title: Comparative study of the detection of joint injury in early-stage rheumatoid arthritis by magnetic resonance imaging of the wrist and finger joints and physical examination.
abstract: OBJECTIVE
  To verify whether magnetic resonance imaging (MRI)-proven joint injury is sensitive as compared with joint injury determined by physical examination.
  
  
  METHODS
  MRI of the wrist and finger joints of both hands was examined in 51 early-stage rheumatoid arthritis (RA) patients by both plain and gadolinium diethylenetriaminepentaacetic acid-enhanced MRI. Synovitis, bone edema, and bone erosion (the latter two included as bone lesions at the wrist joints); metacarpophalangeal joints; and proximal interphalangeal joints were considered as MRI-proven joint injury. Japan College of Rheumatology-certified rheumatologists had given a physical examination just before the MRI study. The presence of tender and/or swollen joints in the same fields as MRI was considered as joint injury on physical examination. The association of MRI-proven joint injury with physical examination-proven joint injury was examined.
  
  
  RESULTS
  A total of 1,110 sites were available to be examined. MRI-proven joint injury was found in 521 sites, whereas the other 589 sites were normal. Physical examination-proven joint injury was found in 305 sites, which was significantly low as compared with MRI-proven joint injury (P = 1.1 × 10(-12) versus MRI). Joint injury on physical examination was not found in 81.5% of the sites where MRI findings were normal. Furthermore, an association of the severity of MRI-proven joint injury with that of joint injury on physical examination was clearly demonstrated (P = 1.6 × 10(-15), r(s) = 0.469).
  
  
  CONCLUSIONS
  Our present data suggest that MRI is not only sensitive but accurately reflects the joint injury in patients with early-stage RA.
authors.affiliation: Nagasaki University, Japan. mmtamami@yahoo.co.jp
authors.forename: Mami
authors.initials: M
authors.lastname: Tamai
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
authors.forename: Naoki
authors.initials: N
authors.lastname: Iwamoto
authors.forename: Shin-Ya
authors.initials: SY
authors.lastname: Kawashiri
authors.forename: Keita
authors.initials: K
authors.lastname: Fujikawa
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Aramaki
authors.forename: Junko
authors.initials: J
authors.lastname: Kita
authors.forename: Akitomo
authors.initials: A
authors.lastname: Okada
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Koga
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Arima
authors.forename: Makoto
authors.initials: M
authors.lastname: Kamachi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamasaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ida
authors.forename: Tomoki
authors.initials: T
authors.lastname: Origuchi
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Takao
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Aoyagi
authors.forename: Masataka
authors.initials: M
authors.lastname: Uetani
authors.forename: Katsumi
authors.initials: K
authors.lastname: Eguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D016009:Chi-Square Distribution; D003287:Contrast Media; D042241:Early Diagnosis; D004487:Edema / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005384:Finger Joint / Q000473:pathology*; D019786:Gadolinium DTPA; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010808:Physical Examination; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013585:Synovitis / Q000175:diagnosis / Q000209:etiology; D014955:Wrist Joint / Q000473:pathology*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA