Ann Rheum Dis 2000;59:521-528 ( July )

Extended report

Magnetic resonance imaging, radiography, and scintigraphy of the finger joints: one year follow up of patients with early arthritis M Klarlund^{a b}, M Østergaard^{a b}, K E Jensen^{a c}, J Lysgård Madsen^d, H Skjødt^b, I Lorenzen^b, and the TIRA group^*

^a The Danish Research Centre of Magnetic Resonance, H:S Hvidovre Hospital, University of Copenhagen, ^b Department Internal Medicine, Division of Rheumatology, H:S Hvidovre Hospital, ^c Department of Radiology, H:S Hvidovre Hospital, ^d Department of Clinical Physiology and Nuclear Medicine, H:S Hvidovre Hospital

Correspondence to: Dr Mette Klarlund, Department of Internal Medicine, Division of Rheumatology, H:S Hvidovre Hospital, Kettegaard Allé 30, DK-2650 Hvidovre, Denmark Email: klarlund{at}dadlnet.dk

Accepted for publication 3 February 2000

OBJECTIVESTo evaluate synovial membrane hypertrophy, tenosynovitis, and erosion development of the 2nd to 5th metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints by magnetic resonance imaging in a group of patients with rheumatoid arthritis (RA) or suspected RA followed up for one year. Additionally, to compare the results with radiography, bone scintigraphy, and clinical findings.
PATIENTS AND METHODSFifty five patients were examined at baseline, of whom 34 were followed up for one year. Twenty one patients already fulfilled the American College of Rheumatology (ACR) criteria for RA at baseline, five fulfilled the criteria only after one year's follow up, whereas eight maintained the original diagnosis of early unclassified polyarthritis. The following MRI variables were assessed at baseline and one year: synovial membrane hypertrophy score, number of erosions, and tenosynovitis score.
RESULTSMRI detected progression of erosions earlier and more often than did radiography of the same joints; at baseline the MRI to radiography ratio was 28:4. Erosions were exclusively found in patients with RA at baseline or fulfilling the ACR criteria at one year. At one year follow up, scores of MR synovial membrane hypertrophy, tenosynovitis, and scintigraphic tracer accumulation had not changed significantly from baseline; in contrast, swollen and tender joint counts had declined significantly (p<0.05).
CONCLUSIONSMRI detected more erosions than radiography. MR synovial membrane hypertrophy and scintigraphy scores did not parallel the changes seen over time in clinically assessed swollen and tender joint counts. Although joint disease activity may be assessed as quiescent by conventional clinical methods, a more detailed evaluation by MRI may show that a pathological condition is still present within the synovium.

---

^* TIRA stands (in Danish) for early rheumatoid arthritis. Others from the TIRA group were: Julia Sidenius Johansen, Trine Jensen, Merete Hetland, and Søren Jacobsen

---

© 2000 by Annals of the Rheumatic Diseases
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Dohn, U M., Boonen, A, Hetland, M L, Hansen, M S, Knudsen, L S, Hansen, A, Madsen, O R, Hasselquist, M, Moller, J M, Ostergaard, M (2009). Erosive progression is minimal, but erosion healing rare, in patients with rheumatoid arthritis treated with adalimumab. A 1 year investigator-initiated follow-up study using high-resolution computed tomography as the primary outcome measure. Ann Rheum Dis 68: 1585-1590 [Abstract] [Full Text]  
• OSTERGAARD, M., CONAGHAN, P. G., O'CONNOR, P., SZKUDLAREK, M., KLARLUND, M., EMERY, P., PETERFY, C., GENANT, H., McQUEEN, F. M., BIRD, P., LASSERE, M., EJBJERG, B. (2009). Reducing Invasiveness, Duration, and Cost of Magnetic Resonance Imaging in Rheumatoid Arthritis by Omitting Intravenous Contrast Injection -- Does It Change the Assessment of Inflammatory and Destructive Joint Changes by the OMERACT RAMRIS?. The Journal of Rheumatology 36: 1806-1810 [Abstract] [Full Text]  
• Duer-Jensen, A, Ejbjerg, B, Albrecht-Beste, E, Vestergaard, A, Dohn, U M., Hetland, M L., Ostergaard, M (2009). Does low-field dedicated extremity MRI (E-MRI) reliably detect bone erosions in rheumatoid arthritis? A comparison of two different E-MRI units and conventional radiography with high-resolution CT scanning. Ann Rheum Dis 68: 1296-1302 [Abstract] [Full Text]  
• Eshed, I., Feist, E., Althoff, C. E., Hamm, B., Konen, E., Burmester, G.-R., Backhaus, M., Hermann, K.-G. A. (2009). Tenosynovitis of the flexor tendons of the hand detected by MRI: an early indicator of rheumatoid arthritis. Rheumatology (Oxford) 48: 887-891 [Abstract] [Full Text]  
• Garrood, T., Blades, M., Haskard, D. O., Mather, S., Pitzalis, C. (2009). A novel model for the pre-clinical imaging of inflamed human synovial vasculature. Rheumatology (Oxford) 48: 926-931 [Abstract] [Full Text]  
• Naraghi, A. M., White, L. M., Patel, C., Tomlinson, G., Keystone, E. C. (2009). Comparison of 1.0-T Extremity MR and 1.5-T Conventional High-Field-Strength MR in Patients with Rheumatoid Arthritis. Radiology 251: 829-837 [Abstract] [Full Text]  
• Duer-Jensen, A, Vestergaard, A, Dohn, U M, Ejbjerg, B, Hetland, M L, Albrecht-Beste, E, Ostergaard, M (2008). Detection of rheumatoid arthritis bone erosions by two different dedicated extremity MRI units and conventional radiography. Ann Rheum Dis 67: 998-1003 [Abstract] [Full Text]  
• Holm, B., Jacobsen, S., Skjodt, H., Klarlund, M., Jensen, T., Hetland, M. L., Ostergaard, M. (2008). Keitel Functional Test for Patients With Rheumatoid Arthritis: Translation, Reliability, Validity, and Responsiveness. ptjournal 88: 664-678 [Abstract] [Full Text]  
• Hameed, B., Pilcher, J., Heron, C., Kiely, P. D. W. (2008). The relation between composite ultrasound measures and the DAS28 score, its components and acute phase markers in adult RA. Rheumatology (Oxford) 47: 476-480 [Abstract] [Full Text]  
• Duer, A, Ostergaard, M, Horslev-Petersen, K, Vallo, J (2008). Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis. Ann Rheum Dis 67: 48-51 [Abstract] [Full Text]  
• Dohn, U. M., Ejbjerg, B. J, Hasselquist, M., Narvestad, E., Court-Payen, M., Szkudlarek, M., Moller, J., Thomsen, H. S, Ostergaard, M. (2007). Rheumatoid arthritis bone erosion volumes on CT and MRI: reliability and correlations with erosion scores on CT, MRI and radiography. Ann Rheum Dis 66: 1388-1392 [Abstract] [Full Text]  
• Schirmer, C., Scheel, A. K, Althoff, C. E, Schink, T., Eshed, I., Lembcke, A., Burmester, G.-R., Backhaus, M., Hamm, B., Hermann, K.-G. A (2007). Diagnostic quality and scoring of synovitis, tenosynovitis and erosions in low-field MRI of patients with rheumatoid arthritis: a comparison with conventional MRI. Ann Rheum Dis 66: 522-529 [Abstract] [Full Text]  
• Combe, B, Landewe, R, Lukas, C, Bolosiu, H D, Breedveld, F, Dougados, M, Emery, P, Ferraccioli, G, Hazes, J M W, Klareskog, L, Machold, K, Martin-Mola, E, Nielsen, H, Silman, A, Smolen, J, Yazici, H (2007). EULAR recommendations for the management of early arthritis: report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 66: 34-45 [Abstract] [Full Text]  
• Palosaari, K., Vuotila, J., Takalo, R., Jartti, A., Niemela, R. K., Karjalainen, A., Haapea, M., Soini, I., Tervonen, O., Hakala, M. (2006). Bone oedema predicts erosive progression on wrist MRI in early RA--a 2-yr observational MRI and NC scintigraphy study. Rheumatology (Oxford) 45: 1542-1548 [Abstract] [Full Text]  
• Robinson, P., Bollen, S. R. (2006). Posterior ankle impingement in professional soccer players: effectiveness of sonographically guided therapy.. Am. J. Roentgenol. 187: W53-W58 [Abstract] [Full Text]  
• Ostergaard, M, Duer, A, Nielsen, H, Johansen, J S, Narvestad, E, Ejbjerg, B J, Baslund, B, Moller, J M, Thomsen, H S, Petersen, J (2005). Magnetic resonance imaging for accelerated assessment of drug effect and prediction of subsequent radiographic progression in rheumatoid arthritis: a study of patients receiving combined anakinra and methotrexate treatment. Ann Rheum Dis 64: 1503-1506 [Abstract] [Full Text]  
• Ejbjerg, B J, Narvestad, E, Jacobsen, S, Thomsen, H S, Ostergaard, M (2005). Optimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints: comparison with conventional high field MRI and radiography. Ann Rheum Dis 64: 1280-1287 [Abstract] [Full Text]  
• Palosaari, K., Vuotila, J., Takalo, R., Jartti, A., Niemela, R., Haapea, M., Soini, I., Tervonen, O., Hakala, M. (2004). Contrast-enhanced dynamic and static MRI correlates with quantitative 99Tcm-labelled nanocolloid scintigraphy. Study of early rheumatoid arthritis patients. Rheumatology (Oxford) 43: 1364-1373 [Abstract] [Full Text]  
• Taouli, B., Zaim, S., Peterfy, C. G., Lynch, J. A., Stork, A., Guermazi, A., Fan, B., Fye, K. H., Genant, H. K. (2004). Rheumatoid Arthritis of the Hand and Wrist: Comparison of Three Imaging Techniques. Am. J. Roentgenol. 182: 937-943 [Abstract] [Full Text]  
• Jensen, T, Klarlund, M, Hansen, M, Jensen, K E, Podenphant, J, Hansen, T M, Skjodt, H, Hyldstrup, L (2004). Bone loss in unclassified polyarthritis and early rheumatoid arthritis is better detected by digital x ray radiogrammetry than dual x ray absorptiometry: relationship with disease activity and radiographic outcome. Ann Rheum Dis 63: 15-22 [Abstract] [Full Text]  
• Taouli, B, Guermazi, A, Sack, K E, Genant, H K (2002). Imaging of the hand and wrist in RA. Ann Rheum Dis 61: 867-869 [Full Text]  
• Carotti, M, Salaffi, F, Manganelli, P, Salera, D, Simonetti, B, Grassi, W (2002). Power Doppler sonography in the assessment of synovial tissue of the knee joint in rheumatoid arthritis: a preliminary experience. Ann Rheum Dis 61: 877-882 [Abstract] [Full Text]  
• Abramson, S. B., Amin, A. (2002). Blocking the effects of IL-1 in rheumatoid arthritis protects bone and cartilage. Rheumatology (Oxford) 41: 972-980 [Abstract] [Full Text]  
• McQueen, F M, Benton, N, Crabbe, J, Robinson, E, Yeoman, S, McLean, L, Stewart, N (2001). What is the fate of erosions in early rheumatoid arthritis? Tracking individual lesions using x rays and magnetic resonance imaging over the first two years of disease. Ann Rheum Dis 60: 859-868 [Abstract] [Full Text]  
• Lindegaard, H, Vallo, J, Horslev-Petersen, K, Junker, P, Ostergaard, M (2001). Low field dedicated magnetic resonance imaging in untreated rheumatoid arthritis of recent onset. Ann Rheum Dis 60: 770-776 [Abstract] [Full Text]