Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare form of seronegative polyarthritis which is characterized by sudden onset of a symmetrical and peripheral polysynovitis, prominent pitting edema of both hands in elderly patient. It has a benign course and remits completely after steroid treatment. We describe a 77-year-old Korean man of RS3PE syndrome He presented with sudden onset polyarthritis and pitting edema of the dorsum of both hands and both feet. Rheumatoid factor was negative and erythrocyte sedimentation rate was high. Bone scintigraphy showed increased uptake in both wrist, knee, and ankle joints. His synovitis and pitting edema completely disappeared after steroid treatment.
Aged ; Ankle Joint ; Arthritis ; Blood Sedimentation ; Edema* ; Foot ; Hand ; Humans ; Knee ; Radionuclide Imaging ; Rheumatoid Factor ; Synovitis* ; Wrist

OBJECTIVE: To evaluate the potential and correlation between near-infrared fluorescence (NIRF) imaging using cyanine 5.5 conjugated with hydrophobically modified glycol chitosan nanoparticles (HGC-Cy5.5) and 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) imaging of collagen-induced arthritis (CIA). MATERIALS AND METHODS: We used 10 CIA and 3 normal mice. Nine days after the injecting collagen twice, microPET imaging was performed 40 minutes after the intravenous injection of 9.3 MBq 18F-FDG in 200 microL PBS. One day later, NIRF imaging was performed two hours after the intravenous injection of HGC-cy5.5 (5 mg/kg). We assessed the correlation between these two modalities in the knees and ankles of CIA mice. RESULTS: The mean standardized uptake values of 18F-FDG for knees and ankles were 1.68 +/- 0.76 and 0.79 +/- 0.71, respectively, for CIA mice; and 0.57 +/- 0.17 and 0.54 +/- 0.20 respectively for control mice. From the NIRF images, the total photon counts per 30 mm2 for knees and ankles were 2.32 +/- 1.54 x 10(5) and 2.75 +/- 1.51 x 10(5), respectively, for CIA mice, and 1.22 +/- 0.27 x 10(5) and 0.88 +/- 0.24 x 10(5), respectively, for control mice. These two modalities showed a moderate correlation for knees (r = 0.604, p = 0.005) and ankles (r = 0.464, p = 0.039). Moreover, both HGC-Cy5.5 (p = 0.002) and 18F-FDG-PET (p = 0.005) imaging also showed statistically significant differences between CIA and normal mice. CONCLUSION: NIRF imaging using HGC-Cy5.5 was moderately correlated with 18F-FDG-PET imaging in the CIA model. As such, HGC-Cy5.5 imaging can be used for the early detection of rheumatoid arthritis.
Animals ; Ankle Joint/radionuclide imaging ; Arthritis, Experimental/*radionuclide imaging ; Carbocyanines/administration & dosage/*diagnostic use ; Chitosan/administration & dosage/*diagnostic use ; Fluorodeoxyglucose F18/administration & dosage/diagnostic use ; Injections, Intravenous ; Knee Joint/radionuclide imaging ; Male ; Mice ; Microscopy, Confocal ; Nanoparticles ; Positron-Emission Tomography/*methods ; Radiopharmaceuticals/administration & dosage/diagnostic use ; Statistics, Nonparametric