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Published in: Arthritis Research & Therapy 6/2007

01-12-2006 | Review

What is MRI bone oedema in rheumatoid arthritis and why does it matter?

Authors: Fiona M McQueen, Benedikt Ostendorf

Published in: Arthritis Research & Therapy | Issue 6/2007

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Abstract

MRI bone oedema occurs in various forms of inflammatory and non-inflammatory arthritis and probably represents a cellular infiltrate within bone. It is common in early rheumatoid arthritis and is associated with erosive progression and poor functional outcome. Histopathological studies suggest that a cellular infiltrate comprising lymphocytes and osteoclasts may be detected in subchondral bone and could mediate the development of erosions from the marrow towards the joint surface. There is emerging evidence from animal models that such an infiltrate corresponds with MRI bone oedema, pointing towards the bone marrow as a site for important pathology driving joint damage in rheumatoid arthritis.
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Literature
1.
go back to reference The Collected Letters of Antoni van Leeuwenhoek 1701–1704. 1996, ISBN: 9026514506. Lisse, The Netherlands: Swets and Zeitlinger, 14: The Collected Letters of Antoni van Leeuwenhoek 1701–1704. 1996, ISBN: 9026514506. Lisse, The Netherlands: Swets and Zeitlinger, 14:
2.
go back to reference McQueen FM, Stewart N, Crabbe J, Robinson E, Yeoman S, Tan PLJ, McLean L: Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals a high prevalence of erosion at four months after symptom onset. Ann Rheum Dis. 1998, 57: 350-356.PubMedCentralCrossRefPubMed McQueen FM, Stewart N, Crabbe J, Robinson E, Yeoman S, Tan PLJ, McLean L: Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals a high prevalence of erosion at four months after symptom onset. Ann Rheum Dis. 1998, 57: 350-356.PubMedCentralCrossRefPubMed
3.
go back to reference Klarlund M, Østergaard M, Jensen KE, Madsen JL, Skjødt H, the TIRA group: Magnetic resonance imaging, radiography, and scintigraphy of the finger joints: one year follow up of patients with early arthritis. Ann Rheum Dis. 2000, 59: 521-528. 10.1136/ard.59.7.521.PubMedCentralCrossRefPubMed Klarlund M, Østergaard M, Jensen KE, Madsen JL, Skjødt H, the TIRA group: Magnetic resonance imaging, radiography, and scintigraphy of the finger joints: one year follow up of patients with early arthritis. Ann Rheum Dis. 2000, 59: 521-528. 10.1136/ard.59.7.521.PubMedCentralCrossRefPubMed
4.
go back to reference Lecouvet FE, van de Berg BC, Maldague BE, Lebon CJ, Jamart J, Saleh M, Noel H, Malghem J: Early irreversible osteonecrosis versus transient lesions of the femoral condyles: prognostic value of subchondral bone and marrow changes on MR imaging. AJR. 1998, 170: 71-77.CrossRefPubMed Lecouvet FE, van de Berg BC, Maldague BE, Lebon CJ, Jamart J, Saleh M, Noel H, Malghem J: Early irreversible osteonecrosis versus transient lesions of the femoral condyles: prognostic value of subchondral bone and marrow changes on MR imaging. AJR. 1998, 170: 71-77.CrossRefPubMed
5.
go back to reference Carrino JA, Blum J, Parellada JA, Schweitzer ME, Morrison WB: MRI of bone marrow edema-like signal in the pathogenesis of subchondral cysts. Osteoarthritis Cartilage. 2006, 14: 1081-1085. 10.1016/j.joca.2006.05.011.CrossRefPubMed Carrino JA, Blum J, Parellada JA, Schweitzer ME, Morrison WB: MRI of bone marrow edema-like signal in the pathogenesis of subchondral cysts. Osteoarthritis Cartilage. 2006, 14: 1081-1085. 10.1016/j.joca.2006.05.011.CrossRefPubMed
6.
go back to reference Braun J, Baraliakos X, Golder W, Brandt J, Rudwaleit M, Listing J, Bollow M, Sieper J, van der Heijde D: Magnetic resonance imaging examinations of the spine in patients with ankylosing spondylitis, before and after successful therapy with infliximab: Evaluation of a new scoring system. Arthritis Rheum. 2003, 48: 1126-1136. 10.1002/art.10883.CrossRefPubMed Braun J, Baraliakos X, Golder W, Brandt J, Rudwaleit M, Listing J, Bollow M, Sieper J, van der Heijde D: Magnetic resonance imaging examinations of the spine in patients with ankylosing spondylitis, before and after successful therapy with infliximab: Evaluation of a new scoring system. Arthritis Rheum. 2003, 48: 1126-1136. 10.1002/art.10883.CrossRefPubMed
7.
go back to reference Hoy G, Wood T, Phillips N, Connell D: When physiology becomes pathology: the role of magnetic resonance imaging in evaluating bone marrow oedema in the humerus in elite tennis players with an upper limb pain syndrome. Br J Sports Med. 2006, 40: 710-713. 10.1136/bjsm.2005.021386.PubMedCentralCrossRefPubMed Hoy G, Wood T, Phillips N, Connell D: When physiology becomes pathology: the role of magnetic resonance imaging in evaluating bone marrow oedema in the humerus in elite tennis players with an upper limb pain syndrome. Br J Sports Med. 2006, 40: 710-713. 10.1136/bjsm.2005.021386.PubMedCentralCrossRefPubMed
8.
go back to reference Peterfy CG: New developments in imaging in rheumatoid arthritis. Curr Opin Rheumatol. 2003, 15: 288-295. 10.1097/00002281-200305000-00017.CrossRefPubMed Peterfy CG: New developments in imaging in rheumatoid arthritis. Curr Opin Rheumatol. 2003, 15: 288-295. 10.1097/00002281-200305000-00017.CrossRefPubMed
10.
go back to reference Szkudlarek M, Court-Payen , Strandberg C, Klarlund M, Klausen T, Østergaard M: Power Doppler ultrasonography for assessment of synovitis in the metacarpophalangeal joints of patients with rheumatoid arthritis: a comparison with dynamic magnetic resonance imaging. Arthritis Rheum. 2001, 44: 2018-2023. 10.1002/1529-0131(200109)44:9<2018::AID-ART350>3.0.CO;2-C.CrossRefPubMed Szkudlarek M, Court-Payen , Strandberg C, Klarlund M, Klausen T, Østergaard M: Power Doppler ultrasonography for assessment of synovitis in the metacarpophalangeal joints of patients with rheumatoid arthritis: a comparison with dynamic magnetic resonance imaging. Arthritis Rheum. 2001, 44: 2018-2023. 10.1002/1529-0131(200109)44:9<2018::AID-ART350>3.0.CO;2-C.CrossRefPubMed
11.
go back to reference Peterfy CG: MR imaging. Baillieres Clin Rheumatol. 1996, 10: 635-678. 10.1016/S0950-3579(96)80055-0.CrossRefPubMed Peterfy CG: MR imaging. Baillieres Clin Rheumatol. 1996, 10: 635-678. 10.1016/S0950-3579(96)80055-0.CrossRefPubMed
12.
go back to reference Appel H, Loddenkemper C, Grozdanowicz Z, Ebhardt H, Dreimann M, Hempfing A, Stein H, Metz-Stavenhagen P, Rudwaleit M, Sieper J: Correlation of histopathological findings and magnetic resonance imaging (MRI) in the spine of patients with ankylosing spondylitis. Arthritis Res Ther. 2006, 8: R143-10.1186/ar2035.PubMedCentralCrossRefPubMed Appel H, Loddenkemper C, Grozdanowicz Z, Ebhardt H, Dreimann M, Hempfing A, Stein H, Metz-Stavenhagen P, Rudwaleit M, Sieper J: Correlation of histopathological findings and magnetic resonance imaging (MRI) in the spine of patients with ankylosing spondylitis. Arthritis Res Ther. 2006, 8: R143-10.1186/ar2035.PubMedCentralCrossRefPubMed
13.
go back to reference Barrie HJ: Histologic changes in rheumatoid disease of the metacarpal and metatarsal heads as seen in surgical material. J Rheumatol. 1981, 8: 246-257.PubMed Barrie HJ: Histologic changes in rheumatoid disease of the metacarpal and metatarsal heads as seen in surgical material. J Rheumatol. 1981, 8: 246-257.PubMed
14.
go back to reference Bugatti S, Caporali R, Manzo A, Vitolo B, Pitzalis C, Montecucco C: Involvement of subchondral bone marrow in rheumatoid arthritis. Lymphoid neogenesis and in situ relationship to subchondral bone marrow osteoclast recruitment. Arthritis Rheum. 2005, 52: 3448-3459. 10.1002/art.21377.CrossRefPubMed Bugatti S, Caporali R, Manzo A, Vitolo B, Pitzalis C, Montecucco C: Involvement of subchondral bone marrow in rheumatoid arthritis. Lymphoid neogenesis and in situ relationship to subchondral bone marrow osteoclast recruitment. Arthritis Rheum. 2005, 52: 3448-3459. 10.1002/art.21377.CrossRefPubMed
15.
go back to reference McQueen FM, Benton N, Perry D, Crabbe J, Robinson E, Yeoman S, McLean L, Stewart N: Bone oedema scored on magnetic resonance scans of the dominant carpus at presentation predicts radiographic joint damage at the hands and feet six years later in patients with rheumatoid arthritis. Arthritis Rheum. 2003, 48: 1814-1827. 10.1002/art.11162.CrossRefPubMed McQueen FM, Benton N, Perry D, Crabbe J, Robinson E, Yeoman S, McLean L, Stewart N: Bone oedema scored on magnetic resonance scans of the dominant carpus at presentation predicts radiographic joint damage at the hands and feet six years later in patients with rheumatoid arthritis. Arthritis Rheum. 2003, 48: 1814-1827. 10.1002/art.11162.CrossRefPubMed
16.
go back to reference McQueen FM, Stewart N, Crabbe J, Robinson E, Yeoman S, Tan PLJ, McLean L: Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals progression of erosions despite clinical improvement. Ann Rheum Dis. 1999, 58: 156-163.PubMedCentralCrossRefPubMed McQueen FM, Stewart N, Crabbe J, Robinson E, Yeoman S, Tan PLJ, McLean L: Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals progression of erosions despite clinical improvement. Ann Rheum Dis. 1999, 58: 156-163.PubMedCentralCrossRefPubMed
17.
go back to reference Benton N, Stewart N, Crabbe J, Robinson E, Yeoman S, McQueen FM: MRI of the wrist in early rheumatoid arthritis can be used to predict functional outcome at 6 years. Ann Rheum Dis. 2004, 63: 555-561. 10.1136/ard.2003.011544.PubMedCentralCrossRefPubMed Benton N, Stewart N, Crabbe J, Robinson E, Yeoman S, McQueen FM: MRI of the wrist in early rheumatoid arthritis can be used to predict functional outcome at 6 years. Ann Rheum Dis. 2004, 63: 555-561. 10.1136/ard.2003.011544.PubMedCentralCrossRefPubMed
18.
go back to reference Zheng S, Yeoman S, Robinson E, Crabbe J, Stewart N, Rouse J, McQueen FM: Magnetic resonance imaging (MRI) bone oedema predicts 8 year tendon function at the wrist but not the requirement for orthopaedic surgery in rheumatoid arthritis patients. Ann Rheum Dis. 2006, 65: 607-611. 10.1136/ard.2005.043323.PubMedCentralCrossRefPubMed Zheng S, Yeoman S, Robinson E, Crabbe J, Stewart N, Rouse J, McQueen FM: Magnetic resonance imaging (MRI) bone oedema predicts 8 year tendon function at the wrist but not the requirement for orthopaedic surgery in rheumatoid arthritis patients. Ann Rheum Dis. 2006, 65: 607-611. 10.1136/ard.2005.043323.PubMedCentralCrossRefPubMed
19.
go back to reference Savnik A, Malmskov H, Thomsen HS, Graff LB, Nielsen H, Danneskiold-Samsoe B, Boesen J, Bliddal H: MRI of the wrist and finger joints in inflammatory joint diseases at 1-yr interval: MRI features to predict bone erosions. Eur Radiol. 2002, 12: 1203-1210. 10.1007/s003300101114.CrossRefPubMed Savnik A, Malmskov H, Thomsen HS, Graff LB, Nielsen H, Danneskiold-Samsoe B, Boesen J, Bliddal H: MRI of the wrist and finger joints in inflammatory joint diseases at 1-yr interval: MRI features to predict bone erosions. Eur Radiol. 2002, 12: 1203-1210. 10.1007/s003300101114.CrossRefPubMed
20.
go back to reference Ostendorf B, Scherer A, Modder U, Schneider M: Diagnostic value of magnetic resonance imaging of the forefeet in early rheumatoid arthritis when findings on imaging of the metacarpophalageal joints of the hands remain normal. Arthritis Rheum. 2004, 50: 2094-2102. 10.1002/art.20314.CrossRefPubMed Ostendorf B, Scherer A, Modder U, Schneider M: Diagnostic value of magnetic resonance imaging of the forefeet in early rheumatoid arthritis when findings on imaging of the metacarpophalageal joints of the hands remain normal. Arthritis Rheum. 2004, 50: 2094-2102. 10.1002/art.20314.CrossRefPubMed
21.
go back to reference Tamai M, Kawakami A, Takao S, Uetani M, Arima K, Tanaka F, Fujikawa K, Aramaki T, Iwanaga N, Izumi Y, et al: Bone marrow oedema determined by MRI reflects severe disease status in patients with early-stage rheumatoid arthritis. Ann Rheum Dis. 2006, 65 (Suppl II): 629- Tamai M, Kawakami A, Takao S, Uetani M, Arima K, Tanaka F, Fujikawa K, Aramaki T, Iwanaga N, Izumi Y, et al: Bone marrow oedema determined by MRI reflects severe disease status in patients with early-stage rheumatoid arthritis. Ann Rheum Dis. 2006, 65 (Suppl II): 629-
22.
go back to reference Gao A, Østergaard M, Robinson E, Dalbeth N, Doyle A, Shalley G, McQueen F: Unexpected finding of frequent high grade MRI bone oedema within the field of surgery in RA patients awaiting joint replacement/fusion at the hands or feet. Arthritis Rheum. 2006, 54 (Suppl): S625- Gao A, Østergaard M, Robinson E, Dalbeth N, Doyle A, Shalley G, McQueen F: Unexpected finding of frequent high grade MRI bone oedema within the field of surgery in RA patients awaiting joint replacement/fusion at the hands or feet. Arthritis Rheum. 2006, 54 (Suppl): S625-
23.
go back to reference Hirohata S, Miura Y, Tmita T, Yoshikawa H, Ochi T, Chiorazzi N: Enhanced expression of mRNA for nuclear factor kB1 (p50) in CD34+ cells of the bone marrow in rheumatoid arthritis. Arthritis Res Ther. 2006, 8: R54-10.1186/ar1915.PubMedCentralCrossRefPubMed Hirohata S, Miura Y, Tmita T, Yoshikawa H, Ochi T, Chiorazzi N: Enhanced expression of mRNA for nuclear factor kB1 (p50) in CD34+ cells of the bone marrow in rheumatoid arthritis. Arthritis Res Ther. 2006, 8: R54-10.1186/ar1915.PubMedCentralCrossRefPubMed
24.
go back to reference Hirohata S, Yanagida T, Nagai T, Sawada T, Nakamura H, Yoshino S, Tomita T, Ochi T: Induction of fibroblast-like cells from CD34(+) progenitor cells of the bone marrow in rheumatoid arthritis. J Leukoc Biol. 2001, 70: 413-421.PubMed Hirohata S, Yanagida T, Nagai T, Sawada T, Nakamura H, Yoshino S, Tomita T, Ochi T: Induction of fibroblast-like cells from CD34(+) progenitor cells of the bone marrow in rheumatoid arthritis. J Leukoc Biol. 2001, 70: 413-421.PubMed
25.
go back to reference Schwarz EM, Looney RJ, Drissi MH, O'Keefe RJ, Boyce BF, Xing L, Ritchlin CT: Autoimmunity and bone. Ann NY Acad Sci. 2006, 1068: 275-283. 10.1196/annals.1346.031.CrossRefPubMed Schwarz EM, Looney RJ, Drissi MH, O'Keefe RJ, Boyce BF, Xing L, Ritchlin CT: Autoimmunity and bone. Ann NY Acad Sci. 2006, 1068: 275-283. 10.1196/annals.1346.031.CrossRefPubMed
26.
go back to reference Maruotti N, Cantatore FP, Crivellato E, Vacca A, Ribatti D: Angiogenesis in rheumatoid arthritis. Review. Histol Histopathol. 2006, 21: 557-566.PubMed Maruotti N, Cantatore FP, Crivellato E, Vacca A, Ribatti D: Angiogenesis in rheumatoid arthritis. Review. Histol Histopathol. 2006, 21: 557-566.PubMed
27.
go back to reference Ostendorf B, Iking-Konert C, Bleck E, Dann P, Pauly Th, Friemann J, Schneider M: Vascular imaging of rheumatoid synovium: Macroscopic and microscopic analysis of synovial tissue obtained by miniarthroscopy from finger joints of patients with rheumatoid arthritis. Ann Rheum Dis. 2006, 65 (Suppl II): 66- Ostendorf B, Iking-Konert C, Bleck E, Dann P, Pauly Th, Friemann J, Schneider M: Vascular imaging of rheumatoid synovium: Macroscopic and microscopic analysis of synovial tissue obtained by miniarthroscopy from finger joints of patients with rheumatoid arthritis. Ann Rheum Dis. 2006, 65 (Suppl II): 66-
28.
go back to reference Stewart N, McQueen FM, Crabbe JC: MRI of the wrist: a pictorial essay. Australas Radiol. 2001, 45: 268-273. 10.1046/j.1440-1673.2001.00919.x.CrossRefPubMed Stewart N, McQueen FM, Crabbe JC: MRI of the wrist: a pictorial essay. Australas Radiol. 2001, 45: 268-273. 10.1046/j.1440-1673.2001.00919.x.CrossRefPubMed
29.
go back to reference Marinova-Mutafchieva L, Williams RO, Funa K, Maini RN, Zvaifler NJ: Inflammation is preceded by tumour necrosis factor-dependent infiltration of mesenchymal cells in experimental arthritis. Arthritis Rheum. 2002, 46: 507-513. 10.1002/art.10126.CrossRefPubMed Marinova-Mutafchieva L, Williams RO, Funa K, Maini RN, Zvaifler NJ: Inflammation is preceded by tumour necrosis factor-dependent infiltration of mesenchymal cells in experimental arthritis. Arthritis Rheum. 2002, 46: 507-513. 10.1002/art.10126.CrossRefPubMed
30.
go back to reference Proulx S, Kwok E, Shealy DJ, Ritchlin CT, Schwarz EM: Understanding bone marrow edema in arthritis: 3D-MRI and histology analyses of TNF-Tg mice. Arthritis Rheum. 2006, 54 (Suppl): S798-S799. Proulx S, Kwok E, Shealy DJ, Ritchlin CT, Schwarz EM: Understanding bone marrow edema in arthritis: 3D-MRI and histology analyses of TNF-Tg mice. Arthritis Rheum. 2006, 54 (Suppl): S798-S799.
31.
go back to reference Ostendorf B, Scherer A, Wirrwar A, Hoppin JW, Lackas C, Schramm NU, Cohnen M, Mödder U, van den Berg WB, Müller HW, et al: High-resolution multi-pinhole single photon emission computed tomography in imaging experimental and human arthritis. Arthritis Rheum. 2006, 54: 1096-1104. 10.1002/art.21732.CrossRefPubMed Ostendorf B, Scherer A, Wirrwar A, Hoppin JW, Lackas C, Schramm NU, Cohnen M, Mödder U, van den Berg WB, Müller HW, et al: High-resolution multi-pinhole single photon emission computed tomography in imaging experimental and human arthritis. Arthritis Rheum. 2006, 54: 1096-1104. 10.1002/art.21732.CrossRefPubMed
32.
go back to reference Ostendorf B, Scherer A, Wirrwar A, Hoppin JW, Schramm NU, Cohnen M, Moedder U, Müller HW, Schneider M: Precise detection of bony changes in arthritis and osteoarthritis with high-resolution scintigraphy. Ann Rheum Dis. 2006, 65 (Suppl II): 590- Ostendorf B, Scherer A, Wirrwar A, Hoppin JW, Schramm NU, Cohnen M, Moedder U, Müller HW, Schneider M: Precise detection of bony changes in arthritis and osteoarthritis with high-resolution scintigraphy. Ann Rheum Dis. 2006, 65 (Suppl II): 590-
33.
go back to reference Edwards JCW, Cambridge G: B-cell targeting in rheumatoid arthritis and other autoimmune diseases. Nat Rev Immunol. 2006, 6: 394-403. 10.1038/nri1838.CrossRefPubMed Edwards JCW, Cambridge G: B-cell targeting in rheumatoid arthritis and other autoimmune diseases. Nat Rev Immunol. 2006, 6: 394-403. 10.1038/nri1838.CrossRefPubMed
34.
go back to reference Lowenthal RM, Francis H, Gill DS: Twenty-year remission of rheumatoid arthritis in 2 patients after allogeneic bone marrow transplant. J Rheumatol. 2006, 33: 812-813.PubMed Lowenthal RM, Francis H, Gill DS: Twenty-year remission of rheumatoid arthritis in 2 patients after allogeneic bone marrow transplant. J Rheumatol. 2006, 33: 812-813.PubMed
Metadata
Title
What is MRI bone oedema in rheumatoid arthritis and why does it matter?
Authors
Fiona M McQueen
Benedikt Ostendorf
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 6/2007
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar2075

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