Using extremity magnetic resonance imaging to assess and monitor early rheumatoid arthritis: the optimal joint combination to be scanned in clinical practice.
OBJECTIVE
To identify the optimal combination for detecting erosions in early rheumatoid arthritis using extremity magnetic resonance imaging (eMRI).


METHODS
In 44 patients, eMRI of 1 hand identified 77% who were erosive, 2 hands 89%, and 2 hands and feet 91%.


RESULTS
eMRI identified 4 times as many erosions as radiography. At 6 months, eMRI of 1 hand identified an increase in erosions in 50% subjects, 2 hands in 55%, and 2 hands and feet in 55%. When only subjects with a change in erosion score above the smallest detectable difference were considered, these numbers were 30%, 25%, and 20%, respectively.


CONCLUSIONS
eMRI provides superior erosion identification compared to radiography. Imaging 2 hands can be used as a screening tool and 1 hand to monitor erosions over time.
Olech
Ewa
E
University of Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma 73104, USA. Ewa-Olech@omrf.ouhsc.edu
Freeston
Jane E
JE
Conaghan
Philip G
PG
Hensor
Elizabeth M A
EM
Emery
Paul
P
Yocum
David
D
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis*; D001175:Arthrography; D018450:Disease Progression; D005121:Extremities / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D007596:Joints / Q000473:pathology*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged