Background MRI is a usefull tool for assessing subclinical synovial inflammation and joint damage in rheumatic diseases. There are no references clarifying the problem of distinguishing arthritis in systemic sclerosis (SSc) and rheumatoid arthritis (RA) so far
Objectives The aim of our investigation is to compare the degree of inflamatory changes of the hand (bone edema, synovitis, bone erosion and tenosynovitis) in SSc and RA.
Methods 82 SSc pts, mean age 54,5y and 35 RA pts (EULAR/ACR 2010 criteria), mean age 54,3y underwent low field MRI with gadolinium at the dominant hand including wrist and MCP joints 2–5. Assessment of bone marrow edema, synovitis, bone erosions and tenosynovitis was performed by the OMERACT RA MRI scoring system. Images were evaluated independently by two blinded readers. The mean scores of the two readers were analyzed.
Results Anti-citrullinated peptide antibodies (ACPA) and rheumatoid factor (RF) were found in 89% and 74,3% of RA pts and 13,4% and 14,6% of SSc pts. Synovitis was more frequently detected on MRI with significantly higher score in RA compared to SSc (wrist:4,37±1,31 vs 2,69±2,29,p<0,001; MCP joints:5,26±2,09 vs 3,15±2,95, p<0, 001). MRI erosion score in the wrist and MCP was significantly higher in RA compared to SSc (wrist:20,57±10,23 vs 6,58±10,89,p<0,001; MCP joints:10,51±7,90 vs 3,99±9,82, p<0,001). MRI bone edema score was also significantly higher in RA compared to SSc (wrist:18,60±5,01 vs 6,84±7,43, p<0,001; MCP joints:9,09±4,27 vs 4,04±4,76, p<0,001).
Conclusions The present data suggest great frequency of inflammatory changes on the hands in SSc and RA using MRI. Inflammation scores were significantly higher in RA compared to SSc. MRI may be helpful in differentiating arthritis in RA and SSc, specially in subclinical inflammation.
Disclosure of Interest None declared