Aims and objectives
The clinical presentation and laboratory results of patients referred to the rheumatologist with the initial diagnosis of arthritis are in many cases equivocal.
Diagnostic imaging can help the clinician to confirm or exclude the diagnosis of rheumatoid arthritis,
seronegative spondyloarthropathy or other diseases.
The study aim was to analyze the predictive value of wrist MRI and ultrasound scans in early undifferentiated arthritis (UA).
Methods and materials
MRI scans were assessed in 54 UA (undiffrenciated arthritis)patients,
according to the OMERACT rheumatoid arthritis MRI scoring system (RAMRIS) recommended by the European League Against Rheumatism.
It included assessment of the presence oferosions(Fig.
bone marrow oedema (Fig.2),
3 and Fig.
4 and Fig 6)of thesynoviumafter i.v.
contrast medium injection as a sign of synovitis in the wrist area and MCPjoints.
The ultrasound assessment included detection of joint and tendon sheath effusion,
synovial hypertrophy and hypervascularity.
Based on the subsequent clinical...
The analysis revealed significant differences in the total MRI OMERACT-RAMRIS score between those groups of patients,
with the highest average score for RA patients - 17.3,
followed by SpA and UA patients with the scores 7.3 and 6.7 respectively.
For “unconfirmed arthritis” patients the average total MRI score was 2.8.
The total MRI score exceeding 20 allowed for distinguishing RA from UA with 91.7% specificity and 27.8% sensitivity.
The total ultrasound score exceeding 5 allowed for the differentiation of RA from the UA with the...
we have confirmed that MRI and ultrasound scans of the wrist can be helpful in prediction of differentiation of RA from early UA patients with high specificity although the sensitivity of detection was low.
Work was supported by the Polish National Science Centre’s grant (N N402 640 440)
An introduction to the EULAR–OMERACT rheumatoid arthritis MRI reference image atlas.Annals of the Rheumatic Diseases,64(Suppl 1),
The EULAR–OMERACT rheumatoid arthritis MRI reference image atlas: the wrist joint.Annals of the Rheumatic Diseases,64(Suppl 1),