الفهرس 
Introduction
Chapter 1 : OsteoarthritisOnly 14 pages are availabe for public view
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Abstract
The aim of the present study was to compare articular subchondral bone changes in a group of patients of early versus late rheumatoid arthritis and osteoarthritis, also to verify the concept that osteoarthritis is an inflammatory disease that involve the whole joint, our study also aimed to detect the different sources and causes of pain in osteoarthritic joint in order to direct the different treatment strategies to the exact cause of pain.
Our study included 60 patients and 20 apparently healthy volunteers served as a control group. Patients were classified into 2 groups; group І: rheumatoid arthritis group and group П: osteoarthritis group, each group classified into 2 subgroups; group І classified to: ІA (early RA): disease duration less than 2 years and ІB (late RA): more than 2 years, group П classified to: П (early OA): knee pain ≤ 1 year and grade 0, 1 or 2 K& L and ПB (late OA): knee pain ˃1 year and grade 3 or 4 K& L.
All patients were subjected to thorough history taking, complete physical examination, disease activity and severity assessment and laboratory investigations in the form of calcium, phosphorus, serum total ALP (as a marker of bone formation), urinary pyridinoline level (as a marker of bone resorption), plain x ray wrist and hand in RA patients and knee for OA patients, MSUS for wrist joint n RA and knee in OA patients, and finally MRI on the wrist joint in RA and on the knee joint in OA patients.
The present study reported BME was present in 56.7% of RA patients with the mean of edema score was 2.70±3.33, erosion was present in 40% of RA patients.
Serum total ALP level was 164.90±129.10 U/L in RA patients compared to 85.7±21.37 in control group, urinary PYD level was 343.1±231.39 nmol/L compared to 141.11±40.1 nmol/L in control group with statistically significant difference.
ALP was positively correlated with age and disease duration while PYD was negatively correlated with disease duration; ALP also was positively correlated with Ritche articular index, HAQ and Steinbrocker functional index while PYD was positively correlated with only Steinbrocker functional index.
Regarding correlation between bone remodeling markers and radiological and ultrasonographic findings, ALP was positively correlated with all parameters of SENS score and negatively correlated with ultrasonographic erosions, while there was no significant correlation between PYD and both radiological and ultrasonographic findings.
Regarding MRI findings in RA patients, BME score was negatively correlated with disease duration and erosion was positively correlated with it. Our study reported that BME was correlated with VAS and DAS-28, while BME score was positively correlated VAS, DAS-28 and HAQ, erosion was positively correlated with VAS, DAS-28, HAQ and functional class.