Delayed contrast MR may predict rheumatoid arthritis

Delayed gadolinium enhancement during MR imaging of cartilage of the metacarpophalangeal joints in patients with rheumatoid arthritis is feasible at 3T and may help predict rheumatoid arthritis.

The procedure involves T1 mapping following intravenous contrast. Concentration of the contrast in cartilage is an indirect measure of glycosaminoglycan (GAG), a component of hyaline cartilage.

The absence of GAG during delayed-contrast MR may help assess cartilage degeneration in the morphologically normal-appearing second and third metacarpophalangeal joints in patients.

Phalangeal and metacarpal delayed-enhancement values in patients with rheumatoid arthritis were significantly lower than in control subjects, although joint thickness was comparable in both groups, according to the researchers. Cartilage damage is a common occurrence in rheumatoid arthritis patients, so imaging may help for diagnosis and treatment purposes (Radiol 2010;257:441-447).