Evaluation of Magnetic Resonance Imaging Responsiveness in Active Psoriatic Arthritis at Multiple Timepoints during the First 12 Weeks of Antitumor Necrosis Factor Therapy

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Figure 1.
Tenosynovitis HF and LF score comparison. HF: high-field; LF: low-field; Pt: patient.
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Figure 2.
PIP joint tenosynovitis and synovitis (arrow) LF and HF MRI. The images demonstrate the difference in appearance at the same timepoint. The LF images demonstrate low-intensity enhancement, with the HF image showing greater thickness of enhancing synovium and greater intensity of enhancement. (A) Patient 6 baseline post-GAD LF PIP (score 1). (B) Patient 6 baseline GAD HF PIP (score 3). PIP: proximal interphalangeal; LF: low-field; HF: high-field; MRI: magnetic resonance imaging; GAD: gadolinium.
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Figure 3.
HF and LF MRI baseline images proximal MCP joints. Images show the comparison between images for tenosynovitis third MCP (arrow) and synovitis MCP3. (A) Patient 1 baseline post-GAD LF proximal MCP, T1 post-GAD non–fat-suppressed image (synovitis score 0, tenosynovitis score 1). (B) Patient 1 baseline HF post-GAD proximal MCP, T1 post-GAD fat-suppressed image (synovitis score 1, tenosynovitis score 2). HF: high-field; LF: low-field; MRI: magnetic resonance imaging; MCP: metacarpophalangeal; GAD: gadolinium.

Table 1.

Clinical variables.

Variables	Patient 1	Patient 2	Patient 3	Patient 4	Patient 5^*	Patient 6	Patient 7	Patient 8	Patient 9	Patient 10	Patient 11	Patient 12
Age, yrs	43	38	37	27	49	49	43	45	42	51	63	42
Sex	M	M	M	M	M	M	F	F	M	F	M	F
Weight, kg	82	92	127	88	91	87	91	—	81	68	70	82.5
PsA duration, yrs	1	2	10	1	6	20	25	13	10	3	6	2
Current DMARD and dose	MTX 20 mg weekly	MTX 25 mg weekly	MTX 20 mg weekly	MTX 20 mg weekly	SSZ 2 g/daily	MTX 25 mg weekly	HCQ 100 mg daily	NIL	NIL	NIL	LEF 20 mg daily, MTX 15 mg weekly	MTX 10 mg weekly, SSZ 2 mg daily
bDMARD	ETN	ADA	ADA	ADA	ADA	ETN	ADA	ADA	IFX	IFX	IFX	IFX
Current PRED	0	0	0	5 mg daily	7.5 mg daily	0	10 mg daily	0	0	0	0	0
TJC baseline/Week 12, 68 joints	3/0	6/2	4/0	5/0	11	4/2	27/1	13/8	1/0	4/0	4/0	14/17
SJC baseline/Week 12, 66 joints	9/3	10/4	9/5	4/3	10	8/8	13/7	8/5	22/11	10/1	10/8	5/9
DAS28-ESR baseline/Week 12	3.30/1.55	3.79/2.51	4.04/1.13	2.89/0.51	—	4.75/2.09	4.63/2.1	4.69/3.94	2.99/0.68	4.45	4.36/1.75	3.31/3.66
DAS28-CRP baseline/Week 12	2.53/1.96	3.90/2.23	2.82/0.64	2.40/0.51	—	4.52/2.09	3.87/1.52	3.81/3.17	2.32/0.93	3.51	3.24/0.53	3.81/NIL
Dactylitis scores/baseline	0	21	41	30	1	52	73	52	90	10	7	40

↵* One subject withdrew from the study after consent and baseline clinical data collection (patient 5).
PsA: psoriatic arthritis; DMARD: disease-modifying antirheumatic drug; bDMARD: biologic DMARD; PRED: prednisolone; TJC: tender joint count; SJC: swollen joint count; DAS28: 28-joint Disease Activity Score; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; MTX: methotrexate; SSZ: sulfasalazine; HCQ: hydroxychloroquine; NIL: none; LEF: leflunomide; ETN: etanercept; ADA: adalimumab; IFX: infliximab.