A cross sectional study of bone and cartilage biomarkers: correlation with structural damage in rheumatoid arthritis.

The aim of our study was to assess the relationship between bone and cartilage remodeling biomarkers and joint damage in Rheumatoid Arthritis (RA), and to detect whether they have the capacity to predict the progression of joint disease assessment by computed tomography (CT) erosion score. We analyzed 65 female patients with established RA in our Rheumatology Department. Serum levels of bone and cartilage markers were measured: osteocalcin (OC), N-propeptide of type I collagen (PINP), collagen type I and II, C-telopeptide (CTX I, CTX-II) and cartilage oligomeric matrix protein (COMP). Radiography of both wrist and MCP joints were available. Two expert-readers independently scored articular damage and progression using the High-resolution low dose CT scan in a blinded fashion. 65 female patients with established RA with a median age of 44 years were included. The median disease-duration was two years and the median (Disease activity score) DAS 28 score at 4.46 [2.65-7.36]. The percentage of patient with low disease activity was 13.8%, while 55.4 and 30.8% for those with moderate and high disease activity respectively. The resorption bone markers were high in active versus non-active RA. Wrist and MCP erosion scores were also associated with RA activity. Our study shows that biomarkers of bone and cartilage collagen breakdown were related to specific joint erosion in RA and could predict subsequent radiographic damage in RA. Further larger scale longitudinal studies maybe needed to confirm our data.

Imaging of Benign Tumors of the Osseous Spine.

The purpose of this paper is to present an overview of the imaging features of the most prevalent benign bone tumors involving the spine. Benign tumors of the osseous spine account approximately for 1% of all primary skeletal tumors. Many lesions exhibit characteristic radiologic features. In addition to age and location of the lesion, radiographs are an essential step in the initial detection and characterization but are limited to complex anatomy and superposition. CT and MR imaging are often mandatory for further characterization, assessment of local extension and guiding biopsy.

Imaging of Malignant Primitive Tumors of the Spine.

Primary malignant tumors of the spine are rare and mainly include chordoma, chondrosarcoma, Ewing sarcoma or primitive neuroectodermal tumor, and osteosarcoma. The final diagnosis is based on the combination of patient age, topographic and histologic features of the tumor, and lesion pattern on computed tomography (CT) and magnetic resonance (MR) imaging. Imaging evaluation includes radiography, CT, bone scintigraphy, and MR imaging. CT is more useful than radiography for evaluating location of the lesion and analyzing bone destruction and matrix, whereas MR has unmatched ability to assess soft tissue extension. This pictorial review provides an overview of the most prevalent primitive malignant tumors of spine.

Traumatic Meniscus and Cruciate Ligament Tears in Young Patients: A Comparison of 3T Versus 1.5T MRI.

OBJECTIVE: To compare diagnosis value of 1.5T and 3T MRI in the detection of traumatic knee injuries in young patients by reference to arthroscopy. MATERIALS AND METHODS: One hundred patients were prospectively included. All patients randomly underwent standardized knee 1.5T or 3T MRI with subsequent knee arthroscopy. Meniscus and cruciate ligaments tears were blindly assessed by two independent musculoskeletal radiologists. RESULTS: Comparison of 1.5T and 3T MRI groups in the diagnosis of medial and lateral meniscal tears showed significantly higher sensitivity (p = 0.015) of 1.5T MRI in the diagnosis of lateral meniscal tears. Sensitivity and specificity for complete ACL tears were 100 percent [35/35] and 100 percent [23/23] at 1.5T MRI (p = < 0.0001) versus 95.5 percent [21/22] and 100 percent [16/16] at 3T MRI (p = < 0.0001).Only three complete PCL tears were observed in this study. Sensitivity and specificity for all complete CL tears were 100 percent [37/37]; 100 percent [77/77] for 1.5T MRI (p < 0.0001); and 95.7 percent [22/23] and 100 percent [59/59] for 3-T MRI (p < 0.0001). Diagnosis value of 1.5T and 3T MRI was equal for ACL and PCL complete tears. CONCLUSION: Diagnosis value of 1.5T was similar to 3T MRI for medial meniscal and cruciate ligament tears of the knee in symptomatic patients and higher for lateral meniscal tears.

[The value of MRI in the diagnosis of joint involvement in malignant primitive tumors of the knee]. / Valeur de l'IRM dans le diagnostic de l'envahissement articulaire par les sarcomes osseux du genou.

INTRODUCTION: Surgical treatment of malignant primitive tumors of bone needs a precise preoperative assessment of tumor local extension. Joint involvement (JI) represents the most important finding to determine, for the choice of surgical procedure (intra- or extra-articular resection). OBJECTIVE: To determine the value of different MR signs for the diagnosis of joint involvement in malignant primitive tumors of the knee. METHODS: Ten-year period retrospective study of 42 patients. Patients' clinical and imaging data have been studied. Two senior musculoskeletal radiologists have blindly and consensually reviewed imaging data. Histopathological data have been reviewed by an experimented pathologist. The results have been compared using several statistical methods to determine the global and detailed (sign by sign) diagnostic value and accuracy of MRI by reference to histopathology. RESULTS: Some MR signs were performant in the diagnosis of joint involvement. The most sensitive were epiphyseal extension (Se: 100%), osteochondral extension (Se: 87.5%) and extension to the tibial spines (Se: 83.3%). The most specific MR signs were the presence of an intra-articular mass (Sp: 84.62%), extension to the intercondylar notch (Sp: 80.77%) and longitudinal axis≥120mm (Sp: 84.62%). CONCLUSION: A rigorous and reproducible MR technique has to be used, the knee being explored in the transversal, sagittal and coronal planes. MR conclusion has to be clear and simple (intact, doubtful or involved joint). MR interpretation has to consider tumoral extension pathways. In doubtful cases, CT may help in this diagnosis by studying the bone cortex. LEVEL OF EVIDENCE: IV.