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Renner N, Kleyer A, Krönke G, Simon D, Söllner S, Rech J, Uder M, Janka R, Schett G, Welsch GH, Pachowsky ML. T2 Mapping as a New Method for Quantitative Assessment of Cartilage Damage in Rheumatoid Arthritis. J Rheumatol 2020; 47:820-825. [PMID: 31416926 DOI: 10.3899/jrheum.180728] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Rheumatoid arthritis (RA) is associated with damage of the articular cartilage and the periarticular bone. While imaging of bone damage has substantially improved in recent years, direct imaging of the articular cartilage of the hand joints in patients with RA is still challenging. The study used T2 mapping of the finger joints to assess cartilage damage in RA. METHODS Magnetic resonance imaging (MRI) at 3 Tesla was done in 30 patients with RA, and T2 relaxation times visualizing alteration in the collagen network and hydration of articular cartilage were mapped in 6 cartilage regions of the metacarpophalangeal (MCP) joints 2 and 3. Values were related to autoantibody status [anticitrullinated protein antibodies (ACPA), rheumatoid factor (RF)], disease duration, and disease activity as well as sex and age of the patients. RESULTS T2 relaxation times could be reliably measured in the 6 regions of the MCP joints. Significantly higher relaxation times indicating more advanced cartilage alterations were observed in the metacarpal heads of ACPA-positive (p = 0.001-0.010) and RF-positive patients (p = 0.013-0.025) as well as those with longer disease duration (> 3 yrs; p = 0.028-0.043). Current disease activity, sex, and age did not influence T2 relaxation times. CONCLUSION These data show that cartilage damage can be localized and quantified in the hand joints of patients with RA by T2 mapping. Further, ACPA and RF positivity as well as disease duration appear to be the crucial factors influencing cartilage damage.
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Affiliation(s)
- Nina Renner
- From the Department of Trauma and Orthopaedic Surgery, the Department of Internal Medicine 3, and the Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU); Universitätsklinikum Erlangen, Erlangen; UKE Athleticum, University Hospital of Hamburg-Eppendorf, Hamburg, Germany.,N. Renner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; A. Kleyer, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G. Krönke, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; D. Simon, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; S. Söllner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; J. Rech, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; M. Uder, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; R. Janka, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; G. Schett, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G.H. Welsch, MD, UKE Athleticum, University Hospital of Hamburg-Eppendorf; M.L. Pachowsky, MD, MHBA, Department of Trauma and Orthopaedic Surgery and Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen
| | - Arnd Kleyer
- From the Department of Trauma and Orthopaedic Surgery, the Department of Internal Medicine 3, and the Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU); Universitätsklinikum Erlangen, Erlangen; UKE Athleticum, University Hospital of Hamburg-Eppendorf, Hamburg, Germany.,N. Renner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; A. Kleyer, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G. Krönke, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; D. Simon, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; S. Söllner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; J. Rech, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; M. Uder, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; R. Janka, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; G. Schett, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G.H. Welsch, MD, UKE Athleticum, University Hospital of Hamburg-Eppendorf; M.L. Pachowsky, MD, MHBA, Department of Trauma and Orthopaedic Surgery and Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen
| | - Gerhard Krönke
- From the Department of Trauma and Orthopaedic Surgery, the Department of Internal Medicine 3, and the Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU); Universitätsklinikum Erlangen, Erlangen; UKE Athleticum, University Hospital of Hamburg-Eppendorf, Hamburg, Germany.,N. Renner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; A. Kleyer, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G. Krönke, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; D. Simon, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; S. Söllner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; J. Rech, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; M. Uder, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; R. Janka, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; G. Schett, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G.H. Welsch, MD, UKE Athleticum, University Hospital of Hamburg-Eppendorf; M.L. Pachowsky, MD, MHBA, Department of Trauma and Orthopaedic Surgery and Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen
| | - David Simon
- From the Department of Trauma and Orthopaedic Surgery, the Department of Internal Medicine 3, and the Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU); Universitätsklinikum Erlangen, Erlangen; UKE Athleticum, University Hospital of Hamburg-Eppendorf, Hamburg, Germany.,N. Renner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; A. Kleyer, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G. Krönke, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; D. Simon, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; S. Söllner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; J. Rech, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; M. Uder, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; R. Janka, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; G. Schett, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G.H. Welsch, MD, UKE Athleticum, University Hospital of Hamburg-Eppendorf; M.L. Pachowsky, MD, MHBA, Department of Trauma and Orthopaedic Surgery and Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen
| | - Stefan Söllner
- From the Department of Trauma and Orthopaedic Surgery, the Department of Internal Medicine 3, and the Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU); Universitätsklinikum Erlangen, Erlangen; UKE Athleticum, University Hospital of Hamburg-Eppendorf, Hamburg, Germany.,N. Renner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; A. Kleyer, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G. Krönke, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; D. Simon, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; S. Söllner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; J. Rech, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; M. Uder, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; R. Janka, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; G. Schett, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G.H. Welsch, MD, UKE Athleticum, University Hospital of Hamburg-Eppendorf; M.L. Pachowsky, MD, MHBA, Department of Trauma and Orthopaedic Surgery and Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen
| | - Jürgen Rech
- From the Department of Trauma and Orthopaedic Surgery, the Department of Internal Medicine 3, and the Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU); Universitätsklinikum Erlangen, Erlangen; UKE Athleticum, University Hospital of Hamburg-Eppendorf, Hamburg, Germany.,N. Renner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; A. Kleyer, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G. Krönke, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; D. Simon, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; S. Söllner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; J. Rech, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; M. Uder, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; R. Janka, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; G. Schett, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G.H. Welsch, MD, UKE Athleticum, University Hospital of Hamburg-Eppendorf; M.L. Pachowsky, MD, MHBA, Department of Trauma and Orthopaedic Surgery and Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen
| | - Michael Uder
- From the Department of Trauma and Orthopaedic Surgery, the Department of Internal Medicine 3, and the Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU); Universitätsklinikum Erlangen, Erlangen; UKE Athleticum, University Hospital of Hamburg-Eppendorf, Hamburg, Germany.,N. Renner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; A. Kleyer, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G. Krönke, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; D. Simon, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; S. Söllner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; J. Rech, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; M. Uder, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; R. Janka, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; G. Schett, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G.H. Welsch, MD, UKE Athleticum, University Hospital of Hamburg-Eppendorf; M.L. Pachowsky, MD, MHBA, Department of Trauma and Orthopaedic Surgery and Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen
| | - Rolf Janka
- From the Department of Trauma and Orthopaedic Surgery, the Department of Internal Medicine 3, and the Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU); Universitätsklinikum Erlangen, Erlangen; UKE Athleticum, University Hospital of Hamburg-Eppendorf, Hamburg, Germany.,N. Renner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; A. Kleyer, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G. Krönke, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; D. Simon, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; S. Söllner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; J. Rech, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; M. Uder, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; R. Janka, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; G. Schett, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G.H. Welsch, MD, UKE Athleticum, University Hospital of Hamburg-Eppendorf; M.L. Pachowsky, MD, MHBA, Department of Trauma and Orthopaedic Surgery and Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen
| | - Georg Schett
- From the Department of Trauma and Orthopaedic Surgery, the Department of Internal Medicine 3, and the Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU); Universitätsklinikum Erlangen, Erlangen; UKE Athleticum, University Hospital of Hamburg-Eppendorf, Hamburg, Germany.,N. Renner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; A. Kleyer, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G. Krönke, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; D. Simon, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; S. Söllner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; J. Rech, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; M. Uder, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; R. Janka, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; G. Schett, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G.H. Welsch, MD, UKE Athleticum, University Hospital of Hamburg-Eppendorf; M.L. Pachowsky, MD, MHBA, Department of Trauma and Orthopaedic Surgery and Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen
| | - Goetz H Welsch
- From the Department of Trauma and Orthopaedic Surgery, the Department of Internal Medicine 3, and the Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU); Universitätsklinikum Erlangen, Erlangen; UKE Athleticum, University Hospital of Hamburg-Eppendorf, Hamburg, Germany.,N. Renner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; A. Kleyer, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G. Krönke, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; D. Simon, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; S. Söllner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; J. Rech, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; M. Uder, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; R. Janka, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; G. Schett, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G.H. Welsch, MD, UKE Athleticum, University Hospital of Hamburg-Eppendorf; M.L. Pachowsky, MD, MHBA, Department of Trauma and Orthopaedic Surgery and Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen
| | - Milena L Pachowsky
- From the Department of Trauma and Orthopaedic Surgery, the Department of Internal Medicine 3, and the Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU); Universitätsklinikum Erlangen, Erlangen; UKE Athleticum, University Hospital of Hamburg-Eppendorf, Hamburg, Germany. .,N. Renner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; A. Kleyer, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G. Krönke, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; D. Simon, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; S. Söllner, MD, Department of Trauma and Orthopaedic Surgery, FAU, and Universitätsklinikum Erlangen; J. Rech, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; M. Uder, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; R. Janka, MD, Department of Radiology, FAU, and Universitätsklinikum Erlangen; G. Schett, MD, Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen; G.H. Welsch, MD, UKE Athleticum, University Hospital of Hamburg-Eppendorf; M.L. Pachowsky, MD, MHBA, Department of Trauma and Orthopaedic Surgery and Department of Internal Medicine 3, FAU, and Universitätsklinikum Erlangen.
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