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Pezeshk P, Soldatos T, Ezzati F, Bhatnagar N, Chhabra A. Spectrum of Hand Arthritis. Magn Reson Imaging Clin N Am 2023; 31:239-253. [PMID: 37019548 DOI: 10.1016/j.mric.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Early diagnosis of arthritis is of paramount importance to slow the progression of disease and joint destruction. Because of temporal dissemination of the clinical and laboratory manifestations of the inflammatory arthritis and overlap of the findings, diagnosis can be challenging in early stages of the disease. This article highlights the utility of advanced cross-sectional imaging, including color-Doppler ultrasound, diffusion-weighted MR imaging, and perfusion MR imaging in the domain of arthropathy so that the reader can apply these principles and techniques in their practices for timely and accurate diagnosis and improved multidisciplinary communications for better management of such conditions.
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2
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Bonner BP, Yurista SR, Coll‐Font J, Chen S, Eder RA, Foster AN, Nguyen KD, Caravan P, Gale EM, Nguyen C. Contrast-Enhanced Cardiac Magnetic Resonance Imaging With a Manganese-Based Alternative to Gadolinium for Tissue Characterization of Acute Myocardial Infarction. J Am Heart Assoc 2023; 12:e026923. [PMID: 37042259 PMCID: PMC10227253 DOI: 10.1161/jaha.122.026923] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 01/05/2023] [Indexed: 04/13/2023]
Abstract
Background Late gadolinium enhancement cardiac magnetic resonance imaging is an effective and reproducible method for characterizing myocardial infarction. However, gadolinium-based contrast agents are contraindicated in patients with acute and chronic renal insufficiency. In addition, several recent studies have noted tissue deposition of free gadolinium in patients who have undergone serial contrast-enhanced magnetic resonance imaging. There is a clinical need for alternative forms of magnetic resonance imaging contrast agents that are acceptable in the setting of renal insufficiency. Methods and Results Three days after 80 minutes of ischemia/reperfusion of the left anterior descending coronary artery, cardiac magnetic resonance imaging was performed to assess myocardial lesion burden using both contrast agents. Late gadolinium enhancement cardiac magnetic resonance imaging was examined 10 and 15 minutes after contrast injection. Contrast agents were administered in alternating manner with a 2- to 3-hour washout period between contrast agent injections. Lesion evaluation and image processing were performed using Segment Medviso software. Mean infarct size and transmurality, measured using RVP-001, were not different compared with those measured using late gadolinium enhancement images. Bland-Altman analysis demonstrated a nominal bias of 0.13 mL (<1% of average total lesion volume) for RVP-001 in terms of gross infarct size measurement. Conclusions The experimental manganese-based contrast agent RVP-001 appears to be an effective agent for assessment of myocardial infarction location, size, and transmurality, and it may be useful as an alternative to gadolinium-based agents.
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Affiliation(s)
- Benjamin P. Bonner
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalBostonMA
- Louisiana State University Health Sciences CenterNew OrleansLA
| | - Salva R. Yurista
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalBostonMA
- Harvard Medical SchoolBostonMA
| | - Jaume Coll‐Font
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalBostonMA
- Harvard Medical SchoolBostonMA
| | - Shi Chen
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalBostonMA
| | - Robert A. Eder
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalBostonMA
| | - Anna N. Foster
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalBostonMA
| | - Khoi D. Nguyen
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalBostonMA
- Harvard Medical SchoolBostonMA
| | - Peter Caravan
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalBostonMA
- Harvard Medical SchoolBostonMA
| | - Eric M. Gale
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalBostonMA
- Harvard Medical SchoolBostonMA
| | - Christopher Nguyen
- Cardiovascular Research CenterMassachusetts General HospitalBostonMA
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalBostonMA
- Harvard Medical SchoolBostonMA
- Division of Health Science TechnologyHarvard–Massachusetts Institute of TechnologyCambridgeMA
- Cardiovascular Innovation Research CenterHeart, Vascular, and Thoracic Institute, Cleveland ClinicClevelandOH
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Synovitis maps for the assessment of inflammatory diseases of the hand. Eur Radiol 2011; 21:1499-508. [DOI: 10.1007/s00330-011-2078-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 12/22/2010] [Accepted: 01/11/2011] [Indexed: 10/18/2022]
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Momeni M, Brindle K. MRI for assessing erosion and joint space narrowing in inflammatory arthropathies. Ann N Y Acad Sci 2009; 1154:41-51. [PMID: 19250230 DOI: 10.1111/j.1749-6632.2009.04384.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The superior soft tissue contrast and multiplanar capability of magnetic resonance imaging has contributed to earlier diagnosis and implementation of effective treatment for a variety of arthropathies. Owing to overlapping clinical signs and symptoms, MRI plays a role in delineating the features and stages of these conditions. With the advent of disease-modifying therapies, it is important to diagnose inflammatory arthropathy as early as possible. In this chapter, we discuss the pathophysiology of bone erosion and joint space narrowing, as well as the role of MRI in the imaging of the seropositive and seronegative inflammatory arthropathies.
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Affiliation(s)
- Mahnaz Momeni
- Rheumatology Division and Department of Radiology, The George Washington University, 2150 Pennsylvania Ave NW, Washington, DC 20037, USA.
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5
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Abstract
Synovial disorders often affect the knee joint and are a common cause of morbidity. Before MR imaging, radiologists were limited in their ability to provide information about the presence or absence of synovial disease. With the advent of MR imaging, useful information can now be provided to referring clinicians, often at a time when the initiation of therapy may mitigate significantly the long-term sequelae of synovial disorders. MR imaging, owing to its superior soft-tissue contrast, is the imaging modality of choice for demonstrating and quantifying pathologic changes of the synovium. MR imaging provides invaluable information to the clinician regarding the need to either initiate or modify therapy in those patients suffering from diseases of, or affecting, the synovium.
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Simon GH, Daldrup-Link HE, Rummeny EJ. [Macrophage specific MRI imaging for antigen induced arthritides. A potential new strategy for the diagnosis of rheumatoid arthritis]. Radiologe 2007; 47:43-52. [PMID: 17221243 DOI: 10.1007/s00117-006-1453-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The present work describes the potential of iron oxides for the detection of macrophages in synovitis in experimental, antigen-induced arthritis. METHODS The pivotal role of macrophages in rheumatoid arthritis (RA) in humans and in antigen-induced arthritis (AIA) in animal models is discussed. The latter appear to be very similar in many aspects to the human RA. We show the potential for iron oxide-enhanced magnetic resonance imaging (MRI) to determine the macrophage content in the arthritic synovial membranes. The results of our own research, as well as those of other research groups, are presented and discussed. RESULTS MRI after the intravenous (i.v.) administration of iron oxides enables the depiction of macrophage content in arthritic synovial membranes in AIA through the effects of the intracellular compartmentalisation of iron oxide particles. These effects can be demonstrated in 24-h delayed images after i.v. contrast application, on T2-weighted spin-echo or turbo-spin-echo sequences, and especially on T2*-weighted gradient-echo sequences. The signal effects are not only apparent in high field strength (4.7 Tesla) but also on 1.5 Tesla clinical scanners. CONCLUSIONS AND PERSPECTIVES The use of iron oxides enables the determination of the macrophage content in synovitis in animals with AIA. This parameter represents a potential marker to determine disease activity, and possibly represents a marker to evaluate the effectiveness of specific therapies in human RA. Current knowledge of iron oxide-enhanced MRI is limited to animal models. The clinical evaluation of this new method in patients with RA has not yet been performed. However, based on the considerations presented here, significant progress in the diagnostic work-up of RA can be expected.
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Affiliation(s)
- G H Simon
- Institut für Radiologie, Technische Universität München, Klinikum rechts der Isar, München.
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Ashikyan O, Tehranzadeh J. The role of magnetic resonance imaging in the early diagnosis of rheumatoid arthritis. Top Magn Reson Imaging 2007; 18:169-76. [PMID: 17762381 DOI: 10.1097/rmr.0b013e318093f59b] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Rheumatoid arthritis (RA) is a common disease that affects 1% of the population. With the advent of disease-modifying therapies, it became particularly important to detect RA as early as possible. In this article, we discuss the role of magnetic resonance imaging (MRI) in the imaging of early RA. Imaging of soft tissues manifestations, which precede the development of osseous erosions, is discussed. We also review the role of MRI in establishing correct diagnosis in cases of arthritis, which do not demonstrate classical clinical presentation. The role of MRI in the follow-up of RA is addressed.
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Affiliation(s)
- Oganes Ashikyan
- Department of Radiological Sciences, University of California, Irvine Orange, CA 92868, USA
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Frick MA, Wenger DE, Adkins M. MR Imaging of Synovial Disorders of the Knee: An Update. Magn Reson Imaging Clin N Am 2007; 15:87-101. [PMID: 17499183 DOI: 10.1016/j.mric.2007.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Synovial disorders often affect the knee joint and are a common cause of morbidity. Before MR imaging, radiologists were limited in their ability to provide information about the presence or absence of synovial disease. With the advent of MR imaging, useful information can now be provided to referring clinicians, often at a time when the initiation of therapy may mitigate significantly the long-term sequelae of synovial disorders. MR imaging, owing to its superior soft-tissue contrast, is the imaging modality of choice for demonstrating and quantifying pathologic changes of the synovium. MR imaging provides invaluable information to the clinician regarding the need to either initiate or modify therapy in those patients suffering from diseases of, or affecting, the synovium.
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Affiliation(s)
- Matthew A Frick
- Division of Musculoskeletal Radiology, Department of Radiology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905, USA.
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Lutz AM, Göpfert K, Jochum W, Nanz D, Fröhlich JM, Weishaupt D. USPIO-enhanced MR imaging for visualization of synovial hyperperfusion and detection of synovial macrophages: preliminary results in an experimental model of antigen-induced arthritis. J Magn Reson Imaging 2007; 24:657-66. [PMID: 16878310 DOI: 10.1002/jmri.20667] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To evaluate whether ultrasmall superparamagnetic iron particles (USPIO)-enhanced MRI is capable of assessing both synovial perfusion characteristics and the presence of synovial macrophages in a model of antigen-induced arthritis. MATERIALS AND METHODS Unilateral arthritis was induced in six knees of six rabbits. The contralateral knees of the rabbits served as control knees. After onset of arthritis, all 12 knees were scanned prior to and immediately following intravenous administration of USPIO using a multiphase T1-weighted (T1w) fast gradient-echo (FGRE) sequence, and T1w spin-echo (SE), T2-weighted (T2w) FSE, T2*w GRE, and short-tau inversion recovery (STIR) sequences prior to and 24 hours following USPIO administration. SI-vs.-time curves (STCs) and the early enhancement rate during the first 56 seconds (REE(56)) were calculated from SI measurements within the synovial tissue of all knees on dynamic T1w images. MR findings were correlated to histopathology. RESULTS REE(56) was significantly higher in the synovial tissue of arthritic knees than in the control knees (P < 0.01). Significant T1-, T2-, and T2* effects (P = 0.03-0.04) and multiple synovial vessels were visually detectable within the arthritic synovial tissue 24 hours after administration of USPIO, whereas no signal changes or synovial vessels were seen in the control knees. Histopathology revealed widened synovial blood vessels in the arthritic knees, and confirmed iron uptake by macrophages in the arthritic knees. CONCLUSION USPIO-enhanced MRI is capable of both assessing synovial hyperperfusion and detecting macrophages in antigen-induced arthritis in rabbits.
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Affiliation(s)
- Amelie M Lutz
- Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
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Caldana WCI, Ciconelli RM, Juliano Y, Fernandes ADRC. A ressonância magnética do quadril na avaliação de pacientes com artrite reumatóide: estudo descritivo. Radiol Bras 2005. [DOI: 10.1590/s0100-39842005000400005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Avaliar o valor da ressonância magnética (RM) como modalidade diagnóstica de imagem em pacientes com artrite reumatóide e estimar a freqüência das alterações no quadril em pacientes sintomáticos e assintomáticos. MATERIAIS E MÉTODOS: Foram avaliados 40 pacientes (17 sintomáticos e 23 assintomáticos) em equipamento de RM com 1,5 T, com o uso do contraste endovenoso. Os achados de RM foram subdivididos em alterações inflamatórias, degenerativas, mistas (inflamatórias e degenerativas) e extra-articulares. RESULTADOS: As alterações mais freqüentes na RM de quadril dos pacientes sintomáticos e assintomáticos foram dos tipos degenerativas (22,5%) e extra-articulares (22,5%). Apenas cinco dos pacientes sintomáticos apresentaram achados inflamatórios (12,5%), sendo quatro (10%) com alterações degenerativas associadas (alterações mistas). CONCLUSÃO: O estudo permitiu avaliar as principais alterações encontradas em pacientes portadores de artrite reumatóide pela RM. As alterações mais freqüentes na RM do quadril desses pacientes foram dos tipos degenerativas e extra-articulares (22,5% de cada grupo). Apenas cinco dos pacientes sintomáticos apresentaram achados inflamatórios (12,5%), sendo quatro (10%) com alterações degenerativas associadas.
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Tehranzadeh J, Ashikyan O, Dascalos J, Dennehey C. Advanced imaging of early rheumatoid arthritis. Magn Reson Imaging Clin N Am 2004. [DOI: 10.1016/j.mric.2004.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Lutz AM, Seemayer C, Corot C, Gay RE, Goepfert K, Michel BA, Marincek B, Gay S, Weishaupt D. Detection of synovial macrophages in an experimental rabbit model of antigen-induced arthritis: ultrasmall superparamagnetic iron oxide-enhanced MR imaging. Radiology 2004; 233:149-57. [PMID: 15333767 DOI: 10.1148/radiol.2331031402] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate intravenously administered ultrasmall superparamagnetic iron oxide (USPIO) as a marker of macrophage activity in an experimental rabbit model of antigen-induced arthritis. MATERIALS AND METHODS Unilateral arthritis was induced by means of intraarticular injection of methylated bovine serum albumin in 10 knees of 10 rabbits that had been presensitized to the same antigen. The contralateral knees in these rabbits, as well as six knees in three other rabbits, served as controls. After onset of arthritis, all knees were imaged prior to and 24 hours after administration of USPIO. The magnetic resonance (MR) imaging protocol included T1-weighted spin-echo, T2-weighted fast spin-echo, T2*-weighted gradient-echo, and short inversion time inversion-recovery sequences. Images were analyzed quantitatively and qualitatively with regard to signal characteristics and pattern. MR findings were correlated with histopathologic findings. Wilcoxon signed rank test was used to compare results of signal-to-noise ratio calculations before and after USPIO administration. RESULTS All knees with intraarticular injection of antigen suspension developed unilateral arthritis, whereas no signs of arthritis occurred in the control knees. On USPIO-enhanced images obtained 24 hours after contrast agent administration, significant T1 (P =.03) and more predominantly T2* (P =.02) and T2 effects (P =.01) were evident in the synovium of all 10 arthritic knees, which reflected USPIO uptake by macrophages in the synovial tissue. To a lesser extent, T2* effects were present also within the joint effusion (P =.01). No significant changes in signal characteristics were detected in the 10 nonarthritic knees in the antigen-injected group or the six knees in the control group (P =.06-.91). Histologic examination confirmed uptake of iron in the macrophages of arthritic knees. Changes in MR signal characteristics within the arthritic synovium and synovial effusion were visually detectable after intravenous administration of USPIO. CONCLUSION MR imaging at 1.5 T can depict USPIO uptake in phagocytic-active macrophages in an antigen-induced arthritis animal model.
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Affiliation(s)
- Amelie M Lutz
- Institute of Diagnostic Radiology and Center for Experimental Rheumatology, Department of Rheumatology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
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Abstract
Advances in MR imaging of arthritis include contrast-enhanced, dynamic, and quantitative imaging techniques. These advances may result in MR imaging becoming the gold standard in diagnosing early RA. MR imaging is a useful technique in diagnosis, follow-up, and evaluation of remission in rheumatic diseases of the joints. Early diagnosis of RA, in the first 6 months after the onset of symptoms, may lead to earlier control and prevent future erosions and deformities.
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Affiliation(s)
- Jamshid Tehranzadeh
- Department of Radiological Sciences, University of California, Irvine Medical Center, 101 The City Drive South, Orange, CA 92868, USA.
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Kuriashkin IV, Losonsky JM. Contrast enhancement in magnetic resonance imaging using intravenous paramagnetic contrast media: a review. Vet Radiol Ultrasound 2000; 41:4-7. [PMID: 10695873 DOI: 10.1111/j.1740-8261.2000.tb00419.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Interest in magnetic resonance (MR) imaging as a major diagnostic tool in veterinary clinical medicine is increasing. Most MR studies are performed with the use of contrast enhancement via intravenous injection of paramagnetic gadolinium-containing contrast media. A vast number of publications are available regarding the use of contrast media in humans. The purpose of this paper is to assist practicing veterinary radiologists in understanding mechanisms of MR contrast enhancement. This paper reviews certain aspects of MR contrast enhancement, including physical, chemical and biologic characteristics of most common MR contrast media targeted primarily at the central nervous system (CNS). Authors also describe processes that explain changes in signal intensity on the MR images.
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Affiliation(s)
- I V Kuriashkin
- College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana 61802, USA
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El-Gabalawy H. The challenge of early synovitis: multiple pathways to a common clinical syndrome. ARTHRITIS RESEARCH 1999; 1:31-6. [PMID: 11094411 PMCID: PMC128867 DOI: 10.1186/ar8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/1999] [Accepted: 10/15/1999] [Indexed: 01/21/2023]
Affiliation(s)
- H El-Gabalawy
- Arthritis and Rheumatism Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
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