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Imaging diagnosis in relapsing polychondritis and correlation with clinical and serological data

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Abstract

Objective

We hypothesize that imaging findings from CT and MRI correlate better with clinical markers for assessment of disease activity in patients with the rare relapsing polychondritis (RPC) than with serological inflammatory markers.

Materials and methods

Retrospective database search at our institution identified 28 patients (13 females; age 49.0 years ± 15.0 SD) with RP between September 2004 and March 2014. Institutional review board approval was obtained for this retrospective data analysis. All patients had clinically proven RPC with at least two episodes of active disease. Of those, 18 patients were examined with CT- and MRI and presented all morphologic features of RPC like bronchial/laryngeal/auricular cartilage thickness, contrast enhancement, increased T2-signal intensity. Imaging data was subsequently correlated with corresponding clinical symptoms like fever, dyspnea, stridor, uveitis, pain, hearing impairment as well as with acute-phase-inflammatory parameters like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).

Results

The clinical parameters were in good agreement with imaging findings and clinical symptoms such as tracheal wall thickening and dyspnea (r =0.65 p = 0.05), joint synovitis on MRI and a higher McAdam score (r = 0.84 p < 0.001). No correlations were found between inflammatory laboratory markers, imaging findings and clinical features.

Conclusion

Imaging diagnosis in RPC using CT and/or MRI delivers information about the degree of disease activity that correlates better with clinical features than unspecific inflammatory laboratory markers. Additionally, clinically unapparent cartilage involvement can be assessed adding value to the clinical diagnosis and therapy planning in this rare disease.

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Author notes

  1. D. Spira

    Present address: Diagnostic and Interventional Radiology, University Medical Center Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany

Authors and Affiliations

  1. Department of Radiology, Diagnostic and Interventional Radiology, Eberhard Karls University, Hoppe-Seyler-Str. 3, D-72076, Tuebingen, Germany

    W. M. Thaiss, K. Nikolaou, D. Spira & M. Horger

  2. Department of Internal Medicine II, Eberhard Karls University, Ottfried-Müller-Str. 10, D-72076, Tuebingen, Germany

    W. Spengler, T. Xenitidis & J. Henes

Authors
  1. W. M. Thaiss
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  2. K. Nikolaou
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  3. W. Spengler
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  4. D. Spira
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  5. T. Xenitidis
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Correspondence to W. M. Thaiss.

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Thaiss, W.M., Nikolaou, K., Spengler, W. et al. Imaging diagnosis in relapsing polychondritis and correlation with clinical and serological data. Skeletal Radiol 45, 339–346 (2016). https://doi.org/10.1007/s00256-015-2270-x

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  • DOI: https://doi.org/10.1007/s00256-015-2270-x

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