A. Scherer et al., MR-morphological changes of the metacarpophalangeal joints in patients with rheumatoid arthritis: Comparison of early and chronical stages., ROFO-F RONT, 173(10), 2001, pp. 902-907
Citations number
39
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging
Journal title
ROFO-FORTSCHRITTE AUF DEM GEBIET DER RONTGENSTRAHLEN UND DER BILDGEBENDEN VERFAHREN
Purpose: Evaluation of MRI findings in the metacarpophalangeal (MCP) joints
in patients with early (eRA) and chronical rheumatoid arthritis (cRA). Mat
erial and Methods: In 22 RA patients (9 with disease duration less than or
equal to1.5 years = eRA) the dominant hands were examined by MRI in coronal
T-2 weighted turbo-spin-echo (TSE). T-1 weighted spin-echo (SE) sequences
before and after injection of Gd-DTPA and fat-suppressed short tau inversio
n recovery (STIR) sequences, followed by miniarthroscopy (MA) of the MCP II
joint after an interval of 24 hours. MRI and MA findings were assessed usi
ng standardised semiquantitative items of synovial and bony pathologies and
a statistical comparison between eRA and cRA patients was performed. Resul
ts: In MRI synovial proliferation was detected in 13/13 cRA and 8/9 eRA pat
ients. It was statistically not significant; the degree of synovial prolife
ration was however lower in the eRA group. All eRA patients with synovial c
hanges showed enhancement after administration of contrast medium, a marker
which correlated with the clinical activity. In 2/13 cRA patients no uptak
e of contrast medium was evident. Bony erosions and strongly narrowing join
t space correlated with disease duration and were documented significantly
rarer in the eRA patients (1/9, 2/9) than in the cRA patients (9/13, 10/13)
. Conclusion: In RA patients, MRI of the metacarpophalangeal joints can det
ect specific pathological changes which are observed significantly more oft
en in either early or chronic stages and which are associated with disease
activity and duration.