Significance of magnetic resonance imaging for early rheumatoid arthritis activity
https://doi.org/10.14412/1995-4484-2009-138
Abstract
Objective. To assess possibility of magnetic resonance image (MRI) application for rheu- matoid arthritis (RA) activity and severity assessment.Material and methods. 100 pts with RA who fulfilled the 1987 ACR criteria with disease duration less than 12 months were included. Standard clinical examination with evaluation of tender and swollen joint counts, acute phase markers, hand and foot X-ray and hand MRI with 0,2 T Artoscan apparatus (ESAOTE Biomedica, Italy) were performed.Results. MRI showed hand joint synovitis in 94,5%, erosions – in 67,3% of cases. X-ray examination revealed erosions in only 20,8% of pts. Localization of erosions revealed by X-ray and MRI coincided in 36,4% of cases and in 61,8% of pts erosions were detected only by MRI. MRI confirmed clinical conclusion about presence or absence of metacarpophalangeal and wrist joint synovitis in 64,5% and 74,5% of cases respectively. In8,2% and 21,8% MRI revealed signs of synovitis in clinically intact joints. MRI synovitis score correlated with clinical and laboratory measures of disease activity – DAS 28 (r=0,37, p=0,001), CRP(r=0,30, p=0,001), ESR (r=0,42, p=0,001), HAQ (r=0,24, p=0,001). Weak correlation was revealed between ESR and presence of erosions (r=0,29), CRP, ESR and MRI signs of bone marrow edema (r=0,27, p=0,005 and r=0,29, p=0,002 respectively). Relationship between laboratory and clinical features was weaker and referred only to CRP level and swollen joint count (p=0,05).Conclusion. MRI signs may be used as additional and independent measures of inflammatory activity (particularly synovitis score) and severity of RA
References
1. <div><p>Насонова В.А., Фоломеева О.М., Эрдес Ш. Ревматические болезни в России в начале XXI века. Научно-практич. ревматол., 2003, 1, 6-10.</p><p>Эрдес Ш., Фоломеева О.М. Проблема ревматичес- ких заболеваний в России. РМЖ, 2004, 20, 1121- 22.</p><p>Каратеев Д.Е., Раденска-Лоповок С.Г., Наснова В.А., Иванова М.М. Синовиальная оболочка на ранней стадии ревматоидного артрита: клиник- морфологические сопоставления. Тер. архив, 2002, 5, 13-20.</p><p>Шехтер А.Б., Чичасова Н.В., Крель А.А. Эволюция морфологических проявлений синовита у больных с начальной стадией ревматоидного артрита при НАУЧНО-ПРАКТИЧЕСКАЯ РЕВМАТОЛОГИЯ № 1, 2009 различных вариантах его дальнейшего течения. Ревматология, 1988, 2, 3-16.</p><p>Насонова В.А., Сигидин Я.А. Базисная терапия ревматоидного артрита в ранней стадии. Тер. архив., 1996, 5,5-8.</p><p>Landewé R.B., Boers M., Verhoeven A.C. et al. COBRA combination therapy in patients with early rheumatoid arthritis: long-term structural benefits of a brief intervention. Arthr. Rheum., 2002,46(2), 347- 56.</p><p>Möttönen T, Hannonen P, Korpela M, et al. Delay to institution of therapy and induction of remission using single-drug or combination-disease-modifying antirheumatic drug therapy in early rheumatoid arthritis. Arthr. Rheum., 2002, 46(4), 894-98.</p><p>Bukhari M.A., Wiles N.J., Lunt M. et al. Influence of disease-modifying therapy on radiographic outcome in inflammatory polyarthritis at five years: results from a large observational inception study. Arthr. Rheum., 2003,48(1),46-53.</p><p>Goekoop-Ruiterman Y.P, de Vries-Bouwstra J.K., Allaart C.F. et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): a randomized, controlled trial. Arthr. Rheum., 2005,52(11), 3381-90.</p><p>Forslind K., Larsson E.M., Johansson A., Svensson B. Detection of joint pathology by magnetic resonance imaging in patients with early rheumatoid arthritis. Br. J. Rheumatol., 1997,36,683–8.</p><p>Jorgensen C., Cyteval C., Anaya J.M., et al. Sensitivity of magnetic resonance imaging of the wrist in very early rheumatoid arthritis. Clin. Exp. Rheumatol., 1993,11,163–8.</p><p>McQueen F.M., Stewart N., Crabbe J., et al. Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals a high prevalence of erosions at four months after symptom onset. Ann. Rheum. Dis, 1998,7,350–6.</p><p>Østergaard M., Hansen M., Stoltenberg M., et al. Magnetic resonance imagingdetermined synovial membrane volume as a marker of disease activity and a predictor of progressive joint destruction in the wrists of patients with rheumatoid arthritis. Arthr. Rheum., 1999,42,918–9.</p><p>Klarlund M., Østergaard M., Gideon P., et al. Wrist and finger joint MR imaging in rheumatoid arthritis. Acta Radiol., 1999,40,400–9.</p><p>Foley N.D., Stack J.P., Ryan M. et al. Magnetic resonance imaging in the assessment of rheumatoid arthritis—a comparison with plain film radiographs. Br. J. Rheumatol., 1991,30, 101–6.</p><p>Østergaard M., Stoltenberg M., Gideon P. et al. Changes in synovial membrane and joint effusion volumes after intraarticular methylprednisolone. Quantitative assessment of inflammatory and destruc- tive changes in arthritis by MRI. J. Rheumatol., 1996, 23,1151–61.</p><p>Arnett F.C., Edworthy S.M., Bloch D.A. et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthr. Rheum., 1988, 31, 315–24.</p><p>Ejbjerg B., McQueen F., Lassere M. et al. The EULAR-OMERACT rheumatoid arthritis MRI reference image atlas: the wrist joint. Ann. Rheum. Dis., 2005,64, 1,i23-47.</p><p>Duer-Jensen A., Vestergaard A., Døhn U.M. et al. Detection of rheumatoid arthritis bone erosions by 2 different dedicated extremity MRI units and conventional radiography. Ann. Rheum. Dis., 2007, 16 [Epub ahead of print]</p><p>Lindegaard H., Vallø J., Hørslev-Petersen K. et al. Low field dedicated magnetic resonance imaging in untreated rheumatoid arthritis of recent onset. Ann. Rheum. Dis., 2001, 60, 770-6.</p><p>Palosaari K., Vuotila J., Takalo R. et al. Bone oedema predicts erosive progression on wrist MRI in early RA – a 2-yr observational MRI and NC scintigraphy study. Rheumatology (Oxford), 2006, 45(12),1542-8.</p><p>Haavardsholm E.A., Bøyesen P., Østergaard M. et al. Magnetic resonance imaging findings in 84 patients with early rheumatoid arthritis: bone marrow oedema predicts erosive progression. Ann. Rheum.Dis., 2008, 67(6), 794-800.</p><p>Østergaard M., Gideon P., Sørensen K. et al. Scoring of synovial membrane hypertrophy and bone erosions by MR imaging in clinically active and inactive rheumatoid arthritis of the wrist. Scand. J.Rheumatol., 1995,24,212–8.</p><p>Klarlund M., Østergaard M., Lorenzen I. Finger joint synovitis in rheumatoid arthritis: quantitative assessment by magnetic resonance imaging. Rheumatology (Oxford), 1999,38, 66–72.</p><p>Østergaard M., Stoltenberg M., Løvgren-Nielsen P. et al. Magnetic resonance imagingdetermined synovial membrane and joint effusion volumes in rheumatoid arthritis and osteoarthritis: comparison with the macroscopic and microscopic appearance of the synovium. Arthr. Rheum., 1997, 40, 1856–67.</p><p>Østergaard M., Hansen M., Stoltenberg M., Lorenzen I. Quantitative assessment of the synovial membrane in the rheumatoid wrist: an easily obtained MRI score reflects the synovial volume. Br. J. Rheumatol., 1996,3, 965–71.</p></div><br />
Review
For citations:
Pogozeva E.Y. Significance of magnetic resonance imaging for early rheumatoid arthritis activity. Rheumatology Science and Practice. 2009;47(1):24-29. (In Russ.) https://doi.org/10.14412/1995-4484-2009-138
Views:
2391
Email this article 