Magnetic resonance imaging of the hand joints in patients with inflammatory bowel disease and arthralgia: a pilot study.
OBJECTIVE
To assess whether subclinical inflammatory changes are present on magnetic resonance imaging (MRI) in patients with inflammatory bowel disease (IBD) and arthralgia.


METHODS
In this pilot study, painful hand joints [metacarpophalangeal (MCP), proximal interphalangeal (PIP), and/or distal interphalangeal (DIP)] of 11 IBD patients (age 18-45 years) with continuous pain for > 6 weeks were scanned on a 1.5-T extremity MRI system. A control group of 11 IBD patients without joint pain who were matched for type and disease duration of IBD, gender, and age was included. All patients were clinically examined by a rheumatologist for the presence of pain and arthritis. Imaging was performed according to a standard arthritis protocol with intravenous contrast administration on the same day. Images (blinded for clinical information) were evaluated by two readers in consensus for the presence of joint fluid, synovitis, tenosynovitis, enthesitis, erosions, cartilage defects, and bone marrow oedema.


RESULTS
Enthesitis was seen in three hand joints (MCP 2, MCP 3, PIP 3) of 2/11 (18%) arthralgia patients and in none of the control group (p = 0.48). A small amount of subchondral bone marrow oedema was seen in the metacarpal head of two controls. No other abnormalities were observed.


CONCLUSIONS
Several young IBD patients with chronic hand pain had subclinical inflammation on MRI, which invites for further study in a larger group of patients.
Departments of Gastroenterology and Hepatology, Leiden University Medical Centre , The Netherlands.
L K P M
LK
Brakenhoff
W
W
Stomp
F A
FA
van Gaalen
D W
DW
Hommes
J L
JL
Bloem
D M F M
DM
van der Heijde
H H
HH
Fidder
M
M
Reijnierse
D000293:Adolescent; D000328:Adult; D018771:Arthralgia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D005384:Finger Joint / Q000473:pathology; D050823:Hand Joints / Q000473:pathology*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008662:Metacarpophalangeal Joint / Q000473:pathology; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D055815:Young Adult