SUGGESTED MR STAGING CLASSIFICATION OF EA RLY RHEUMATOID-ARTHRITIS ATTHE METACARPOPHALANGEAL AND PROXIMAL INTERPHALANGEAL JOINTS

Purpose: MRI can demonstrate pathology of joint disease in the early c ourse of rheumatoid arthritis prior to destructions seen on convention al radiographs. In a prospective study, we tried to develop a systemat ical classification of joint pathology demonstrated by MRI, which woul d be essential for scoring the course of the disease. Patients and met hod: Metacarpophalangeal and interphalangeal joints of 48 patients suf fering from early rheumatoid arthritis (mean disease duration: 6.4 mon ths) were evaluated by MR[ using a high-resolution transmitter-receive r coil. Examinations included 2mm sliced T-2-, T-1- and gadolinium enh anced T-1-SE sequences in coronal and axial orientation. In considerat ion of pathological findings on MR[ and histopathogenetical pathways o f destruction in rheumatoid arthritis a MR-score (0-5) was established . Results: This allowed to score each joint examined: score 0 (normal) in 47.8 % / 49.5 %, score 1 in 35.5 % / 50.5 %, score 2 in 4.2 % / 0 %, score 3 in 10.8 % / 0 %, score 4 in 1.5 % / 0 % of the metacarpopha langeal/interphalangeal joints, respectively. Conclusions: Using the M R-score a relative individual destruction number can be calculated, wh ich may be used to follow up patients in the early course of rheumatoi d arthritis (e.g. drug therapy studies). The presented MR scoring syst em has to be evaluated further in longitudinal studies and must be cor related to radiographical and clinical findings.