rss
Ann Rheum Dis 2009;68:279-282 doi:10.1136/ard.2008.096024
  • Basic and translational research

Cellular characterisation of magnetic resonance imaging bone oedema in rheumatoid arthritis; implications for pathogenesis of erosive disease

  1. N Dalbeth,
  2. T Smith,
  3. S Gray,
  4. A Doyle,
  5. P Antill,
  6. M Lobo,
  7. E Robinson,
  8. A King,
  9. J Cornish,
  10. G Shalley,
  11. A Gao,
  12. F M McQueen
  1. University of Auckland, Auckland, New Zealand
  1. Dr Nicola Dalbeth, Bone Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, Grafton, Auckland, New Zealand; n.dalbeth{at}auckland.ac.nz
  • Accepted 22 August 2008
  • Published Online First 2 September 2008

Abstract

Objectives: Magnetic resonance imaging (MRI) bone oedema is an important predictor of bone erosion in rheumatoid arthritis (RA). This study aimed to determine the cellular components of MRI bone oedema, and clarify the relationship between bone erosion and MRI bone oedema.

Methods: Twenty-eight bones from 11 patients with RA undergoing orthopaedic surgery were analysed by quantitative and semi-quantitative immunohistochemistry. Pre-operative contrast-enhanced MRI scans were analysed for bone oedema.

Results: The density of osteoclasts was higher in those samples with MRI bone oedema than those without MRI bone oedema (p = 0.01). Other cells identified within bone marrow included macrophages and plasma cells, and these were more numerous in samples with MRI bone oedema (p = 0.02 and 0.05 respectively). B cells were present in lower numbers, but B cell aggregates were identified in some samples with MRI bone oedema. There was a trend to increased RANKL expression in samples with MRI bone oedema (p = 0.09). Expression of RANKL correlated with the number of osteoclasts (r = 0.592, p = 0.004).

Conclusions: The increased number of osteoclasts and RANKL expression in samples with MRI bone oedema supports the hypothesis that bone erosion in RA occurs through activation of local bone resorption mechanisms within subchondral bone as well as through synovial invasion into bone.

Footnotes

  • Competing interests: None.

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. web only appendix
  5. All versions of this article:
    1. ard.2008.096024v1
    2. 68/2/279 most recent

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.