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Objective: to study the features of rheumatoid arthritis (RA) on MRI of hands and wrists and compare MRI with clinical manifestations and laboratory tests of RA., Methods: a total of 25 patients fulfilling the 2009 ACR/EULAR RA criteria were enrolled. MRI and plain films of hands and wrists and clinical data of swollen joints, tender joints, visual scale (VAS) score, DAS28 score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), RF classification, anti-cyclic citrullinated peptide antibodies (anti-CCP antibodies) were obtained simultaneously., Results: MRI revealed pathologic findings on the wrist and hand joints in all diagnosed RA patients. VAS had a positive correlation with bone marrow edema(r = 0.562, P = 0.003). Although the disease duration was less or more than 1 year, the difference of bone erosion had statistical significance between anti-CCP antibody-positive group and anti-CCP antibody negative group (all P = 0.000). The serum concentration of RF-IgA had a positive correlation with bone marrow edema (r = 0.561, P = 0.041). The synovitis score of MRI of RA was higher in the RF-IgG positive group than that in the RF-IgG negative group (P = 0.035). There was significant difference in MRI synovitis between the RF-IgG or RF-IgM positive and negative groups of patients with a disease course of under 1 year (P = 0.015, P = 0.007). The serum CRP level had a positive correlation with arthroderma (r = 0.457, P = 0.022)., Conclusion: MRI is proved to be a valuable examination for an early diagnosis and assessment of RA.

Objective: To investigate the significance of citrullinated collagen type II and its antibodies in the pathogenesis and diagnosis of rheumatoid arthritis (RA)., Methods: Serum samples were obtained from 175 patients with RA, 112 patients with systemic lupus erythematosus (SLE), 37 patients with osteoarthritis (OA), and 160 healthy controls. Arginine residues of bovine collagen type II (bCII) were converted to citrulline residues by peptidylarginine deiminase (PAD). The presence of antibodies against citullinated bCII (Cit-bCII) and bCII, a substrate protein of PAD, were examined by using enzyme-linked immunosorbent assay (ELISA) and Western blotting. The levels of anti-cyclic citrullinated peptide (CCP) antibodies, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF) in the above patients were detected., Results: The positive rate of anti-CitbCII antibodies of the RA patients was 50.3% (88/175), significantly higher than those of the SLE patients (17.9%, 20/112), OA patients (18.9%, 7/37), and healthy controls (2.5%, 4/160). The positive rate of anti-b of the RA patients was 33.7% (59/175), significantly lower than that of the CII antibodies. The levels of anti-CitbCII and anti-bCII antibodies were not statistically different from SLE and OA patients. There was a close correlation between anti-CitbCII and anti-CCP antibodies. Spearman correlation analysis showed that anti-CitbCII antibodies were positively correlated with anti-CCP antibodies, and CRP, ESR, RF, X ray imaging, course of disease, and age were not associated with anti-CitbCII antibodies., Conclusion: Anti-citrullinated bCII antibody is relatively RA-specific. Citrullination appears to be important in RA.