Learning objectives
1.
Briefly discuss the epidemiology,
pathophysiology and clinical presentation of rheumatoid arthritis
2.
Review the common and uncommon imaging manifestations of rheumatoid arthritis on MRI with radiographic correlation when appropriate
3.
Briefly review differential diagnostic considerations with regards to the MRI findings in rheumatoid arthritis
Background
Epidemiology:
- Prevalence of RA 0.5-1.0% in general population
- In 2005,
approximately 1.5 million US adults (0.6%) had RA
- The most recent US data on incidence of RA is from the Rochester Epidemiology Project:
From 1995-2007,
41 per 100,000 people were diagnosed with RA each year
Increased incidence with age:8.7 per 100,000 people among those aged 18-34 compared with 54 per 100,000 among those aged ≥ 85 years
Incidence peaked among people aged65-74 years:89 per 100,000
From 1995 to 2007 rates increased by...
Imaging findings OR Procedure details
Bone Erosions:
- Due to proliferative synovium
- Definition on MRI: Sharply marginated bone lesion,
juxtaarticular in location and with evidence of a cortical break seen on at least one plane
- Early erosions will be seen at the bare areas of the joint,
that is the intra-articular portion which is not covered by articular cartilage
- While RA is a bilateral symmetric disease,
erosions are less commonly bilateral compared with synovitis and tenosynovitis
- Commonly involved bones include:
Radial aspect of 2nd and 3rd...
Conclusion
1.
Rheumatoid arthritis is typically thought of as an autoimmune disease presenting with erosions and synovitis/pannus formation of the hands and wrist
2.
In this educational exhibit we demonstrated the not infrequent presence of pathology in other joints as well as numerous other (albeit less common) MR imaging manifestations of rheumatoid arthritis including tenosynovitis,
bursitis and rice bodies
3.
These findings are particularly well seen by MRI and should be looked for in a patient with a history of rheumatoid arthritis
References
1.
Abd El-Azeem M,
Taha HA,
El-Sherif AM Role of MRI in evaluation of hip joint involvement in juvenile idiopathic arthritis.
The Egyptian Rheumatologist 2012; 34:75-82
2.
Boutry N,
Morel M,
Flipo RM,
et al.
Early rheumatoid arthritis: a review of MRI and sonographic findings.
AJR Am J Roentgenol 2007; 189:1502-1509
3.
Center for Disease Control and Prevention.
Rheumatoid Arthritis.
http://www.cdc.gov/arthritis/basics/rheumatoid.htm.
Accessed December 28 2012
4.
Conaghan PG,
Bird P,
McQueen F,
et al.
The OMERACT MRI inflammatory arthritis group: advances and future research priorities....
Personal Information
Rikesh J.
Makanji,
M.D.
Musculoskeletal Radiology Fellow
University of South Florida
Morsani College of Medicine
Contact:
[email protected]
