Article

The EULAR–OMERACT rheumatoid arthritis MRI reference image atlas: the wrist joint

B Ejbjerg¹, F McQueen², M Lassere³, E Haavardsholm⁴, P Conaghan⁵, P O’Connor⁶, P Bird⁷, C Peterfy⁸, J Edmonds⁹, M Szkudlarek¹⁰, H Genant¹¹, P Emery¹², M Østergaard¹³

¹ Departments of Rheumatology, Radiology and MRI, Copenhagen University Hospital at Hvidovre, Copenhagen, Denmark
² Department of Molecular Medicine and Pathology, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
³ Department of Rheumatology, St George Hospital, University of NSW, Sydney, Australia
⁴ Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo, Oslo, Norway
⁵ Academic Unit of Musculoskeletal Disease, University of Leeds, Leeds, UK
⁶ Department of Radiology, Leeds General Infirmary, Leeds, UK
⁷ Department of Rheumatology, St George Hospital, University of NSW, Sydney, Australia
⁸ Synarc Inc, San Francisco, CA, USA
⁹ Department of Rheumatology, St George Hospital, University of NSW, Sydney, Australia
¹⁰ Department of Rheumatology, Copenhagen University Hospital at Hvidovre, Copenhagen, Denmark
¹¹ Department of Radiology, University of California at San Francisco, San Francisco, CA, USA
¹² Academic Unit of Musculoskeletal Disease, University of Leeds, Leeds, UK
¹³ Departments of Rheumatology, Copenhagen University Hospitals at Herlev and Hvidovre, Copenhagen, Denmark

Correspondence to:
Correspondence to:
Prof Mikkel Østergaard
Department of Rheumatology, Copenhagen University Hospital at Hvidovre, Kettegaard alle 30, DK-2650 Hvidovre, Denmark; mo{at}dadlnet.dk

This paper presents the wrist joint MR images of the EULAR–OMERACT rheumatoid arthritis MRI reference image atlas. Reference images for scoring synovitis, bone oedema, and bone erosions according to the OMERACT RA MRI scoring (RAMRIS) system are provided. All grades (0–3) of synovitis are illustrated in each of the three wrist joint areas defined in the scoring system—that is, the distal radioulnar joint, the radiocarpal joint, and the intercarpal-carpometacarpal joints. For reasons of feasibility, examples of bone abnormalities are limited to five selected bones: the radius, scaphoid, lunate, capitate, and a metacarpal base. In these bones, grades 0–3 of bone oedema are illustrated, and for bone erosion, grades 0–3 and examples of higher grades are presented. The presented reference images can be used to guide scoring of wrist joints according to the OMERACT RA MRI scoring system.

Abbreviations: EULAR, European League Against Rheumatism; Gd, gadolinium containing contrast agent; MCP, metacarpophalangeal; MRI, magnetic resonance imaging; OMERACT, Outcome Measures in Rheumatology Clinical Trials; RA, rheumatoid arthritis

Keywords: magnetic resonance imaging; erosion; rheumatoid arthritis; synovitis; wrist

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