Detection of joint pathology by magnetic resonance imaging in patients with early rheumatoid arthritis

Abstract

Magnetic resonance imaging (MRI) permits the visualization of anatomical structures not appreciated by conventional radiographic imaging, and may assess inflammatory disease and its progression with greater sensitivity than conventional radiography. In this study of 30 patients with early rheumatoid arthritis (RA), which could be considered as a pilot study because of the relatively small number of patients, we compare MRI of the knee and the fifth metatarsophalangeal joint with clinical and radiographic findings. A parallel study of 10 healthy individuals served as a reference group. In all but one of the 30 patients, MRI revealed some kind of joint abnormality, whereas conventional radiography was normal in 14 patients. The present study thus suggests that MRI may detect inflammatory and/or destructive joint changes in patients with early RA, and that these changes may occur in the absence of clinical symptoms or signs and/or radiographic signs in the examined joint. If these data prove to be confirmed in further controlled studies, MRI may be of importance both for the assessment of prognosis and for the decision to treat in the early critical stages of RA.

Arthritis of the finger joints: A comprehensive approach comparing conventional radiography, scintigraphy, ultrasound, and contrast-enhanced magnetic resonance imaging

“…MRI detected erosions in 92 finger joints (20%; 26 patients) in group 1 that were not detected by conventional radiography. Other investigators as well as our group have reported similar results for the wrists (24,25,(37)(38)(39), shoulders (40)(41)(42)(43), and knees of RA patients (26,(44)(45)(46) and for the sacroiliac joints of patients with spondylarthropathies (6,7,9).…”

Extremity magnetic resonance imaging in rheumatoid arthritis: Report of the american college of rheumatology extremity magnetic resonance imaging task force

“…Several studies have investigated the role of MR scans in RA patients (6)(7)(8)(9). Most of them are cross-sectional and indicate that, compared with traditional radiographs, MR scans are not only more sensitive in identifying erosions, but also allow diagnosis of them early in the course of the disease.…”

“…Although MRI technology has been available for the last 30 years, experience in patients with RA is limited (6)(7)(8). Over the last decade, a number of reports have described the efficacy of MRI in patients with RA, demonstrating the ability to document erosions and synovitis with a greater sensitivity than conventional radiography (9)(10)(11)(12).…”

Frühdiagnostik der chronischen Polyarthritis mit konventionellem Röntgen

“…Schon bald nach der Entdeckung und Entwicklung der Röntgentechnik durch Conrad Röntgen wurden zu Beginn des vorigen Jahrhunderts die typischen Zeichen der Arthritis beschrieben (12).…”

“…In einer erst kürzlich publizierten Studie wurde erstmals systematisch der Frage nachgegangen, welchen Beitrag der Röntgenbefund bei Patienten mit früher Arthritis zur Diagnosestellung einer chronischen Polyarthritis liefert (24) Neuere bildgebende Verfahren, insbesondere die Kernspintomographie, liefern faszinierende Einblicke besonders in die der Röntgentechnik nur eingeschränkt zugänglichen Weichteile (12). Das mit dieser Technik bestimmbare Volumen der Handgelenksynovialitio als area under the curve im Zeitverlauf korreliert gut mit der Entwicklung von Läsionen, die im Kernspin als Erosionen beschrieben werden aber weniger gut mit der Entwicklung radiologisch erkennbarer Erosionen (22).…”