MR Imaging of Early Rheumatoid Arthritis

Abstract

Early diagnosis and treatment have been recognized as essential for improving clinical outcomes in patients with early rheumatoid arthritis. However, diagnosis is somewhat difficult in the early stages of the disease because the diagnostic criteria were developed from data obtained in patients with established rheumatoid arthritis and therefore are not readily applicable. Magnetic resonance (MR) imaging is increasingly being used in the assessment of rheumatoid arthritis due to its capacity to help identify the key pathologic features of this disease entity at presentation. MR imaging has demonstrated greater sensitivity for the detection of synovitis and erosions than either clinical examination or conventional radiography and can help establish an early diagnosis of rheumatoid arthritis. It also allows the detection of bone marrow edema, which is thought to be a precursor for the development of erosions in early rheumatoid arthritis as well as a marker of active inflammation. In addition, MR imaging can help differentiate rheumatoid arthritis from some clinical subsets of peripheral spondyloarthropathies by allowing identification of inflammation at the insertions of ligaments and tendons (enthesitis).

Pulmonary tuberculosis in a patient with rheumatoid arthritis undergoig immunosuppressive treatment: case report

“…The main characteristic of rheumatoid arthritis is the symmetrical involvement of both small and large joints, most frequently affecting hands and feet (1) . The early diagnosis of such a condition may improve the prognosis, avoiding disease progression to critical stages and allowing a long and effective treatment (3) . Intrathoracic alterations are numerous and variable and most frequently include interstitial pulmonary fibrosis, bron-tion of cavitating rheumatoid nodules is extremely uncommon.…”

Potential of PET-MRI for imaging of non-oncologic musculoskeletal disease

“…MRI has similarly been developed for early detection of RA and to assess disease severity. Unlike PET, MRI provides high-resolution anatomical images to assess structural changes (e.g., peri-articular erosions, BMLs and synovial thickening) for diagnosis and staging of RA disease ( Figure 3C,D) (79). Contrast enhancement following injection of gadolinium can further differentiate active inflammation from synovitis.…”

High-resolution ultrasound of the extrinsic carpal ligaments

“…During the course of the disease, active synovial tissue may extend to bone, tendons, capsule, and ligaments [18]. The hand and wrist are the most frequent sites of involvement in patients with RA [19].…”

“…Wrist instability may become a significant problem in advanced RA [19,20]. The structural equilibrium of the wrist balance derives from the integrity of the articular surfaces of the bones as well as that of the supporting capsular and ligamentous structures [21,22].…”