title: [Bony pathologies of the metacarpophalangeal joints in early rheumatoid arthritis: comparison of MRI and high-resolution SPECT].
abstract: OBJECTIVE
  Comparison of MRI with a newly developed high-resolution multi-pinhole single photon emission computed tomography (MPH-SPECT) regarding the detection of bony pathologies of the metacarpophalangeal (MCP) joints in patients with early rheumatoid arthritis (ERA).
  
  
  METHODS
  The clinically dominant hand of 15 patients with ERA (disease duration 6 months) was examined using MRI and MPH-SPECT. The evaluation of MRI was achieved according to RAMRIS criteria and for the MPH SPECT regarding pathological tracer uptake and distribution. Image fusions of MRI and MPH-SPECT were provided and the two methods were compared.
  
  
  RESULTS
  In MRI 12 of 15 patients showed arthritic joint pathologies, while 8 patients exhibited soft tissue and bony changes. 4 patients had only soft tissue inflammation (synovitis) with a normal bone signal. In MPH-SPECT 10 of 15 patients showed pathologically increased bone metabolism. The fusion images presented a high agreement of the pathological changes in both methods, while areas with increased bone metabolism were not only present in the case of erosions, but also in the case of bone edema. In 2 patients increased bone metabolism was detectable in areas of MR tomographic normal bone, while a clear surrounding synovitis was present in each case here.
  
  
  CONCLUSIONS
  The comparison of MPH-SPECT with MRI proves that the latter is a sensitive procedure for the detection of bony pathologies of MCP joints in ERA. A normal bone signal in MRI does not exclude early changes in bone metabolism in cases of severe synovialitis.
authors.affiliation: Radiologie, Heinrich-Heine Universität, Düsseldorf. axelscherer@gmx.de
authors.forename: A
authors.initials: A
authors.lastname: Scherer
authors.forename: A
authors.initials: A
authors.lastname: Wirrwar
authors.forename: K
authors.initials: K
authors.lastname: Mattes-György
authors.forename: D
authors.initials: D
authors.lastname: Blondin
authors.forename: D
authors.initials: D
authors.lastname: Reichelt
authors.forename: H-W
authors.initials: HW
authors.lastname: Müller
authors.forename: M
authors.initials: M
authors.lastname: Schneider
authors.forename: U
authors.initials: U
authors.lastname: Mödder
authors.forename: B
authors.initials: B
authors.lastname: Ostendorf
mesh_terms: D001172:Arthritis, Rheumatoid / Q000175:diagnosis*; D042241:Early Diagnosis; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008662:Metacarpophalangeal Joint / Q000473:pathology*; D012149:Restraint, Physical / Q000295:instrumentation; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D013583:Synovial Membrane / Q000473:pathology; D013585:Synovitis / Q000175:diagnosis; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation / Q000379:methods*