RESEARCH - MRI is more sensitive than radiographs in dectecting change in size of erosions in RA

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J Rheumatol. 2006 Aug 1; [Epub ahead of print]

Magnetic Resonance Imaging Is More Sensitive Than Radiographs in Detecting

Change in Size of Erosions in Rheumatoid Arthritis.

Chen TS, Crues JV 3rd, Ali M, Troum OM.

OBJECTIVE: To evaluate the technological performance of magnetic resonance

imaging (MRI) with respect to projection radiography by determining the

incidence of changes in the size of individual bone lesions in inflammatory

arthritis, using serial high-resolution in-office MRI over short time

intervals (8 months average followup), and by comparing the sensitivity of

3-view projection radiography with in-office MRI for detecting changes in

size and number of individual erosions. METHODS: MR examinations of the

wrists and second and third metacarpophalangeal joints were performed using

a portable in-office MR system in a total of 405 patients with inflammatory

arthritis, from one rheumatologist's practice, who were undergoing

aggressive disease modifying antirheumatic drug therapy. Of the patients,

156 were imaged at least twice, allowing evaluation of 246 followup

examinations (mean followup interval of 8 months over a 2-year period).

Baseline and followup plain radiographs were obtained in 165 patient

intervals. Patients refused radiographic examination on 81 followup visits.

RESULTS: MRI demonstrated no detectable changes in 124 of the 246 (50%)

followup MRI examinations. An increase in the size or number of erosions was

demonstrated in 74 (30%) examinations, a decrease in the size or number of

erosions in 36 (15%), and both increases and decreases in erosions were seen

in 11 (4%). In the 165 studies with followup radiographic comparisons, only

one examination (0.8%) showed an erosion not seen on the prior examination

and one (0.8%) showed an increase in a previously noted erosion.

CONCLUSION: We showed that high-resolution in-office MRI with an average

followup of 8 months detects changes in bony disease in 50% of compliant

patients during aggressive treatment for inflammatory arthritis in a single

rheumatologist's office practice. Plain radiography is insensitive for

detecting changes in bone erosions for this patient population in this time

frame.

PMID: 16881098

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

6881098

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