RA (DAS28 >3.2) were stained for determination of the synovitis score, CD68, vascular endothelial growth factor (VEGF), hypoxia-inducible factor 1α (HIF-1α). MRI and ultrasound were used to calculate the RAMRIS and US7 score respectively. Arthroscopy of the same joint was repeated in 6 patients after 6 months. RESULTS The synovitis score significantly correlated to DAS28 (Spearman r=0.74), CRP (r=0.69), and US7 (r=0.66); sublining CD68 macrophages to CRP (r=0.6); HIF-1α to DAS28 (r=0.77), CRP (r=0.73); and VEGF to DAS28 (r=0.753) and RAMRIS (r=0.663). All patients showed a reduction of the DAS28 after 6 months (mean±SD: 5.2±1.5 vs. 2.75±1.1; p<0.05). There were three patients with a good EULAR response, and only these showed declining sublining CD68 macrophages in the control biopsy (χ2 test: LR 8.3, p=0.05). Two of the remaining patients with increasing CD68 sublining macrophages showed a deterioration of the RAMRIS. CONCLUSIONS Some histological findings in arthroscopically-guided biopsies of the dominantly affected MCP joint reflect global disease activity measures and their changes in RA patients. Moreover, repeated MCP synovial biopsy may distinguish true responders from individuals with residual disease activity, who are not readily recognized by clinical means.
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Budde PI, Ostendorf B, Lueking A, von Darl M, Sörgel A, Theek C, Goehler H, Schwermann J, Gamer M, Marquardt K, Telaar A, Chamrad D, Vordenbäumen S, Schulz-Knappe P, Schneider M. AB0746 Diagnostic autoantibody signatures of rheumatoid arthritis patients identified with a bead-based assay approach. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.3068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ostendorf B. SP0128 Cutting edge molecular imaging techniques for inflammation. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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