title: A retrospective analysis of low-field strength magnetic resonance imaging and the management of patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To assess how in-office magnetic resonance imaging (MRI) scans of the hand/wrist or feet are utilized in a rheumatology practice to make clinical evaluations regarding therapeutic options for rheumatoid arthritis (RA) patients.
  
  
  METHODS
  In a large clinical practice, a retrospective review was conducted on the first 300 RA patients who had office-based MRI scans at baseline. Information was collected on demographics, baseline therapy, and whether any change in therapy occurred at the time of the MRI scans. MR images of the affected wrist were obtained with a low-field strength dedicated extremity unit.
  
  
  RESULTS
  Of the 300 patients, 99 patients (33%) had MRIs that exhibited signs of erosions, joint space narrowing, or bone edema. These patients were classified as MRI-positive. The remaining 201 patients (67%) were classified as MRI-negative. A substantial majority (85%) of MRI-positive patients received a change in their therapeutic regimen, compared with only 9.5% of the MRI-negative patients (p < 0.001). In the 84 MRI-positive patients who had their therapy changed, 65% received a new prescription for a biologic or an increase in the dose of their existing biologic and 34% of the MRI-positive patients received a DMARD. In the 19 MRI-negative patients with a therapeutic change, 11% received a biologic agent and 88% received a DMARD. The major limitation of this study is that it was a retrospective analysis and the assessments of MRI findings were qualitative.
  
  
  CONCLUSIONS
  In this large population of RA patients, there was an association between MRI detection of joint space narrowing, erosions, and/or bone edema and change in therapeutic management.
authors.affiliation: Denver Arthritis Clinic, Denver, CO 80230, USA. crendon@denverarthritisclinic.com
authors.forename: Michael H
authors.initials: MH
authors.lastname: Schiff
authors.forename: Kathryn F
authors.initials: KF
authors.lastname: Hobbs
authors.forename: Timothy
authors.initials: T
authors.lastname: Gensler
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Keenan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012698:Serologic Tests
chemical_list: D015415:Biomarkers