Concordance between inflammation at physical examination and on MRI in patients with early arthritis

Abstract

Inflammation on MRI is not only present in clinically swollen but also in non-swollen joints. In particular BME occurred in clinically non-inflamed joints. The relevance of subclinical inflammation for the disease course is a subject for further studies.

Characterising arthralgia in the preclinical phase of rheumatoid arthritis using MRI

“…The joints and bones mostly affected by MRI-defined inflammation in our CSA cohort were locations where MRI inflammation is observed in patients with early arthritis patients (MCP3 joint, capitate and lunate, radiocarpal and intercarpal joints) 22. This strengthens the indication that the inflammation observed in the patients with CSA in our study might be a precursor of clinical arthritis.…”

“…Local inflammation in small joints has also been observed using different imaging technologies 19–21. MRI is a sensitive tool and is more sensitive than physical examination to measure local inflammation 22. It detects synovitis, bone marrow oedema (BME), this is also called osteitis and tenosynovitis, and is most suitable for evaluating the earliest inflammatory changes in the small joints of patients considered potentially to be in the preclinical phase of RA 23 24…”

The diagnostic accuracy of the squeeze test to identify arthritis: a cross-sectional cohort study

“…MRI-detected joint inflammation was studied as secondary outcome. MRI is more sensitive in detecting joint inflammation 16 17. However, the specificity of MRI-detected inflammation is not yet known.…”

“…To capture subclinical joint inflammation, MRI-detected inflammation rheumatoid arthritis MRI score (RAMRIS) was studied as secondary outcome. Contrast-enhanced MRI is more sensitive in detecting joint inflammation in wrist and MCP joints than physical examination 16 17. Importantly, however, the diagnostic value of MRI is not yet established and the value of MRI of the foot particularly is relatively unexplored.…”

Closing the Gap between Preclinical Biologic Development and Clinical Application in Rheumatoid Arthritis

“…However, nowadays, in addition to the aforementioned traditional markers, a more sensitive imaging method, magnetic resonance imaging (MRI) with features of high soft-tissue resolution, multisection and multiparameter, has the unique advantage of being able to visualize the subclinical inflammatory synovium in clinical studies (3). In RA patients in remission according to the 28-joint Disease Activity Score-Creactive protein (DAS28-CRP), persistent active synovial inflammation detected by MRI is a high-risk predictor of subsequent joint destruction (4).…”