CLINICAL STAGING AND GADOLINIUM-DTPA ENHANCED IMAGES OF THE WRIST IN RHEUMATOID-ARTHRITIS

The usefulness of gadolinium (Gd)-DTPA enhanced magnetic resonance ima ging (MRI) of the wrist joint for predicting articular destruction was investigated in 49 patients with rheumatoid arthritis (RA). On T1 wei ghted images with Gd-DTPA enhancement, the synovium showed a localized or diffuse pattern of enhancement. Many patients classed as stage II or higher by plain radiography had diffuse enhancement on MRI, while a ll except one stage I patient had relatively confined localized enhanc ement. Our study showed that MRI of the carpus could detect soft tissu e changes in patients with RA earlier than anything revealed by radiog raphy, and suggested that contrast MRI may be useful for predicting ar ticular destruction.