The OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging (MRI) Scoring System: Updated Recommendations by the OMERACT MRI in Arthritis Working Group

Abstract

Objective.The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Magnetic Resonance Imaging (MRI) scoring system (RAMRIS), evaluating bone erosion, bone marrow edema/osteitis, and synovitis, was introduced in 2002, and is now the standard method of objectively quantifying inflammation and damage by MRI in RA trials. The objective of this paper was to identify subsequent advances and based on them, to provide updated recommendations for the RAMRIS.Methods.MRI studies relevant for RAMRIS and technical and scientific advances were analyzed by the OMERACT MRI in Arthritis Working Group, which used these data to provide updated considerations on image acquisition, RAMRIS definitions, and scoring systems for the original and new RA pathologies. Further, a research agenda was outlined.Results.Since 2002, longitudinal studies and clinical trials have documented RAMRIS variables to have face, construct, and criterion validity; high reliability and sensitivity to change; and the ability to discriminate between therapies. This has enabled RAMRIS to demonstrate inhibition of structural damage progression with fewer patients and shorter followup times than has been possible with conventional radiography. Technical improvements, including higher field strengths and improved pulse sequences, allow higher image resolution and contrast-to-noise ratio. These have facilitated development and validation of scoring methods of new pathologies: joint space narrowing and tenosynovitis. These have high reproducibility and moderate sensitivity to change, and can be added to RAMRIS. Combined scores of inflammation or joint damage may increase sensitivity to change and discriminative power. However, this requires further research.Conclusion.Updated 2016 RAMRIS recommendations and a research agenda were developed.

High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis

“…1; 3 T Tim Coil, Siemens Healthineers, Erlangen, Germany) were used, allowing for Table 1 Characteristics of the study population. For patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA), as well as healthy controls the population size, the mean age in years ± standard deviation and range, the mean disease duration (except HC) in years (PsA) and weeks (RA) ± standard deviation and range and the sex are presented The imaging protocol followed the recommendations of the OMERACT working group for PsA and RA [21,27]. In PsA patients this included pre-and post-contrast (DOTA − , Dotarem, Guerbet, Villepinte, France; intravenous-injection of 0.4 ml/kg bodyweight) T1-weighted turbo spin echo (TSE) and non-contrast-enhanced fat-saturated T2weighted TSE or short tau inversion recovery (STIR) sequences in two different orthogonal planes.…”

Validity and Responsiveness of Combined Inflammation and Combined Joint Damage Scores Based on the OMERACT Rheumatoid Arthritis MRI Scoring System (RAMRIS)

“…In previous studies, combined scores have been obtained through slightly differing methods (3,17,19). To ensure comparability between studies, and to avoid biased reporting, there is need for consensus regarding which method to use (20).…”

Magnetresonanztomografie peripherer Gelenke

“…Die aktuelle Version des RAMRIS evaluiert und graduiert das Vorliegen von Erosionen, Synovialitis, Knochenmarködem, Tendovaginitis der Flexorensehnen und Gelenkspaltverschmälerung an den metakarpophalangealen (MCP) Gelenken, den Handwurzelknochen sowie am Radiokarpal-und Ulnokarpalgelenk [6]. Der PsAMRIS beinhaltet Erosionen, Synovialitis, Knochenmarködem, Tendovaginitis der Flexorensehnen, periartikuläre Inflammation und Knochenproliferationen an MCP, proximalen (PIP) und distalen (DIP) Interpha langealgelenken [4].…”

“…Die für RA und PsA charakteristische Entzündung der streck-und beugeseitigen Sehnenscheiden kann mittels MRT in den flüssigkeitssensitiven und T1w-Sequenzen nach Kontrastmittelgabe als signalreiche Verdickung nachgewiesen werden [4,6]. Normale Sehnen und Sehnenscheiden sind hingegen signalarm Periartikuläre/extrakapsuläre Entzündung Die periartikuläre/extrakapsuläre Entzündung kommt zwar auch bei der RA vor, ist jedoch insbesondere typisch für die PsA [4,32].…”

“…Unterstützend finden seit einigen Jahren standardisierte Klassifikationssysteme, z. B. der RA/PsA magnetic resonance imaging score (RAMRIS; PsAMRIS), in und auch außerhalb wissenschaftlicher Studien Anwendung [4][5][6].…”