RESEARCH - Low-cost, low-field dedicated extremity MRI in early RA: a 1-year follow-up study

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Ann Rheum Dis. 2006 Sep;65(9):1208-12. Epub 2006 Mar 15.

Low-cost, low-field dedicated extremity magnetic resonance imaging in early

rheumatoid arthritis: a 1-year follow-up study.

Lindegaard HM, Vallo J, Horslev-sen K, Junker P, Ostergaard M.

Department of Internal Medicine C, Section of Rheumatology, Odense

University Hospital, Sondre Boulevard 29, Dk-5000 Odense C, Denmark.

lindegaard@...

OBJECTIVE: To study the ability of low-cost low-field dedicated extremity

magnetic resonance imaging (E-MRI) to assess and predict erosive joint

damage in the wrist and metacarpophalangeal (MCP) joints of patients with

early rheumatoid arthritis. METHODS: 24 previously untreated patients with

rheumatoid arthritis with joint symptoms for <1 year were evaluated at the

time of diagnosis and after 6 and 12 months of methotrexate treatment with

conventional clinical or biochemical examinations, x rays of both hands and

wrists, and E-MRI of the dominant wrist and MCP joints. RESULTS: At

baseline, all patients showed magnetic resonance imaging (MRI) synovitis,

and MRI erosions were detected in 21 bones (10 patients). 6 (29%) of these,

distributed among two patients, were seen on x ray. One x ray erosion was

not detected by MRI. At 1 year, MRI and x ray detected 15 and 8 new

erosions, respectively, and 19% of MRI erosions at baseline had progressed

to x ray erosions. In bones with MRI erosions at baseline, the relative risk

of having x ray erosions at the 1-year follow-up was 12.1, compared with

bones without baseline MRI erosions (lesion-centred analysis). If bones with

baseline x ray erosions were excluded, the relative risk was 5.2. In

patients with baseline MRI bone erosion or oedema, the relative risk of

having x ray erosions at 1 year was 4.0, compared with patients without

these signs at baseline (patient-centred analysis).

CONCLUSION: In this group of patients with early rheumatoid arthritis who

were treated uniformly, baseline E-MRI erosions in MCP or wrist bones

markedly increased the risk of x ray erosions at the 1-year follow-up.

Low-cost, low-field dedicated extremity MRI is promising for assessment and

prognostication of early rheumatoid arthritis.

PMID: 16540550

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6540550

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