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MRI, Not Radiography, Detects Inflammation in Early Arthritis

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Subclinical inflammation of non-swollen joints not seen on radiographs can be detected on MRI.

Subclinical inflammation of non-swollen joints can be detected by MRI in patients with early arthritis, even if there is no evidence of progression as per radiography, according to a study published in the Annals of the Rheumatic Diseases.

Researchers from the Netherlands sought to demonstrate that MRI could detect inflammation in early arthritis and its relevance with regard to radiographic progression.

A total of 113 patients with early arthritis (1,130 joints) were examined and underwent MRI and radiographs at baseline and again at one-year follow-up. The MRIs were read by two readers who scored for synovitis, bone marrow edema (BME) and tenosynovitis according to Rheumatoid Arthritis (RA) Magnetic Resonance Imaging (MRI) Scoring System (RAMRIS).

“On patient level, BME, synovitis and tenosynovitis were associated with radiographic progression, independent of known risk factors,” wrote the authors.[[{"type":"media","view_mode":"media_crop","fid":"26741","attributes":{"alt":"MRI","class":"media-image media-image-right","id":"media_crop_7123215057745","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2527","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 150px; width: 150px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":" ","typeof":"foaf:Image"}}]]

Subclinical inflammation (≥1 MRI-inflammation feature present) was detected in 232 of the 932 non-swollen joints (26 percent), which were distributed among 91 percent of the patients. Radiographic progression was present in 4 percent of non-swollen joints with subclinical inflammation compared to 1 percent of non-swollen joints without subclinical inflammation. The researchers noted similar observations BME, synovitis and tenosynovitis.

The authors concluded that while the radiographic progression of swelling in the joints in early arthritis was infrequent, subclinical inflammation had increased and was seen by MRI.

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