Objective. To study diagnostic possibilities of magnetic resonance imaging (MRI) of sacroiliac joints (SIJ) in pts with seronegative spondyloarthritides (SS). Material and methods. MRI and radiological examination was performed in 15 pts: 10 with ankylosing spondylitis (AS) and 5 with undifferentiated SS. MRI was done with Magnetom Symphony apparatus (Siemens, Germany) with magnetic-field strength 1,5 tesla. Tl, T2 and T2-FS weighted were used. Tl-FS weighted performed in 3-4 minutes after intravenous infusion of gadolinium were additionally used in 5 pts. Inflammatory and structural (erosions, subchondral sclerosis) MRI changes of SIJ were studied. Inflammatory changes of SIJ were analyzed in subchondral bone, bone marrow, joint capsule, joint cavity, interosseous ligaments. SS activity was assessed with BASDAI. Results. Median age of pts was 24 years, median SS duration — 3 years. HLA-B27 was revealed in 13 from 15 pts. All pts had radiological signs of sacroiliitis: 13 - bilateral (12 - II or III stage and 1 — I and III stage according to Kellgren), 2 — unilateral (II stage). So radiological signs of inflammation were revealed in 28 from 30 examined SIJ. MRI signs of sacroiliitis were present in the same 28 SIJ. Subchondral edema of sacrum and/or huckle-bone was revealed in 23 SIJ of 13 pts, bone marrow edema — in 20 SIJ of 13 pts, joint cavity edema - in 21 SIJ of 14 pts, capsule edema — in 12 SIJ of 8 pts, interosseous ligaments inflammation signs — in 3 SIJ of 2 pts. Inflammatory changes of all 5 examined anatomic structures were present in 1, 4 — in 9, 3 — in 13 SIJ. In 1 SIJ inflammation was localized in capsule only. Structural changes were revealed in 22 (73%) SIJ of 14 pts. Structural MRI changes of SIJ at II radiological stage of sacroiliitis were noted in 67% and at III stage — in 83%. Combination of inflammatory and structural changes was present in 22 from 30 SIJ (73%). Frequency of such combination was similar at different radiological stages of sacroiliitis. Isolated inflammatory signs without structural changes were present in 3 SIJ of 3 pts. Gadolinium administration allowed to reveal 5 additional edema zones in SIJ region of 4 from 5 pts. Inflammatory changes of SIJ were revealed with similar frequency in presence (81%) or absence (88%) of pain in this region. Pts with high (BASDAI>40) or not high (BASDAK40) general activity of the disease had about the same mean number of SIJ inflammatory changes (7,6 and 7,8 respectively). Conclusion. MRI is highly sensitive method for revealing SIJ changes in pts with SS. Inflammatory MRI changes were present in all joints with radiological changes irrespectively from radiological stage.

Objective. To study the structure and functional peculiarities of left-ventricular myocardium and endothelial dysfunction in rheumatoid arthritis (RA) in connection with the course of disease, concomitant arterial hypertension (AH) and cardiovascular risk factors. Material and methods. Before the beginning of regular antihypertensive therapy we observed 55 pts with RA, 30 of them had mild or moderate AH developed in the course of RA and 36 pts with essential hypertension (EH) without rheumatic diseases. Wfe evaluated anamnesis, blood pressure level (BPL), echocardiography data, endothelial vasodilation capacity and endothelial dysfunction index. All pts were purely comparable in age; RA with AH pts and EH pts — in BPL, anamnesis duration, SCORE-risk. No one of the observed persons had associated clinical states. 26 healthy subjects made control group. Results. RA with AH pts in comparison with EH had marked left-ventricular hypertrophy. Concentric hypertrophy prevailed in RA. 65,3% of RA-pts had diastolic dysfunction type 1. Endothelial dysfunction in RA-pts was found more often (in 57,9% individuals with RA and normal BPL and in 50% pts with RA and concomitant AH) (p<0,05) than in EH-pts (20%). Thus, left-ventricular hypertrophy in RA optionally depended on AH presence but it is closely connected with metabolic (hyperlipidemia, abdominal obesity) and endocrine (menopause) disorders in pts with chronic autoimmune inflammation.

Objective. To study function of endothelium in pts with gout associated with coronary heart disease (CHD) depending on hyperuricemia (HU) expression. Material and methods. 86 male with primary gout associated with CHD (stable exertional angina pectoris of functional class (FC) II-III) aged 42 to 67 years were included. 30 (34,9%) from them had low, 36 (41,8%) - moderate and 20 (23,3%) - high grade HU. 28 pts with stable exertional angina pectoris of FC II-III were included in the group of comparison and 20 healthy donors - in the control group. Circulating endothelial cells (CEC) quantity was assessed with the method of J. Hladovec (1978), endothelin 1 (ET1) level was evaluated with a radioimmunoassay kit (Amersham, USA), endothelium- dependent vasodilatation (EDVD) was assessed by change of brachial artery (BA) diameter in test with reactive hyperemia. Results. Pts with gout associated with CHD had significantly higher level of CEC and ET1 than pts with CHD. Maximal ET1 level was revealed in gout pts witn CHD and high degree HU (52,2+1,1 ng/1, p,0,01). Uric acid concentration correlated with CEC and ET1 level in serum of gout pts with CHD (r=0,74, p<0,001, r=0,68, p<0,01 respectively). BA EDVD in gout pts with CHD was decreased in comparison with control and pts with CHD. In gout pts with CHD low degree HU associated with maximal (5,2±1,2%) and HU exceeding 620 pmol/l with minimal (2,6±1,1%) relative vasodilatation. Presence of obesity and/or hypertension increased disturbances of endothelium functional state. Conclusion. Combination of gout and CHD was accompanied by increase of CEC, ET1 and decrease of EDVD progressing with increase of HU.

Bone mineral density (BMD), bone biochemical markers, influence of inflammation and glucocorticoid administration on bone metabolism in 70 children with chronic arthritis were studied. Osteopenia was detected by dual energetic X-ray absorptiometry L1-L4 in 18,7% children. Disease duration enhanced osteopenia frequency. Low BMD was associated with low levels of total calcium and osteocalcine. We revealed that BMD parameters positively correlated with anthropometry and negatively correlated with total alkaline phosphatase activity and osteocalcine and p — CrossLaps levels. As inflammatory activity, as glucocorticoids decreased BMD parameters and bone biochemical markers levels. The most negative changes were been revealed in children with systemic variant of arthritis and little changes in children with monooligoarthicular variant of arthritis. Conclusion. BMD, levels of bone biochemical markers, osteopenia risk realization depend on arthritis duration, inflammatory activity, disease degree, number of joints, involved in arthritis and therapy.