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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EConventional radiography has long been used to track changes and diagnose rheumatoid arthritis (RA), ankylosing spondylitis, and osteoarthritis. Though still valuable, conventional radiography cannot detect soft tissue changes or early RA bone damage. Magnetic resonance imaging (MRI) and ultrasonography (US) allow direct visualization of early inflammatory changes in the joint. MRI measurements\/scores for erosion, bone edema, and synovitis have been developed for the hand, wrist, and foot.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Erheumatoid arthritis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Einflammatory disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Earthritis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Emagnetic resonance imaging\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/6\/3\/28\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Prof. Mikkel \u0026#xD8;stergaard\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-167183714\u0022 data-figure-caption=\u0022Prof. Mikkel \u0026#xD8;stergaard\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure1\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/6\/3\/28\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/6\/3\/28\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure1\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/6\/3\/28\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/10860\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\n               \u003Cp id=\u0022p-2\u0022 class=\u0022first-child\u0022\u003EProf. Mikkel \u00d8stergaard\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EConventional radiography has long been used to track changes and diagnose RA, AS, and OA. Though still valuable, conventional radiography cannot detect soft tissue changes or early RA bone damage. Magnetic resonance imaging (MRI) and ultrasonography (US) allow direct visualization of early inflammatory changes in the joint. MRI measurements\/scores for erosion, bone edema, and synovitis have been developed for the hand, wrist, and foot. Prof. Mikkel \u00d8stergaard, Copenhagen University Hospitals at Herlev and Hvvidovre, Denmark, discussed the advantages of using MRI and US for the diagnosis and follow-up of RA and other inflammatory diseases, delineating the following clinical situations where using MRI or US would be beneficial: suspected inflammatory joint disease to determine the presence or absence of synovitis, erosions, etc; clinically difficult RA, for prognostication and establishing baseline values in early RA (MRI only); and to guide aspirations and injections of joints, bursae or tendon sheaths (US only).\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EMRI discriminates better than x-ray between efficient and inefficient therapy, as well as baseline erosive progression. In clinical studies, baseline MRI findings predicted unilateral wrist and metacarpophalangeal joint erosions after 12 weeks versus 24 weeks with radiography. It is also possible to improve diagnoses of sacroiliitis accompanying AS using MRI versus radiography. MRI reveals early cartilage changes and bone marrow edema associated with AS and picks up an additional 75% of early cases not diagnosed by radiography.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EProf. \u00d8stergaard concluded by saying \u201cMRI could be a useful element in future diagnostic criteria in early RA. High baseline combined scores of wrist joint MRI erosions and synovitis was the best predictor (OR 3.59) of severe radiological erosive progression 10 years later.\u201d (\u003Cem\u003EAnn Rheum Dis.\u003C\/em\u003E 2005;64:1280\u20137; 64 Suppl 1:123\u201347; \u003Cem\u003EJ Rheum\u003C\/em\u003E 1996;23:2107\u201315; \u003Cem\u003ESkeletal Radiol\u003C\/em\u003E 1998;27:311\u201320; \u003Cem\u003EArthritis Rheum.\u003C\/em\u003E 2004;50:2622\u201332).\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EThe main extraspinal manifestations of AS, peripheral enthesitis and arthritis, are usually diagnosed clinically, but ultrasound and MRI may be helpful. Dr. Xenophaon Baraliakos, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Germany, stated that \u201cdespite limitations, scintigraphy of the sacroiliac joint (SIJ) is a useful screening method for detecting bony or entheseal inflammation.\u201d The overall sensitivity for the detection of active sacroiliitis is 95% to 100% for MRI, 48% to 71% for scintigraphy, and 19% to 33% for conventional radiography. Conventional radiography is still the most common method employed for the diagnosis of AS, as well as AS related structural spinal changes, such as syndesmophytes and ankylosis. Dr. Baraliakos presented data showing that examination of the spine with MRI is useful in assessing inflammatory changes or for diagnosis of early and active stages of the disease. MRI sequences useful for assessing active disease are the STIR (short \u003Cem\u003Etau\u003C\/em\u003E inversion recovery), the T2-fat saturated, and the T1 post-adolinium MRI sequence. The thoracic spine is the most commonly affected area in AS. For assessment of structural changes in this area, the T1-weighted MRI sequence is used (\u003Cem\u003EAnn Rheum Dis.\u003C\/em\u003E 2005;64:1462\u20136; 2004;63:1046\u201355; \u003Cem\u003EArthritis Rheum.\u003C\/em\u003E 2005;52:1756\u201365; 52(4):1216\u201323; \u003Cem\u003EMagn Reson Imaging.\u003C\/em\u003E 1999; 42:695\u2013703).\u003C\/p\u003E\n         \u003Cdiv id=\u0022F2\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/6\/3\/28\/F2.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Philip Lang, MD\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-167183714\u0022 data-figure-caption=\u0022Philip Lang, MD\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure2\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/6\/3\/28\/F2.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/6\/3\/28\/F2.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure2\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/6\/3\/28\/F2.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/10862\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022\u003E\n               \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EPhilip Lang, MD\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EDr. Philip Lang, Department of Radiology, Harvard Medical School, Cambridge, MA, believes MRI has the potential to detect signal and morphological changes in the cartilage associated with OA if used with targeted visual scoring methods and targeted quantitative techniques. \u201cBy using a scoring system designed to capture entire spectrums of cartilage disease, not only late disease, scoring subsegments within each compartment, and using a focal assessment targeted to the disease area, we can maximize the scoring system sensitivity to change.\u201d said Dr Lang. (\u003Cem\u003EArthritis Rheum.\u003C\/em\u003E 2002;46:2065\u201372).\u003C\/p\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EProf. Philip Conaghan, University of Leeds, Leeds, UK, and Prof. Desiree Van der Heijde of the University Hospital Maastricht, Netherlands, session Co-Chairs, closed by expressing the opinion that diagnosis and management of inflammatory disease is going through exciting changes, in part due to the advances in diagnostic and imaging techniques.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2006 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/6\/3\/28.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzm5lq\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzm5lq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}