title: Monitoring total-body inflammation and damage in joints and entheses: the first follow-up study of whole-body magnetic resonance imaging in rheumatoid arthritis.
abstract: OBJECTIVE
  To investigate changes in whole-body magnetic resonance imaging (WBMRI) inflammatory and structural lesions in most joints and entheses in patients with rheumatoid arthritis (RA) treated with adalimumab.
  
  
  METHODS
  WBMRI was obtained at weeks 0, 6, 16, and 52 in a 52 week follow-up study of 37 RA patients starting treatment with adalimumab. Readability and reliability of WBMRI were investigated for 76 peripheral joints, 23 discovertebral units, the sacroiliac joints, and 33 entheses. Changes in WBMRI joint and entheses counts were investigated.
  
  
  RESULTS
  The readability of peripheral and axial joints was 82-100%, being less for elbows and small joints of the feet. For entheses, 72-100% were readable, except for entheses at the anterior chest wall, elbow, knee, and plantar fascia. The intrareader agreement was high for bone marrow oedema (BMO), bone erosion (80-100%), and enthesitis (77-100%), and slightly lower for synovitis and soft tissue inflammation (50-100%). All synovitis, BMO, and soft tissue inflammation counts decreased numerically during treatment. The 26-joint synovitis WBMRI count decreased significantly during the first 16 weeks for patients with a good European League Against Rheumatism (EULAR) response (from median 6 to 4, p < 0.05), but not for patients with a moderate or no EULAR response. There were no overall changes in structural lesions.
  
  
  CONCLUSIONS
  WBMRI allows simultaneous monitoring of most axial and peripheral joints and entheses in RA patients and can visualize a decrease in inflammatory counts during treatment. This first WBMRI follow-up study of patients with RA encourages further investigation of the usefulness of WBMRI in RA.
authors.affiliation: a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark.
authors.forename: M B
authors.initials: MB
authors.lastname: Axelsen
authors.affiliation: b Department of Diagnostic Imaging, Sheba Medical Center , Tel Aviv University , Tel Giborim , Israel.
authors.forename: I
authors.initials: I
authors.lastname: Eshed
authors.affiliation: a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark.|c Department of Clinical Medicine, Faculty of Health Sciences , University of Copenhagen , Copenhagen , Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Østergaard
authors.affiliation: a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark.|c Department of Clinical Medicine, Faculty of Health Sciences , University of Copenhagen , Copenhagen , Denmark.
authors.forename: M L
authors.initials: ML
authors.lastname: Hetland
authors.affiliation: d Department of Radiology , Herlev Hospital, University of Copenhagen , Herlev , Denmark.
authors.forename: J M
authors.initials: JM
authors.lastname: Møller
authors.affiliation: e Center for Rheumatology and Spine Diseases, Nordsjællands Hospital Hillerød , University of Copenhagen , Hillerød , Denmark.
authors.forename: D V
authors.initials: DV
authors.lastname: Jensen
authors.affiliation: a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark.
authors.forename: S B
authors.initials: SB
authors.lastname: Krintel
authors.affiliation: f Center for Rheumatology and Spine Diseases , University of Copenhagen , Gentofte , Denmark.
authors.forename: M S
authors.initials: MS
authors.lastname: Hansen
authors.affiliation: a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Terslev
authors.affiliation: a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Klarlund
authors.affiliation: a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark.
authors.forename: R P
authors.initials: RP
authors.lastname: Poggenborg
authors.affiliation: d Department of Radiology , Herlev Hospital, University of Copenhagen , Herlev , Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Balding
authors.affiliation: a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark.
authors.forename: S J
authors.identifier: http://orcid.org/0000-0002-6500-9263
authors.initials: SJ
authors.lastname: Pedersen
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy; D001853:Bone Marrow / Q000000981:diagnostic imaging; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D004487:Edema / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D033023:Foot Joints / Q000000981:diagnostic imaging; D050823:Hand Joints / Q000000981:diagnostic imaging; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D007249:Inflammation; D007403:Intervertebral Disc / Q000000981:diagnostic imaging; D007596:Joints / Q000000981:diagnostic imaging*; D007719:Knee Joint / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging; D013585:Synovitis / Q000000981:diagnostic imaging*; D051598:Whole Body Imaging
chemical_list: D018501:Antirheumatic Agents; D000068879:Adalimumab