Early-stage rheumatoid arthritis: diagnostic accuracy of MR imaging.
OBJECTIVE
To investigate the role of magnetic resonance (MR) imaging in diagnosing early rheumatoid arthritis (RA).


METHODS
Twenty patients (three men, 17 women; age range, 21-72 years) with clinically and radiologically proved RA underwent evaluation to define an MR imaging criterion for diagnosing synovial inflammation due to RA. Twenty-seven patients (16 with RA, 11 without RA [control patients]; three men, 24 women; age range, 19-75 years) suspected to have early RA but without radiographic abnormalities underwent evaluation to test the accuracy of using the criterion to diagnose RA. In each patient, coronal, fat-suppressed, and gadolinium contrast material-enhanced, T1-weighted images of both hands were obtained.


RESULTS
The MR imaging criterion was periarticular contrast material enhancement of the wrists or the metacarpophalangeal and/or proximal interphalangeal joints in both hands. In the diagnosis of early RA, sensitivity and negative predictive value were both 100%, specificity was 73%, and accuracy was 89%.


CONCLUSIONS
MR imaging is extremely useful in diagnosing early RA.
Department of Radiology, Jichi Medical School, Japan.
H
H
Sugimoto
A
A
Takeda
J
J
Masuyama
M
M
Furuse
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis*; D003287:Contrast Media; D004338:Drug Combinations; D005260:Female; D005384:Finger Joint / Q000473:pathology; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine; D008662:Metacarpophalangeal Joint / Q000473:pathology; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013585:Synovitis / Q000175:diagnosis; D014955:Wrist Joint / Q000473:pathology
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D019786:Gadolinium DTPA