Magnetic resonance imaging in rheumatoid arthritis

2020 ◽  
pp. 207-218
Author(s):  
Mikkel Østergaard ◽  
Philip G. Conaghan ◽  
Charles Peterfy
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissue ◽  
Joint Damage ◽  
Resonance Imaging ◽  
Established Disease ◽  
Tissue Changes ◽  
Magnetic Resonance Imaging Mri ◽  
Soft Tissue Changes

In rheumatoid arthritis (RA), early diagnosis combined with early initiation of appropriate therapy and tight control of inflammation have been recognized as essential for optimal clinical outcomes. Conventional radiography, though able to detect structural joint damage in patients with established disease, is not sensitive in detecting early disease manifestations such as soft tissue changes and bone damage at its earliest stages. Magnetic resonance imaging (MRI) allows multiplanar tomographic imaging of the body in any plane without geometric distortions associated with projectional techniques, such as radiography, and no ionizing radiation is used. Early bone involvement and inflammatory soft tissue changes of synovitis and tenosynovitis, which are not detectable by conventional clinical, biochemical, and radiographic methods, can be directly visualized and evaluated in detail by MRI. MRI is an increasingly available sensitive technique which has documented utility in the diagnosis, monitoring, and prognostication of patients with RA, and important new knowledge and technical improvements are continuously being acquired.

Patterns of Magnetic Resonance Imaging Bone Erosion in Rheumatoid Arthritis — Which Bones Are Most Frequently Involved and Show the Most Change?: Figure 1.

2011 ◽  
Vol 38 (9) ◽  
pp. 2014-2017 ◽  
Author(s):  
MIKKEL ØSTERGAARD ◽  
UFFE MØLLER DØHN ◽  
ANNE DUER-JENSEN ◽  
MERETE LUND HETLAND ◽  
KIM HØRSLEV-PETERSEN ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disease Duration ◽  
Bone Erosion ◽  
Resonance Imaging ◽  
Early Ra ◽  
Established Disease ◽  
Magnetic Resonance Imaging Mri ◽  
Erosive Progression

Objective.To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA).Methods.MRI datasets from 258 RA patients [126 with early RA (disease duration < 6 months)] were analyzed, of whom 223, including 126 with early RA, had 1-year followup MRI. All patients had MRI of one wrist, whereas 86 patients had additional images of 2nd–5th MCP joints, and 46 patients additional images of the contralateral wrist. MRI were evaluated blinded by one reader, according to the OMERACT RA MRI scoring system (RAMRIS) for erosions, and presence/absence of erosions was noted in each bone, as was presence/absence of erosive progression.Results.The capitate, ulna, lunate, triquetrum, and scaphoid were the 5 bones with both most frequent baseline erosions and most frequently demonstrated erosive progression. No bones were without erosions. Patterns of erosions and progression were similar in early and established RA. No major difference between dominant and nondominant wrists was detected. In the fingers, the 2nd–3rd MCP joint most frequently displayed erosions and erosive progression.Conclusion.The distribution and frequency of bone erosion and erosive progression as detected by MRI in RA wrists and MCP joints were identified. No pattern differences between early versus established disease and dominant versus nondominant sides were detected. No bones showed erosive progression. Thus, no self-evident simplification of the RAMRIS erosion score was identified. Bone involvement patterns may be considered, when joints are selected for MRI protocols for clinical trials and practice.

Vertebral osteoid osteoma associated with paravertebral soft-tissue changes on magnetic resonance imaging

2004 ◽  
Vol 100 (5) ◽  
pp. 532-536 ◽  
Author(s):  
Feyza Karagöz Güzey ◽  
M. Hakan Seyithanoglu ◽  
Altay Sencer ◽  
Erhan Emel ◽  
Ibrahim Alatas ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissue ◽  
Osteoid Osteoma ◽  
Resonance Imaging ◽  
Tissue Changes ◽  
Soft Tissue Changes

scholarly journals Magnetic Resonance Imaging (MRI) Results Following Discontinuation of Methotrexate in Rheumatoid Arthritis Treated with Subcutaneous Tocilizumab: The COMP-ACT MRI Substudy

2019 ◽  
Vol 47 (3) ◽  
pp. 325-332
Author(s):  
Charles Peterfy ◽  
Joel Kremer ◽  
William Rigby ◽  
Nora Singer ◽  
Christine Birchwood ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disease Activity ◽  
Joint Damage ◽  
Cartilage Loss ◽  
Resonance Imaging ◽  
Low Disease Activity ◽  
Magnetic Resonance Imaging Mri ◽  
And Cartilage

Objective.To assess differences in joint damage and inflammation using magnetic resonance imaging (MRI) between patients with rheumatoid arthritis (RA) who achieved low disease activity with tocilizumab (TCZ) + methotrexate (MTX) and subsequently continued or discontinued MTX.Methods.In the COMP-ACT trial, US patients with RA received subcutaneous TCZ 162 mg + MTX. Those who achieved 28-joint count Disease Activity Score calculated with erythrocyte sedimentation rate (DAS28-ESR) ≤ 3.2 at Week 24 were randomized 1:1 (double-blind) to discontinue MTX (TCZ monotherapy; mono) or continue TCZ + MTX until Week 52. In a subset of patients, 1.5-Tesla MRI was used to obtain images of bilateral hands and wrists at weeks 24 and 40. Outcomes included changes in MRI-assessed synovitis, osteitis, erosion, and cartilage loss from Week 24 to Week 40, and in the proportion of patients with progression of each score.Results.Of 296 patients who achieved DAS28-ESR ≤ 3.2 at Week 24, 79 were enrolled in the pilot MRI substudy and randomized to TCZ mono (n = 38) or TCZ + MTX (n = 41). Treatment with either TCZ mono or TCZ + MTX suppressed erosion progression, synovitis, osteitis, and cartilage loss. The proportion of patients with no progression in each outcome measure was similar between groups (range, TCZ mono: 84.8–97.0%; TCZ + MTX: 92.3–100%).Conclusion.In a subset of patients who achieved low disease activity with TCZ + MTX, MRI changes were minimal in intraarticular inflammation and damage measures in patients who discontinued MTX versus those who continued TCZ + MTX.

scholarly journals Non-invasive diagnostics in fossils - Magnetic Resonance Imaging of pathological belemnites

2005 ◽  
Vol 2 (2) ◽  
pp. 133-140 ◽  
Author(s):  
D. Mietchen ◽  
H. Keupp ◽  
B. Manz ◽  
F. Volke
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissue ◽  
Clinical Diagnostics ◽  
Resonance Imaging ◽  
Non Invasive ◽  
Physiological Processes ◽  
Magnetic Resonance Imaging Mri ◽  
Invasive Diagnostics

Abstract. For more than a decade, Magnetic Resonance Imaging (MRI) has been routinely employed in clinical diagnostics because it allows non-invasive studies of anatomical structures and physiological processes in vivo and to differentiate between healthy and pathological states, particularly of soft tissue. Here, we demonstrate that MRI can likewise be applied to fossilized biological samples and help in elucidating paleopathological and paleoecological questions: Five anomalous guards of Jurassic and Cretaceous belemnites are presented along with putative paleopathological diagnoses directly derived from 3D MR images with microscopic resolution. Syn vivo deformities of both the mineralized internal rostrum and the surrounding former soft tissue can be traced back in part to traumatic events of predator-prey-interactions, and partly to parasitism. Besides, evidence is presented that the frequently observed anomalous apical collar might be indicative of an inflammatory disease. These findings highlight the potential of Magnetic Resonance techniques for further paleontological applications.

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