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Extended report
MRI in early rheumatoid arthritis: synovitis and bone marrow oedema are independent predictors of subsequent radiographic progression
  1. Pernille Bøyesen1,
  2. Espen A Haavardsholm1,
  3. Mikkel Østergaard2,
  4. Désirée van der Heijde1,3,
  5. Sølve Sesseng4,
  6. Tore K Kvien1
  1. 1Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  2. 2Department of Rheumatology, Copenhagen University Hospitals at Hvidovre and Glostrup, Copenhagen, Denmark
  3. 3Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
  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 determine whether MRI and conventional (clinical and laboratory) measures of inflammation can predict 3-year radiographic changes measured by the van der Heijde Sharp score in patients with early rheumatoid arthritis (RA).

Methods 55 patients with RA with disease duration <1 year participated in this 3-year follow-up study. Patients were evaluated at baseline, 3, 6, 12 and 36 months by swollen and tender joint count, disease activity score based on 28-joint count, erythrocyte sedimentation rate (ESR), C reactive protein, MRI measures of synovitis, bone marrow oedema and tenosynovitis of the dominant wrist, as well as conventional x-rays of the hands and wrists.

Results All measures of inflammation decreased during the follow-up period. ESR, MRI synovitis and MRI bone marrow oedema were independent predictors of 3-year radiographic progression adjusted for age, sex and anti-citrullinated protein antibodies. The 1-year cumulative measures of MRI synovitis and bone marrow oedema provided an improved explanation of variation (adjusted R2) in radiographic change compared with the baseline MRI values (adjusted R2=0.32 and 0.20 vs 0.11 and 0.04, respectively).

Conclusions Both baseline and 1-year cumulative measures of MRI synovitis and bone marrow oedema independently predicted 3-year radiographic progression. These results confirm that MRI synovitis and MRI bone marrow oedema precede radiographic progression in patients with early RA.

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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 None.

  • Ethics approval This study was conducted with the approval of the regional ethic committee, region south-east, Box 1130, Blindern, N-0318 Oslo.

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