School of Medical Sciences


Rheumatology

Principal investigator


Current members of the rheumatology research group core:


Nicola Dalbeth, Anthony Doyle, Quentin Reeves, Elizabeth Robinson, Fiona McQueen en

Research Fellows: Ravi Suppiah, Angela Crowley
Research Nurses:  Megan Williams, Maria Lobo
Technicians:        Bregina Poole
Students:           Arista Chand, Jing Dong

Rheumatology research output


We have an extremely active rheumatology research unit at present. Projects can be categorised as follows:

The Auckland Rheumatology Imaging Group (ARIG)

is a collaboration between academic rheumatologists and radiologists within the Auckland region. This group first achieved recognition through a cohort study investigating rheumatoid arthritis (RA) patients from 1996 to 2003. Findings from that study were pivotal in defining MRI features as imaging biomarkers. Members of ARIG continue to collaborate with members of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) group. Currently these include the "MRI in inflammatory arthritis" initiative and the "Imaging In Gout" group. A new group is being formed currently to investigate MRI changes in the cervical spine in rheumatoid arthritis – to present to OMERACT 10 in Borneo (May 2010). The MRI imaging group initially took on the challenge of developing a scoring system to measure the impact of joint disease in RA. The now widely accepted RA MRI scoring system (RAMRIS) was developed with publication of a reference atlas. More recently this work has extended to developing a Psoriatic Arthritis MRI scoring system (PsAMRIS) and examining the role of extremity MRI.

Bone histology

A productive collaboration with members of the Auckland Bone Group has also allowed us to explore the histopathological basis of MRI bone oedema and erosion in RA. Studies have also recently been published investigating tophus histology in gout.

Gout

This is being explored via imaging and bone histology studies. Over the past two years the Auckland group has become recognised as a world leader in gout research under the direction of Dr Nicola Dalbeth. Collaborations continue with OMERACT in terms of imaging and clinical gout research projects. There are also important collaborations with podiatry (see below). A large HRC funded project is now underway investigating the effects of zoledronic acid in preventing erosion in patients with gout (Dr Dalbeth, Novartis, Auckland Bone group). There are also collaborations with Fonterra (urate and milk study) (Dr Dalbeth).

Other clinical projects

Other projects broadly encompass themes of inflammatory arthritis, lupus and medical education. Collaboration continues within the OMERACT framework for the wider gout research agenda which includes exploring clinical outcome measures (for use in clinical trials).

The following are primarily imaging projects:

  • Developing a Cartilage Scoring System for RA Using 3T MRI Scanning (ARIG)
  • Quantifying Synovitis in Rheumatoid Arthritis using 3T MRI Scanning (ARIG)
  • 3T MRI to assess bone oedema and erosions in early rheumatoid arthritis: RAMRIS scores vs segmentation (ARIG)
  • Imaging in gout: MRI, multidetector CT, high resolution ultrasound and radiology (ARIG)
  • Reader Reliability of the OMERACT Psoriatic Arthritis Magnetic Resonance Score - Results From An OMERACT Workshop (OMERACT MRI Imaging Group)
  • Wrist MRI After 2 Years Treatment of Early Aggressive RA (FM/UCLA collaboration; TEAR study)
  • MRI bone oedema in the rheumatoid cervical spine (ARIG/collaboration with Prof Jurgen Braun, Berlin
  • Zoledronic acid in psoriatic arthritis (ZAPA): imaging follow-up response using MRI (ARIG)

The following are gout projects:

  • The Acute Effect of Skim Milk On Serum Urate Concentrations: A Randomized Controlled Cross-Over Trial (Auckland Bone group, Dr Dalbeth)
  • Cellular Characterization of the Gouty Tophus: a Quantitative Analysis (Collaboration with Auckland Bone Group)
  • Impact of Chronic Gout On Foot Function: Case-Control Study (collaboration with Dr Dalbeth and Prof Keith Rome, Podiatry AUT)
  • Illness Perception in Patients with Gout (collaboration with NZ gout group, Universities of Auckland and Otago – Wellington Clinical School)
  • ACR / EULAR Gout Response Criteria Survey (Assoc Prof Will Taylor, Wellington Clinical School, Prof Ralph Schumacher)

Clinical/ immunology rheumatology research projects include:

  • Circulating microRNAs in Crohn’s disease: can they provide insights into disease pathogenesis and might they have diagnostic utility?” Dr Geoff Krissansen (Dept MMP University of Auckland)
  • Medication adherence in SLE patients. Dr Elizabeth Broadbent and Gabrielle Daleboudt (Dept Psychology University of Auckland)
  • Basing musculoskeletal curriculum changes on the opinions of practicing physicians (FM, Phillippa Poole)

Recent relevant publications


  1. Dalbeth N, Gracey E, Palmano K, Callon K, Pool B, Cornish J, McQueen F, MacGibbon A. Identification of dairy fractions with anti-inflammatory properties in models of acute gout. Ann Rheum Dis 2009. In Press (Online First). ANNRHEUMDIS/2009/113290.
  2. McQueen FM, Dalbeth N. Editorial. Predicting joint damage in rheumatoid arthritis using MRI scanning. Arthritis Research & Therapy 2009, 11:124 (14 September 2009).
  3. McQueen FMF, Dalbeth N. Will Jill come tumbling after? The case for a JAK2-type mutation as a prequel to the connective tissue disorders. Medical Hypotheses 2009 In Press. doi:10.1016/j.mehy.2009.03.050.
  4. Schumacher HR, Jr, Grainger R, Taylor W, Dalbeth N, Perez-Ruiz F, Singh JA, Waltrip RW, Schlesinger N, Evans R, Edwards NL, Silvera F, Diaz-Torne C, MacDonald PA, McQueen FM. Outcome Domains for Studies of Acute and Chronic Gout. J Rheumatol 2009 (In Press).
  5. Grainger R, Taylor W, Dalbeth N, Perez-Ruiz F, Singh JA, Waltrip RW, Schlesinger N, Evans R, Edwards L, Silvera F, Diaz-Torne C, MacDonald PA, McQueen FM, Schumacher HR. Progress in measurement instruments for acute and chronic gout studies. J Rheumatol 2009 (In Press).
  6. Tan YM, Ostergaard M, Doyle A, Dalbeth N, Lobo M, Reeves Q, Robinson E, Taylor W, Jones P, Pui K, Lee J, McQueen FM. MRI bone oedema scores are higher in the arthritis mutilans form of psoriatic arthritis and correlate with high radiographic scores for joint damage. Arthritis Research & Therapy 2009;10 Issue: 1 Article Number: R2 (6 January 2009).
  7. Dalbeth N, McQueen FM. Use of imaging to evaluate gout and other crystal deposition disorders. Current Opinion in Rheumatology 2009;21:124-131.
  8. McQueen FM. Response to McGonagle et al. Comment on: The use of MRI in early RA: reply. Rheumatology 2009;48:451-451.
  9. Conaghan PG, Bird P, McQueen F, Peterfy C, Bøyesen P, Gandjbakhch F, Duer-Jensen A, Haavardsholm E, Ejbjerg B, Wiell C, Coates L, Hermann KG, O’Connor P, Lassere M, Freeston J, Anandarajah A, Genant H, Emery P, Østergaard M. The OMERACT MRI Inflammatory Arthritis Group - Advances and future research priorities. J Rheum (In Press).
  10. Østergaard M, Conaghan PG, O’Connor P, Szkudlarek M, Klarlund M, Emery P, Peterfy C, Genant H, McQueen F, Bird P, Lassere M, Ejbjerg B. Reducing invasiveness, duration and costs of MRI in rheumatoid arthritis by omitting intravenous contrast injection – does it change the assessment of inflammatory and destructive joint changes? J Rheum (In Press).
  11. McQueen F, Lassere M, Duer-Jensen A, Wiell C, Conaghan P, Gandjbakhch F, Hermann KG, Bird P, Bøyesen P, Peterfy C, Ejbjerg B, Haavardsholm E, Coates L, Østergaard M. Testing an OMERACT MRI scoring system for peripheral psoriatic arthritis in cross-sectional and longitudinal settings. J Rheum (In Press).
  12. Østergaard M, McQueen F, Wiell C, Bird P, Bøyesen P, Peterfy C, Ejbjerg B, Gandjbakhch F, Duer-Jensen A, Coates L, Haavardsholm E, Hermann KG, Lassere M, Emery P, Genant H, Conaghan P. The OMERACT psoriatic arthritis magnetic resonance imaging scoring system (PsAMRIS): Definitions of key pathologies, suggested MRI sequences and preliminary scoring system for PsA hands. J Rheum (In Press).
  13. Dalbeth N, Horne A, Gamble G, Ames R, Mason B, McQueen FM, Bolland M, Grey A, Reid IR. The Effect of Calcium Supplementation on Serum Urate; Analysis of a Randomized Controlled Trial. Rheumatology 2009; 48: 195 - 197.
  14. Ostendorf B, McQueen F, Scherer A, Schneider M. Prognosis in Early (Rheumatoid) Arthritis – The Value of MRI and Arthrosonography. Akt Rheumatol 2008;33:337–341.
  15. Dalbeth N, Smith T, Gray S, Doyle A, Antill P, Lobo M, Robinson E, King A, Cornish J, Shalley G, Gao A, McQueen FM. Cellular characterisation of magnetic resonance imaging bone oedema in rheumatoid arthritis; implications for pathogenesis of erosive disease Ann Rheum Dis, Feb 2009; 68: 279 - 282.
  16. Dalbeth N, Clark B, Gregory K, Gamble G, Sheehan T, Doyle A, McQueen FM. Mechanisms of bone erosion in gout; a quantitative analysis of plain radiography and computed tomography. Ann Rheum Dis Aug 2009; 68: 1290 - 1295.
  17. Ly J, Pinto C, Doyle A, Dalbeth N, McQueen FM. Axial bone proliferation causing cervical myelopathy in mutilans form of psoriatic arthritis despite peripheral bone erosion. Ann Rheum Dis, Mar 2009; 68: 443 - 444.
  18. McQueen FM. The Use of MRI in early RA. Editorial. Rheumatology. November 2008; 47: 1597 - 1599.
  19. McQueen FM, Dalbeth N, Doyle A. MRI Studies in Psoriatic Arthritis: Insights into Pathogenesis and Treatment Response. Current Rheumatology Reports 2008;10:303-310.
  20. Suppiah R, McQueen F. Hypertrophic osteoarthropathy associated with a left ventricular tumour. Rheumatology 2008; 47 (9): 1277.
  21. Dalbeth N, Smith T, Nicolson B, Clark B, Callon K, Naot D, Haskard DO, McQueen FM, Reid IR, Cornish J. Enhanced osteoclastogenesis in patients with tophaceous gout: urate crystals promote osteoclast development through interactions with stromal cells. Arthritis & Rheumatism. 58(6):1854-65, 2008.
  22. W.J. Taylor, K. Colvine, K. Gregory, J. Collis, F.M. McQueen, N. Dalbeth. The Health Assessment Questionnaire Disability Index is a valid measure of physical function in gout. Clinical and Experimental Rheumatology 2008;26;4;620-626.
  23. Taylor WJ, Schumacher HR Jr, Baraf HS, Chapman P, Stamp L, Doherty M, McQueen F, Dalbeth N, Schlesinger N, Furst DE, Mellado JV, Becker MA, Kavanaugh A, Louthrenoo W, Bardin T, Khanna D, Simon LS, Yamanaka H, Choi HK, Zeng X, Strand V, Grainger R, Clegg D, Singh JA, Diaz-Torne C, Boers M, Gow P, Barskova VG. A modified Delphi exercise to determine the extent of consensus with OMERACT outcome domains for studies of acute and chronic gout. [Journal Article] Annals of the Rheumatic Diseases. 67(6):888-91, 2008 Jun.
  24. Taylor WJ, Harrison AA, Highton J, Chapman P, Stamp L, Dockerty J, McQueen F, Jones PB, Ching D, Porter D, Rajapakse C, Rudge SR, Taylor G, Kumar S, Macedo T, Hoy MS. Disease Activity Score 28-ESR bears a similar relationship to treatment decisions across different rheumatologists, but misclassification is too frequent to replace physician judgement. Rheumatology, April 2008; 47: 514 - 518.
  25. McQueen FM. A vital clue to deciphering bone pathology: MRI bone oedema in rheumatoid arthritis and osteoarthritis. Editorial. Ann Rheum Dis. 2007;66:1549-1552.
  26. Fitzgibbon B, Fairhall S, Kirk I, Kalev-Zylinska M, Pui K, Dalbeth N, Keelan S, Robinson E, During M, McQueen FM. Functional MRI in NP-SLE patients reveals increased parietal and frontal brain activation during a working memory task compared with controls. Rheumatology 2008;47:50-53.
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