Rheumatoid arthritis imaging

Selective AR agonists are undergoing clinical trials for cardiac arrhythmias and pain (Ai) cardiac imaging and inflammation (A2a) colon cancer, rheumatoid arthritis, psoriasis, and dry eye (A3). Selective AR antagonists are either in or advancing toward clinical trials for kidney disorders (Ax) Parkinson s disease (A2a) diabetes and asthma (A2B) cancer and glaucoma (A3). 

Keen HI, Emery P. How should we manage early rheumatoid arthritis From imaging to intervention. Curr Opin Rheumatol 2005 17(3) 280-285. 

C. M. Paulos, M. J. Turk, G. J. Breur, and P. S. Low. Folate receptor-mediated targeting of therapeutic and imaging agents to activated macrophages in rheumatoid arthritis. Adv. Drug Deliv. Rev. 56 1205-1217 (2004). 

Taylor P. VEGF and imaging of vessels in rheumatoid arthritis. Arthritis Res 2002 4(Suppl 3) S99-S107. 

Ando Y, Kai S, Uyama E lyonaga K, Hashimoto Y, Uchino M, Andro M (1995) Involvement of the central nervous system in rheumatoid arthritis its clinical manifestations and analysis by magnetic resonance imaging. Intern Med 34 188-191. 

A 45-year-old woman with resistant rheumatoid arthritis was given etanercept 25 mg twice weekly. Nine days later she developed total acute sensory loss, with flaccid paraplegia, fecal incontinence, and urinary retention. MRI imaging and cerebrospinal fluid analysis were consistent with a diagnosis of transverse myelitis. She also had positive antinuclear and anticardiohpin antibodies. After etanercept withdrawal and treatment with dexa-methasone and cyclophosphamide, her motor function improved with no change in sensory function. 

The targeting of molecular markers associated with inflammation could, in principle, be useful for the imaging and therapy of several other inflammatory diseases. Besides rheumatoid arthritis, these include inflammatory bowel diseases (Crohn s disease and ulcerative cohtis), psoriasis, atherosclerosis, and diseases of the central nervous system (Alzheimeris disease, multiple sclerosis, etc.). 

Conaghan PG, O Connor P, McGonagle D, Astin P, Wakeeield RJ, Gibbon WW, Quinn M, Karim Z, Green MJ, Proudman S, Isaacs J and Emery P (2003) Elucidation of the relationship between synovitis and bone damage a randomized magnetic resonance imaging study of individual joints in patients with early rheumatoid arthritis. Arthritis Rheum 48 64- 71. 

Cytokines, hormone-like proteins, enable cells of the immune system to communicate. Signore et al. (1992) have shown the feasibility of imaging infectious foci with radioiodinated cytokines. I-IL-1 has been studied to image inflammation in patients with rheumatoid arthritis. It allowed visualization of inflamed joints, but without speciflc flxation (Barrera et al., 2000). I-IL-8, radioiodinated by the Bolton-Hunter method, shows a hyperfixation in the rabbit, localized in the infectious foci, obtained by injection of Escherichia coli in the muscle (Van der Laken et al, 2000). 

Image of hands with extensive rheumatoid arthritis. This image was produced by recording the gamma emissions of a small amount of the radioisotope, a compound containing technetium-99m, which was injected into the patient. 

Carloni A, Piciucchi S, Giannakakis K, Nori G, Zobel BB, Poletti V. Diffuse alveolar hemorrhage after leflunomide therapy in a patient with rheumatoid arthritis. J Thorac Imaging 2008 23(1) 57-9. 

Shannon TM, Gale ME. Noncardiac manifestations of rheumatoid arthritis in the thorax. J Thorac Imaging 1992 7 19-29. 

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