Quantifying Bone Marrow Edema in the Rheumatoid Cervical Spine Using Magnetic Resonance Imaging

Suppiah, Ravi; Doyle, Anthony; Rai, Raylynne; Dalbeth, Nicola; Lobo, Maria; Braun, Jürgen; McQueen, Fiona

doi:10.3899/jrheum.091299

Cited by 11 publications

(6 citation statements)

References 18 publications

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“…STIR hyperintense edema can also be caused, for instance, by primary inflammatory conditions, excessive functional (occlusal) stress, chronic inflammation, or previous endodontic or surgical treatment. [ 14 , 15 ] For our study, we excluded patients who underwent surgery < 12 months before the first scan. However, at some sites, occlusal forces associated with primary or secondary malposition of teeth might have been at least partially responsible for the manifestation of osseous edema.…”

Section: Discussionmentioning

confidence: 99%

MRI-detected intraosseous bone marrow edema recedes after effective therapy of periodontitis

Schwarting,

Probst,

Griesbauer

et al. 2023

Eur Radiol

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Objectives T2 STIR MRI sequences can detect preclinical changes associated with periodontal inflammation, i.e. intraosseous edema in the tooth-supporting bone. In this study, we assessed whether MRI can be used for monitoring periodontal disease. Material and methods In a prospective cohort study, we examined 35 patients with periodontitis between 10/2018 and 04/2019 by using 3D isotropic T2-weighted short tau inversion recovery (STIR) and Fast Field Echo T1-weighted Black bone sequences. All patients received standardized clinical exams before and three months after non-surgical periodontal therapy. Bone marrow edema extent was quantified in the STIR sequence at 922 sites before and after treatment. Results were compared with standard clinical findings. Non-parametric statistical analysis was performed. Results Non-surgical periodontal treatment caused significant improvement in mean probing depth (p < 0.001) and frequency of bleeding on probing (p < 0.001). The mean depth of osseous edema per site was reduced from a median [IQR] of 2 [1, 3] mm at baseline to 1 [0, 3] mm, (p < 0.001). Periodontal treatment reduced the frequency of sites with edema from 35 to 24% (p < 0.01). Conclusion The decrease of periodontal bone marrow edema, as observed with T2 STIR MR imaging, is indicative of successful periodontal healing. Clinical relevance statement T2 STIR hyperintense bone marrow edema in the periodontal bone decreases after treatment and can therefore be used to evaluate treatment success. Furthermore, MRI reveals new options to depict hidden aspects of periodontitis. Key Points • T2 STIR hyperintense periodontal intraosseous edema was prospectively investigated in 35 patients with periodontitis before and after treatment and compared to clinical outcomes. • The frequency of affected sites was reduced from 35 to 24% (p < 0.001), and mean edema depth was reduced from a median [IQR] of 2 [1, 3] mm at baseline to 1 [0, 3] mm 3 months after treatment. (p < 0.001). • T2 STIR sequences can be used to monitor the posttreatment course of periodontitis.

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Section: Discussionmentioning

confidence: 99%

MRI-detected intraosseous bone marrow edema recedes after effective therapy of periodontitis

Schwarting,

Probst,

Griesbauer

et al. 2023

Eur Radiol

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“…Secondly, although RADAI, which was used for the assessment of disease activity, is an index correlating with Disease Activity Score in 28 joints, its association with bone destruction is controversial. 33 For this reason, we did not evaluate the relationship of RADAI and bone destruction markers.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Various Factors Leading to Osteolytic and Antiosteolytic Effects in Patients With Rheumatoid Arthritis

et al. 2015

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Objectives:This study aims to evaluate the biomarkers of bone formation and resorption to determine the mechanism of bone deformities in patients with rheumatoid arthritis (RA). Patients and methods: Thirty patients (9 males, 21 females; mean age, 51.5 years; range 23 to 73 years) with RA and 19 healthy individuals (7 males, 12 females; mean age 51 years; range 24 to 61 years) were included in this study. Patients with RA were subgrouped according to disease activity (active, n=21, mean age 53.0; range 37 to 73 years; inactive, n=9, mean age 46.0; range 23 to 62 years). Levels of receptor activator of nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG), tartrate-resistant acid phosphatase-5b, tumor necrosis factor-alpha (TNF-α), cathepsin-K, and activity of matrix metalloproteinase-3 (MMP-3) were measured in patient and control groups with enzyme-linked immunosorbent assay method. Results: Levels of RANKL, OPG, cathepsin-K, TNF-α and MMP-3 activities of the patients were significantly higher when compared with the controls (p<0.05). A comparison of the active and inactive patients with RA revealed that OPG levels and MMP-3 activities were significantly higher in active group than inactives (p<0.05), while there was no significant difference in TNF-α, RANKL levels, and tartrate-resistant acid phosphatase-5b and cathepsin-K activities between two groups (p>0.05). Conclusion: Increased RANKL, OPG, TNF-α, cathepsin-K levels and MMP-3 activities in RA patients demonstrated that these parameters are related to bone deformities which occur in the process of RA. Widespread use of these parameters may be beneficial for the early diagnosis and effective treatment of RA and similar diseases resulting in bone deformities in the future.Keywords: Cathepsin-K; matrix metalloproteinase-3; receptor activator of nuclear factor kappa B ligand; rheumatoid arthritis; tumor necrosis factor alpha.Rheumatoid arthritis (RA) is a common chronic autoimmune disorder characterized by synovial inflammation. Bone loss in the inflamed joints occurs in the early stage of the disease, followed by the destruction of articular cartilage and bones.

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“…Die MRT ist die Methode der Wahl, um eine Entzündung oder eine Myelopathie im Bereich der Wirbelsäule zu diagnostizieren [1,19], aber auch eine anteriore atlantoaxiale oder eine subaxiale Subluxation bzw. eine atlantoaxiale Kompression können so nachgewiesen werden [18,20]. Im Vergleich bildgebender Verfahren stellt die MRT die sensitivste Methode zur Detektion von Pannusbildung und Denserosionen dar, atypische Rotationen und laterale atlantoaxiale Dislokationen kommen am besten in der CT zur Darstellung und anteriore Luxationen im konventionellen Röntgen der HWS in Inklination [18].…”

Section: Diskussionunclassified

Atlantoaxiale Arthritis mit entzündlichem Nackenschmerz als Erstmanifestation einer seronegativen rheumatoiden Arthritis

Haeusler

Dybowski

Wittkaemper

et al. 2010

Dtsch med Wochenschr

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Quantifying Bone Marrow Edema in the Rheumatoid Cervical Spine Using Magnetic Resonance Imaging

Cited by 11 publications

References 18 publications

MRI-detected intraosseous bone marrow edema recedes after effective therapy of periodontitis

MRI-detected intraosseous bone marrow edema recedes after effective therapy of periodontitis

Evaluation of Various Factors Leading to Osteolytic and Antiosteolytic Effects in Patients With Rheumatoid Arthritis

Atlantoaxiale Arthritis mit entzündlichem Nackenschmerz als Erstmanifestation einer seronegativen rheumatoiden Arthritis

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