Document Detail

Assessment of cartilage loss at the wrist in rheumatoid arthritis using a new MRI scoring system.
MedLine Citation:
PMID:  20472589     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To develop and test an MRI cartilage scoring system for use at the wrist in rheumatoid arthritis (RA). METHODS: MRI scans were obtained using a 3T MRI scanner with dedicated wrist coil in 22 early and 16 established RA patients plus 22 controls. Axial and coronal T1-weighted (precontrast and postcontrast) and T2-weighted turbo spin echo sequences were obtained. Eight wrist joints were scored for cartilage narrowing: distal radioulnar, radiolunate, radioscaphoid, triquetrum-hamate, capitate-lunate, scaphotrapezoid, second metacarpal base-trapezoid and third metacarpal base-capitate, using a system based on the Sharp van der Heijde x-ray joint space narrowing (JSN) score by three radiologists. Fifteen sites at the wrist were also scored for synovitis, bone oedema and erosion using the RA MRI score. RESULTS: Interobserver (three-reader) and intraobserver reliability (readers 1 and 2) for the cartilage score were excellent: intraclass correlations (ICC (95% CI)) 0.91, (0.86 to 0.94), 0.98 (0.96 to 1.00) and 0.94 (0.87 to 1.00), respectively. Cartilage scores (median, range) were higher in the established RA group (11.9, 2.3-27.3) than the early RA group (2.15, 0-6) (p≤0.001) but early RA scores did not differ from healthy controls (2.3, 1-8.7). Cartilage scores correlated with synovitis (R=0.52), bone oedema (R=0.63) and erosion scores (R=0.66), p<0.001 for all, and with x-ray JSN scores (R=0.68 to 0.78). CONCLUSION: This MRI cartilage score demonstrated excellent reliability when tested in a three-reader system. However, cartilage loss in early RA could not be distinguished from that seen in healthy controls.
Fiona McQueen; Andrew Clarke; Alex McHaffie; Quentin Reeves; Megan Williams; Elizabeth Robinson; Jing Dong; Arista Chand; Desiree Mulders; Nicola Dalbeth
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-14
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  69     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-20     Completed Date:  2010-11-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  1971-5     Citation Subset:  IM    
Department of Molecular Medicine and Pathology, University of Auckland, New Zealand.
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MeSH Terms
Aged, 80 and over
Arthritis, Rheumatoid / complications,  pathology*
Bone Marrow Diseases / diagnosis,  etiology
Cartilage, Articular / pathology*,  radiography
Case-Control Studies
Edema / diagnosis,  etiology
Foot Joints / radiography
Hand Joints / radiography
Magnetic Resonance Imaging / methods
Middle Aged
Observer Variation
Reproducibility of Results
Synovitis / diagnosis,  etiology
Wrist Joint / pathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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