Detection of bone erosions in rheumatoid arthritis wrist joints with magnetic resonance imaging, computed tomography and radiography

Abstract

Background The objectives of the present study were, with multidetector computed tomography (CT) as the reference method, to determine the performance of magnetic resonance imaging (MRI) and radiography for the detection of bone erosions in rheumatoid arthritis wrist bones, and to test whether measuring volumes of erosions on CT and MRI is reproducible and correlated to semiquantitative assessments (scores) of erosions on CT, MRI and radiography.

Consenso da Sociedade Brasileira de Reumatologia 2011 para o diagnóstico e avaliação inicial da artrite reumatoide

“…It allows the assessment of structural changes in soft tissues, bones, and cartilages, in addition to erosions, prior to conventional radiographies. 69 In addition to RA conventional radiographic fi ndings, magnetic resonance can detect bone edema, which proved to be a predictor of bone erosion. 65 In Brazil, factors such as its high cost and method standardization have limited its use in clinical practice.…”

High-resolution18F-FDG PET/CT for assessing disease activity in rheumatoid and psoriatic arthritis: findings of a prospective pilot study

“…CT also provides direct information on pathological changes in the bone structure and composition, such as those observed in inflammatory arthritis. 10 In RA and PsA, the small joints of the wrist and hand are considered early targets of the disease and provide a reasonable picture of disease progression. 11,12 Currently available whole-body PET/ CT scanners-optimized for imaging large regions of the bodyare suboptimal for quantifying radiotracer concentration (and hence, disease activity) for the small joints of the hand and wrist.…”

Joint blood flow is more sensitive to inflammatory arthritis than oxyhemoglobin, deoxyhemoglobin, and oxygen saturation

“…Specifically, clinical examination based on joint counts-the cornerstone of RA treatment monitoring in clinical trials-is too time consuming and as such, is seldom used in clinical practice [18]. As well, the high inter-operator variability of US and the high cost of MRI preclude their wide clinical adaptation [13,19], while laboratory tests and X-ray radiography do not have enough sensitivity to monitor treatment [20]. There is clearly a need for safe, fast, and inexpensive methods that can objectively assess treatment response with a sensitivity that rivals clinical examination and diagnostic imaging.…”