99m Tc-albumin nanocolloid joint scintigraphy in rheumatoid arthritis patients who are in clinical remission - is remission real ?

CER644
2010 Vol.28, N°3
PI 0360, PF 0364
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PMID: 20426913 [PubMed]

Received: 26/09/2009
Accepted : 08/01/2010
In Press: 23/06/2010
Published: 23/06/2010

Abstract

OBJECTIVES:
To make a comparison between the clinical data and the imaging results with 99mTc-nanocolloid scintigraphy in rheumatoid arthritis (RA) patients considered to be in remission.
METHODS:
Forty RA patients found to be in clinical remission according to the ACR and the EULAR (DAS28<2.6) criteria were studied. The group included 29 females and 11 males with a mean age of 60.8±13.5 years (range 22–86) and a mean disease duration of 13.4±7.7 years (range 2–23). The mean time of remission in the study group was 22.2±5.2 months (range 11-36). Each patient was given an intravenous injection of 555MBq of 99mTc-nanocalloid (NC). Spot views of the skeleton were taken and a SPECT-CT was done on the wrists and hands. A scan was considered positive when at least one of the hand joints showed increased tracer uptake.
RESULTS:
The 99mTc-nanocalloid scintigraphy was negative in 14 (35%) and positive for active joint disease in 26 (65%) patients. Twenty four out of the 26 patients with positive scan (92%) were sero-positive while those who had a negative scintigraphy were all sero-negative except one. No correlation was found between the type of treatment used, the time that elapsed from remission, or laboratory parameters (ESR CRP) and the scintigraphic results.
CONCLUSIONS:
The clinical criteria used for remission in RA are not consistent with the actual inflammatory activity in the joints. These results are especially emphasised in the subgroup of sero-positive patients.