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Prediction of MRI erosive progression: a comparison of modern imaging modalities in early rheumatoid arthritis patients
  1. Pernille Bøyesen1,
  2. Espen A Haavardsholm1,
  3. Désirée van der Heijde1,2,
  4. Mikkel Østergaard3,
  5. Hilde Berner Hammer1,
  6. Sølve Sesseng4,
  7. Tore K Kvien1
  1. 1Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  2. 2Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
  3. 3Department of Rheumatology, Copenhagen University Hospitals at Hvidovre and Gentofte, Copenhagen, Denmark
  4. 4Department of Radiology, Diakonhjemmet Hospital, Oslo, Norway
  1. Correspondence to Dr Pernille Bøyesen, Department of Rheumatology, Diakonhjemmet Hospital, Box 23, Vinderen, N-0319 Oslo, Norway; pernilleboyesen{at}


Objectives To examine the associations between modern imaging modalities and joint damage measured as 1-year MRI erosive progression, in early rheumatoid arthritis (RA) patients.

Methods 84 RA patients with disease duration of less than 1 year were included in this inception cohort. Patients were evaluated at baseline, 3, 6 and 12 months by core measures of disease activity, MRI and ultrasound grey-scale (USGS) of inflammation, conventional radiography and digital x-ray radiogrammetry (DXR) bone mineral density (BMD) of cortical hand bone.

Results 53 of the 79 patients (67%) who completed the follow-up had MRI erosive progression (dependent variable). USGS and MRI bone marrow oedema (BME) were in multivariate analyses independent predictors of 1-year MRI erosive progression. There was a trend towards higher MRI synovitis score and 3-month DXR BMD loss in patients developing MRI erosions. On an individual level, USGS inflammation, MRI synovitis and MRI BME also somewhat better predicted outcome than rheumatoid factor, anticitrullinated protein antibodies and disease activity score 28.

Conclusions USGS inflammation and MRI BME were independent predictors of MRI erosive progression in early RA patients on a group level. The exact prognosis of the individual patients could not be determined by imaging alone.

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  • Funding This study was funded by the Eastern Norway Regional Health Authority, the Research Council of Norway, the Norwegian Rheumatism Association, the Norwegian Women Public Health Association, Grethe Harbitz Legacy and Marie and Else Mustad's Legacy.

  • Competing interests Johannes WJ Bijlsma was the handling editor for this manuscript.

  • Ethics approval This study was conducted with the approval of the regional ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.