Rheumatoid knee: role of gadopentetate-enhanced MR imaging.

Kursunoglu-Brahme, S; Riccio, Thomas; Weisman, M H; Resnick, D; Zvaifler, Nathan J.; Sanders, ME; Fix, Catherine

doi:10.1148/radiology.176.3.2389044

Cited by 130 publications

(57 citation statements)

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“…In particular, MRI allowed differentiation of infl ammatory pannus from effusion in the knee joint when gadopentetate dimeglumin was applied for enhancement of the infl amed synovium/pannus formation [Reiser et al, 1989;König et al, 1990;Kursunoglu-Brahme et al, 1990].…”

Section: Imaging Findings In Patients With Arthritidesmentioning

confidence: 99%

Role of Magnetic Resonance Imaging in the Clinical Diagnosis of the Temporomandibular Joint

Larheim¹

2005

Cells Tissues Organs

164

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Temporomandibular joint (TMJ) abnormalities cannot be reliably assessed by a clinical examination. Magnetic resonance imaging (MRI) may depict joint abnormalities not seen with any other imaging method and thus is the best method to make a diagnostic assessment of the TMJ status. In patients with temporomandibular joint disorder (TMD) referred for diagnostic imaging the predominant TMJ finding is internal derangement related to disc displacement. This finding is significantly more frequent than in asymptomatic volunteers, and occurs in up to 80% of patients consecutively referred for TMJ imaging. Moreover, certain types of disc displacement seem to occur almost exclusively in TMD patients, namely complete disc displacements that do not reduce on mouth opening. Other intra-articular abnormalities may additionally be associated with the disc displacement, predominantly joint effusion (which means more fluid than seen in any asymptomatic volunteer) and mandibular condyle marrow abnormalities (which are not seen in volunteers). These conditions seem to be closely related. Nearly 15% of TMD patients consecutively referred for TMJ MRI will have joint effusion, of whom about 30% will show bone marrow abnormalities. In a surgically selected material of joints with histologically documented bone marrow abnormalities nearly 40% showed joint effusion. Disc displacement is mostly bilateral, but joint effusion seems to be unilateral or with a lesser amount of fluid in the contralateral joint. Abnormal bone marrow is also mostly unilateral. Many patients have unilateral pain or more pain on one side. In a regression analysis the self-reported in-patient TMJ pain side difference was positively dependent on TMJ effusion and condyle marrow abnormalities, but negatively dependent on cortical bone abnormalities. Of the joints with effusion only one fourth showed osteoarthritis. Thus, there seems to be a subgroup of TMD patients showing more severe intra-articular pathology than disc displacement alone, and mostly without osteoarthritis. It should, however, be emphasized that patients with TMJ effusion and/or abnormal bone marrow in the mandibular condyle seem to constitute only a minor portion (less than one fourth) of consecutive TMD patients referred for diagnostic TMJ imaging. The majority of patients have internal derangement related to disc displacement, but without accompanying joint abnormalities. In patients with rheumatoid arthritis and other arthritides TMJ involvement may mimick the more common TMDs. Using MRI it is possible, in most cases, to distinguish these patients from those without synovial proliferation.

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Section: Imaging Findings In Patients With Arthritidesmentioning

confidence: 99%

Role of Magnetic Resonance Imaging in the Clinical Diagnosis of the Temporomandibular Joint

Larheim¹

2005

Cells Tissues Organs

164

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“…The differentiation between joint effusion, synovitis, pannus, and subchondral sclerosis in the knee is easily made possible, and enhancement of the synovium and pannus indicate acute inflammation [2,3]. Clinically important abnormalities, such as proliferative synovitis, cartilage thinning, cartilage erosion, bone infarction and synovial invagination into bone, can easily be revealed by MRI [4].…”

Section: Introductionmentioning

confidence: 99%

NMR monitoring of rheumatoid arthritis patients receiving anti-TNF-? monoclonal antibody therapy

et al. 1997

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The aim of this study was to investigate if dynamic gadolinium-DTPA-supported magnetic resonance (MR) imaging can monitor the therapeutic effect of a fast-acting immuno-modulating drug like anti-tumour necrosis factor alpha (anti-TNF-alpha) monoclonal antibody (moab) in patients with rheumatoid arthritis (RA). Dynamic MR imaging was performed on 64 joints in a total of 18 patients before and after infusion with either a placebo or 1 or 10 mg/kg of anti-TNF-alpha moab. Additionally, treating the placebo group and reinfusing the verum group with either 3 or 10 mg/kg was monitored by quantitative nuclear magnetic resonance (NMR). Time-dependent signal intensity changes were then correlated with a total of five Paulus criteria and with ESR and C-reactive protein (CRP). No changes in either the gadolinium uptake or clinical parameters were seen after the infusion of a placebo. Therapy with 1 mg/kg anti-TNF-alpha moab resulted in a significant decrease in clinical disease activity, as well as in gadolinium-DTPA uptake in dynamic NMR studies. However, correlations between singal intensity changes and Paulus criteria were only demonstrated for the variable "doctor's evaluation of disease activity". Patients given 10 mg/kg moab demonstrated a very significant improvement in all clinical manifestations of their disease, as well as a high significant reduction in gadolinium uptake (P = 0.004). In addition, the latter group showed significant correlations between time-dependent signal intensity changes and five Paulus criteria: "number of swollen joints", "number of painful joints", "duration of morning stiffness", "doctor's evaluation of disease activity" and "patient's evaluation of disease activity". No differences and correlations were seen for ESR and CRP. We concluded that dynamic NMR studies are suitable to monitor inflammatory activity in RA patients under therapy with biological response modifiers such as anti-TNF-alpha moab.

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“…Thus, the theoretical maximum interstitial concentration after an intravenous dose of 0.3 mmol/kg, or 0.21-0.23 l/kg, would be 1.3-1.4 mmol/l (14). The intraarticular gadolinium concentration measured after intravenous administration of Gd-DTPA or Gd-DOTA 0.1 mmol/kg body weight is 0.029-0.44 mmol/l (14,(52)(53)(54). These values are lower than expected based on a uniform distribution in the extracellular space because the contrast medium is rapidly excreted by the renal system and only the synovial membrane of the joint capsule can be regarded as a diffusing tissue (14,(52)(53)(54).…”

mentioning

confidence: 99%

Comparison study of intraarticular and intravenous gadolinium-enhanced magnetic resonance imaging of cartilage in a canine model

et al. 2008

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Rheumatoid knee: role of gadopentetate-enhanced MR imaging.

Cited by 130 publications

References 0 publications

Role of Magnetic Resonance Imaging in the Clinical Diagnosis of the Temporomandibular Joint

Role of Magnetic Resonance Imaging in the Clinical Diagnosis of the Temporomandibular Joint

NMR monitoring of rheumatoid arthritis patients receiving anti-TNF-? monoclonal antibody therapy

Comparison study of intraarticular and intravenous gadolinium-enhanced magnetic resonance imaging of cartilage in a canine model

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