Skip to main content

Advertisement

SpringerLink
Log in

Early rheumatoid arthritis—do we really know what it means? Consistency and distribution of MRI findings according to different definitions for early rheumatoid arthritis

  • Brief Report
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

This study aims to characterize patients with early rheumatoid arthritis (RA) based on different definitions of early RA (disease duration, fulfillment of the American College of Rheumatology (ACR) criteria), and to determine whether these different definitions affect magnetic resonance imaging (MRI) findings of the hand. A cohort of 58 patients with early RA previously described was re-evaluated. There were 43 women and 15 men with a median age of 49 years, a disease duration of less than 2 years, and negative radiographs who were followed up for 6–41 months. MR images of the hand and wrist of these patients were retrospectively evaluated for the presence of synovitis, erosions, and tenosynovitis. The presence and distribution of these MRI findings were analyzed in three groups: fulfillment of 1987-ACR criteria, 6-month disease duration, and 12-month disease duration. Median disease duration was 11 months (range 1–24 months). Thirty patients (52%) fulfilled the ACR criteria. More patients fulfilling ACR criteria had MCP erosions and carpal synovitis compared with those not fulfilling the criteria; however, the difference was not significant. No significant difference was seen in the prevalence of synovitis, tenosynovitis, or erosions between the three groups. Patients with early RA of 2-years duration and negative hand X-ray findings are a homogenous group, regarding their MRI findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Lard LR, Visser H, Speyer I, vander Horst-Bruinsma IE, Zwinderman AH, Breedveld FC, Hazes JM (2001) Early versus delayed treatment in patients with recent-onset rheumatoid arthritis: comparison of two cohorts who received different treatment strategies. Am J Med 111:446–451

    Article  PubMed  CAS  Google Scholar 

  2. Green M, Marzo-Ortega H, McGonagle D, Wakefield R, Proudman S, Conaghan P, Gooi J, Emery P (1999) Persistence of mild, early inflammatory arthritis: the importance of disease duration, rheumatoid factor, and the shared epitope. Arthritis Rheum 42:2184–2188

    Article  PubMed  CAS  Google Scholar 

  3. Benton N, Stewart N, Crabbe J, Robinson E, Yeoman S, McQueen FM (2004) MRI of the wrist in early rheumatoid arthritis can be used to predict functional outcome at 6 years. Ann Rheum Dis 63:555–561

    Article  PubMed  CAS  Google Scholar 

  4. van Aken J, van Dongen H, le Cessie S, Allaart CF, Breedveld FC, Huizinga TW (2006) Comparison of long term outcome of patients with rheumatoid arthritis presenting with undifferentiated arthritis or with rheumatoid arthritis: an observational cohort study. Ann Rheum Dis 65:20–25

    Article  PubMed  Google Scholar 

  5. Tamai M, Kawakami A, Uetani M et al (2006) The presence of anti-cyclic citrullinated peptide antibody is associated with magnetic resonance imaging detection of bone marrow oedema in early stage rheumatoid arthritis. Ann Rheum Dis 65:133–134

    Article  PubMed  CAS  Google Scholar 

  6. Sugimoto H, Takeda A, Hyodoh K (2000) Early-stage rheumatoid arthritis: prospective study of the effectiveness of MR imaging for diagnosis. Radiology 216:569–575

    PubMed  CAS  Google Scholar 

  7. Sugimoto H, Takeda A, Masuyama J, Furuse M (1996) Early-stage rheumatoid arthritis: diagnostic accuracy of MR imaging. Radiology 198:185–192

    PubMed  CAS  Google Scholar 

  8. Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  PubMed  CAS  Google Scholar 

  9. Harrison BJ, Symmons DP, Barrett EM, Silman AJ (1998) The performance of the 1987 ARA classification criteria for rheumatoid arthritis in a population based cohort of patients with early inflammatory polyarthritis. American Rheumatism Association. J Rheumatol 25:2324–2330

    PubMed  CAS  Google Scholar 

  10. Savnik A, Malmskov H, Thomsen HS, Bretlau T, Graff LB, Nielsen H, Danneskiold-Samsoe B, Boesen J, Bliddal H (2001) MRI of the arthritic small joints: comparison of extremity MRI (0.2 T) vs high-field MRI (1.5 T). Eur Radiol 11:1030–1038

    Article  PubMed  CAS  Google Scholar 

  11. Aletaha D, Neogi T, Silman AJ et al (2010) 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62:2569–2581

    Article  PubMed  Google Scholar 

  12. Aletaha D, Neogi T, Silman AJ et al (2010) 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 69:1580–1588

    Article  PubMed  Google Scholar 

  13. Eshed I, Feist E, Althoff CE, Hamm B, Konen E, Burmester GR, Backhaus M, Hermann KG (2009) Tenosynovitis of the flexor tendons of the hand detected by MRI: an early indicator of rheumatoid arthritis. Rheumatology 48:887–891

    Article  PubMed  Google Scholar 

  14. Eshed I, Althoff CE, Schink T, Scheel AK, Schirmer C, Backhaus M, Lembcke A, Bollow M, Hamm B, Hermann KG (2006) Low-field MRI for assessing synovitis in patients with rheumatoid arthritis. Impact of Gd-DTPA dose on synovitis scoring. Scand J Rheumatol 35:277–282

    Article  PubMed  CAS  Google Scholar 

  15. Ejbjerg B, Narvestad E, Jacobsen S, Thomsen HS, Ostergaard M (2005) Optimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints: a comparison with conventional high-field MRI and radiography. Ann Rheum Dis 64:1280–1287

    Article  PubMed  CAS  Google Scholar 

  16. Ostergaard M, Peterfy C, Conaghan P et al (2003) OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Core set of MRI acquisitions, joint pathology definitions, and the OMERACT RA-MRI scoring system. J Rheumatol 30:1385–1386

    PubMed  Google Scholar 

  17. Schirmer C, Scheel AK, Althoff CE, Schink T, Eshed I, Lembcke A, Burmester GR, Backhaus M, Hamm B, Hermann KG (2007) Diagnostic quality and scoring of synovitis, tenosynovitis and erosions in low-field MRI of patients with rheumatoid arthritis: a comparison with conventional MRI. Ann Rheum Dis 66:522–529

    Article  PubMed  Google Scholar 

  18. Banal F, Dougados M, Combescure C, Gossec L (2009) Sensitivity and specificity of the American College of Rheumatology 1987 criteria for the diagnosis of rheumatoid arthritis according to disease duration: a systematic literature review and meta-analysis. Ann Rheum Dis 68:1184–1191

    Article  PubMed  CAS  Google Scholar 

  19. Amjadi-Begvand S, Khanna D, Park GS, Bulpitt KJ, Wong WK, Paulus HE (2004) Dating the “window of therapeutic opportunity” in early rheumatoid arthritis: accuracy of patient recall of arthritis symptom onset. J Rheumatol 31:1686–1692

    PubMed  Google Scholar 

  20. Resnick D, Kransdorf MJ (2005) Bone and joint imaging, 3rd edn. Elsevier Saunders, Philadelphia, xiv, 1522 p

    Google Scholar 

  21. Boutry N, Larde A, Lapegue F, Solau-Gervais E, Flipo RM, Cotten A (2003) Magnetic resonance imaging appearance of the hands and feet in patients with early rheumatoid arthritis. J Rheumatol 30:671–679

    PubMed  Google Scholar 

  22. Klarlund M, Ostergaard M, Jensen KE, Madsen JL, Skjodt H, Lorenzen I (2000) Magnetic resonance imaging, radiography, and scintigraphy of the finger joints: one year follow up of patients with early arthritis. The TIRA Group. Ann Rheum Dis 59:521–528

    Article  PubMed  CAS  Google Scholar 

  23. Tehranzadeh J, Ashikyan O, Dascalos J (2004) Advanced imaging of early rheumatoid arthritis. Radiol Clin North Am 42:89–107

    Article  PubMed  Google Scholar 

  24. Ostendorf B, Scherer A, Modder U, Schneider M (2004) Diagnostic value of magnetic resonance imaging of the forefeet in early rheumatoid arthritis when findings on imaging of the metacarpophalangeal joints of the hands remain normal. Arthritis Rheum 50:2094–2102

    Article  PubMed  Google Scholar 

  25. McQueen FM (2000) Magnetic resonance imaging in early inflammatory arthritis: what is its role? Rheumatology (Oxford) 39:700–706

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The use of the MR imaging device was possible due to a research contract between Charité Medical School and Esaote Biomedica SA, Genoa, Italy.

Disclosures

None.

Author information

Authors and Affiliations

  1. Department of Radiology, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Iris Eshed

  2. Department of Rheumatology and Clinical Immunology, Charité Medical School, Berlin, Germany

    Eugen Feist, Marina Backhaus & Gerd R. Burmester

  3. Department of Radiology, Charité Medical School, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany

    Christian E. Althoff, Bernd Hamm & Kay-Geert A. Hermann

Authors
  1. Iris Eshed
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eugen Feist
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christian E. Althoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marina Backhaus
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gerd R. Burmester
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bernd Hamm
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kay-Geert A. Hermann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kay-Geert A. Hermann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Eshed, I., Feist, E., Althoff, C.E. et al. Early rheumatoid arthritis—do we really know what it means? Consistency and distribution of MRI findings according to different definitions for early rheumatoid arthritis. Clin Rheumatol 30, 551–555 (2011). https://doi.org/10.1007/s10067-010-1631-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-010-1631-z

Keywords

Search

Navigation