Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.


A Prediction Rule for Disease Outcome in Patients with Undifferentiated Arthritis by MRI of the Wrists and Finger Joints and Serologic Autoantibodies: Second Report Regarding to the Utility of Plain MRI

Tamai,  Mami, Kawakami,  Atsushi, Uetani,  Masataka, Arima,  Kazuhiko, Fujikawa,  Keita, Iwamoto,  Naoki, Kawashiri,  Shin-ya

Purpose:

We have recently reported a prediction rule for disease outcome in patients with undifferentiated arthritis (UA) by MRI of the wrists and finger joints and serologic autoantibodies in Arthritis Rheum (61; 772–778, 2009). In this report, the presence of synovitis, bone edema and bone erosion were considered by both plain and Gd-enhanced MRI. If plain MRI is enough for the consideration, a cost as well as adverse events due to Gd can be reduced. To investigate whether plain MRI of the wrists and finger joints with serologic autoantibodies at entry is equally efficient for the prediction of development of RA at 1 year, as comparison with our recent report obtaining by plain and Gd-enhanced MRI (Arthritis Rheum 2009; 61: 772–778).

Method:

The patients population is exactly same as our recent report which contains 129 UA patients. Seventy-five progressed to RA at 1 year (RA group) whereas 54 did not develop in RA at 1 year (non-RA group). The presence of synovitis, bone edema and bone erosion in MRI of the wrists and finger joints of both hands, read by plain MRI, was compared with those read by both plain and Gd-enhanced MRI. We also tried to find a suitability of plain MRI-interpreted features at entry, with serologic autoantibodies, for the prediction toward RA at 1 year.

Results:

As compared with the features interpreted by both plain and Gd-enhanced MRI, symmetrical synovitis as well as bone erosion interpreted by plain MRI were more frequently distributed in non-RA group though a significantly high distribution of bone edema in RA group was still found in plain MRI. Accordingly, in UA patients positive with both plain MRI-proven bone edema and anti-CCP antibodies who were considered to have progressed to RA at 1 year, PPV was still in 100% of 24 patients.

Conclusion:

Even in plain MRI of the wrists and finger joints, bone edema is a RA-prone feature as compared with symmetrical synovitis and bone erosion. Plain MRI can be an alternative to Gd-enhanced MRI to examine the progression of RA among patients with UA.

To cite this abstract, please use the following information:
Tamai, Mami, Kawakami, Atsushi, Uetani, Masataka, Arima, Kazuhiko, Fujikawa, Keita, Iwamoto, Naoki, et al; A Prediction Rule for Disease Outcome in Patients with Undifferentiated Arthritis by MRI of the Wrists and Finger Joints and Serologic Autoantibodies: Second Report Regarding to the Utility of Plain MRI [abstract]. Arthritis Rheum 2009;60 Suppl 10 :356
DOI: 10.1002/art.25439

Abstract Supplement

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