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An introduction to the EULAR–OMERACT rheumatoid arthritis MRI reference image atlas
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  1. M Østergaard1,
  2. J Edmonds2,
  3. F McQueen3,
  4. C Peterfy4,
  5. M Lassere5,
  6. B Ejbjerg6,
  7. P Bird7,
  8. P Emery8,
  9. H Genant9,
  10. P Conaghan10
  1. 1Departments of Rheumatology, Copenhagen University Hospitals at Herlev and Hvidovre, Copenhagen, Denmark
  2. 2Department of Rheumatology, St George Hospital, University of NSW, Sydney, Australia
  3. 3Department of Molecular Medicine and Pathology, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
  4. 4Synarc Inc, San Francisco, CA, USA
  5. 5Department of Rheumatology, St George Hospital, University of NSW, Sydney, Australia
  6. 6Departments of Rheumatology, Radiology and MRI, Copenhagen University Hospital at Hvidovre, Copenhagen, Denmark
  7. 7Department of Rheumatology, St George Hospital, University of NSW, Sydney, Australia
  8. 8Academic Unit of Musculoskeletal Disease, University of Leeds, Leeds, UK
  9. 9Department of Radiology, University of California at San Francisco, San Francisco, CA, USA
  10. 10Academic Unit of Musculoskeletal Disease, University of Leeds, Leeds, UK
  1. Correspondence to:
    Prof M Østergaard
    Copenhagen University Hospital at Hvidovre, Kettegaard alle 30, DK-2650 Hvidovre, Denmark; modadlnet.dk

Abstract

This article gives a short overview of the development and characteristics of the OMERACT rheumatoid arthritis MRI scoring system (RAMRIS), followed by an introduction to the use of the EULAR–OMERACT rheumatoid arthritis MRI reference image atlas. With this atlas, MRIs of wrist and metacarpophalangeal joints of patients with rheumatoid arthritis can be scored for synovitis, bone oedema, and bone erosion, guided by standard reference images.

  • EULAR, European League Against Rheumatism
  • MCP, metacarpophalangeal
  • MRI, magnetic resonance imaging
  • OMERACT, Outcome Measures in Rheumatology Clinical Trials
  • RA, rheumatoid arthritis
  • EULAR
  • magnetic resonance imaging
  • OMERACT
  • arthritis
  • rheumatoid arthritis

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Footnotes

  • * Can be acquired by obtaining a two dimensional sequence in two planes, or a three dimensional sequence with isometrical voxels in one plane allowing reconstruction in other planes.

  • Intravenous gadolinium injection is probably not essential if only destructive changes (bone erosions) are considered important.

  • * Enhancement is judged by comparison of T1 weighted images obtained before and after intravenous gadolinium contrast.

  • An T1 weighted images this is loss of normal low signal intensity of cortical bone and loss of normal high signal intensity of trabecular bone. Quick post-gadolinium enhancement suggests presence of active, hypervascularised pannus tissue in the erosion.

  • Other focal bone lesions, including metastases must obviously be considered but are generally distinguishable with associated imaging and clinical findings.

  • May occur alone or surrounding an erosion or other bone abnormalities.

  • § High signal intensity on weighted fat saturated and STIR images, and low signal intensity on T1 weighted images.

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