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AB0336 Magnetic resonance imaging-assessed synovial and bone changes in hand and wrist joints of rheumatoid arthritis patients
  1. KA Lee,
  2. S-H Min,
  3. T-H Kim,
  4. S-H Lee,
  5. H-R Kim
  1. Internal Medicine, Konkuk University Medical Center, Seoul, Korea, Republic Of


Background Magnetic resonance imaging (MRI) is a sensitive and useful method for the detection of synovitis and joint destruction in rheumatoid arthritis (RA) patients. However, the patterns of MRI-detected bone erosion, bone marrow edema (BME), synovitis, and tenosynovitis have received insufficient attention.

Objectives Therefore, this study evaluated the patterns of bone erosion, BME, synovitis, and tenosynovitis, and calculated the RA-MRI score (RAMRIS) of patients with RA at the carpal and metacarpophalangeal (MCP) joints using MRI.

Methods MRI datasets from 43 RA patients were analyzed. All patients had undergone MRI of one wrist. In addition, 36 patients had MCP joint images taken, and 3 had also received MRI of the contralateral wrist and MCP joints. The MR images were evaluated for bone erosion, BME, and synovitis in consensus by 2 blinded readers according to the OMERACT RA-MRI score (RAMRIS). The MRI-detected tenosynovitis was evaluated based on Haavardsholm's tenosynovitis score.

Results The capitate, lunate, triquetrum, and hamate bones were the most common sites of erosion and BME and showed the highest RAMRIS erosion and BME scores. Moreover, MRI-detected tenosynovitis was present in 78.3% of all patients with RA, and the extensor compartment 4 and flexor digitorum profundus and superficialis were frequently affected.

Conclusions This study identified the distribution and prevalence of MRI-detected bone erosion, BME, synovitis, and tenosynovitis of the wrist and MCP joints in RA patients. The patterns of the MRI-detected abnormalities may help to select sites for the application of MRI protocols in clinical trials and practice.


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  2. Ostergaard M, Edmonds J, McQueen F, Peterfy C, Lassere M, Ejbjerg B, et al. An introduction to the EULAR-OMERACT rheumatoid arthritis MRI reference image atlas. Annals of the rheumatic diseases. 2005;64 Suppl 1:i3–7.

  3. Conaghan P, Bird P, Ejbjerg B, O'Connor P, Peterfy C, McQueen F, et al. The EULAR-OMERACT rheumatoid arthritis MRI reference image atlas: the metacarpophalangeal joints. Annals of the rheumatic diseases. 2005;64 Suppl 1:i11–21.

  4. Haavardsholm EA, Ostergaard M, Ejbjerg BJ, Kvan NP, Kvien TK. Introduction of a novel magnetic resonance imaging tenosynovitis score for rheumatoid arthritis: reliability in a multireader longitudinal study. Annals of the rheumatic diseases. 2007;66(9):1216–20.


Acknowledgements The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Disclosure of Interest None declared

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