Extremity magnetic resonance imaging in rheumatoid arthritis: Report of the american college of rheumatology extremity magnetic resonance imaging task force

Cohen, Stanley

doi:10.1002/art.21763

Cited by 27 publications

(7 citation statements)

References 34 publications

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“…We agree with the American College of Rheumatology Extremity Magnetic Resonance Imaging Task Force that stated, ''imaging may be helpful in select patients when the history, physical examination, routine laboratory testing, and standard radiographic imaging are inadequate to enable a rational decision regarding management.'' 25 Our results support the use of MRI for this indication. They also stated that, ''ideally, scanning would be performed only when the results would provide information that is otherwise unavailable and would affect management.''…”

Section: Discussionsupporting

confidence: 88%

“…They also stated that, ''ideally, scanning would be performed only when the results would provide information that is otherwise unavailable and would affect management.'' 25 With this in mind, when our rheumatologists were unable to confidently determine whether active synovitis was present or whether modifications to medical therapy were indicated, contrastenhanced MRI often proved beneficial. In fact, we report significant treatment modifications in 50% of the patients in our study.…”

Section: Discussionmentioning

confidence: 98%

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Contrast-Enhanced Magnetic Resonance Imaging Positively Impacts the Management of Some Patients With Rheumatoid Arthritis or Suspected RA

Fox

Stephens

Jarjour

et al. 2012

JCR: Journal of Clinical Rheumatology

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 98%

Contrast-Enhanced Magnetic Resonance Imaging Positively Impacts the Management of Some Patients With Rheumatoid Arthritis or Suspected RA

Fox

Stephens

Jarjour

et al. 2012

JCR: Journal of Clinical Rheumatology

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“…Such machines have modest space requirements with only the extremity of interest needing to be placed inside the machine, enhancing patient acceptance, reducing cost and increasing availability 6. While these provide valuable alternatives to high field machines, there are some significant trade-offs.…”

mentioning

confidence: 99%

Does extremity-MRI improve erosion detection in severely damaged joints? A study of long-standing rheumatoid arthritis using three imaging modalities

Freeston

Conaghan

Dass

et al. 2007

Annals of the Rheumatic Diseases

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Background: Long-standing rheumatoid arthritis produces unique challenges when assessing damage due to joint deformity. The use of extremity magnetic resonance imaging (eMRI) offers the possibility of improved disease assessment because of greater patient tolerability. Objectives: The aim of this cross-sectional study was to compare the identification of wrist erosions in a severe rheumatoid arthritis cohort by eMRI with a restricted field of view (eMRI-RV) to radiography and high field MRI, using the latter as the reference. Methods: Fifteen patients (87% female, median age 56 years) with active rheumatoid arthritis (median DAS28 7.01 and disease duration 11 years) on leflunomide were enrolled. Radiography of hands, eMRI-RV (0.2 T MagneVu MV 1000) and high field MRI of unilateral wrist joints were performed. Results: Of 86 comparable wrist joint areas, high field MRI identified 70 erosions, eMRI-RV 32 and radiography 4. With high field MRI considered the reference, the sensitivity, specificity and accuracy of eMRI-RV for erosions were 46%, 94% and 55%, and the corresponding values for x ray were 6%, 100% and 23%, respectively. Conclusions: In severely damaged rheumatoid arthritis joints, sensitivity of erosion detection was markedly higher for eMRI-RV than radiography, using high field MRI as the reference. eMRI-RV was, however, less sensitive than high field MRI.

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“…Such machines have modest space requirements with only the extremity of interest needing to be placed inside the machine, enhancing patient acceptance, reducing cost and increasing availability 5. While these provide valuable alternatives to high field machines, there are some significant trade-offs.…”

mentioning

confidence: 99%

A modification of the Omeract RA MRI score for erosions for use with an extremity MRI system with reduced field of view

Freeston

Olech

Yocum

et al. 2007

Annals of the Rheumatic Diseases

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Objectives: To develop and test the reliability of a modified version of the OMERACT rheumatoid arthritis magnetic resonance imaging score (RAMRIS) for erosions using extremity MRI (eMRI) with reduced field of view (RAMRIS-RV). Methods: Using a MagneVu 0.2 T machine, the preliminary RAMRIS-RV assessed erosions in metacarpophalangeal (MCP) joints 2-3, bases of metacarpal (MC) 2-5, and all wrist bones excluding base MC 1, pisiform and trapezium. T1 weighted images of >500 MCP and wrist bony sites from a mixed severity RA and control cohort were evaluated. An inter-reader reliability study evaluating 300 wrist and 160 MCP bony sites was then performed. Results: Mean per cent exact (and close) agreement results were as follows: MCP proximal sites 83.5 (96.2), MCP distal 54.4 (77.2), bases MC 2-4 85.2 (96.7), carpal bones 79.0 (92.1), distal radius/ulna 66.4 (87.8). The base of MCP 5 was visualised in (50% cases (13/25) and was removed from the final RAMRIS-RV. Conclusions: The RAMRIS-RV is a practical tool that can be used with eMRI with a reduced field of view. This study shows excellent inter-reader reliability for erosion assessment, albeit in a reduced number of bony sites. M agnetic resonance imaging (MRI) has become increasingly recognised as a validated outcome measure for evaluating rheumatoid arthritis (RA).1 In terms of bone damage evaluation, the tomographic nature of MRI provides a significant improvement in sensitivity for erosion detection, as evidenced by recent studies comparing computed tomography, MRI and conventional radiographs. 2-4Extremity-MRI (eMRI) machines have been developed primarily for use in the outpatient clinic setting. Such machines have modest space requirements with only the extremity of interest needing to be placed inside the machine, enhancing patient acceptance, reducing cost and increasing availability. 5While these provide valuable alternatives to high field machines, there are some significant trade-offs. For example, since most of the machines use a smaller magnet strength, this results in a degree of compromise for image clarity as well as limitations in the field of view (FOV).In order to use MRI as an outcome measure in a reliable and validated form, the MRI Inflammatory Arthritis Task Force of the Outcome Measures in RA Clinical Trials group (OMERACT) has developed the RA MRI score (RAMRIS) which is presented in the EULAR-OMERACT Image Reference Atlas 6 and has been subsequently validated. [7][8][9] However, the application of the RAMRIS to all eMRI machine images may be limited, as it was developed using images that evaluated all the metacarpophalangeal (MCP) joints and/or the entire carpus.The primary objective of this work was to develop a modified version of the RAMRIS scoring system-the RAMRIS-RV (Restricted field of View)-which could be used to score erosions on images produced by eMRI machines with a restricted field of view. The performance of the RAMRIS-RV was then assessed by an inter-reader reliability study and final modifications to the scoring system made....

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Extremity magnetic resonance imaging in rheumatoid arthritis: Report of the american college of rheumatology extremity magnetic resonance imaging task force

Cited by 27 publications

References 34 publications

Contrast-Enhanced Magnetic Resonance Imaging Positively Impacts the Management of Some Patients With Rheumatoid Arthritis or Suspected RA

Contrast-Enhanced Magnetic Resonance Imaging Positively Impacts the Management of Some Patients With Rheumatoid Arthritis or Suspected RA

Does extremity-MRI improve erosion detection in severely damaged joints? A study of long-standing rheumatoid arthritis using three imaging modalities

A modification of the Omeract RA MRI score for erosions for use with an extremity MRI system with reduced field of view

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