Korean J Intern Med.  2019 May;34(3):651-659. 10.3904/kjim.2016.271.

Magnetic resonance imaging-assessed synovial and bone changes in hand and wrist joints of rheumatoid arthritis patients

• Lee KA
• Min SH
• Kim TH
• Lee SH
• Kim HR

• KMID: 2448358
• DOI: http://doi.org/10.3904/kjim.2016.271

Abstract

BACKGROUND/AIMS
Magnetic resonance imaging (MRI) is a sensitive and useful method for the detection of synovitis and joint destruction in rheumatoid arthritis (RA) patients. However, the patterns of MRI-detected bone erosion, bone marrow edema (BME), synovitis, and tenosynovitis have received insufficient attention. Therefore, this study evaluated the patterns of bone erosion, BME, synovitis, and tenosynovitis, and calculated the RA-MRI score (RAMRIS) of patients with RA at the carpal and metacarpophalangeal (MCP) joints using MRI.
METHODS
MRI datasets from 43 RA patients were analyzed. All patients had undergone MRI of one wrist. In addition, 36 patients had MCP joint images taken, and three had also received MRI of the contralateral wrist and MCP joints. The MR images were evaluated for bone erosion, BME, and synovitis in consensus by two blinded readers according to the Outcome Measures in Rheumatology Clinical Trials (OMERACT) RAMRIS. The MRI-detected tenosynovitis was evaluated based on Haavardsholm's tenosynovitis score.
RESULTS
The capitate, lunate, triquetrum, and hamate bones were the most common sites of erosion and BME and showed the highest RAMRIS erosion and BME scores. Moreover, MRI-detected tenosynovitis was present in 78.3% of all patients with RA, and the extensor compartment 4 and flexor digitorum profundus and superficialis were frequently affected.
CONCLUSIONS
This study identified the distribution and prevalence of MRI-detected bone erosion, BME, synovitis, and tenosynovitis of the wrist and MCP joints in RA patients. The patterns of the MRI-detected abnormalities may help to select sites for the application of MRI protocols in clinical trials and practice.

Keyword

Arthritis, rheumatoid; Magnetic resonance imaging; Synovitis; Tenosynovitis

MeSH Terms

Arthritis, Rheumatoid*
Bone Marrow
Consensus
Dataset
Edema
Hamate Bone
Hand*
Humans
Joints
Magnetic Resonance Imaging
Methods
Outcome Assessment (Health Care)
Prevalence
Rheumatology
Synovitis
Tenosynovitis
Wrist Joint*
Wrist*