Magnetic resonance imaging findings in 84 patients with early rheumatoid arthritis: bone marrow oedema predicts erosive progression
Objectives:To examine the spectrum and severity of magnetic resonance imaging (MRI) findings in patients with early rheumatoid arthritis (RA), and to investigate the predictive value of MRI findings for subsequent development of conventional radiographic (CR) damage and MRI erosions.Methods:84 conse...
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| Veröffentlicht in: | Annals of the rheumatic diseases 2008-06, Vol.67 (6), p.794-800 |
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| creator | Haavardsholm, E A Bøyesen, P Østergaard, M Schildvold, A Kvien, T K |
| description | Objectives:To examine the spectrum and severity of magnetic resonance imaging (MRI) findings in patients with early rheumatoid arthritis (RA), and to investigate the predictive value of MRI findings for subsequent development of conventional radiographic (CR) damage and MRI erosions.Methods:84 consecutive patients with RA with disease duration 2 RAMRIS units) was identified as an independent predictor of both CR (odds ratio = 2.77 (95% confidence interval (CI) 1.06 to 7.21)) and MRI erosive progression (B = 0.21 (95% CI 0.08 to 0.34)).Conclusions:MRI findings were common in early RA, and MRI bone marrow oedema was an independent predictor of radiographic damage. These results suggest that MRI scans of the dominant wrist may help clinicians to determine which patients need early and aggressive treatment to avoid subsequent joint damage. |
| doi_str_mv | 10.1136/ard.2007.071977 |
| format | Article |
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Patients were treated according to standard clinical practice, and evaluated at baseline, 3, 6 and 12 months by core measures of disease activity, conventional radiographs of both hands and wrists and MRI of the dominant wrist. MR images were scored according to the OMERACT rheumatoid arthritis magnetic resonance imaging score (RAMRIS), and conventional radiographs according to the van der Heijde modified Sharp score.Results:MRI findings reflecting inflammation (synovitis, bone marrow oedema and tenosynovitis) decreased during follow-up, while there was a small increase in MRI erosion score and CR damage. The proportion of patients with erosive progression at 1 year was 48% for conventional radiography and 66% for MRI. Baseline MRI bone marrow oedema (score >2 RAMRIS units) was identified as an independent predictor of both CR (odds ratio = 2.77 (95% confidence interval (CI) 1.06 to 7.21)) and MRI erosive progression (B = 0.21 (95% CI 0.08 to 0.34)).Conclusions:MRI findings were common in early RA, and MRI bone marrow oedema was an independent predictor of radiographic damage. These results suggest that MRI scans of the dominant wrist may help clinicians to determine which patients need early and aggressive treatment to avoid subsequent joint damage.</description><identifier>ISSN: 0003-4967</identifier><identifier>EISSN: 1468-2060</identifier><identifier>DOI: 10.1136/ard.2007.071977</identifier><identifier>PMID: 17981915</identifier><identifier>CODEN: ARDIAO</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><subject>Aged ; Antirheumatic Agents - therapeutic use ; Arthritis, Rheumatoid - diagnosis ; Arthritis, Rheumatoid - diagnostic imaging ; Arthritis, Rheumatoid - drug therapy ; Biological and medical sciences ; Blood Sedimentation ; Bone marrow ; Bone Marrow Diseases - diagnosis ; Bone Marrow Diseases - diagnostic imaging ; Bone Marrow Diseases - drug therapy ; Clinical medicine ; Data collection ; Disease Progression ; Diseases of the osteoarticular system ; Edema - diagnosis ; Edema - diagnostic imaging ; Edema - drug therapy ; Female ; Finger Joint - diagnostic imaging ; Finger Joint - pathology ; Follow-Up Studies ; Gangrene ; Humans ; Inflammatory joint diseases ; Laboratories ; Logistic Models ; Magnetic Resonance Imaging ; Male ; Medical prognosis ; Medical sciences ; Mens health ; Middle Aged ; NMR ; Nuclear magnetic resonance ; Phosphatase ; Predictive Value of Tests ; Radiography ; Rheumatoid arthritis ; Studies ; Synovitis - diagnostic imaging ; Synovitis - pathology ; Tenosynovitis - diagnostic imaging ; Tenosynovitis - pathology ; Tumor necrosis factor-TNF ; Wrist Joint - diagnostic imaging ; Wrist Joint - pathology</subject><ispartof>Annals of the rheumatic diseases, 2008-06, Vol.67 (6), p.794-800</ispartof><rights>2008 BMJ Publishing Group and European League Against Rheumatism</rights><rights>2008 INIST-CNRS</rights><rights>Copyright: 2008 2008 BMJ Publishing Group and European League Against Rheumatism</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b426t-7bb9e82103a667cc613ec887db42d703045ff23d6ca9352dba26a7805695a3363</citedby><cites>FETCH-LOGICAL-b426t-7bb9e82103a667cc613ec887db42d703045ff23d6ca9352dba26a7805695a3363</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://ard.bmj.com/content/67/6/794.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://ard.bmj.com/content/67/6/794.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3182,23551,27903,27904,77346,77377</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20348786$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17981915$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haavardsholm, E A</creatorcontrib><creatorcontrib>Bøyesen, P</creatorcontrib><creatorcontrib>Østergaard, M</creatorcontrib><creatorcontrib>Schildvold, A</creatorcontrib><creatorcontrib>Kvien, T K</creatorcontrib><title>Magnetic resonance imaging findings in 84 patients with early rheumatoid arthritis: bone marrow oedema predicts erosive progression</title><title>Annals of the rheumatic diseases</title><addtitle>Ann Rheum Dis</addtitle><description>Objectives:To examine the spectrum and severity of magnetic resonance imaging (MRI) findings in patients with early rheumatoid arthritis (RA), and to investigate the predictive value of MRI findings for subsequent development of conventional radiographic (CR) damage and MRI erosions.Methods:84 consecutive patients with RA with disease duration <1 year were enrolled. Patients were treated according to standard clinical practice, and evaluated at baseline, 3, 6 and 12 months by core measures of disease activity, conventional radiographs of both hands and wrists and MRI of the dominant wrist. MR images were scored according to the OMERACT rheumatoid arthritis magnetic resonance imaging score (RAMRIS), and conventional radiographs according to the van der Heijde modified Sharp score.Results:MRI findings reflecting inflammation (synovitis, bone marrow oedema and tenosynovitis) decreased during follow-up, while there was a small increase in MRI erosion score and CR damage. The proportion of patients with erosive progression at 1 year was 48% for conventional radiography and 66% for MRI. Baseline MRI bone marrow oedema (score >2 RAMRIS units) was identified as an independent predictor of both CR (odds ratio = 2.77 (95% confidence interval (CI) 1.06 to 7.21)) and MRI erosive progression (B = 0.21 (95% CI 0.08 to 0.34)).Conclusions:MRI findings were common in early RA, and MRI bone marrow oedema was an independent predictor of radiographic damage. These results suggest that MRI scans of the dominant wrist may help clinicians to determine which patients need early and aggressive treatment to avoid subsequent joint damage.</description><subject>Aged</subject><subject>Antirheumatic Agents - therapeutic use</subject><subject>Arthritis, Rheumatoid - diagnosis</subject><subject>Arthritis, Rheumatoid - diagnostic imaging</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Biological and medical sciences</subject><subject>Blood Sedimentation</subject><subject>Bone marrow</subject><subject>Bone Marrow Diseases - diagnosis</subject><subject>Bone Marrow Diseases - diagnostic imaging</subject><subject>Bone Marrow Diseases - drug therapy</subject><subject>Clinical medicine</subject><subject>Data collection</subject><subject>Disease Progression</subject><subject>Diseases of the osteoarticular system</subject><subject>Edema - diagnosis</subject><subject>Edema - diagnostic imaging</subject><subject>Edema - drug therapy</subject><subject>Female</subject><subject>Finger Joint - diagnostic imaging</subject><subject>Finger Joint - pathology</subject><subject>Follow-Up Studies</subject><subject>Gangrene</subject><subject>Humans</subject><subject>Inflammatory joint diseases</subject><subject>Laboratories</subject><subject>Logistic Models</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Mens health</subject><subject>Middle Aged</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Phosphatase</subject><subject>Predictive Value of Tests</subject><subject>Radiography</subject><subject>Rheumatoid arthritis</subject><subject>Studies</subject><subject>Synovitis - diagnostic imaging</subject><subject>Synovitis - pathology</subject><subject>Tenosynovitis - diagnostic imaging</subject><subject>Tenosynovitis - pathology</subject><subject>Tumor necrosis factor-TNF</subject><subject>Wrist Joint - diagnostic imaging</subject><subject>Wrist Joint - 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diagnostic imaging</topic><topic>Synovitis - pathology</topic><topic>Tenosynovitis - diagnostic imaging</topic><topic>Tenosynovitis - pathology</topic><topic>Tumor necrosis factor-TNF</topic><topic>Wrist Joint - diagnostic imaging</topic><topic>Wrist Joint - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haavardsholm, E A</creatorcontrib><creatorcontrib>Bøyesen, P</creatorcontrib><creatorcontrib>Østergaard, M</creatorcontrib><creatorcontrib>Schildvold, A</creatorcontrib><creatorcontrib>Kvien, T K</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of the rheumatic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haavardsholm, E A</au><au>Bøyesen, P</au><au>Østergaard, M</au><au>Schildvold, A</au><au>Kvien, T K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Magnetic resonance imaging findings in 84 patients with early rheumatoid arthritis: bone marrow oedema predicts erosive progression</atitle><jtitle>Annals of the rheumatic diseases</jtitle><addtitle>Ann Rheum Dis</addtitle><date>2008-06-01</date><risdate>2008</risdate><volume>67</volume><issue>6</issue><spage>794</spage><epage>800</epage><pages>794-800</pages><issn>0003-4967</issn><eissn>1468-2060</eissn><coden>ARDIAO</coden><abstract>Objectives:To examine the spectrum and severity of magnetic resonance imaging (MRI) findings in patients with early rheumatoid arthritis (RA), and to investigate the predictive value of MRI findings for subsequent development of conventional radiographic (CR) damage and MRI erosions.Methods:84 consecutive patients with RA with disease duration <1 year were enrolled. Patients were treated according to standard clinical practice, and evaluated at baseline, 3, 6 and 12 months by core measures of disease activity, conventional radiographs of both hands and wrists and MRI of the dominant wrist. MR images were scored according to the OMERACT rheumatoid arthritis magnetic resonance imaging score (RAMRIS), and conventional radiographs according to the van der Heijde modified Sharp score.Results:MRI findings reflecting inflammation (synovitis, bone marrow oedema and tenosynovitis) decreased during follow-up, while there was a small increase in MRI erosion score and CR damage. The proportion of patients with erosive progression at 1 year was 48% for conventional radiography and 66% for MRI. Baseline MRI bone marrow oedema (score >2 RAMRIS units) was identified as an independent predictor of both CR (odds ratio = 2.77 (95% confidence interval (CI) 1.06 to 7.21)) and MRI erosive progression (B = 0.21 (95% CI 0.08 to 0.34)).Conclusions:MRI findings were common in early RA, and MRI bone marrow oedema was an independent predictor of radiographic damage. These results suggest that MRI scans of the dominant wrist may help clinicians to determine which patients need early and aggressive treatment to avoid subsequent joint damage.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and European League Against Rheumatism</pub><pmid>17981915</pmid><doi>10.1136/ard.2007.071977</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Antirheumatic Agents - therapeutic use Arthritis, Rheumatoid - diagnosis Arthritis, Rheumatoid - diagnostic imaging Arthritis, Rheumatoid - drug therapy Biological and medical sciences Blood Sedimentation Bone marrow Bone Marrow Diseases - diagnosis Bone Marrow Diseases - diagnostic imaging Bone Marrow Diseases - drug therapy Clinical medicine Data collection Disease Progression Diseases of the osteoarticular system Edema - diagnosis Edema - diagnostic imaging Edema - drug therapy Female Finger Joint - diagnostic imaging Finger Joint - pathology Follow-Up Studies Gangrene Humans Inflammatory joint diseases Laboratories Logistic Models Magnetic Resonance Imaging Male Medical prognosis Medical sciences Mens health Middle Aged NMR Nuclear magnetic resonance Phosphatase Predictive Value of Tests Radiography Rheumatoid arthritis Studies Synovitis - diagnostic imaging Synovitis - pathology Tenosynovitis - diagnostic imaging Tenosynovitis - pathology Tumor necrosis factor-TNF Wrist Joint - diagnostic imaging Wrist Joint - pathology |
| title | Magnetic resonance imaging findings in 84 patients with early rheumatoid arthritis: bone marrow oedema predicts erosive progression |
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