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14 results on '"MESH: Synovitis"'

1. Predictors of radiographic progression in the ESPOIR cohort: the season of first symptoms may influence the short-term outcome in early arthritis

Author

Mouterde, G., Lukas, C., Logeart, I., Flipo, R. M., Rincheval, N., Daurès, J. P., Combe, B., Saraux, Alain, Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Service de rhumatologie[Lille], Hôpital Roger Salengro [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, MESH: Synovitis, [SDV]Life Sciences [q-bio], MESH: Epidemiologic Methods, Logistic regression, Arthritis, Rheumatoid, 0302 clinical medicine, MESH: Early Diagnosis, MESH: Autoantibodies, Immunology and Allergy, MESH: HLA-DRB1 Chains, MESH: Aged, MESH: Arthritis, Rheumatoid, 0303 health sciences, Univariate analysis, Synovitis, MESH: Middle Aged, medicine.diagnostic_test, Middle Aged, Prognosis, 3. Good health, MESH: Young Adult, Rheumatoid arthritis, Erythrocyte sedimentation rate, Cohort, Disease Progression, Female, MESH: Disease Progression, Seasons, Adult, medicine.medical_specialty, MESH: Rheumatoid Factor, Immunology, MESH: Arthritis, Blood Sedimentation, Peptides, Cyclic, MESH: Prognosis, General Biochemistry, Genetics and Molecular Biology, Young Adult, 03 medical and health sciences, Rheumatology, Rheumatoid Factor, Internal medicine, medicine, Humans, Rheumatoid factor, MESH: Blood Sedimentation, MESH: Peptides, Cyclic, Aged, Autoantibodies, 030304 developmental biology, 030203 arthritis & rheumatology, MESH: Humans, Receiver operating characteristic, business.industry, Arthritis, MESH: Biological Markers, MESH: Adult, HLA-DR Antigens, MESH: HLA-DR Antigens, medicine.disease, MESH: Male, Surgery, Radiography, Early Diagnosis, Epidemiologic Methods, business, MESH: Female, MESH: Seasons, Biomarkers, HLA-DRB1 Chains
Abstract

International audience; OBJECTIVES: To determine predictors of short-term radiographic progression in an inception cohort of patients with early arthritis. METHODS: Patients presenting with synovitis of at least two joints for 6 weeks to 6 months were included in the Etude et Suivi des POlyarthrites Indifferenciées Récentes (ESPOIR) cohort. Univariate analysis was used to determine the relationship between baseline variables and radiographic outcome (assessed by the modified total Sharp score (mTSS)) after 6 and 12 months. Stepwise multiple logistic regression was used to select independent predictive factors. The sensitivity and specificity of rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) at baseline in discriminating between erosive and non-erosive disease were determined by receiver operating characteristic (ROC) curves. RESULTS: From data available for 736 patients, radiographic progression at 6 months was independently predicted by baseline ACPA, human leucocyte antigen (HLA)-DRB1*01 and/or 04 genes, erythrocyte sedimentation rate and mTSS. Interestingly, the season of onset of the first symptoms was associated with the severity of early arthritis (OR 1.66, 95% CI 1.07 to 2.59, in winter and spring vs summer and autumn). Univariate analysis revealed similar results for season at 12 months (OR 1.68, 95% CI 1.20 to 2.37). The peak of the ROC curves for radiographic outcome occurred with ACPA and RF values similar to the cut-offs provided by manufacturers. CONCLUSION: The authors found the onset of arthritis symptoms during winter or spring associated with greater radiographic progression at 6 months for patients with early arthritis. These data could reinforce the role of environmental factors in the development and outcome of rheumatoid arthritis.

Published
2011
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2. Benefits of ultrasonography in the management of early arthritis: a cross-sectional study of baseline data from the ESPOIR cohort

Author

Funck-Brentano, Thomas, Etchepare, Fabien, Jousse-Joulin, Sandrine, Gandjbakch, Frédérique, Devauchelle-Pensec, Valérie, Cyteval, Catherine, Miquel, Anne, Benhamou, Mathilde, Banal, Frédéric, Le Loet, Xavier, Cantagrel, Alain, Bourgeois, Pierre, Fautrel, Bruno, Saraux, Alain, Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Hôpital Lapeyronie [Montpellier] (CHU), Physiopathologie et biothérapies des maladies inflammatoires et autoimmunes, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Rhumatologie, Université Paris Diderot - Paris 7 (UPD7), Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, Metatarsophalangeal Joint, medicine.medical_specialty, MESH: Synovitis, Cross-sectional study, Radiography, Arthritis, MESH: Observer Variation, Severity of Illness Index, Arthritis, Rheumatoid, Metacarpophalangeal Joint, 03 medical and health sciences, MESH: Cross-Sectional Studies, 0302 clinical medicine, Rheumatology, MESH: Early Diagnosis, MESH: Severity of Illness Index, Internal medicine, Immunopathology, Severity of illness, medicine, Humans, Pharmacology (medical), MESH: Metacarpophalangeal Joint, 030212 general & internal medicine, Ultrasonography, Observer Variation, 030203 arthritis & rheumatology, MESH: Arthritis, Rheumatoid, MESH: Humans, MESH: Middle Aged, Synovitis, business.industry, Middle Aged, medicine.disease, MESH: Male, MESH: Metatarsophalangeal Joint, 3. Good health, Surgery, Cross-Sectional Studies, Early Diagnosis, Rheumatoid arthritis, Cohort, Female, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; OBJECTIVE: To assess ultrasonography's (US) performance to detect the structural damage in the initial evaluation of early arthritis (EA) using the Etude et Suivides Polyarthrites Indifférenciées Récentes (ESPOIR) cohort. METHODS: ESPOIR is a French, multi-centric EA cohort. Four centres assessed the structural damage by both X-ray and US examination at baseline. X-rays of hands and feet were read first by the centre's local investigator (usual reading), then in the X-ray coordinating centre (central reading). Four trained examiners performed US blindly from clinical data to detect erosions on the second and fifth MCP (MCP2 and 5) and the fifth MTP (MTP5) joints bilaterally. RESULTS: Patients' characteristics (n = 126) were: female 78%; mean age 50.3 years; disease duration 103 days; disease activity score on 28 joints 5; CRP level 22.7 mg/l; and 79.4% of the patients fulfilling RA ACR criteria. Twelve patients had missing data for X-rays. US revealed 42 (36.8%) patients with erosive disease, whereas radiography revealed only 30 (26%) with central reading and only 11% with usual reading. US missed erosive disease present in X-rays in 10 (8.8%) patients. Combined technique of both revealed 52 (45.6%) patients with erosive diseases. On the targeted joints, US detected erosion on 75 (11%) joints vs X-rays on only 11 (1.5%). Only three joints with erosion(s) detected on X-rays were missed on US. At baseline, the presence of PD activity was not associated with joint erosions. CONCLUSIONS: US on six joints detected 1.4-fold more patients with erosions (3.3-fold more with the usual reading). In clinical practice, US combined with X-rays is of helpful diagnostic value in EA.

Published
2009
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3. Evaluation of serum interleukin-6 level as a surrogate marker of synovial inflammation and as a factor of structural progression in early rheumatoid arthritis: results from a French national multicenter cohort

Author

Baillet, Athan, Gossec, Laure, Paternotte, Simon, Etcheto, Adrien, Combe, Bernard, Meyer, Olivier, Mariette, Xavier, Gottenberg, Jacques-Eric, Dougados, Maxime, Saraux, Alain, Service de Rhumatologie [CHU Pitié Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Institut de Génétique Moléculaire de Montpellier (IGMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université Paris Diderot - Paris 7 (UPD7), Hôpital Bichat, AP-HP, Service de rhumatologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Régulation de la réponse immune, infection VIH-1 et autoimmunité, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Lymphocytes B, Autoimmunité et Immunothérapies (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Rhumatologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie, Institut de Génétique Moléculaire de Montpellier ( IGMM ), Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Diderot - Paris 7 ( UPD7 ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de Strasbourg ( UNISTRA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'Investigation Clinique INSERM 1412 ( CIC 1412 - BREST ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Lymphocyte B et Auto-immunité ( LBAI ), Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHRU Brest - Service de Rhumatologie ( CHU - BREST - Rhumato ), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Bicêtre, Centre d'Investigation Clinique INSERM 1412 (CIC 1412 - BREST), Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Strasbourg (UNISTRA)

Subjects
Male, MESH: Synovitis, [SDV]Life Sciences [q-bio], Arthritis, Rheumatoid, Cohort Studies, MESH : Female, Longitudinal Studies, MESH : Biomarkers, MESH: Longitudinal Studies, MESH: Cohort Studies, Ultrasonography, MESH : Longitudinal Studies, MESH : Synovitis, MESH : Ultrasonography, MESH: Arthritis, Rheumatoid, Synovitis, MESH: Middle Aged, MESH: Follow-Up Studies, Middle Aged, MESH : Adult, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Disease Progression, Female, MESH: Disease Progression, France, Adult, MESH : Interleukin-6, MESH : Male, MESH : Cohort Studies, [ SDV.MHEP.RSOA ] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Humans, MESH : Middle Aged, MESH : France, MESH: Humans, [ SDV ] Life Sciences [q-bio], Interleukin-6, MESH : Humans, MESH : Follow-Up Studies, MESH: Adult, MESH : Disease Progression, MESH: Interleukin-6, MESH: Male, MESH: France, MESH : Arthritis, Rheumatoid, MESH: Biomarkers, MESH: Female, Biomarkers, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies, MESH: Ultrasonography
Abstract

International audience; Objective: Interleukin-6 (IL-6) is a key cytokine in rheumatoid arthritis pathogenesis. We aimed to analyze the association between IL-6 serum levels and joint inflammation at baseline and the correlation of time-integrated IL-6 values with structural damage during the first 36 months of early arthritis.Methods: IL-6 was assessed by 2 different methods in 813 patients of the French early arthritis cohort ESPOIR (Etude et Suivi des Polyarthrites Indifférenciées Récentes) over 36 months. IL-6 and C-reactive protein (CRP) changes were correlated to radiographic progression assessed by the total Sharp/van der Heijde score (SHS). Synovium inflammation was assessed in a subgroup of 126 patients by ultrasonography (US). The relationship between SHS change and IL-6 or CRP levels at baseline was investigated by a univariate regression and a multivariable analysis. A longitudinal model nested by visit and patient was conducted to assess the role of IL-6 on SHS at each visit.Results: At baseline, IL-6 was more strongly correlated with the swollen joint count than CRP level. In the univariate analysis, the time-integrated value of IL-6 was more strongly correlated with the swollen joint count and the variation of SHS than time-integrated CRP level. Baseline IL-6 was not independently associated with SHS change. Longitudinal models nested by patient showed that IL-6 levels were associated with structural damage independently from the Disease Activity Score in 28 joints, smoking status, rheumatoid factor, and anti-citrullinated protein peptide antibody serology, treatments, and CRP levels.Conclusion: IL-6 level was a marker of US synovitis at baseline. Repeated measurements of IL-6 are associated with structural damage.

Published
2015
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4. The ability of synovitis to predict structural damage in rheumatoid arthritis: a comparative study between clinical examination and ultrasound

Author

Maxime, Dougados, Valérie, Devauchelle-Pensec, Jean François, Ferlet, Sandrine, Jousse-Joulin, Maria-Antonietta, D'Agostino, Marina, Backhaus, Jacques, Bentin, Gérard, Chalès, Isabelle, Chary-Valckenaere, Philip, Conaghan, Richard J, Wakefield, Fabien, Etchepare, Frédéric, Etcheparre, Philippe, Gaudin, Walter, Grassi, Désirée van der, Heijde, Xavier, Mariette, Esperanza, Naredo, Marcin, Szkudlarek, Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Statistique, RCTS, Lyon, RCTS Lyon, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Service de Rhumatologie, CHU Brugmann, CHU Brugmann, Belgium, CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Section of Musculoskeletal Diseasee, University of Leeds, Academic Unit of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, Chapel Allerton Hospital, Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Rhumatologie [CHU de Grenoble], Hôpital Sud de Grenoble, Univ Ancona, Politecn Marche, Leiden University Medical Center (LUMC), Universiteit Leiden, CHU Le Kremlin-Bicêtre (Rheumatology Department), Department of Rheumatology, Severo Ochoa Hospital, Hvidovre University Hospital, and University of Leeds & NIHR Leeds Musculoskeletal Biomedical Research Unit

Subjects
Male, Settore MED/16 - REUMATOLOGIA, MESH: Synovitis, Arthritis, Rheumatoid, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, Rheumatoid, Immunologie, Immunology and Allergy, Medicine, 030212 general & internal medicine, Longitudinal Studies, Prospective Studies, Prospective cohort study, MESH: Longitudinal Studies, Ultrasonography, MESH: Aged, MESH: Arthritis, Rheumatoid, Synovitis, MESH: Middle Aged, medicine.diagnostic_test, Ultrasound, Doppler, MESH: Follow-Up Studies, Middle Aged, Connective tissue disease, MESH: Predictive Value of Tests, 3. Good health, MESH: Reproducibility of Results, Rhumatologie, MESH: Joints, Rheumatoid arthritis, Predictive value of tests, Disease Progression, Female, MESH: Disease Progression, Radiology, Biologie, Adult, medicine.medical_specialty, Allergie et immunopathologie, Immunology, Physical examination, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Power doppler, MESH: Physical Examination, Rheumatology, Predictive Value of Tests, Humans, [SDV.BBM.BC]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biochemistry [q-bio.BM], Physical Examination, Aged, 030203 arthritis & rheumatology, MESH: Humans, business.industry, Arthritis, Reproducibility of Results, Ultrasonography, Doppler, MESH: Adult, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Clinical and Epidemiological Research, medicine.disease, MESH: Prospective Studies, MESH: Male, Surgery, MESH: Ultrasonography, Doppler, Joints, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract

Objectives To evaluate synovitis (clinical vs ultrasound (US)) to predict structural progression in rheumatoid arthritis (RA). Methods Patients with RA. Study design Prospective, 2-year follow-up. Data collected Synovitis (32 joints (2 wrists, 10 metacarpophalangeal, 10 proximal interphalangeal, 10 metatarsophalangeal)) at baseline and after 4 months of therapy by clinical, US grey scale (GS-US) and power doppler (PD-US); x-rays at baseline and at year 2. Analysis Measures of association (OR) were tested between structural deterioration and the presence of baseline synovitis, or its persistence, after 4 months of therapy using generalised estimating equation analysis. Results Structural deterioration was observed in 9% of the 1888 evaluated joints in 59 patients. Baseline synovitis increased the risk of structural progression: OR=2.01 (1.36-2.98) p, SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2013
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5. Improving agreement in assessment of synovitis in rheumatoid arthritis

Author

Peter P. Cheung, Emmanuel Chatelus, François Pouyol, Adeline Ruyssen-Witrand, Laure Gossec, Mélanie Gilson, Sandrine Guis, Martin Soubrier, Nathalie Balandraud, Thierry Marhadour, Pascal Richette, Ghislaine Gill, Isabelle Chary-Valckenaere, Stephan Pavy, Emmanuelle Dernis, Vincent André, Gérard Chalès, Gaël Mouterde, Maxime Dougados, National University Health System, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Centre Hospitalier du Mans, Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), CHU Pontchaillou [Rennes], Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Rhumatologie, Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de Référence pour les Maladies Systémiques Autoimmunes Rares, CHU Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Lapeyronie, Service de rhumatologie, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hôpital Roger Salengro, CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), AP-HP, pôle appareil locomoteur, Service de rhumatologie, Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], CHU Gabriel Montpied (CHU), CHU Clermont-Ferrand, National University Health System [Singapore] (NUHS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Roger Salengro [Lille], Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), CHU Gabriel Montpied [Clermont-Ferrand], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Paris Descartes - Faculté de Médecine ( UPD5 Médecine ), Université Paris Descartes - Paris 5 ( UPD5 ), Hôpital Sainte-Marguerite [CHU - APHM] ( Hôpitaux Sud ), Ingénierie Moléculaire et Physiopathologie Articulaire ( IMoPA ), Université de Lorraine ( UL ) -Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble, Centre de résonance magnétique biologique et médicale ( CRMBM ), Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) -Centre National de la Recherche Scientifique ( CNRS ), CHRU Brest - Service de Rhumatologie ( CHU - BREST - Rhumato ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 ( UPD7 ), and CHU Gabriel Montpied ( CHU )

Subjects
Male, MESH: Synovitis, MESH : Aged, Arthritis, MESH: Observer Variation, Severity of Illness Index, MESH : Consensus, Arthritis, Rheumatoid, MESH : Cross-Sectional Studies, [ SDV.BBM.BC ] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biomolecules [q-bio.BM], 0302 clinical medicine, Medicine, MESH : Female, 030212 general & internal medicine, skin and connective tissue diseases, MESH : Joints, MESH : Synovitis, Observer Variation, MESH: Aged, MESH: Arthritis, Rheumatoid, Synovitis, MESH: Middle Aged, medicine.diagnostic_test, Swollen joints, MESH : Adult, Middle Aged, 3. Good health, [SDV.BBM.BC]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biomolecules [q-bio.BM], MESH: Reproducibility of Results, MESH: Joints, Rheumatoid arthritis, MESH : Severity of Illness Index, Female, Clinical Competence, MESH: Clinical Competence, Clinical competence, Adult, musculoskeletal diseases, medicine.medical_specialty, Validation study, Consensus, MESH : Male, Physical examination, [ SDV.BBM.BM ] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, 03 medical and health sciences, MESH: Cross-Sectional Studies, Rheumatology, MESH: Rheumatology, MESH: Severity of Illness Index, Humans, MESH : Middle Aged, [SDV.BBM.BC]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biochemistry [q-bio.BM], MESH: Consensus, MESH : Rheumatology, Aged, 030203 arthritis & rheumatology, MESH: Humans, business.industry, MESH : Reproducibility of Results, MESH : Humans, Reproducibility of Results, MESH: Adult, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, MESH : Observer Variation, medicine.disease, MESH : Clinical Competence, MESH: Male, Cross-Sectional Studies, MESH : Arthritis, Rheumatoid, Physical therapy, Joints, Treatment decision making, business, MESH: Female
Abstract

International audience; Synovitis assessment through evaluation of swollen joints is integral in steering treatment decisions in rheumatoid arthritis (RA). However, there is high inter-observer variation. The objective was to assess if a short collegiate consensus would improve swollen joint agreement between rheumatologists and whether this was affected by experience.; Eighteen rheumatologists from French university rheumatology units participated in three 30 minutes rounds over a half day meeting evaluating joint counts of RA patients in small groups, followed by short consensus discussions. Agreement was evaluated at the end of each round as follows: (i) global agreement of swollen joints (ii) swollen joint agreement according to level of experience of the rheumatologist (iii) swollen joint count and (iv) agreement of disease activity state according to the Disease Activity Score (DAS28). Agreement was calculated using percentage agreement and kappa.; Global agreement of swollen joints failed to improve (kappa 0.50 to 0.52) at the joint level. Agreement between seniors did not improve but agreement between newly qualified rheumatologists and their senior peer, which was initially poor (kappa 0.28), improved significantly (to 0.54) at the end of the consensus exercises. Concordance of DAS28 activity states improved from 71% to 87%.; Consensus exercises for swollen joint assessment is worthwhile and may potentially improve agreement between clinicians in clinical synovitis and disease activity state, benefit was mostly observed in newly qualified rheumatologists.

Published
2013
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6. Evidence of the symptomatic and structural efficacy of methotrexate in daily practice as the first disease-modifying drug in rheumatoid arthritis despite its suboptimal use: results from the ESPOIR early synovitis cohort

Author

Gaujoux-Viala, Cécile, Paternotte, Simon, Combe, Bernard, Dougados, Maxime, Saraux, Alain, Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de Génétique Moléculaire de Montpellier (IGMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Rhumatologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Institut de Génétique Moléculaire de Montpellier ( IGMM ), Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Immunologie et Pathologie ( EA2216 ), Université de Brest ( UBO ) -IFR148, CHRU Brest - Service de Rhumatologie ( CHU - BREST - Rhumato ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Centre d'Investigation Clinique ( CIC - Brest ), and Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM )

Subjects
Male, MESH: Antirheumatic Agents, MESH: Synovitis, Health Status, MESH : Aged, Arthritis, MESH : Dose-Response Relationship, Drug, Severity of Illness Index, Gastroenterology, MESH: Dose-Response Relationship, Drug, Arthritis, Rheumatoid, Cohort Studies, 0302 clinical medicine, Outcome Assessment, Health Care, Pharmacology (medical), MESH : Female, 030212 general & internal medicine, skin and connective tissue diseases, MESH: Cohort Studies, MESH: Health Status, media_common, MESH: Treatment Outcome, MESH : Synovitis, MESH: Aged, MESH: Arthritis, Rheumatoid, Synovitis, MESH: Middle Aged, Middle Aged, MESH : Adult, MESH : Antirheumatic Agents, 3. Good health, Treatment Outcome, MESH: Methotrexate, MESH: Young Adult, Antirheumatic Agents, Rheumatoid arthritis, Cohort, Disease Progression, Drug Therapy, Combination, Female, MESH : Severity of Illness Index, MESH: Disease Progression, medicine.drug, Adult, Drug, musculoskeletal diseases, medicine.medical_specialty, Adolescent, MESH : Outcome Assessment (Health Care), media_common.quotation_subject, MESH : Male, MESH : Young Adult, MESH : Cohort Studies, MESH : Treatment Outcome, MESH: Folic Acid, Young Adult, 03 medical and health sciences, Folic Acid, Rheumatology, Internal medicine, MESH : Adolescent, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, MESH: Severity of Illness Index, medicine, Humans, MESH : Middle Aged, MESH : Health Status, MESH: Outcome Assessment (Health Care), Aged, 030203 arthritis & rheumatology, MESH: Adolescent, MESH : Folic Acid, MESH: Humans, Dose-Response Relationship, Drug, business.industry, MESH : Drug Therapy, Combination, MESH : Humans, MESH: Adult, MESH : Disease Progression, medicine.disease, MESH: Male, Surgery, MESH: Drug Therapy, Combination, Methotrexate, Concomitant, MESH : Methotrexate, Propensity score matching, MESH : Arthritis, Rheumatoid, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; OBJECTIVE: To describe the use of MTX in early arthritis (EA) in daily clinical practice and to evaluate its 6-month symptomatic efficacy and 12-month structural efficacy. METHODS: Patients included in the French observational ESPOIR cohort were assessed. Evaluation of the symptomatic and structural efficacy was performed by generalized linear regression after adjustment on propensity score (PS) in the group of patients receiving at least 3 months of MTX vs the ones receiving any other treatment except LEF, SSZ or TNF inhibitors. RESULTS: Within the first 6 months of follow-up of 777 EA patients, 59% received a DMARD, which was MTX in 68% (N = 313) of patients. The mean dose of MTX was 12.7 ± 3.8 mg/week. Only 53.7% of the patients received folic acid supplementation. MTX was initiated in patients with more active and severe disease. At 6 months, in unadjusted analysis, patients starting MTX had a significantly higher DAS-28 (3.58 vs 3.23; P = 0.001) and a significantly higher HAQ (0.60 vs. 0.48; P = 0.01) compared with controls. After adjustment by PS, there were no significant differences. Adjustment for the PS also revealed a statistically significant decrease in the radiological progression at 12 months in the MTX group [total Sharp-van der Heijde score (SHS), 1.05 ± 0.29 vs 2.02 ± 0.29, P = 0.025]. CONCLUSION: This study confirms the symptomatic and structural efficacy of MTX in EA in daily practice despite the non-optimal use of MTX, including low doses and infrequent concomitant folic acid supplementation.

Published
2012
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7. Interleukin 34 expression is associated with synovitis severity in rheumatoid arthritis patients

Author

Jérôme Amiaud, Céline Cozic, Martine Berreur, M Chemel, Franck Verrecchia, Gwenola Bougras, B. Le Goff, M.-F. Heymann, J M Berthelot, S Touchais, Dominique Heymann, Frédéric Blanchard, Régis Brion, Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Pôle Ostéoarticulaire, Centre hospitalier universitaire de Nantes (CHU Nantes), This work was supported by the ARTHRITIS Fondation Courtin (to Dr J.M. Berthelot), Heymann, D, and Institut National de la Recherche Agronomique (INRA)-Université de Nantes (UN)

Subjects
Male, Pathology, MESH: Synovitis, medicine.medical_treatment, Inflammatory arthritis, Interleukin-1beta, Arthritis, MESH: NF-kappa B, MESH: Dose-Response Relationship, Drug, Arthritis, Rheumatoid, 0302 clinical medicine, MESH: Aged, 80 and over, MESH: Osteoarthritis, MESH: Interleukin-1beta, Synovial Fluid, Immunology and Allergy, Cells, Cultured, Aged, 80 and over, MESH: Aged, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, 0303 health sciences, MESH: Arthritis, Rheumatoid, Synovitis, MESH: Middle Aged, NF-kappa B, Interleukin, Middle Aged, MESH: Gene Expression Regulation, Cytokine, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, 030220 oncology & carcinogenesis, Rheumatoid arthritis, Female, MESH: Cells, Cultured, Adult, medicine.medical_specialty, MESH: Interleukins, MAP Kinase Signaling System, Immunology, Rheumatoid Arthritis, Article, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Rheumatology, MESH: Synovial Fluid, Osteoarthritis, medicine, Humans, Synovial fluid, RNA, Messenger, Aged, 030304 developmental biology, MESH: RNA, Messenger, MESH: Humans, Dose-Response Relationship, Drug, Tumor Necrosis Factor-alpha, business.industry, MESH: MAP Kinase Signaling System, Interleukins, MESH: Adult, Fibroblasts, medicine.disease, Interleukin-34, MESH: Male, Gene Expression Regulation, inflammation, MESH: Fibroblasts, MESH: Tumor Necrosis Factor-alpha, Interleukin 34, business, MESH: Female
Abstract

ObjectivesInterleukin (IL) 34 is a new cytokine implicated in macrophage differentiation and osteoclastogenesis. This study assessed IL-34 expression in the tissue of patients with rheumatoid arthritis (RA).MethodsImmunohistochemistry was performed in synovial biopsies from patients with RA (n=20), osteoarthritis (n=3) or other inflammatory arthritis (n=4). IL-34 was detected in the synovial fluid by ELISA and its messenger RNA expression was studied by quantitative PCR in rheumatoid synovial fibroblasts after stimulation by tumour necrosis factor α (TNFα) and IL-1β. Wild-type, jnk1−/−–jnk2−/− and nemo−/− murine fibroblasts and pharmacological inhibition were used to determine the involvement of nuclear factor kappa B (NF-κB) and JNK in that effect.ResultsIL-34 was expressed in 24/27 biopsies, with three samples from RA patients being negative. A significant association was found between IL-34 expression and synovitis severity. Levels of IL-34 and the total leucocyte count in synovial fluid were correlated. TNFα and IL-1β stimulated IL-34 expression by synovial fibroblasts in a dose/time-dependent manner through the NF-κB and JNK pathway.ConclusionThis work for the first time identifies IL-34 expression in the synovial tissue of patients with arthritis. This cytokine, as a downstream effector of TNFα and IL-1β, may contribute to inflammation and bone erosions in RA.

Published
2012
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8. 2010 Rheumatoid Arthritis Classification Criteria An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative

Author

Aletaha, Daniel, Neogi, Tuhina, Silman, J., Funovits, Julia, Felson, David T, Bingham, Clifton O, Birnbaum, Neal S, Burmester, Gerd R, Bykerk, P., Combe, Bernard, Costenbader, Karen H, Dougados, Maxime, Emery, Paul P, Ferraccioli, Gianfranco, Hazes, Johanna M W, Hobbs, Kathryn, Huizinga, Tom W J, Kavanaugh, Arthur, Kay, Jonathan, Kvien, Tore K, Laing, Timothy, Mease, Philip, Menard, H. A., Moreland, Larry W, Naden, Raymond L, Pincus, Theodore, Smolen, Josef S, Stanislawska-Biernat, Ewa, Symmons, Deborah, Tak, Paul P, Upchurch, Katherine S, Vencovsky, Jirí, Wolfe, Frederick, Hawker, Gillian, Silman, Alan J, Bykerk, Vivian P, Cohen, Marc D, Ménard, Henri A, Saraux, A., AII - Amsterdam institute for Infection and Immunity, Clinical Immunology and Rheumatology, Tufts University School of Medicine [Boston], University of North Carolina [Chapel Hill] (UNC), University of North Carolina System (UNC), Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin / Charite - University Medicine Berlin, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Service de rhumatologie [CHU Cochin], CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), University of Leeds, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Leiden University Medical Center (LUMC), Virginia Tech [Blacksburg], University of Colorado [Boulder], Department of Rheumatology, Diakonhjemmet Hospital, CHU Pontchaillou [Rennes], Division of Rheumatology (NYU Hospital - Rheumato), New York University Langone Medical Center (NYU Langone Medical Center), NYU System (NYU)-NYU System (NYU), Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, University of Amsterdam [Amsterdam] (UvA), Institute of Rheumatology, Institut de Neurosciences de la Timone (INT), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), ARC Epidemiology Unit, The University of Manchester, Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre d'Investigation Clinique INSERM 1412 (CIC 1412 - BREST), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Rheumatology, Faculteit der Geneeskunde, The University of North Carolina at Chapel Hill, Charité - University Medicine, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Recherche Agronomique ( INRA ), Service de Rhumatologie [CHU Cochin], CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Erasmus MC, University Medical Center Rotterdam, Hogeschool Rotterdam, University of Colorado Boulder [Boulder], Division of Rheumatology ( NYU Hospital - Rheumato ), New York University Hospital, University of Amsterdam [Amsterdam] ( UvA ), Institut de Neurosciences de la Timone ( INT ), Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Lymphocyte B et Auto-immunité ( LBAI ), Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHRU Brest - Service de Rhumatologie ( CHU - BREST - Rhumato ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Centre d'Investigation Clinique INSERM 1412 ( CIC 1412 - BREST ), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Universiteit Leiden, Medizinische Universität Wien = Medical University of Vienna, Lymphocytes B, Autoimmunité et Immunothérapies (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest, and Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut Brestois Santé Agro Matière (IBSAM)

Subjects
Time Factors, MESH : International Cooperation, MESH: Synovitis, International Cooperation, [SDV]Life Sciences [q-bio], Arthritis, Disease, Severity of Illness Index, MESH : Early Diagnosis, Arthritis, Rheumatoid, MESH : North America, MESH: Early Diagnosis, MESH: Acute-Phase Reaction, Immunology and Allergy, Pharmacology (medical), MESH : Algorithms, Societies, Medical, MESH : Synovitis, MESH: Arthritis, Rheumatoid, Synovitis, biology, undifferentiated arthritis citrullinated peptide controlled-trial methotrexate disease progression antibodies therapies erosions, Anti–citrullinated protein antibody, Early Inflammatory Arthritis, Connective tissue disease, Europe, Rheumatoid arthritis, MESH : Severity of Illness Index, Algorithms, MESH : Time Factors, medicine.medical_specialty, MESH: Terminology as Topic, MESH : Europe, Immunology, MESH: Societies, Medical, MESH: Algorithms, MESH : Acute-Phase Reaction, General Biochemistry, Genetics and Molecular Biology, Rheumatology, Terminology as Topic, Internal medicine, MESH: Severity of Illness Index, Severity of illness, medicine, MESH : Societies, Medical, Humans, Acute-Phase Reaction, MESH: Humans, [ SDV ] Life Sciences [q-bio], business.industry, MESH : Humans, MESH: Time Factors, medicine.disease, MESH : Terminology as Topic, MESH: North America, MESH: International Cooperation, Early Diagnosis, MESH : Arthritis, Rheumatoid, North America, Physical therapy, biology.protein, MESH: Europe, business, Rheumatism
Abstract

Objective. The 1987 American College of Rheumatology (ACR; formerly, the American Rheumatism Association) classification criteria for rheumatoid arthritis (RA) have been criticized for their lack of sensitivity in early disease. This work was undertaken to develop new classification criteria for RA. Methods. A joint working group from the ACR and the European League Against Rheumatism developed, in 3 phases, a new approach to classifying RA. The work focused on identifying, among patients newly presenting with undifferentiated inflammatory synovitis, factors that best discriminated between those who were and those who were not at high risk for persistent and/or erosive disease-this being the appropriate current paradigm underlying the disease construct "rheumatoid arthritis." Results. In the new criteria set, classification as "definite RA" is based on the confirmed presence of synovitis in at least 1 joint, absence of an alternative diagnosis that better explains the synovitis, and achievement of a total score of 6 or greater (of a possible 10) from the individual scores in 4 domains: number and site of involved joints (score range 0-5), serologic abnormality (score range 0-3), elevated acute-phase response (score range 0-1), and symptom duration (2 levels; range 0-1). Conclusion. This new classification system redefines the current paradigm of RA by focusing on features at earlier stages of disease that are associated with persistent and/or erosive disease, rather than defining the disease by its late-stage features. This will refocus attention on the important need for earlier diagnosis and institution of effective disease-suppressing therapy to prevent or minimize the occurrence of the undesirable sequelae that currently comprise the paradigm underlying the disease construct "rheumatoid arthritis."

Published
2010
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9. Comparison of clinical and ultrasonographic evaluations for peripheral synovitis in juvenile idiopathic arthritis

Author

Alain Saraux, Loic de Parscau, Sandrine Jousse-Joulin, Luc Bressolette, Sylvain Breton, Danielle Colin, Claire Cangemi, Valérie Devauchelle-Pensec, Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, CHRU de Brest - Département de Pédiatrie (CHU BREST Pédiatrie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Réseau Maladies Métaboliques, Hôpitaux Universitaires du Grand Ouest, Service de Pédiatrie et Génétique Médicale, Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), and CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato)

Subjects
Male, MESH: Range of Motion, Articular, MESH: Synovitis, Arthritis, Severity of Illness Index, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, MESH: Child, Range of Motion, Articular, Child, Ultrasonography, Synovitis, medicine.diagnostic_test, 3. Good health, MESH: Joints, medicine.anatomical_structure, Joint pain, Child, Preschool, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Radiology, medicine.symptom, musculoskeletal diseases, medicine.medical_specialty, Adolescent, Physical examination, MESH: Physical Examination, 03 medical and health sciences, Rheumatology, MESH: Severity of Illness Index, Internal medicine, medicine, Synovial fluid, Humans, Physical Examination, MESH: Adolescent, 030203 arthritis & rheumatology, MESH: Humans, business.industry, MESH: Child, Preschool, Metacarpophalangeal joint, medicine.disease, MESH: Male, Arthritis, Juvenile, Surgery, Anesthesiology and Pain Medicine, MESH: Arthritis, Juvenile Rheumatoid, Joints, business, MESH: Female, Juvenile rheumatoid arthritis
Abstract

International audience; OBJECTIVES: The characteristics of synovitis in juvenile idiopathic arthritis (JIA) are important to evaluate, as they define several clinical categories. The metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints are frequently involved. Few studies have investigated peripheral joint evaluation using ultrasonography, a sensitive tool for detecting subclinical synovitis. Our objectives here were to compare clinical and ultrasound evaluations of MCP and MTP joint synovitis and to determine the prevalence of predefined ultrasound abnormalities in JIA patients and healthy controls. METHODS: Standardized physical and ultrasound assessments of the same joints were done in 31 consecutive patients with JIA and 41 healthy volunteers. Joint pain, motion limitation, and swelling were recorded. Ultrasonography was performed on the same joints by 2 trained sonographers who recorded synovial fluid, synovial hypertrophy, erosion, and power Doppler signal. Intraobserver reproducibility of ultrasonography was assessed. RESULTS: Of 558 peripheral joints examined in JIA patients, 69 (12.5%) had ultrasonographic synovitis and 83 (15%) had abnormal physical findings. All the physical abnormalities were significantly associated with ultrasonographic synovitis (P < 0.0001) but agreement was low between ultrasonographic and physical findings. Ultrasonographic synovitis was most common at the feet (59.4%), where it was detected clinically in only 25% of cases. Ultrasonographic synovitis was associated with the presence of synovial fluid. Cartilage vascularization was found in 2 (4.2%) healthy controls. CONCLUSION: Ultrasonography is useful for monitoring synovitis in JIA. Subclinical involvement of the MTP joints is common. Clinicians should be aware of the specific ultrasonographic findings in children.

Published
2010
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10. Reproducibility of joint swelling assessment by sonography in patients with long-lasting rheumatoid arthritis (SEA-Repro study part II)

Author

Christophe Hudry, Jérémie Sellam, Maxime Dougados, M.A. D'Agostino, F. Etchepare, Cécile Hacquard, Isabelle Chary Valckenaere, Gérard Chalès, Jean David Albert, Sandrine Jousse-Joulin, Laurent Grange, Alain Saraux, Thierry Marhadour, Jacques Bentin, Damien Loeuille, Philippe Gaudin, Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Service de Rhumatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Service de rhumatologie [Rennes] = Rheumatology [Rennes], CHU Pontchaillou [Rennes], Service de Rhumatologie, CHU Brugmann, CHU Brugmann, Belgium, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Foie, métabolismes et cancer, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Physiopathologie, Pharmacologie et Ingénierie articulaires (PPIA), Université Henri Poincaré - Nancy 1 (UHP)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Ambroise Paré, Service de rhumatologie, Hôpital Sud, Service de Rhumatologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Immunologie et Pathologie ( EA2216 ), Université de Brest ( UBO ) -IFR148, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Ambroise Paré, Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Physiopathologie, Pharmacologie et Ingénierie articulaires ( PPIA ), Université Henri Poincaré - Nancy 1 ( UHP ) -Centre National de la Recherche Scientifique ( CNRS ), Centre de Recherche Saint-Antoine ( CR Saint-Antoine ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP]

Subjects
Male, Settore MED/16 - REUMATOLOGIA, MESH: Synovitis, MESH : Aged, Severity of Illness Index, Arthritis, Rheumatoid, 0302 clinical medicine, Cohen's kappa, Rheumatoid, Immunology and Allergy, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, MESH : Female, 030212 general & internal medicine, Disease activity, MESH : Joints, Ultrasonography, MESH : Synovitis, MESH: Aged, MESH: Arthritis, Rheumatoid, Synovitis, MESH: Middle Aged, medicine.diagnostic_test, Doppler, Middle Aged, Reference Standards, MESH : Ultrasonography, Doppler, MESH: Reproducibility of Results, MESH: Joints, Rheumatoid arthritis, [SDV.IMM]Life Sciences [q-bio]/Immunology, MESH : Severity of Illness Index, Female, MESH: Reference Standards, Long lasting, medicine.medical_specialty, MESH : Male, Immunology, Physical examination, 03 medical and health sciences, Rheumatology, MESH: Severity of Illness Index, Ultrasound, medicine, Humans, In patient, MESH : Middle Aged, Aged, 030203 arthritis & rheumatology, Reproducibility, MESH: Humans, business.industry, MESH : Reproducibility of Results, Arthritis, MESH : Humans, Reproducibility of Results, Ultrasonography, Doppler, medicine.disease, MESH: Male, Surgery, Sonographer, MESH : Arthritis, Rheumatoid, MESH : Reference Standards, MESH: Ultrasonography, Doppler, Joints, Nuclear medicine, business, MESH: Female
Abstract

Objective.To evaluate the intraobserver and interobserver reproducibility of B-mode and power Doppler (PD) sonography in patients with active long-standing rheumatoid arthritis (RA) comparatively with clinical data.Methods.In each of 7 patients being considered for a change in their RA treatment regimen, 7 healthcare professionals examined the 28 joints used in the Disease Activity Score 28-joint count (DAS28). Then 7 sonographers examined each of the 7 patients twice, using previously published B-mode and PD grading systems. The clinical reference standard was presence of synovitis according to at least 4/7 examiners. The sonographic reference standard was at least grade 1 (ALG1) or 2 (ALG2) synovitis according to at least 4/7 sonographers. Interobserver reproducibility of sonography was assessed versus the sonographer having the best intraobserver reproducibility. Agreement was measured by Cohen’s kappa statistic.Results.Intraobserver and interobserver reproducibility of B-mode and PD used separately was fair to good. Agreement between clinicians and sonographers at all sites using B-mode, PD, and both was 0.46, 0.37, and 0.36, respectively, for grade 1 synovitis; and 0.58, 0.19, and 0.19 for grade 2 synovitis. The number of joints with synovitis was smaller by physical examination (36.7%) than by B-mode with ALG1 (58.6%; p < 0.001). The number of joints with synovitis was higher by physical examination than by PD with both ALG1 (17.8%; p < 0.0001) and ALG2 (6.6%; p < 0.0001).Conclusion.PD findings explain most of the difference between clinical and sonographic joint assessments for synovitis in patients with long-standing RA.

Published
2010
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11. Reproducibility of joint swelling assessments in long-lasting rheumatoid arthritis: Influence on disease activity score-28 values (SEA-repro study part I)

Author

Laurent Grange, Jean-David Albert, Christophe Hudry, Jérémie Sellam, F. Etchepare, Cécile Hacquard, Sandrine Jousse-Joulin, M.A. D'Agostino, Maxime Dougados, Thierry Marhadour, Alain Saraux, Philippe Gaudin, Gérard Chalès, Isabelle Chary Valckenaere, Jacques Bentin, Damien Loeuille, Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Service de rhumatologie [Rennes] = Rheumatology [Rennes], CHU Pontchaillou [Rennes], Foie, métabolismes et cancer, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Rhumatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Physiopathologie, Pharmacologie et Ingénierie articulaires (PPIA), Université Henri Poincaré - Nancy 1 (UHP)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Rhumatologie, CHU Brugmann, CHU Brugmann, Belgium, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de rhumatologie, Hôpital Sud, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Ambroise Paré, Centre de Recherche Saint-Antoine (CR Saint-Antoine), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Rhumatologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Immunologie et Pathologie ( EA2216 ), Université de Brest ( UBO ) -IFR148, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Ambroise Paré, Physiopathologie, Pharmacologie et Ingénierie articulaires ( PPIA ), Université Henri Poincaré - Nancy 1 ( UHP ) -Centre National de la Recherche Scientifique ( CNRS ), Centre de Recherche Saint-Antoine ( CR Saint-Antoine ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), and Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM )

Subjects
Male, Settore MED/16 - REUMATOLOGIA, MESH: Synovitis, MESH : Aged, Arthritis, Severity of Illness Index, Arthritis, Rheumatoid, 0302 clinical medicine, Cohen's kappa, Rheumatoid, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, Immunology and Allergy, MESH : Female, MESH : Joints, Ultrasonography, MESH : Synovitis, MESH: Aged, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, Synovitis, Disease activity score-28, Technician, Middle Aged, Reference Standards, Reproducibility, MESH: Reproducibility of Results, MESH: Joints, Rheumatoid arthritis, [SDV.IMM]Life Sciences [q-bio]/Immunology, MESH : Severity of Illness Index, MESH: Reference Standards, Female, musculoskeletal diseases, medicine.medical_specialty, MESH : Male, Immunology, Rheumatoid Arthritis, Disease activity, 03 medical and health sciences, Rheumatology, MESH: Severity of Illness Index, Severity of illness, medicine, Humans, MESH : Middle Aged, Joint swelling, Aged, 030203 arthritis & rheumatology, MESH: Humans, business.industry, MESH : Reproducibility of Results, MESH : Humans, Reproducibility of Results, medicine.disease, MESH: Male, MESH : Reference Standards, MESH : Arthritis, Rheumatoid, Physical therapy, Joints, business, MESH: Female, 030215 immunology
Abstract

Objectives.To evaluate the reproducibility of clinical synovitis assessments in rheumatoid arthritis and the effect of variability on the Disease Activity Score-28 (DAS28).Methods.Seven healthcare professionals from different cities examined the same patients with active non-early rheumatoid arthritis (RA; duration > 4 yrs), for whom a treatment change was being considered. There was no training session and the examination was to be performed as quickly as possible. The healthcare professionals assessed the 28 joints of the DAS28 in 7 patients (196 joints), then reexamined the same 28 joints in 4 of these 7 patients (112 joints), who had been rendered unrecognizable. Then 7 sonographers examined each of the 7 patients twice, using B-mode and power Doppler ultrasound (PD). The reference standards were presence of synovitis according to at least 50% of clinical examiners and 50% of sonographers. Agreement was assessed by Cohen’s kappa statistic.Results.Intraobserver reliability ranged from 0.31 (least experienced research technician) to 0.77 (most experienced physician). Interobserver reliability ranged from 0.18 to 0.62. The largest difference between the lowest and the highest swollen joint counts in the same patient was 15, and the greatest variation in the DAS28 score was 0.92. Agreement between clinical and sonographic reference standards was 0.46, 0.37, and 0.36 for B-mode, PD, and both, respectively.Conclusion.Clinical inter- and intraobserver reliability is highly dependent on the examiner. Consequences on the DAS28 score can be substantial. Agreement with sonography is poor when both B-mode and PD are used but seems better, although low, when B-mode is used alone.

Published
2010
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12. Inflammatory and structural evaluation in spondyloarthritis: magnetic resonance imaging analysis of axial and peripheral involvement

Author

Hoenen-Clavert, Virginie, Rat, Anne Christine, Loeuille, Damien, Bettembourg-Brault, Isabelle, Michel-Batot, Christine, Alain Blum, Pourel, Jacques, Chary-Valckenaere, Isabelle, Rat, Anne-Christine, Service de Rhumatologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Physiopathologie, Pharmacologie et Ingénierie articulaires (PPIA), Université Henri Poincaré - Nancy 1 (UHP)-Centre National de la Recherche Scientifique (CNRS), Département de Radiologie adultes [CHRU Nancy], and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Lorraine (UL)

Subjects
Male, MESH: Synovitis, education, MESH: Ligaments, MESH: Tenosynovitis, MESH: Pain Measurement, MESH: Observer Variation, Sensitivity and Specificity, Severity of Illness Index, MESH: Magnetic Resonance Imaging, MESH: Severity of Illness Index, Image Interpretation, Computer-Assisted, Humans, Single-Blind Method, Osteitis, Pain Measurement, Observer Variation, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Humans, Ligaments, Synovitis, Tenosynovitis, MESH: Single-Blind Method, equipment and supplies, Magnetic Resonance Imaging, MESH: Male, MESH: Sensitivity and Specificity, MESH: Joints, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Osteitis, Spondylarthropathies, Female, Joints, MESH: Female, MESH: Image Interpretation, Computer-Assisted, human activities, MESH: Spondylarthropathies
Abstract

To determine the magnetic resonance imaging (MRI) criteria of most value in the assessment of patients with spondyloarthropathy (SpA) with axial or peripheral involvement.Fat suppressed (FS)-T2 and pre- and postinjection FS-T1 images were obtained in the most symptomatic region (axial or peripheral) of patients requiring tumor necrosis factor-a blockers. Thirty-eight MRI (21 axial and 17 peripheral) were blindly scored at synovial (S) and entheseal (E) sites by 2 experienced observers screening for 7 inflammatory and 7 structural predefined criteria, which were evaluated for frequency (N) and intra- and interobserver reproducibility.In peripheral regions, synovitis (S; N = 69.4%), ligament inflammation (E; N = 39.7%), bone marrow edema (S; N = 22.1%; E; N = 15%), and tenosynovitis (S; N = 21%) were recorded with good to excellent intraobserver reproducibility [intraclass correlation coefficient (ICC) 0.49-0.93] and moderate to good interobserver reproducibility (ICC 0.49-0.66). With regard to structural criteria, erosions (S; N = 17.1%) and enthesophytes (E; N = 13.9%) exhibited good to excellent intraobserver (ICC 0.71-0.85) and moderate interobserver reproducibility (ICC 0.54-0.49); the reproducibility of fat inflation (N = 1.4%) was good (ICC 0.76-0.78). In axial regions, no inflammatory criteria achieved good interobserver reproducibility. However, fat inflation (S; N = 86%), chondral lesions (S; N = 85.8%), enthesophytes (E; N = 76.7%), fusion (S; N = 41.2%), and erosions (S; N = 25.1%) showed excellent intraobserver reproducibility (ICC 0.81-0.98), and moderate to excellent interobserver reproducibility (ICC 0.50-0.96).In terms of intra- and interobserver reproducibility, MRI is a reliable tool with which to assess synovitis, bone edema, ligament inflammation, tenosynovitis, erosion, enthesophytes, and fat inflation in patients with peripheral involvement. In those with axial involvement, inflammatory criteria lack interobserver reproducibility, but chondral lesions, erosion, fat inflation, fusion, and enthesophytes are relevant.

Published
2007

13. Role of hypersensitivity in experimental staphylococcal infection of the chicken

Author

A, Forget, A, Frappier, S, Sonea, A G, Borduas, Institut Armand Frappier (INRS-IAF), Institut National de la Recherche Scientifique [Québec] (INRS)-Réseau International des Instituts Pasteur (RIIP), Université de Montréal (UdeM), CRLC Val d'Aurelle-Paul Lamarque, CRLCC Val d'Aurelle - Paul Lamarque, and Courcelles, Michel

Subjects
Synovitis, MESH: Synovitis, [SDV]Life Sciences [q-bio], MESH: Chickens, MESH: Staphylococcal Infections, Staphylococcal Infections, [SDV] Life Sciences [q-bio], Bursa of Fabricius, MESH: Bursa of Fabricius, Animals, Hypersensitivity, Delayed, MESH: Animals, MESH: Hypersensitivity, Delayed, Chickens, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
1968

14. [Role of facilitating antibodies on the development of a chronic bacterial infection: experimental staphylococcal synovitis in chickens]

Author

Forget, A., Borduas, A, Richer, G, Frappier, Armand, Courcelles, Michel, Institut Armand Frappier (INRS-IAF), Institut National de la Recherche Scientifique [Québec] (INRS)-Réseau International des Instituts Pasteur (RIIP), CRLC Val d'Aurelle-Paul Lamarque, CRLCC Val d'Aurelle - Paul Lamarque, and Université de Montréal (UdeM)

Subjects
Synovitis, MESH: Synovitis, MESH: Chronic Disease, [SDV]Life Sciences [q-bio], MESH: Chickens, MESH: Staphylococcal Infections, MESH: Thymus Gland, Thymus Gland, Staphylococcal Infections, MESH: Antibody Formation, [SDV] Life Sciences [q-bio], Bursa of Fabricius, MESH: Antilymphocyte Serum, MESH: Bursa of Fabricius, Antibody Formation, Chronic Disease, Animals, MESH: Animals, Chickens, ComputingMilieux_MISCELLANEOUS, Antilymphocyte Serum
Abstract

International audience

Published
1970

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