Objectives In patients with rheumatoid arthritis (RA) to compare the development of wrist joint bone erosions on conventional radiography (CR) performed annually for 5 years with erosions detected by magnetic resonance imaging (MRI) at baseline and 1-year follow-up.
Methods Fifteen patients with RA (disease duration 0.5–20 years, median 1.5 years) were followed for 5 years. MRI of the dominant wrist was performed at year 0 and 1, and CR at years 0, 1, 2, 3, 4 and 5. In each image set, the number of wrist bones (metacarpal bases, carpal bones, radius and ulna) with erosions was determined.
Results The number of bones with erosions detected by CR and MRI at the different time points are shown in the Table 1. The total number of CR-erosions at baseline and after 5 years, compared with the number of MRI-erosions at baseline, were 21% and 64%, respectively.
The MRI-erosion score at 1 year was the parameter from the initial 1 year of follow-up, that showed the closest statistical correlation with the radiographic erosion score at 5 years (rho = 0.67, p = 0.006), while corresponding correlations for radiographic erosion scores at baseline and 1 year were rho = 0.41 (p = 0.12, NS) and rho = 0.60 (p = 0.02).
The erosive progression rate on radiographs during the 5 years (CR 5 minus CR 0) was significantly correlated with the MRI erosive progression rate during the initial year (MRI 1 minus MRI 0) (rho = 0.64, p = 0.01), and, more weakly, with the corresponding 1-year radiographic progression rate (rho = 0.56, p = 0.03).
Conclusion In the present study, short-term (1-year) MRI progression was highly significantly correlated with long-term (5 year) erosive progression. The study suggests that MRI is more useful than radiography itself for prediction of long term radiographic joint damage in rheumatoid arthritis.
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