Objectives Objectives: MRI sensitively depicts erosions, bone marrow edema (BME), synovitis and tenosynovitis in rheumatoid arthritis (RA). Recently developed EULAR recommendations stated that MRI is valuable to improve the certainty of a considered diagnosis and to detect structural damage at an early time point.  These recommendations were based on data of patients; the prevalence of lesions in the general population was not extensively explored. We performed a literature review to study to what extend MRI lesions prevail in the general population.
Methods Methods: Medical literature databases up to September 2013 were systematically reviewed for symptom-free persons with MRI data. Data were summarized and combined when allowed.
Results Results: Of all screened 338 articles, 31 evaluated MRI-findings in symptom-free persons and in total 516 MRIs of symptom-free persons were evaluated. Both the imaging techniques and the scoring methods varied widely, prohibiting direct comparisons of the results of some studies. Fifteen studies scored data according to RAMRIS and showed erosions in 33-52% of symptom-free persons and bone marrow edema in 10-16%. Due to different protocols, data on synovitis and tenosynovitis could not be easily compared and the observed prevalence's of synovitis ranged widely; synovitis was recorded in 0-82% of symptom-free persons. The prevalence of MRI-detected erosions increased with age, the same goes for BME. No differences were observed for gender or between dominant and non-dominant sites.
Conclusions Conclusions: MRI lesions, erosions in particular, occur frequently in symptom free persons. This is important for the implementation of MRI in the diagnostic process.
Colebatch AN, Edwards CJ, Østergaard M, et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis 2013;:annrheumdis–2012–203158. doi:10.1136/annrheumdis-2012-203158
Disclosure of Interest None declared