Background It is proved that early treatment can modify the further course of rheumatoid arthritis (RA), so early diagnosis is very important for better results of treatment. at present the most sensitive method for the detection of significant changes in the joints in the early stages of RA is magnetic resonance imaging (MRI).
Objectives We have used this method to detect early RA in patients with seronegative (anticitrullinated peptide antibody (ACPA)/RF –negative) arthritis.2
Methods 52 ACPA/RF-negative patients aged between 18 to 65 years with undifferentiated arthritis lasted for no more than 6 months and no clinical signs of hands and wrists joints involvement underwent MRI of hands and wrists; level of CRP and ESR was determined as well. Synovitis and bone marrow oedema (BME) were scored according to the OMERACT rheumatoid arthritis magnetic resonance imaging scoring system.
Results In 22 of 52 patients (42.31%) MRI had detected significant signs of inflammation and BME in small hands joint and/or wrists which was used to establish diagnosis of early RA. The hither synovitis scores were correlated with CRP levels (P=0.007) and ESR (P=0.022).
Conclusions MRI signs of synovitis in the small joints of the hands and wrists are observed in a significant amount of patients (42.31%) with seronegative arthritis without clinical signs of hands joints or wrists involvement, which can be used for early RA detection in patients without enough RA diagnostic criteria.1
Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 2010;62:2569–81.
Scott DL, Pugner K, Kaarela K, Doyle DV, Woolf A, Holmes J, et al. The links between joint damage and disability in rheumatoid arthritis. Rheumatology (Oxford)2000;39:122–32.
Disclosure of Interest None declared
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