DETECTION OF JOINT PATHOLOGY BY MAGNETIC-RESONANCE-IMAGING IN PATIENTS WITH EARLY RHEUMATOID-ARTHRITIS

Magnetic resonance imaging (MRI) permits the visualization of anatomic al structures not appreciated by conventional radiographic imaging, an d may assess inflammatory disease and its progression with greater sen sitivity than conventional radiography. In this study of 30 patients w ith early rheumatoid arthritis (RA), which could be considered as a pi lot study because of the relatively small number of patients, we compa re MRI of the knee and the fifth metatarsophalangeal joint with clinic al and radiographic findings. A parallel study of 10 healthy individua ls served as a reference group. In all but one of the 30 patients, MRI revealed some kind of joing abnormality, whereas conventional radiogr aphy was normal in 14 patients. The present study thus suggests that M RI may detect inflammatory and/or destructive joint changes in patient s with early RA, and that these changes may occur in the absence of cl inical symptoms or signs and/or radiographic signs in the examined joi nt. If these data prove to be confirmed in further controlled studies, MRI may be of importance both for the assessment of prognosis and for the decision to treat in the early critical stages of RA.