Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Evaluation of the Patients with Early Arthritis by 2010 RA Criteria in Conjunction with MRI of Wrists and Finger Joints.
Tamai1, Mami, Arima1, Kazuhiko, Uetani1, Masataka, Iwamoto1, Naoki, Kita1, Junko, Okada1, Akitomo, Koga2, Tomohiro
Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
Nagasaki University School of Medicine, Nagasaki, Japan
Kurume University School of Medicine, Kurume, Japan
Sasebo City General Hospital, Sasebo, Nagasaki, Japan
2010 rheumatoid arthritis (RA) criteria was published last year and are going to be applied in the clinical field of rheumatology. We have also been investigating a prediction rule for RA using magnetic resonance imaging (MRI) of wrists and finger joints at Nagasaki University. We have tried to examine the utility of MRI of wrists and finger joints in conjunction with 2010 RA criteria toward patients with early undifferentiated arthritis at our cohort.
Two hundred patients with early arthritis, who are not better explained by other diagnosis than RA at entry whose mean duration of symptoms is 3 months, were consecutively enrolled into this study. Japan College of Rheumatology-certified rheumatologists have examined the patients for at least 1 year. At entry, all of the patients were examined by gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA)-enhanced MRI of both wrists and finger joints. Patients were evaluated by 2010 RA criteria at the initial visit. Diagnosis of RA was defined by the initiation of disease-modifying antirheumatic drugs (DMARDs) therapy during the first year. Diagnostic performance of 2010 RA criteria in conjunction with MRI of wrists and finger joints were investigated.
At least one swollen joints were found in 138 patients at entry, being examined for further analysis. 2010 RA criteria classified RA at sensitivity 76.3 %, specificity 70.7 %, positive predictive value (PPV) 86.0 %, negative predictive value (NPV) 55.8 % and accuracy 76.4 %. However, twenty-three out of 52 patients, who had not been classified as RA at entry by 2010 RA criteria, developed RA at 1 year. Bone edema was defined as most RA-specific MRI finding. If we considered the patients to have RA in case bone edema is found, the diagnosis of RA was made at sensitivity 87.6% and specificity 65.9% in whom 2010 RA criteria at entry was less than 6.
MRI findings, especially bone edema, are quite useful to assist the diagnostic performance of 2010 RA criteria.
To cite this abstract, please use the following information:
Tamai, Mami, Arima, Kazuhiko, Uetani, Masataka, Iwamoto, Naoki, Kita, Junko, Okada, Akitomo, et al; Evaluation of the Patients with Early Arthritis by 2010 RA Criteria in Conjunction with MRI of Wrists and Finger Joints. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :318