Enhanced MRI in early undifferentiated oligoarthritis of the knee joints: improvements already visible after 2 months of DMARDs treatment.
To describe (1) the findings with MRI in a series of patients with early undifferentiated oligoarthritis of the knee joint(s) and (2) the early effect after 2 months of treatment with only methotrexate (MTX) and hydroxychloroquine (HCQ) as disease-modifying antirheumatic drugs (DMARDs), 15 consecutive patients with undifferentiated oligoarthritis of the knee joint(s) were recruited. The mean age was 31.7 years (SD = 8.1 years), and the mean disease duration was 15.3 months (SD = 12.2 months). In all patients, synovial fluid analysis, RF, anti-CCP2 antibodies, ANA, CRP, ESR, and routine laboratory investigations were performed. Enhanced MRI was done at initial evaluation and after 2 months treatment. Four of the 15 patients had positive RF and 6 had positive anti-CCP2. After treatment with DMARDs, a regression was seen regarding effusion and synovitis in all patients; in one of three patients, the bone edema had regressed. Synovial thickening as measured by enhanced MRI decreased significantly (p < 0.01) and correlated significantly with the improved ESR and CRP (p < 0.01). After 2 months treatment with MTX and HCQ, the MRI improved considerably especially regarding synovial thickening.
Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt. yasseremad68@yahoo.com
Yasser
Y
Emad
Yasser
Y
Ragab
Ahmed
A
Shaarawy
Hala
H
Raafat
H A
HA
El-Kiki
Johannes J
JJ
Rasker
D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001168:Arthritis / Q000188:drug therapy*; D005682:Gadolinium; D006886:Hydroxychloroquine / Q000627:therapeutic use; D007089:Image Enhancement; D007719:Knee Joint; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008727:Methotrexate / Q000627:therapeutic use; D013997:Time Factors
D018501:Antirheumatic Agents; D006886:Hydroxychloroquine; D005682:Gadolinium; D008727:Methotrexate