Background Magnetic resonance imaging (MRI) is known as high sensitive imaging modality toward the patients with rheumatoid arthritis (RA). We have reported an importance of MRI-proven symmetrical synovitis, osteitis and bone erosion of wrist and finger joints toward the early diagnosis of RA from the prospective early arthritis cohort at Nagasaki University, Japan.
Objectives To investigate whether MRI assessment of joint injury predict the development of rapid radiographic progression (RRP) in early RA patients by our cohort.
Methods Ninety-five RA patients, who fulfilled 2010 RA classification criteria and introduced disease-modifying antirheumatic drugs (DMARDs) including biologics within the first 1 year, were consecutively enrolled in this study. All of the subjects had been examined by gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA)-enhanced MRI and plain radiograph of both wrist and finger joints every 6 months during 2 years. Synovitis, osteitis and bone erosion in MRI were determined by RAMRI scoring (RAMRIS) technique. RRP in the present study was defined as yearly progression of Genant-modified Sharp score >3.0.
Results The mean disease duration, age, tender joint count (TJC) 28, swollen joint count (SJC) 28, prevalence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (ACPA) at entry were 3.7 months, 55.7 years-old, 9.9, 4.9, 54.7% and 57.9%, respectively. The frequency of symmetrical synovitis, osteitis and bone erosion proved by MRI at entry was 82.1%, 46.8% and 32.9%, respectively. Seventeen patients (17.5%) were classified as RRP at 2 years. RF (p=0.017), ACPA (p=0.0013) and MRI-proven osteitis (p=0.040) at entry were defined as the variables to predict the development of RRP at 2 years.
Conclusions In addition to the diagnostic assessment, the present study has revealed that MRI-proven osteitis at entry is a prognostic marker in patients with early RA.
Disclosure of Interest None Declared