title: Patterns of magnetic resonance imaging bone erosion in rheumatoid arthritis--which bones are most frequently involved and show the most change?
abstract: OBJECTIVE
  To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA).
  
  
  METHODS
  MRI datasets from 258 RA patients [126 with early RA (disease duration < 6 months)] were analyzed, of whom 223, including 126 with early RA, had 1-year followup MRI. All patients had MRI of one wrist, whereas 86 patients had additional images of 2nd-5th MCP joints, and 46 patients additional images of the contralateral wrist. MRI were evaluated blinded by one reader, according to the OMERACT RA MRI scoring system (RAMRIS) for erosions, and presence/absence of erosions was noted in each bone, as was presence/absence of erosive progression.
  
  
  RESULTS
  The capitate, ulna, lunate, triquetrum, and scaphoid were the 5 bones with both most frequent baseline erosions and most frequently demonstrated erosive progression. No bones were without erosions. Patterns of erosions and progression were similar in early and established RA. No major difference between dominant and nondominant wrists was detected. In the fingers, the 2nd-3rd MCP joint most frequently displayed erosions and erosive progression.
  
  
  CONCLUSIONS
  The distribution and frequency of bone erosion and erosive progression as detected by MRI in RA wrists and MCP joints were identified. No pattern differences between early versus established disease and dominant versus nondominant sides were detected. No bones showed erosive progression. Thus, no self-evident simplification of the RAMRIS erosion score was identified. Bone involvement patterns may be considered, when joints are selected for MRI protocols for clinical trials and practice.
authors: Department of Rheumatology and Department of Radiology, Copenhagen University Hospital at Glostrup, Copenhagen. mo@dadlnet.dk
authors: Mikkel
authors: M
authors: Ostergaard
authors: Uffe
authors: U
authors: Møller Døhn
authors: Anne
authors: A
authors: Duer-Jensen
authors: Merete Lund
authors: ML
authors: Hetland
authors: Kim
authors: K
authors: Hørslev-Petersen
authors: Kristian
authors: K
authors: Stengaard-Pedersen
authors: Peter
authors: P
authors: Junker
authors: Jan
authors: J
authors: Pødenphant
authors: Bo
authors: B
authors: Ejbjerg
mesh_terms: D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology*; D002348:Carpal Bones / Q000473:pathology*; D050824:Carpal Joints / Q000473:pathology; D016208:Databases, Factual / Q000706:statistics & numerical data*; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D050279:Metacarpal Bones / Q000473:pathology*; D008662:Metacarpophalangeal Joint / Q000473:pathology; D012720:Severity of Illness Index; D014955:Wrist Joint / Q000473:pathology