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Abstract Number: 537

The Course of Bone Marrow Edema in Early Undifferentiated and Rheumatoid Arthritis; A Longitudinal MRI Study on Bone Level

W.P. Nieuwenhuis1, H.W. van Steenbergen2, W. Stomp3, T. Stijnen4, T. W. J. Huizinga1, J.L Bloem3, D. van der Heijde1, M. Reijnierse3 and A.H.M. van der Helm- van Mil2, 1Rheumatology, Leiden University Medical Center, Leiden, Netherlands, 2Leiden University Medical Center, Leiden, Netherlands, 3Radiology, Leiden University Medical Center, Leiden, Netherlands, 4Medical Statistics, Leiden University Medical Center, Leiden, Netherlands

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: bone marrow lesions, MRI, rheumatoid arthritis (RA) and synovitis

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Session Information

Date: Sunday, November 8, 2015

Session Title: Rheumatoid Arthritis - Human Etiology and Pathogenesis Poster I

Session Type: ACR Poster Session A

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

Background/Purpose:

In rheumatoid arthritis (RA) patients, bone marrow edema (BME)-scores are associated with development of erosions. However, little is known on the course and outcome of BME at bone level. Therefore this study determined the association of BME and MRI-synovitis in the same bone longitudinally.

Methods:

1,947 bones of MCP, wrist and MTP-joints of 59 patients presenting with rheumatoid or undifferentiated arthritis were studied using 1.5T MRI at baseline, after four and twelve months. Scanning and scoring of BME, synovitis and erosions were performed according to RAMRIS. The relation of the course of BME and synovitis to erosive progression at bone level during 1-year was evaluated.

Results:

Of the bones showing BME at baseline (n=203), BME persisted in 56%, disappeared in 39%, and disappeared-reappeared seldom (5%). Stratified analyses at baseline revealed that BME was associated with erosive progression, in presence and in absence of local synovitis (ORs 7.5 95%CI 3.8-14.9 and 6.9 95%CI 1.9-25.6). Local synovitis, however, was not associated with erosive progression (OR 2.0 95%CI 0.6-7.0 in presence of BME and 1.9 95%CI 0.8-4.1 in the absence of BME). In multivariable GEE-analyses, persistent BME was strongly associated with erosive progression (OR 60 95%CI 17-318), in contrast to persistent synovitis (OR 1.4 95%CI 0.4-5.3).

Conclusion:

BME frequently persists during the first year. Persistent BME was strongly associated with erosive progression in the same bone, independent of local synovitis. No independent association was observed for persistent synovitis. These findings are relevant for the comprehension on the development of erosions in RA.


Disclosure: W. P. Nieuwenhuis, None; H. W. van Steenbergen, None; W. Stomp, None; T. Stijnen, None; T. W. J. Huizinga, None; J. L. Bloem, None; D. van der Heijde, None; M. Reijnierse, None; A. H. M. van der Helm- van Mil, None.

To cite this abstract in AMA style:

Nieuwenhuis WP, van Steenbergen HW, Stomp W, Stijnen T, Huizinga TWJ, Bloem JL, van der Heijde D, Reijnierse M, van der Helm- van Mil AHM. The Course of Bone Marrow Edema in Early Undifferentiated and Rheumatoid Arthritis; A Longitudinal MRI Study on Bone Level [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/the-course-of-bone-marrow-edema-in-early-undifferentiated-and-rheumatoid-arthritis-a-longitudinal-mri-study-on-bone-level/. Accessed May 25, 2022.
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