Skip to main content

Main menu

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • COVID-19 and Rheumatology
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • JRheum Supplements
  • Services

User menu

  • My Cart
  • Log In

Search

  • Advanced search
The Journal of Rheumatology
  • JRheum Supplements
  • Services
  • My Cart
  • Log In
The Journal of Rheumatology

Advanced Search

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • COVID-19 and Rheumatology
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • Follow jrheum on Twitter
  • Visit jrheum on Facebook
  • Follow jrheum on LinkedIn
  • Follow jrheum on YouTube
  • Follow jrheum on Instagram
  • Follow jrheum on RSS
LetterCorrespondence

Significance of “Erosion-like Lesions” in “Healthy Controls”

BRUCE M. ROTHSCHILD
The Journal of Rheumatology September 2010, 37 (9) 1964; DOI: https://doi.org/10.3899/jrheum.100205
BRUCE M. ROTHSCHILD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: bmr@ku.edu
  • Article
  • Info & Metrics
  • References
  • PDF
  • eLetters
PreviousNext
Loading

To the Editor:

Olech and colleagues note that erosions are commonly found in metacarpal phalangeal and wrist joints of “healthy subjects”1 and “healthy employees”2. Olech, et al2 report observation of “erosion-like lesions” on magnetic resonance imaging (MRI) of 26 of 40 (65%) healthy employees of the Oklahoma Medical Research Foundation (Oklahoma City, OK, USA). This contrasts with “at least one erosion in the hands or wrists” of 90% of individuals with rheumatoid arthritis. The latter correlates nicely with macroscopic observations of defleshed bones, where the frequency of erosions correlates with the frequency of synovitis3,4,5,6,7,8,9,10,11. However, the frequency of MRI-diagnosed erosions in “healthy subjects” far exceeds the < 1% seen in human populations12,13 as well as the rarity of isolated erosion detection in the zoologic record14,15,16,17,18.

This contrasts with recognition of bone edema in 7 subjects (17.5%) and the damage shown in Olech, et al, Figure 1, which clearly document pathology in a wrist and metacarpal phalangeal joint. The illustrated MRI reveals substantial damage, with no discernible synovial proliferation. This is similar to changes observed in sickle cell anemia19, which were originally thought erosive in derivation. It was only when the defleshed skeleton of an afflicted individual was examined that the etiology of “erosions” in sickle cell anemia was actually related to avascular necrosis20.

It is unclear what the MRI-detected abnormalities represent in “healthy employees.” While plain radiograph and computed tomography images may clarify the underlying disease, more in-depth interviewing and physical examinations seem warranted in the subgroup with such “lesions.” Are these the result of long-forgotten events or similar to spondylosis deformans21, anomalies without clinical significance? The latter is unlikely for the lesions illustrated in Olech, et al, Figure 1. The authors2 most appropriately label these “erosion-like lesions.” It will be intriguing to learn of their natural history.

    REFERENCES

    1. 1.↵
      1. Elbjerg B,
      2. Narvestad E,
      3. Rostrup E,
      4. Szkudlarek M,
      5. Jacobsen S,
      6. Thomsen HS,
      7. et al.
      Magnetic resonance imaging of wrist and finger joints in healthy subjects occasionally shows changes resembling erosions and synovitis as seen in rheumatoid arthritis. Arthritis Rheum 2004;50:1097–106.
      OpenUrlCrossRefPubMed
    2. 2.↵
      1. Olech E,
      2. Crues JV III.,
      3. Yocum DE,
      4. Merrill JT
      . Bone marrow edema is the most specific finding for rheumatoid arthritis on noncontrast magnetic resonance imaging of the hands and wrists: A comparison of patients with rheumatoid arthritis and healthy controls. J Rheumatol 2010;37:265–74.
      OpenUrlAbstract/FREE Full Text
    3. 3.↵
      1. Rothschild BM,
      2. Woods RJ
      . Synovitis equivalent to erosions in rheumatoid arthritis: Implications of skeletal analysis for clinical management of contemporary rheumatoid arthritis. Clin Exp Rheumatol 1992;10:117–22.
      OpenUrlPubMed
    4. 4.↵
      1. Woods RJ,
      2. Rothschild BM
      . Population analysis of symmetrical erosive arthritis in Ohio Woodland Indians (1200 years before the present time). J Rheumatol 1988;15:1258–63.
      OpenUrlPubMed
    5. 5.↵
      1. Rothschild BM,
      2. Turner KR,
      3. DeLuca MA
      . Symmetrical erosive peripheral polyarthritis in the Late Archaic period of Alabama. Science 1988;241:1498–501.
      OpenUrlAbstract/FREE Full Text
    6. 6.↵
      1. Rothschild BM,
      2. Woods RJ,
      3. Ortel W
      . Rheumatoid arthritis “In the buff”: Erosive arthritis in representative defleshed bones. Am J Phys Anthropol 1990;82:441–9.
      OpenUrlCrossRefPubMed
    7. 7.↵
      1. Rothschild BM,
      2. Woods RJ
      . Rheumatoid arthritis in Fort Ancient-Anderson Village, Ohio: La polyarthrite rhumatoide vient-elle du Nouveau Monde? Rev Rhum 1990;57:271–4.
      OpenUrlPubMed
    8. 8.↵
      1. Rothschild BM,
      2. Woods RJ
      . Character of pre-Columbian North American spondyloarthropathy. J Rheumatol 1992;19:1229–35.
      OpenUrlPubMed
    9. 9.↵
      1. Rothschild C,
      2. Rothschild BM,
      3. Woods RJ
      . Patterns of spread of arthritis in North America. Prog Rheumatol 1993;5:116–9.
      OpenUrl
    10. 10.↵
      1. Rothschild BM,
      2. Rothschild C
      . Inflammatory arthritis in the first century Negev. Prog Rheumatol 1992;5:112–5.
      OpenUrl
    11. 11.↵
      1. Rothschild BM,
      2. Woods RJ
      . Implications of osseous changes for diagnosis of spondyloarthropathy. J Orthop Rheumatol 1992;5:155–62.
      OpenUrl
    12. 12.↵
      1. Rothschild BM,
      2. Woods RJ
      . Isolated erosions in antiquity: the hole truth. Paleopathol Newsl 1990;71:6–8.
      OpenUrlPubMed
    13. 13.↵
      1. Rothschild BM,
      2. Woods RJ
      . Implications of isolated osseous erosions related to population skeletal health. Hist Biol 1993;7:21–8.
      OpenUrlCrossRef
    14. 14.↵
      1. Rothschild BM,
      2. Woods RJ
      . Spondyloarthropathy in gorillas. Semin Arthritis Rheum 1989;18:267–76.
      OpenUrlCrossRefPubMed
    15. 15.↵
      1. Rothschild BM,
      2. Woods RJ
      . Reactive erosive arthritis in chimpanzees. Am J Primatol 1991;25:49–56.
      OpenUrlCrossRef
    16. 16.↵
      1. Rothschild BM,
      2. Woods RJ
      . Spondyloarthropathy as an Old World phenomenon. Semin Arthritis Rheum 1992;21:306–16.
      OpenUrlCrossRefPubMed
    17. 17.↵
      1. Rothschild BM,
      2. Woods RJ
      . Erosive arthritis and spondyloarthropathy in Old World primates. Am J Phys Anthropol 1992;88:389–400.
      OpenUrlCrossRefPubMed
    18. 18.↵
      1. Rothschild BM,
      2. Rothschild C
      . Nineteenth century spondyloarthropathy independent of socioeconomic status: Lack of skeletal collection bias. J Rheumatol 1993;20:314–9.
      OpenUrlPubMed
    19. 19.↵
      1. Rothschild BM
      . Calcaneal abnormalities and erosive bone disease associated with sickle cell anemia. Am J Med 1981;71:427–30.
      OpenUrlCrossRefPubMed
    20. 20.↵
      1. Hershkovitz I,
      2. Rothschild BM,
      3. Latimer B,
      4. Dutour O,
      5. Rothschild C,
      6. Jellema LM
      . Recognition of sickle cell anemia in skeletal remains of children. Am J Phys Anthropol 1997;104:213–26.
      OpenUrlCrossRefPubMed
    21. 21.↵
      1. Rothschild BM
      . eMedicine. Lumbar spondylosis (Spondylosis deformans). [Internet. Accessed May 26, 2010.] Available from: http://emedicine.medscape.com/article/249036-overview
    PreviousNext
    Back to top

    In this issue

    The Journal of Rheumatology
    Vol. 37, Issue 9
    1 Sep 2010
    • Table of Contents
    • Table of Contents (PDF)
    • Index by Author
    • Editorial Board (PDF)
    Print
    Download PDF
    Article Alerts
    Sign In to Email Alerts with your Email Address
    Email Article

    Thank you for your interest in spreading the word about The Journal of Rheumatology.

    NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

    Enter multiple addresses on separate lines or separate them with commas.
    Significance of “Erosion-like Lesions” in “Healthy Controls”
    (Your Name) has forwarded a page to you from The Journal of Rheumatology
    (Your Name) thought you would like to see this page from the The Journal of Rheumatology web site.
    CAPTCHA
    This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
    Citation Tools
    Significance of “Erosion-like Lesions” in “Healthy Controls”
    BRUCE M. ROTHSCHILD
    The Journal of Rheumatology Sep 2010, 37 (9) 1964; DOI: 10.3899/jrheum.100205

    Citation Manager Formats

    • BibTeX
    • Bookends
    • EasyBib
    • EndNote (tagged)
    • EndNote 8 (xml)
    • Medlars
    • Mendeley
    • Papers
    • RefWorks Tagged
    • Ref Manager
    • RIS
    • Zotero

     Request Permissions

    Share
    Significance of “Erosion-like Lesions” in “Healthy Controls”
    BRUCE M. ROTHSCHILD
    The Journal of Rheumatology Sep 2010, 37 (9) 1964; DOI: 10.3899/jrheum.100205
    del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
    • Tweet Widget
    • Facebook Like
    • Google Plus One
    Bookmark this article

    Jump to section

    • Article
      • REFERENCES
    • Info & Metrics
    • References
    • PDF
    • eLetters

    Related Articles

    Cited By...

    More in this TOC Section

    • Dr. Kitajima et al reply
    • Dr. Putman et al reply
    • Drs. Chung and McMahan reply
    Show more Correspondence

    Similar Articles

    Content

    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • COVID-19 and Rheumatology

    Resources

    • Guide for Authors
    • Submit Manuscript
    • Author Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies

    Subscribers

    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions

    More

    • About Us
    • Contact Us
    • My Alerts
    • My Folders
    • Privacy/GDPR Policy
    • RSS Feeds
    The Journal of Rheumatology
    The content of this site is intended for health care professionals.
    Copyright © 2022 by The Journal of Rheumatology Publishing Co. Ltd.
    Print ISSN: 0315-162X; Online ISSN: 1499-2752
    Powered by HighWire