Drs. Tamai and Kawakami contributed equally to this work.
Comparative study of the detection of joint injury in early-stage rheumatoid arthritis by magnetic resonance imaging of the wrist and finger joints and physical examination
Article first published online: 25 FEB 2011
Copyright © 2011 by the American College of Rheumatology
Arthritis Care & Research
Volume 63, Issue 3, pages 436–439, March 2011
How to Cite
Tamai, M., Kawakami, A., Iwamoto, N., Kawashiri, S.-Y., Fujikawa, K., Aramaki, T., Kita, J., Okada, A., Koga, T., Arima, K., Kamachi, M., Yamasaki, S., Nakamura, H., Ida, H., Origuchi, T., Takao, S., Aoyagi, K., Uetani, M. and Eguchi, K. (2011), Comparative study of the detection of joint injury in early-stage rheumatoid arthritis by magnetic resonance imaging of the wrist and finger joints and physical examination. Arthritis Care Res, 63: 436–439. doi: 10.1002/acr.20395
- Issue published online: 25 FEB 2011
- Article first published online: 25 FEB 2011
- Accepted manuscript online: 15 NOV 2010 11:14AM EST
- Manuscript Accepted: 26 OCT 2010
- Manuscript Received: 1 JUN 2010
- The Ministry of Health, Labour and Welfare, Japan
To verify whether magnetic resonance imaging (MRI)–proven joint injury is sensitive as compared with joint injury determined by physical examination.
MRI of the wrist and finger joints of both hands was examined in 51 early-stage rheumatoid arthritis (RA) patients by both plain and gadolinium diethylenetriaminepentaacetic acid–enhanced MRI. Synovitis, bone edema, and bone erosion (the latter two included as bone lesions at the wrist joints); metacarpophalangeal joints; and proximal interphalangeal joints were considered as MRI-proven joint injury. Japan College of Rheumatology–certified rheumatologists had given a physical examination just before the MRI study. The presence of tender and/or swollen joints in the same fields as MRI was considered as joint injury on physical examination. The association of MRI-proven joint injury with physical examination–proven joint injury was examined.
A total of 1,110 sites were available to be examined. MRI-proven joint injury was found in 521 sites, whereas the other 589 sites were normal. Physical examination–proven joint injury was found in 305 sites, which was significantly low as compared with MRI-proven joint injury (P = 1.1 × 10−12 versus MRI). Joint injury on physical examination was not found in 81.5% of the sites where MRI findings were normal. Furthermore, an association of the severity of MRI-proven joint injury with that of joint injury on physical examination was clearly demonstrated (P = 1.6 × 10−15, rs = 0.469).
Our present data suggest that MRI is not only sensitive but accurately reflects the joint injury in patients with early-stage RA.