PT - JOURNAL ARTICLE AU - Barbara Herz AU - Andreas Albrecht AU - Matthias Englbrecht AU - Götz H Welsch AU - Michael Uder AU - Nina Renner AU - Philipp Schlechtweg AU - Dominik Paul AU - Lars Lauer AU - Klaus Engelke AU - Rolf Janka AU - Jürgen Rech AU - Georg Schett AU - Stephanie Finzel TI - Osteitis and synovitis, but not bone erosion, is associated with proteoglycan loss and microstructure damage in the cartilage of patients with rheumatoid arthritis AID - 10.1136/annrheumdis-2012-202850 DP - 2014 Jun 01 TA - Annals of the Rheumatic Diseases PG - 1101--1106 VI - 73 IP - 6 4099 - http://ard.bmj.com/content/73/6/1101.short 4100 - http://ard.bmj.com/content/73/6/1101.full SO - Ann Rheum Dis2014 Jun 01; 73 AB - Objectives To investigate the relation between anatomic changes of the synovium, the bone, the bone marrow and the cartilage to biochemical properties of the cartilage in patients with rheumatoid arthritis (RA). Methods 33 patients with RA received 3-T MRI scans of the metacarpophalangeal joints. Two independent methods, (A) the delayed gadolinium enhanced MRI of the cartilage (dGEMRIC, T2-mapping), which was used to assess the biochemical properties of the cartilage; (B) synovitis, osteitis and bone erosions were quantified according to the RA MRI scoring (RAMRIS) method and cartilage thickness (CT), interbone joint space (IBJS, distance between proximal and distal bone surface) and intercartilage joint space (ICJS, distance between proximal and distal cartilage surface) were measured. Results Biochemical changes of the cartilage, corresponding to low dGEMRIC and high T2 values, were more likely to be seen in joints with decreased IBJS and ICJS as well as decreased CT. For instance, dGEMRIC was directly correlated to the IBJS (p=0.001) and ICJS (p=0.001), whereas T2 mapping was inversely correlated to IBJS and ICJS (both p=0.017). Moreover, the degree of osteitis, and to some extent synovitis, was correlated to biochemical cartilage changes as measured by dGEMRIC (p=0.003) or the T2 mapping (p=0.013). By contrast, bone erosions did not correlate to the degree of biochemical cartilage changes. Discussion These data support the concept that synovitis and osteitis may be two main triggers for cartilage damage. Thus, the actual inflammatory state of a joint, but not so much the degree of bone erosion, appears to influence cartilage properties in RA.