Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
Mod Rheumatol. 2013 Mar;23(2):254-9. doi: 10.1007/s10165-012-0646-5. Epub 2012 Jun 6.
To identify the value of magnetic resonance imaging (MRI)-proven bone edema in patients with very early rheumatoid arthritis (RA).
All of the 13 patients included in the study were positive at entry for MRI-proven bone edema of the wrist and finger joints and anti-cyclic citrullinated peptide antibodies or IgM-rheumatoid factor. A tight control approach was applied for 12 months. Plain MRI and radiographs of both wrist and finger joints were examined every 6 months. MRI was scored by the RA MRI scoring (RAMRIS) technique and plain radiographs were scored using the Genant-modified Sharp score. Variables that were correlated with plain radiographic changes at 12 months were examined.
Simplified disease activity index (SDAI) remission was achieved in 7 patients, and a significant reduction in the RAMRIS bone edema score, which declined to <33 % as compared with the baseline, was achieved in 8 out of 13 patients. Four patients showed plain radiographic progression while 9 patients did not. Significant reductions in the RAMRIS bone edema score (p = 0.007) and the time-integrated SDAI (p = 0.031) were the variables involved in plain radiographic progression.
Improvement in bone edema may be associated with protection against structural damage in very early RA patients managed using the tight control approach.
确定磁共振成像（MRI）证实的早期类风湿关节炎（RA）患者骨水肿的价值。
所有纳入研究的 13 例患者均在腕关节和手指关节 MRI 证实骨水肿和抗环瓜氨酸肽抗体或 IgM-类风湿因子阳性时进入研究。采用严格控制方法治疗 12 个月。每 6 个月检查腕关节和手指关节的平扫 MRI 和 X 线片。MRI 采用 RA MRI 评分（RAMRIS）技术评分，X 线片采用 Genant 改良 Sharp 评分评分。检查与 12 个月时 X 线片变化相关的变量。
7 例患者达到简化疾病活动指数（SDAI）缓解，13 例患者中有 8 例 RAMRIS 骨水肿评分显著降低，与基线相比降至<33%。4 例患者出现 X 线片进展，9 例患者未出现。RAMRIS 骨水肿评分（p=0.007）和时间积分 SDAI（p=0.031）的显著降低与 X 线片进展有关。
在采用严格控制方法治疗的早期 RA 患者中，骨水肿的改善可能与预防结构损伤有关。
