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Low-cost, low-field dedicated extremity magnetic resonance imaging in early rheumatoid arthritis: a 1-year follow-up study
  1. H M Lindegaard1,
  2. J Vallø2,
  3. K Hørslev-Petersen3,
  4. P Junker1,
  5. M Østergaard4
  1. 1Department of Internal Medicine C, Section of Rheumatology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
  2. 2Department of Radiology, Aabenraa Hospital, Aabenraa, Denmark
  3. 3Department of Rheumatology, Graasten Gigthospital, Graasten, Denmark
  4. 4The Danish Research Centre of Magnetic Resonance, Department of Rheumatology, Copenhagen University Hospitals at Hvidovre and Herlev, University of Copenhagen, Copenhagen, Denmark
  1. Correspondence to:
    H M Lindegaard
    Department of Internal Medicine C, Section of Rheumatology, Odense University Hospital, Søndre Boulevard 29, Dk-5000 Odense C, Denmark; lindegaard{at}


Objective: To study the ability of low-cost low-field dedicated extremity magnetic resonance imaging (E-MRI) to assess and predict erosive joint damage in the wrist and metacarpophalangeal (MCP) joints of patients with early rheumatoid arthritis.

Methods: 24 previously untreated patients with rheumatoid arthritis with joint symptoms for <1 year were evaluated at the time of diagnosis and after 6 and 12 months of methotrexate treatment with conventional clinical or biochemical examinations, x rays of both hands and wrists, and E-MRI of the dominant wrist and MCP joints.

Results: At baseline, all patients showed magnetic resonance imaging (MRI) synovitis, and MRI erosions were detected in 21 bones (10 patients). 6 (29%) of these, distributed among two patients, were seen on x ray. One x ray erosion was not detected by MRI. At 1 year, MRI and x ray detected 15 and 8 new erosions, respectively, and 19% of MRI erosions at baseline had progressed to x ray erosions. In bones with MRI erosions at baseline, the relative risk of having x ray erosions at the 1-year follow-up was 12.1, compared with bones without baseline MRI erosions (lesion-centred analysis). If bones with baseline x ray erosions were excluded, the relative risk was 5.2. In patients with baseline MRI bone erosion or oedema, the relative risk of having x ray erosions at 1 year was 4.0, compared with patients without these signs at baseline (patient-centred analysis).

Conclusion: In this group of patients with early rheumatoid arthritis who were treated uniformly, baseline E-MRI erosions in MCP or wrist bones markedly increased the risk of x ray erosions at the 1-year follow-up. Low-cost, low-field dedicated extremity MRI is promising for assessment and prognostication of early rheumatoid arthritis.

  • CRP, C reactive protein
  • DMARD, disease-modifying antirheumatic drug
  • E-MRI, extremity magnetic resonance imaging
  • ESR, erythrocyte sedimentation rate
  • FOV, field of view
  • IQR, interquartile range
  • MCP, metacarpophalangeal
  • MRI, magnetic resonance imaging
  • OMERACT, Outcome Measures in Rheumatology
  • STIR, short T1-inversion recovery

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  • Published Online First 15 March 2006

  • Competing interests: None declared.

  • Ethical approval: This study was conducted in accordance with the Declaration of Helsinki, and approval was obtained from the local ethics committee before starting the study (J No 19980024).

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