Contrast-enhanced whole-body joint MRI in patients with unclassified arthritis who develop early rheumatoid arthritis within 2 years: feasibility study and correlation with MRI findings of the hands.
OBJECTIVE
The purpose of this article is to examine the feasibility of whole-body joint MRI for detecting systemic joint synovitis and for analyzing the relationship between the hands and systemic joint involvement in patients with unclassified arthritis who later develop early rheumatoid arthritis (RA).


METHODS
The study included 17 patients (five men and 12 women; median age, 65 years [range, 38-77 years]; median symptom duration, 3 months [range, 1-6 months]). MRI of the systemic joints was performed for patients with unclassified arthritis without radiographic evidence of RA and who were diagnosed as having RA according to 1987 revised classification criteria within 2 years.


RESULTS
The chosen 4-point scale for image quality was moderate to excellent. MRI findings of systemic joints were in accordance with joint swelling and tenderness (chi-square test, p < 0.0001). Sixty percent (45/75) of hand joints and 67% (12/18) of systemic joints other than hands showed MR synovitis without swelling. With regard to the correlation of MRI findings between hands and joints other than hands, there was a statistically significant positive correlation in the joint count (r = 0.5514 and p = 0.0218) and semiquantitative value of hand synovitis (r = 0.5382 and p = 0.0258).


CONCLUSIONS
Whole-body joint MRI in early RA is feasible in terms of image quality and agreement with the results of clinical examination. MRI may be more sensitive for depicting synovitis-positive joints than clinical examination. Estimation of the systemic burden of synovitis detected by MRI may be possible via MRI of the hands.
Kamishima
Tamotsu
T
Department of Radiology, Hokkaido University Hospital, Kita-Ku, Sapporo City, Hokkaido 0600815, Japan. ktamotamo2@yahoo.co.jp
Fujieda
Yuichiro
Y
Atsumi
Tatsuya
T
Mimura
Rie
R
Koike
Takao
T
Terae
Satoshi
S
Shirato
Hiroki
H
D000328:Adult; D000368:Aged; D001168:Arthritis / Q000150:complications* / Q000175:diagnosis*; D001172:Arthritis, Rheumatoid / Q000209:etiology*; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D050823:Hand Joints / Q000473:pathology; D006801:Humans; D007089:Image Enhancement; D007596:Joints / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
D003287:Contrast Media