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MRI bone oedema occurs in various forms of inflammatory and non-inflammatory arthritis and probably represents a cellular infiltrate within bone.

Fiona M McQueen et al.

Arthritis Research & Therapy 8 (6), 2006

Histopathological studies suggest that a cellular infiltrate comprising lymphocytes and osteoclasts may be detected in subchondral bone and could mediate the development of erosions from the marrow towards the joint surface.

Fiona M McQueen et al.

Arthritis Research & Therapy 8 (6), 2006

They described the presence of bone oedema and correlated this histologically with a highly cellular infiltrate within the bone marrow.

Fiona M McQueen et al.

Arthritis Research & Therapy 8 (6), 2006

Figure 2 Potential role of bone marrow-derived stem cells in trafficking to the subchondral bone and synovial membrane in rheumatoid arthritis joints, resulting in a subchondral cellular infiltrate (seen as bone oedema on MRI) followed by erosion. (a) CD34+ stem cells from bone marrow express high levels of NFkB, which leads to unusual sensitivity to TNFα. (b) Stem cells differentiate into fibroblast-like cells and travel via the circulation to synovial membrane to become type B synoviocytes – here they mediate formation of erosions via production of proinflammatory cytokines and matrix metalloproteinases [23,25]. (c) Stem cells may also traffic to the subchondral bone marrow where they differentiate into mesenchymal cells.

Fiona M McQueen et al.

Arthritis Research & Therapy 8 (6), 2006

Surrogate markers of disease activity and outcome that have been identified in synovial tissue include components of the cellular infiltrate, and several mediators of inflammation and matrix degradation.

Barry Bresnihan

Arthritis Research & Therapy 5 (6), 2003

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