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BackgroundAlthough one study showed minimal progression of erosions in patients with rheumatoid arthritis (RA) one year after TNFα inhibition therapy, no studies have investigated very early bone changes after initiation of anti-TNFα treatment. We investigated the effects of 3-month anti-TNFα treatment on bone erosion progression and bone microarchitecture in RA patients using high-resolution peripheral quantitative computed tomography (HR-pQCT).MethodsPatients with RA (n = 27) (17 in the anti-TNFα and 10 in the MTX-only group) underwent assessment of disease activity score in 28 joints (DAS-28), radiographs, 3-T magnetic resonance imaging (MRI) and HR-pQCT of metacarpophalangeal and wrist joints at baseline and 3 months. HR-pQCT-derived erosion volume, joint volume/width and bone microarchitecture were computed and joint destruction was assessed using Sharp and RAMRIS scorings on radiographs and MRI, respectively.ResultsOverall, 73 erosions were identified by HR-pQCT at baseline. Over 3 months, the anti-TNFα group had decreased mean erosion volume; increased erosion volume was observed in one clinical non-responder. The MTX-only group in contrast, trended toward increasing erosion volume despite low disease activity. In the anti-TNFα group, joint-space width and volume of MCP joints decreased significantly and was positively correlated with erosion volume changes (R 2 = 0.311, p = 0.013; R 2 = 0.527, p = 0.003, respectively). In addition, erosion volume changes were significantly negatively correlated with changes in trabecular bone mineral density (R 2 = 0.353, p = 0.020) in this group. We observed significant correlation between percentage change in erosion volume and change in DAS-28 erythrocyte sedimentation rate and C-reactive protein CRP scores (R 2 = 0.558, p < 0.001; R 2 = 0.745, p < 0.001, respectively) in all patients.ConclusionsUsing HR-pQCT, our data suggest that anti-TNFα treatment prevents erosion progression and deterioration of bone microarchitecture within the first 3 months of treatment, one patient not responding to treatment, had significant progression of bone erosions within this short time period. Patients with low disease activity scores (<3.2) can have continuous HR-pQCT-detectable progression of erosive disease with MTX treatment only. HR-pQCT can be a sensitive, powerful tool to quantify bone changes and monitor RA treatment short term (such as 3 months).

Objectives To investigate the association of weight change over 48 months with progression of meniscal intrasubstance degeneration (MID). Methods We studied 487 subjects with MID at baseline and after 48 months using 3-T MRI with the same protocol (FSE sequences with and without fat suppression). These participants lost weight (≥3%, n = 141), had moderate weight gain (3-10%, n = 77), substantial weight gain (>10%, n = 15) or maintained stable weight (n = 254). Progression of MID to a meniscal tear was assessed using the WORMS grading system and compared among weight change groups using logistic regression. ANOVA and chi-square tests were used to study the differences in subjects' characteristics. Results Progression of MID increased from weight loss to substantial weight gain (p < 0.001) and was significantly more likely with both moderate weight gain (odds ratio [OR], 4.9; 95% confidence interval [CI] 2.4-8.9) and substantial weight gain (OR, 9.5; 95% CI 3.2-28.5) compared to stable weight. Results were similar in both menisci for moderate weight gain (medial: OR, 6.8; 95% CI 3.5-11.3; lateral: OR, 2.6; 95% CI 1.1-6.6) and substantial weight gain (medial: OR, 21.0; 95% CI 5.1-80.7; lateral: OR, 9.7; 95% CI 0.95-100.2).

Purpose: To investigate the association of the presence and severity of diabetes mellitus (DM) with articular cartilage composition, using magnetic resonance imaging (MRI)-based T 2 relaxation time measurements, and structural knee abnormalities. Materials and Methods: In the Osteoarthritis Initiative 208, participants with DM (age 63.0 6 8.9 years; 111 females) and risk factors for osteoarthritis (OA) or mild radiographic tibiofemoral OA (Kellgren-Lawrence [KL] grade 2) were identified and group-matched with 208 controls without DM (age 63.3 6 9.1 years; 111 females). Subjects with diabetes-related renal or ophthalmological complications or insulin treatment at baseline (n 5 50) were defined as severe DM. 3T MR images of the right knee were assessed for articular cartilage T 2 , including texture and laminar analyses derived from the patella, medial, and lateral femur and tibia and for structural abnormalities using the modified whole-organ magnetic resonance imaging score (WORMS). Clustered linear regression analyses were used to assess associations of DM with MRI findings. Results: DM subjects had significantly higher cartilage T 2 in the patella (mean difference 0.92 msec [95% confidence interval (CI) 0.79, 1.06]; P 5 0.001) and medial femur (mean difference 0.36 msec [95% CI 0.27, 0.81]; P 5 0.006) compared to controls. Averaged over all compartments, DM subjects showed significantly higher texture parameters (variance, P 5 0.001; contrast, P 5 0.002; entropy, P < 0.001). Subjects with severe DM additionally showed higher T 2 in the medial tibial deep and superficial layers (P 5 0.011 and P 5 0.041) compared to controls. No significant differences in cartilage, meniscus, and overall WORMS were found between the groups (P > 0.05). Conclusion: In comparison to nondiabetic controls, cartilage in DM subjects showed higher and more heterogeneous cartilage T 2 values, indicating increased articular cartilage degeneration. This affected even more compartments in subjects with severe DM. Level of Evidence: 2 Technical Efficacy: 5