ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1445

MRI Bone Erosions in RA Patients Relatives with Clinically Suspicious Arthralgia

David Vega-Morales1, Jorge Esquivel-Valerio2, Mario Alberto Garza-Elizondo3, Dionicio A. Galarza-Delgado4, Miguel A Villarreal-Alarcón5, Cassandra Skinner-Taylor1, Diana Flores-Alvarado6, Janett Riega-Torres7, Lorena Pérez-Barbosa8, Brenda Vazquez-Fuentes9 and Maria Del Carmen Larios-Forte1, 1Rheumatology, University Hospital “Dr. José Eleuterio González”, UANL, Monterrey, Mexico, 2Rheumatology, University Hospital “Dr. José Eleuterio González”, UANL, Mexico, Monterrey, Mexico, 3Rheumatology, Hospital Universitario, UANL., Monterrey, Mexico, 4Chief of Rheumatology, Hospital Universitario, UANL, Monterrey, Mexico, 5Servicio de Reumatología, Departamento de Medicina Interna del Hospital Universitario “Dr. Jose Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico, 6Servicio de Reumatología, Departamento de Medicina Interna del Hospital Universitario “Dr. José Eleuterio González”. Universidad Autónoma de Nuevo León, Monterrey, Mexico, 7University Hospital “Dr. José Eleuterio González”, UANL, Monterrey, Mexico, 8Hospital Universitario, Monterrey, Mexico, 9Servicio de Reumatología, Departamento de Medicina Interna. Hospital Universitario “Dr. José Eleuterio González”. Universidad Autónoma de Nuevo León, Monterrey, Mexico

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Date: Monday, October 22, 2018

Session Title: Rheumatoid Arthritis – Diagnosis, Manifestations, and Outcomes Poster II: Diagnosis and Prognosis

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:

Rheumatoid arthritis (RA) has a preclinical phase without symptoms that progress to symptomatic phases. Clinically suspect arthralgia (CSA) refers to patients with symptoms without clinically apparent synovitis. The presence of erosions of grade 2 or greater by MRI was reported to be specific to the diagnosis of RA. We do not know the frequency of RA specific erosions, defined by RAMRIS in CSA patients.

Methods:

Cross-sectional and observational study with 60 patients older than 18 years, divided into two groups: CSA group: n = 23 (38%) RA first-degree relatives with hand arthralgia without clinical inflammation, and RA group: n = 37 (%) patients who met 2010 ACR/EULAR criteria. MRI images were evaluated looking for synovitis, bone erosion, and bone marrow edema (BME). The bone erosions were scored on a scale of 0 to 10 based on the proportion of eroded.

Results:

Baseline and clinical characteristics are depicted in table 1. No difference was found in the frequency of patients without any bone erosion in MCP between CSA versus RA, 7/22(31.8%) and 12/38(31.6%), respectively. However, 18/60(30%) patients had ≥ 2 bone erosions, 6/22(27.3%) in CSA patients and 12/38(31.6%) in established RA patients (p=0.72).

Conclusion:

There were a similar number of patients with bone erosions Grade ≥2 in both groups. The presence of the combination of the MCP joints of bone erosions with bone edema and synovitis is more frequent in patients with RA compared to patients with CSA.

Table 1: Baseline characteristics of CSA patients and RA patients

TOTAL

(N=60)

Total

n = 60

(100%)

CSA

n = 22 (36.6%)

RA

n = 38

(63.3%)

Age in years. median

(IQR)

41.5(26)

35(12)

49.5(23)

> 40 years. n(%)

31(51.7)

5(22.7)

26(68.4)

≤40 years. n(%)

29(48.3)

17(77.3)

12(31.6)

Female. n(%)

50(83.3)

17(77.3)

33(86.8)

Dominant Hand: Right

55(91.7)

21(95.4)

34(89.5)

Symptoms duration in months. Median (IQR):

6(8)

65(33.5)

PVAS (0-100), median(IQR)

20(50)

0(0)

3.5(3)

66 SJC, median (IQR)

3(9)

0(2)

5(8)

68 TJC: median (IQR)

5(12)

0(5)

8(11)

ACPA positivity, n(%)

19/45(42.2)

8/21(38.0)

11/24(45.8)

RF positivity, n(%)

42/50(84)

20/21(95.2)

22/29(75.8)

CRP (mg/dl), median(IQR)

0(1)

0(1)

0.5(1)

CSA, clinically suspect arthralgia (CSA); RA, rheumatoid arthritis; ACPA, anti-citrullinated protein antibodies; CRP, C-reactive protein; RF, rheumatoid factor; ESR, erytrosedimentation rate; PVAS, Patient Global Assessment of the Disease Activity; SJC, swollen joints count; TJC, tender joint count.

Table 2: Frequencies of patients with RA and CSA with erosions and with erosions and with the simultaneous presence of local inflammation in MCP joints.

Total

of

Patients

N=60

Erosion+

BME-

Synovitis-

n=1

Erosion+

BME+

Synovitis-

n=3

Erosion+

BME-

Synovitis+

n=18

Erosion+

BME+

Synovitis+

n=19

Number of MCP bones without erosions, n=19

RA < 40 years

n= 12 pt

0

0

3(2.5%)

6(50%)

3(25%)

RA ≥ 40 years

n=26 pt

0

0

8(30.7%)

9(34.6%)

9(34.6%)

CSA < 40 years

n=17 pts

1(5.8%)

1(5.8%)

6(35.3%)

3(17.6%)

6(35.2%)

CSA ≥ 40 years

n=5 pts

0

2(40%)

1(20 %)

1(20%)

1(20%)

Inflammation was defined as the presence of synovitis and/or bone marrow oedema; The presence of BME and/or synovitis was defined as a score of ≥1; MCP, metacarpo–phalangical joint; RA, rheumatoid arthritis; CSA, clinically suspect arthralgia (CSA).

Disclosure: D. Vega-Morales, None; J. Esquivel-Valerio, None; M. A. Garza-Elizondo, None; D. A. Galarza-Delgado, None; M. A. Villarreal-Alarcón, None; C. Skinner-Taylor, None; D. Flores-Alvarado, None; J. Riega-Torres, None; L. Pérez-Barbosa, None; B. Vazquez-Fuentes, None; M. D. C. Larios-Forte, None.

To cite this abstract in AMA style:

Vega-Morales D, Esquivel-Valerio J, Garza-Elizondo MA, Galarza-Delgado DA, Villarreal-Alarcón MA, Skinner-Taylor C, Flores-Alvarado D, Riega-Torres J, Pérez-Barbosa L, Vazquez-Fuentes B, Larios-Forte MDC. MRI Bone Erosions in RA Patients Relatives with Clinically Suspicious Arthralgia [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/mri-bone-erosions-in-ra-patients-relatives-with-clinically-suspicious-arthralgia/. Accessed December 14, 2019.

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