Objectives This study is planned as a prospective investigation of the accuracy of magnetic resonance imaging for the demonstration of early-stage rheumatoid arthritis findings of both hands, with the goal of differentiating magnetic resonance imaging and plain film findings of the patients having early -stage rheumatoid arthritis.
Methods Ten patients who met American Rheumatism Association criteria for rheumatoid arthritis and symptoms of less than one year duration were accepted for the study. After full clinical assessment, laboratory tests and radiographs of the hands were undertaken, magnetic resonance imaging was performed on a 1.5 tesla imager using an extremity coil using SE T1, TSE T2, fat suppressed T2, flash 2d 3DGRE and postcontrast fat suppressed T1 weighted sequences.
Results 6 of 10 patients had periarticular osteoporosis on plain radiography. All of the 10 patients had subcondral erosions, 8 patients had effusion in proximal interphalangeal joints, 8 had synovial hypertrophy, 7 had tendonitis, 5 had tendon erosions and tears and 2 had ulnar collateral ligament ruptures.
Conclusion Magnetic resonance imaging not only allows direct visualisation of the inflammatory soft tissue, but also its effect on the bone, cartilage, tendons and ligaments. Magnetic resonance imaging, due to its superior soft-tissue contrast and tomographic changes is more sensitive to than plain radiography in demonstrating the changes due to rheumatoid arthritis. This may contribute to more accurate diagnosis in early-stage rheumatoid arthritis patients and allow an earlier decision to start proper medication and defining progression or remission of the disease.
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