Falk Roland Miese MD, Presenter: Nothing to Disclose

Benedikt Ostendorf, Abstract Co-Author: Nothing to Disclose

Dorothea Christina Margarete Franziska Reichelt, Abstract Co-Author: Nothing to Disclose

Patrick Kroepil MD, Abstract Co-Author: Nothing to Disclose

Rotem Shlomo Lanzman MD, Abstract Co-Author: Nothing to Disclose

Axel Scherer MD, Abstract Co-Author: Nothing to Disclose

Hans-Joerg Wittsack MD, Abstract Co-Author: Nothing to Disclose

Tallal Charles Mamisch MD, Abstract Co-Author: Consultant, Siemens AG

Christoph Zilkens, Abstract Co-Author: Nothing to Disclose

Bernd Bittersohl MD, Abstract Co-Author: Nothing to Disclose

Christan Buchbender, Abstract Co-Author: Nothing to Disclose

Guenther H. Fuerst MD, Abstract Co-Author: Nothing to Disclose

To assess cartilage quality of metacarpophalangeal joints (MCP) in patients with rheumatoid arthritis (RA) using Delayed Gd(DTPA)2- enhanced MRI of the cartilage (dGEMRIC).

Following ethics approval and informed consent, dGEMRIC using a variable flip angle approach (VFA) was acquired of the MCP II and III in nine healthy volunteers and eighteen patients with established RA. The volunteer group consisted of three men and six women (mean age 51 years, 30 – 66 years), there were five male and thirteen female patients in the RA group (mean age 58 years, 35 - 77 years). dGEMRIC Index was measured in MCP II and III cartilage with manually drawn region-of-interest evaluation. Additionally, cartilage thickness was determined as a conventional measure of cartilage integrity. Signs of Inflammation (Joint swelling, pain and tenderness as well as disease activity score DAS 28) were recorded in clinical examination. Statistical analyses used non-parametric Mann-Whitney-U-Test for significant differences between the groups and Spearman Rho to test for correlation of parameters.

A total of 27 MCP II and 24 MCP III joints were evaluated. dGEMRIC index was significantly decreased in RA patients compared to healthy subjects (385 ms ± 17 ms vs. 522 ms ± 91 ms, p<.001). Age (p=.181) and cartilage thickness (1.23 mm ± .38 mm vs. 1.28 mm ± .33 mm, p=.729) were not significantly different. There was a significant correlation between clinical symptoms and dGEMRIC Index (r= -.405, p=.019). dGEMRIC Index was not significantly correlated with age (p=.404) or cartilage thickness (p=.701).

dGEMRIC of finger joints is feasible in patients with RA. Morphologically normal appearing cartilage shows significantly decreased dGEMRIC Index in RA, pointing towards cartilage degeneration on a molecular level. Further studies are needed to establish the usefulness of this technique for early diagnosis, prognosis and therapy monitoring.

This study provides the rationale for studies on cartilage quality in RA. With the advent of target-oriented therapy (e.g. biologicals), dGEMRIC bears the potential to monitor cartilage

Miese, F, Ostendorf, B, Reichelt, D, Kroepil, P, Lanzman, R, Scherer, A, Wittsack, H, Mamisch, T, Zilkens, C, Bittersohl, B, Buchbender, C, Fuerst, G, Assessment of Cartilage Quality of Metacarpophalangeal Joints in Rheumatoid Arthritis Using Delayed Gd (DTPA)2-enhanced MRI of the Cartilage (dGEMRIC) at 3 T.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9003179.html