Magnetic resonance imaging (MRI) has important applications in musculoskeletal medicine. It allows the visualization of bone and soft tissues in three dimensions using a multiplanar technique and is uniquely suited to imaging the rheumatoid joint. Bony erosions are seen well using MRI in early rheumatoid arthritis and are frequently detected before they appear on plain radiographs. Bone marrow oedema is another important MRI feature associated with inflammatory joint disease and may be a forerunner of erosion. Synovial membrane inflammation and hypertrophy are detected after contrast enhancement and also by the use of dynamic MRI techniques, which provide a non-invasive method to accurately measure the inflammatory process. This information can be analysed and collated using MRI scoring systems and ultimately may be used to improve diagnostic accuracy, predict prognosis and monitor therapy in these patients. This review examines the case for the use of MRI in early inflammatory arthritis, outlining its strengths and potential weaknesses as an imaging modality in this context and indicating its potential role in clinical practice.
mortality than RF or ESR. In GEE analyses, the strongest predictor of PMN was, by far, the use of prednisone, with users having 1.8 (1.6, 2.0) thousand cells increase compared to non-users. Weaker predictors of PMN included sex, HAQ, ESR, RF, disease duration, but not age. Conclusion Total PMN predicts mortality in RA as effectively as RF, and the predictability is robust to duration of disease as well as to fixed and time-dependent disease severity covariates. This simple test appears to have been overlooked, but adds significantly to our ability to predict mortality in RA. Corticosteroids are the strongest influence on PMN among RA patients, and might be an important factor in mortality increase in RA. Treatment related PMN reduction that occurs in clinical trials of biologic agents may be a marker for increased survival, and is a candidate variable for measurement of pharmaco-economic benefit.
Conclusion Retinal vascular disease may be frequent in patients with RA. The presence of aPL may be associated with a higher prevalence of retinal abnormalities in RA patients.
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