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a Department of
Internal Medicine C, Section of Rheumatology, Odense University,
Denmark, b Department of Radiology, Sønderborg Hospital, c Graasten Gigthospital, d The
Danish Research Centre of Magnetic Resonance, H:S Hvidovre Hospital,
University of Copenhagen, Denmark
Correspondence to: Dr H Lindegaard, Department of Internal Medicine, Section of Rheumatology, Odense University Hospital, Søndre Boulevard 29, Dk-5000 Odense C, Denmark lindegaard{at}dadlnet.dk
Accepted for publication 15 November
2000
OBJECTIVE
To compare a
low field dedicated extremity magnetic resonance imaging system (E-MRI)
with x ray and clinical examination, in the
detection of inflammation and erosive lesions in wrist and
metacarpophalangeal (MCP) joints in newly diagnosed, untreated rheumatoid arthritis (RA).
PATIENTS AND
METHODSTwenty five patients (disease duration
1 year) and three healthy controls entered the study. An
x ray examination and MRI (before and after
intravenous injection of a contrast agent) of the 2nd-5th MCP joints
and the wrist was performed. The number of erosions on
x ray examination and MRI was calculated,
and synovitis in the MCP joints and wrists was graded semiquantitatively.
RESULTSE-MRI detected
57 bone erosions, whereas only six erosions were disclosed by
x ray examination (ratio 9.5:1). Synovial
hypertrophy grades were significantly higher in RA joints with clinical
signs of joint inflammationthat is, swelling and/or tenderness
(median 3, 5th-95th centile 1-4) than without these clinical signs
(median 2, 5th-95th centile 1-3), p<0.001. 51% of the joints
without clinical signs of synovitis showed synovial hypertrophy on
E-MRI. There was a positive correlation between MRI scores of synovitis
and the number of erosions detected by MRI in the MCP joints (Spearman rs=0.31, p<0.01). No healthy
controls had erosions or synovitis on MRI.
CONCLUSIONJoint
destruction starts very early in RA and E-MRI allows detailed
evaluation of inflammatory and destructive changes in wrists and MCP
joints in patients with incipient RA.
This article has been cited by other articles:
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  A Duer, M Ostergaard, K Horslev-Petersen, and J Vallo Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis Ann Rheum Dis, January 1, 2008; 67(1): 48 - 51. [Abstract] [Full Text] [PDF]
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H M Lindegaard, J Vallo, K Horslev-Petersen, P Junker, and M Ostergaard Low-cost, low-field dedicated extremity magnetic resonance imaging in early rheumatoid arthritis: a 1-year follow-up study Ann Rheum Dis, September 1, 2006; 65(9): 1208 - 1212. [Abstract] [Full Text] [PDF]
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B J Ejbjerg, E Narvestad, S Jacobsen, H S Thomsen, and M Ostergaard Optimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints: comparison with conventional high field MRI and radiography Ann Rheum Dis, September 1, 2005; 64(9): 1280 - 1287. [Abstract] [Full Text] [PDF]
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M Ostergaard, J Edmonds, F McQueen, C Peterfy, M Lassere, B Ejbjerg, P Bird, P Emery, H Genant, and P Conaghan An introduction to the EULAR-OMERACT rheumatoid arthritis MRI reference image atlas Ann Rheum Dis, February 1, 2005; 64(suppl_1): i3 - i7. [Abstract] [Full Text] [PDF]
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C G Peterfy MRI of the wrist in early rheumatoid arthritis Ann Rheum Dis, May 1, 2004; 63(5): 473 - 477. [Full Text] [PDF]
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 B. Taouli, S. Zaim, C. G. Peterfy, J. A. Lynch, A. Stork, A. Guermazi, B. Fan, K. H. Fye, and H. K. Genant Rheumatoid Arthritis of the Hand and Wrist: Comparison of Three Imaging Techniques Am. J. Roentgenol., April 1, 2004; 182(4): 937 - 943. [Abstract] [Full Text] [PDF]
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