Ontology type: schema:ScholarlyArticle Open Access: True
2014-03-26
AUTHORSPhilipp Sewerin, Christian Buchbender, Stefan Vordenbäumen, Axel Scherer, Falk Miese, Ralph Brinks, Hans-Joerg Wittsack, Sabine Klein, Matthias Schneider, Gerald Antoch, Benedikt Ostendorf
ABSTRACTBackgroundTo evaluate a combined rheumatoid arthritis magnetic resonance imaging score (RAMRIS) for hand and foot (HaF-score) in rheumatoid arthritis (RA).MethodsMagnetic 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.ResultsΔHaF-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.ConclusionsThe 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. More... »
PAGES104
http://scigraph.springernature.com/pub.10.1186/1471-2474-15-104
DOIhttp://dx.doi.org/10.1186/1471-2474-15-104
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PUBMEDhttps://www.ncbi.nlm.nih.gov/pubmed/24669889
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