MRI of the hand in psoriatic and rheumatical arthritis

Giovagnoni, Andrea; Grassi, Walter; Terilli, F; Blasetti, P; Paci, Enrico; Ercolani, P; Cervini, C

doi:10.1007/bf00190921

Cited by 27 publications

(19 citation statements)

References 10 publications

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“…Other studies indicate that the localisation of inflammatory changes may be used to differentiate between rheumatoid arthritis and spondylarthropathy [31,32,33]. Bone marrow oedema may be useful in differentiating patients in groups with poor prognosis from good prognosis [12].…”

mentioning

confidence: 98%

MRI of the wrist and finger joints in inflammatory joint diseases at 1-year interval: MRI features to predict bone erosions

et al. 2001

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The aim of this study was to assess the ability of MRI determined synovial volumes and bone marrow oedema to predict progressions in bone erosions after 1 year in patients with different types of inflammatory joint diseases. Eighty-four patients underwent MRI, laboratory and clinical examination at baseline and 1 year later. Magnetic resonance imaging of the wrist and finger joints was performed in 22 patients with rheumatoid arthritis less than 3 years (group 1) who fulfilled the American College of Rheumatology (ACR) criteria for rheumatoid arthritis, 18 patients with reactive arthritis or psoriatic arthritis (group 2), 22 patients with more than 3 years duration of rheumatoid arthritis, who fulfilled the ACR criteria for rheumatoid arthritis (group 3), and 20 patients with arthralgia (group 4). The volume of the synovial membrane was outlined manually before and after gadodiamide injection on the T1-weighted sequences in the finger joints. Bones with marrow oedema were summed up in the wrist and fingers on short-tau inversion recovery sequences. These MRI features was compared with the number of bone erosions 1 year later. The MR images were scored independently under masked conditions. The synovial volumes in the finger joints assessed on pre-contrast images was highly predictive of bone erosions 1 year later in patients with rheumatoid arthritis (groups 1 and 3). The strongest individual predictor of bone erosions at 1-year follow-up was bone marrow oedema, if present at the wrist at baseline. Bone erosions on baseline MRI were in few cases reversible at follow-up MRI. The total synovial volume in the finger joints, and the presence of bone oedema in the wrist bones, seems to be predictive for the number of bone erosions 1 year later and may be used in screening. The importance of very early bone changes on MRI and the importance of the reversibility of these findings remain to be clarified.

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confidence: 98%

MRI of the wrist and finger joints in inflammatory joint diseases at 1-year interval: MRI features to predict bone erosions

et al. 2001

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“…11,75 Other small studies have shown that in RA, MRI signs of inflammation are more frequent in the synovial membrane than at the insertions of ligaments and tendons (enthesitis), while the opposite is true for seronegative spondyloarthropathies. [81][82][83] The available studies confirm that the ACR 1987 criteria are not sufficiently sensitive in early RA and indicate that MRI may be helpful. The results strongly encourage retesting this hypothesis in larger studies, particularly in patients with early unclassified arthritis.…”

Section: Diagnostic Valuementioning

confidence: 69%

Magnetic Resonance Imaging of the Synovium in Rheumatoid Arthritis

Østergaard

Ejbjerg

2004

Semin Musculoskelet Radiol

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Early diagnosis, followed by early initiation and optimal adjustments of aggressive therapies, are acknowledged as essential to optimize long-term clinical and radiological outcome in rheumatoid arthritis (RA). This requires sensitive methods for detection and monitoring of the primary feature of RA--the synovitis. In comparison with conventional methods, magnetic resonance imaging (MRI) offers assessment of the rheumatoid synovium with improved sensitivity to early pathology and to change. Various aspects such as volume, vascularity, and edema can be assessed by different metrological approaches. MRI findings are of prognostic value to the long-term radiological outcome. This article reviews current knowledge on MRI for assessment of the synovium in RA, focusing on the validity of MRI measures of synovitis. Future perspectives and suggested research priorities are described. The rationale is provided for MRI becoming the new gold standard for assessment of RA joints and for MRI assessments of synovitis being reliable and valid measures of rheumatoid disease activity.

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“…Small studies have shown that, in RA, MRI signs of inflammation are more frequent in the synovial membrane than at the insertions of ligaments and tendons (enthesitis), while the opposite is true for seronegative spondyloarthropathies 13 14. However, definite answers concerning the differential diagnostic value of MRI should obviously be achieved through longitudinal studies of patients with undifferentiated arthritis.…”

Section: Discussionmentioning

confidence: 99%