MRI detects erosions 2 years sooner than x-ray

[Guest guest]

Jun 21, 2002

MRI detects erosions 2 years sooner than x-ray

Stockholm, Sweden ‹ MRI was able to detect a greater number of wrist joint

bone erosions, and on average 2 years earlier, than x-ray, according to a

study presented at a news conference at last week's EULAR meeting. Another

study, however, indicates that MRI is no better than x-ray in detecting

erosions in a foot joint.

Radiography is the mainstay of imaging in RA, used in diagnosis and

monitoring and as a predictor of long-term outcome, said lead author Dr

Mikkel Østergaard (Department of Rheumatology, Hvidovre University Hospital,

Denmark). While several studies indicate that bone erosions are found more

frequently with MRI, there are no long-term follow-up studies of MRI and

minimal knowledge of its potential time advantage and predictive value.

Østergaard and colleagues explored the value of MRI and radiography in 10 RA

patients with a median age of 62 and disease duration of 1.5 years. MRI and

x-rays of the wrist were performed every year for 5 years. Each wrist bone

including the metacarpal bases, carpal bones, radius, and ulna were

assessed for the absence of presence of bone erosions. Observers were

blinded to the findings of the other imaging modality.

Seventy-seven percent of new erosions seen at least 1 year earlier with MRI

There were 9 bones with radiographic erosions at baseline. A total of 27 new

bone erosions developed during the 5-year follow-up period. Of these, 20

were detected by MRI 1 to 5 years earlier, 3 were seen at the same time by

both techniques, 2 were detected by MRI 1 to 2 years later than radiography,

and 1 (detected by radiography at 5-year follow-up) was not registered by

MRI.

" Seventy-seven percent of new radiographic erosions that developed through

the 5-year follow-up were seen with MRI 1 or more years earlier, meaning

that radiography in a lot of cases provides only delayed information on

joint damage compared with MRI, " said Østergaard. As well, " the presence of

MR erosions at baseline gave a 4.5-fold increasing risk of radiographic

erosions 5 years later. "

As a whole, the median time that MRI detection preceded new radiographic

erosions was 2 years. In addition, of 37 baseline bone erosions detected

with MRI, only 51% could be detected by radiography as many as 5 years

later.

" The presence of MR erosions at baseline gave a 4.5-fold increasing risk of

radiographic erosions 5 years later. "

Østergaard said that MRI provides a greater range of images, allowing for

the visualization of holes in bone and synovitis. He suggested that its use

could help in earlier diagnosis (as well as the actual identification of a

given type of rheumatic disease), improved monitoring, and the prediction of

long-term outcome.

" Performing an MRI study is not as simple as taking a blood sample or an

x-ray, but the early information appears so important that it justifies the

complexity of the technique, " he concluded, though he noted that studies

need to be done to determine whether the wrist bone is representative of

other joints.

MRI not superior to x-ray in detecting MTP5 erosions in early RA

Findings from another study presented in a poster at EULAR seem to speak to

this very issue. Dr a Forslind (Section for Rheumatology,

Helsingborgs Iasarett AB, Helsingborg, Sweden) and colleagues found that MRI

and radiography are almost equally able to detect erosions in the fifth

metatarsophalangeal (MTP5) joint (the joint next to the baby, or fifth, toe)

in patients with early RA.

Given that the MTP5 joint is considered to be the one that first shows

erosions on plain x-rays, Forslind and colleagues undertook to explore

whether MRI can show erosions earlier than conventional radiography, as it

has been shown to do in knee RA. They used the modality (after contrast

injection) in 23 patients, using it 1 year from the onset of RA and 3 years

thereafter.

At baseline, MRI identified 12 erosions in 10 patients, and after 3 years,

35 erosions in 15 patients. Of the 5 patients with new erosions, 3 were

visible by x-ray. With conventional radiography, there were 22 erosions in

10 patients (8 the same as on MRI) at baseline and 79 in 16 patients (13

were the same) after 3 years. In the 6 patients with erosions on radiography

after 3 years (who had none at baseline), 4 were visible on MRI.

With x-rays, a greater number of erosions could be seen, note the

researchers, although MRI was able to demonstrate that most of these were

part of a single erosion. They conclude that, on the basis of these data,

MRI will not replace radiography for the detection of early erosions in the

MTP5 joint.

[Guest guest]

Yes ...but the question is .....how many MRIs can one

have in a year as they only do one body part at a

time.....sorry a right now I am not a big MRI fan

although the article has proven true in my case....I

just go crazy at 40 minutes A knee....the crazy in OK

--- a <paula54@...> wrote:

> Jun 21, 2002

>

> MRI detects erosions 2 years sooner than x-ray

>

> Stockholm, Sweden ‹ MRI was able to detect a greater

> number of wrist joint

> bone erosions, and on average 2 years earlier, than

> x-ray, according to a

> study presented at a news conference at last week's

> EULAR meeting. Another

> study, however, indicates that MRI is no better than

> x-ray in detecting

> erosions in a foot joint.

>

> Radiography is the mainstay of imaging in RA, used

> in diagnosis and

> monitoring and as a predictor of long-term outcome,

> said lead author Dr

> Mikkel Østergaard (Department of Rheumatology,

> Hvidovre University Hospital,

> Denmark). While several studies indicate that bone

> erosions are found more

> frequently with MRI, there are no long-term

> follow-up studies of MRI and

> minimal knowledge of its potential time advantage

> and predictive value.

>

> Østergaard and colleagues explored the value of MRI

> and radiography in 10 RA

> patients with a median age of 62 and disease

> duration of 1.5 years. MRI and

> x-rays of the wrist were performed every year for 5

> years. Each wrist bone

> including the metacarpal bases, carpal bones,

> radius, and ulna were

> assessed for the absence of presence of bone

> erosions. Observers were

> blinded to the findings of the other imaging

> modality.

> Seventy-seven percent of new erosions seen at least

> 1 year earlier with MRI

>

> There were 9 bones with radiographic erosions at

> baseline. A total of 27 new

> bone erosions developed during the 5-year follow-up

> period. Of these, 20

> were detected by MRI 1 to 5 years earlier, 3 were

> seen at the same time by

> both techniques, 2 were detected by MRI 1 to 2 years

> later than radiography,

> and 1 (detected by radiography at 5-year follow-up)

> was not registered by

> MRI.

>

>

>

>

>

> " Seventy-seven percent of new radiographic erosions

> that developed through

> the 5-year follow-up were seen with MRI 1 or more

> years earlier, meaning

> that radiography in a lot of cases provides only

> delayed information on

> joint damage compared with MRI, " said Østergaard. As

> well, " the presence of

> MR erosions at baseline gave a 4.5-fold increasing

> risk of radiographic

> erosions 5 years later. "

>

> As a whole, the median time that MRI detection

> preceded new radiographic

> erosions was 2 years. In addition, of 37 baseline

> bone erosions detected

> with MRI, only 51% could be detected by radiography

> as many as 5 years

> later.

> " The presence of MR erosions at baseline gave a

> 4.5-fold increasing risk of

> radiographic erosions 5 years later. "

>

> Østergaard said that MRI provides a greater range of

> images, allowing for

> the visualization of holes in bone and synovitis. He

> suggested that its use

> could help in earlier diagnosis (as well as the

> actual identification of a

> given type of rheumatic disease), improved

> monitoring, and the prediction of

> long-term outcome.

>

> " Performing an MRI study is not as simple as taking

> a blood sample or an

> x-ray, but the early information appears so

> important that it justifies the

> complexity of the technique, " he concluded, though

> he noted that studies

> need to be done to determine whether the wrist bone

> is representative of

> other joints.

> MRI not superior to x-ray in detecting MTP5 erosions

> in early RA

>

> Findings from another study presented in a poster at

> EULAR seem to speak to

> this very issue. Dr a Forslind (Section for

> Rheumatology,

> Helsingborgs Iasarett AB, Helsingborg, Sweden) and

> colleagues found that MRI

> and radiography are almost equally able to detect

> erosions in the fifth

> metatarsophalangeal (MTP5) joint (the joint next to

> the baby, or fifth, toe)

> in patients with early RA.

>

> Given that the MTP5 joint is considered to be the

> one that first shows

> erosions on plain x-rays, Forslind and colleagues

> undertook to explore

> whether MRI can show erosions earlier than

> conventional radiography, as it

> has been shown to do in knee RA. They used the

> modality (after contrast

> injection) in 23 patients, using it 1 year from the

> onset of RA and 3 years

> thereafter.

>

> At baseline, MRI identified 12 erosions in 10

> patients, and after 3 years,

> 35 erosions in 15 patients. Of the 5 patients with

> new erosions, 3 were

> visible by x-ray. With conventional radiography,

> there were 22 erosions in

> 10 patients (8 the same as on MRI) at baseline and

> 79 in 16 patients (13

> were the same) after 3 years. In the 6 patients with

> erosions on radiography

> after 3 years (who had none at baseline), 4 were

> visible on MRI.

>

> With x-rays, a greater number of erosions could be

> seen, note the

> researchers, although MRI was able to demonstrate

> that most of these were

> part of a single erosion. They conclude that, on the

> basis of these data,

> MRI will not replace radiography for the detection

> of early erosions in the

> MTP5 joint.

>

>

__________________________________________________

[Guest guest]

Can't say I blame you Kathy. Would you believe I've never had one?

My husband had a few when he herniated discs in his back, and after

hearing his description of it, I'm glad I never had one. I don¹t think I'm

claustrophobic, but that could make me one!

a

> Yes ...but the question is .....how many MRIs can one

> have in a year as they only do one body part at a

> time.....sorry a right now I am not a big MRI fan

> although the article has proven true in my case....I

> just go crazy at 40 minutes A knee....the crazy in OK

> --- a <paula54@...> wrote:

>> Jun 21, 2002

>>

>> MRI detects erosions 2 years sooner than x-ray

>>

>

[Guest guest]

OK ....how did you get out of never having one?...I

thought they made everyone undergo this

torture?LOL...Kathi in OK

--- a <paula54@...> wrote:

> Can't say I blame you Kathy. Would you believe I've

> never had one?

> My husband had a few when he herniated discs in his

> back, and after

> hearing his description of it, I'm glad I never had

> one. I don¹t think I'm

> claustrophobic, but that could make me one!

> a

>

>

> > Yes ...but the question is .....how many MRIs can

> one

> > have in a year as they only do one body part at a

> > time.....sorry a right now I am not a big MRI

> fan

> > although the article has proven true in my

> case....I

> > just go crazy at 40 minutes A knee....the crazy

> in OK

> > --- a <paula54@...> wrote:

> >> Jun 21, 2002

> >>

> >> MRI detects erosions 2 years sooner than x-ray

> >>

> >

>

>

__________________________________________________

[Guest guest]

Kathi,

I really don't know why I missed out on this wonderful experience.

I guess because my damage is so severe and shows up on x-ray.

When I was first diagnosed in the 70's the MRI wasn't an option.

Now they just use x-rays to monitor my erosion. I'm not complaining,

I don't WANT an MRI!

a

> OK ....how did you get out of never having one?...I

> thought they made everyone undergo this

> torture?LOL...Kathi in OK

> --- a <paula54@...> wrote:

>> Can't say I blame you Kathy. Would you believe I've

>> never had one?

>> My husband had a few when he herniated discs in his

>> back, and after

>> hearing his description of it, I'm glad I never had

>> one. I don?t think I'm

>> claustrophobic, but that could make me one!

>> a