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Further support for an uncoupling of inflammation and new tissue formation may come from the observation that inhibition of osteoclasts, preventing bone erosion, does not affect ankylosis in a mouse model [ 48].
This limitation has been an obstacle to substituting MRI for XR in clinical trials, as articular cartilage loss is at least as important, if not more, as bone erosion in determining long-term disability in RA [ 8], and suppressing bone erosion does not always ensure that cartilage loss has been suppressed as well [ 2].
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Likewise, PsA bone erosions do not have disease specific MRI features, but little is known concerning how they progress over time.
Such changes are desirable as long as 'genetic erosion does not take place'.
Including cartilage loss in MRI assessment of RA is important because this feature of joint destruction does not always follow the same pattern of response to therapy as bone erosion does.
Indeed, OPG blocked bone erosion but did not affect synovial inflammation.
In contrast, OPG or anti-TNF alone led to arrest of bone erosions but did not achieve repair.
In contrast, OPG and anti-TNF alone led to arrest of bone erosions but did not achieve repair.
Moreover, data correlating bone markers to the results from radiographs only addressed catabolic bone changes (erosions) and did not account for anabolic bone changes (osteophytes).
Clearly, CT would have no role in the diagnosis of acute gout, prior to the development of bone erosions or tophi, as it does not provide imaging of synovitis, tenosynovitis, or osteitis.
Thus, whereas systemic increased bone resorption resulted in secondary cartilage erosions, local increased bone turnover did not result in cartilage degradation.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com