Active synovitis in the presence of osteitis predicts residual synovitis in patients with rheumatoid arthritis with a clinical response to treatment.
OBJECTIVE
To clarify the relationship between active synovitis/osteitis and subsequent residual synovitis (R-synovitis) in patients with rheumatoid arthritis (RA).


METHODS
Three hundred and twenty finger joints of 16 patients with active RA at baseline (Disease Activity Score with 28 joints - erythrocyte sedimentation rate > 3.2) who subsequently achieved clinical low disease activity or remission afterwards were analyzed. Synovial vascularity (SV) was assessed according to a semi-quantitative ultrasound score (grades 0-3). Active synovitis was defined by SV positivity at baseline. R-synovitis was defined by the presence of grade > 2 SV at the 24th week. Osteitis was detected by magnetic resonance imaging (MRI) at baseline as trabecular bone lesions with water content and indistinct margins.


RESULTS
Ultrasonography detected active synovitis in 116 joints at baseline. Forty-seven joints had R-synovitis at the 24th week. MRI detected osteitis in 12 joints at baseline. The presence of active synovitis with osteitis at baseline was significantly correlated with R-synovitis at the 24th week.


CONCLUSIONS
Active synovitis in the presence of osteitis predicted R-synovitis regardless of whether there was a clinical improvement in RA.
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Jun
J
Fukae
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Kazuhide
K
Tanimura
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Masato
M
Isobe
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Akemi
A
Kitano
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Mihoko
M
Henmi
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Maria
M
Nakai
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Yuko
Y
Aoki
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Fumihiko
F
Sakamoto
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Akihiro
A
Narita
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Takeya
T
Ito
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Akio
A
Mitsuzaki
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Megumi
M
Matsuhashi
Hokkaido Medical Center for Rheumatic Diseases, Sapporo, Japan.
Masato
M
Shimizu
Faculty of Health Science, Hokkaido University, Sapporo, Japan.
Tamotsu
T
Kamishima
Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Tatsuya
http://orcid.org/0000-0001-5657-962X
T
Atsumi
Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Takao
T
Koike
D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010000:Osteitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D020127:Recovery of Function; D012074:Remission Induction; D012720:Severity of Illness Index; D013585:Synovitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
D018501:Antirheumatic Agents
magnetic resonance imaging; musculoskeletal ultrasound; osteitis; rheumatoid arthritis; synovitis