{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T19:41:38Z","timestamp":1792870898635,"version":"4.5.0"},"reference-count":51,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T00:00:00Z","timestamp":1598572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["T32 AR053459"],"award-info":[{"award-number":["T32 AR053459"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["K08 AR067885"],"award-info":[{"award-number":["K08 AR067885"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01 AR056702"],"award-info":[{"award-number":["R01 AR056702"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P30 AR069655"],"award-info":[{"award-number":["P30 AR069655"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2020,9]]},"abstract":"Objective<\/jats:title>To assess differences between lymphatic function in the affected hands of rheumatoid arthritis (RA<\/jats:styled-content>) patients with active synovitis and that of healthy controls, using indocyanine green (ICG<\/jats:styled-content>) dye and near\u2010infrared (NIR<\/jats:styled-content>) imaging.<\/jats:p><\/jats:sec>Methods<\/jats:title>NIR<\/jats:styled-content> imaging of the hands of 8 patients with active RA<\/jats:styled-content> and 13 healthy controls was performed following web space injection of 0.1 ml of 100 \u03bcM <\/jats:italic>ICG<\/jats:styled-content>. The percentage of ICG<\/jats:styled-content> retention in the web spaces was determined by NIR<\/jats:styled-content> imaging at baseline and at 7 days (\u00b11 day) after the initial injections; image analysis provided contraction frequency. ICG<\/jats:styled-content>+ lymphatic vessel (LV<\/jats:styled-content>) length and branching architecture were assessed.<\/jats:p><\/jats:sec>Results<\/jats:title>Retention of ICG<\/jats:styled-content> in RA<\/jats:styled-content> hands was higher compared to controls (P<\/jats:italic> < 0.01). The average contraction frequency of ICG<\/jats:styled-content>+ LV<\/jats:styled-content>s in RA<\/jats:styled-content> patients and in controls did not differ (mean \u00b1 SD<\/jats:styled-content> 0.53 \u00b1 0.39 contractions\/minute versus 0.51 \u00b1 0.35 contractions\/minute). Total ICG<\/jats:styled-content>+ LV<\/jats:styled-content> length in RA<\/jats:styled-content> hands was lower compared to healthy controls (58.3 \u00b1 15.0 cm versus 71.4 \u00b1 16.1 cm; P<\/jats:italic> < 0.001), concomitant with a decrease in the number of ICG<\/jats:styled-content>+ basilic LV<\/jats:styled-content>s in the hands of RA<\/jats:styled-content> patients (P<\/jats:italic> < 0.05).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Lymphatic drainage in the hands of RA<\/jats:styled-content> patients with active disease was reduced compared to controls. This reduction was associated with a decrease in total length of ICG<\/jats:styled-content>+ LV<\/jats:styled-content>s on the dorsal surface of the hands, which continued to contract at a similar rate to that observed in controls. These findings provide a plausible mechanism for exacerbation of synovitis and joint damage, specifically the accumulation and retention of inflammatory cells and catabolic factors in RA<\/jats:styled-content> joints due to impaired efferent lymphatic flow. NIR<\/jats:styled-content>\/ICG<\/jats:styled-content> imaging of RA<\/jats:styled-content> hands is feasible and warrants formal investigation as a primary outcome measure for arthritis disease severity and\/or persistence in future clinical trials.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.41311","type":"journal-article","created":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T05:12:50Z","timestamp":1589778770000},"page":"1447-1455","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Altered Lymphatic Vessel Anatomy and Markedly Diminished Lymph Clearance in Affected Hands of Patients With Active Rheumatoid Arthritis"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1562-3879","authenticated-orcid":false,"given":"Richard D.","family":"Bell","sequence":"first","affiliation":[{"name":"Center for Musculoskeletal Research University of Rochester Medical Center Rochester New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4028-7723","authenticated-orcid":false,"given":"Homaira","family":"Rahimi","sequence":"additional","affiliation":[{"name":"University of Rochester Medical Center Rochester New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0598-3232","authenticated-orcid":false,"given":"H. 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