Document Detail

Characterisation of hand small joints arthropathy using high-resolution MRI--limited discrimination between osteoarthritis and psoriatic arthritis.
MedLine Citation:
PMID:  23300035     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To test the hypothesis that microanatomical differences in joint disease localisation could be exploited using high-resolution MRI to better differentiate among rheumatoid arthritis (RA), spondyloarthritis/psoriatic arthritis (SpA/PsA) and osteoarthritis (OA) in clinical practice.
METHODS: Sixty-nine patients with suspected inflammatory joint disease of the hand or feet underwent high-resolution MRI using a small loop coil. Images were scored blinded to the clinical status. Various joint changes like periostitis, osteitis, erosions, enthesitis and synovitis were recorded. The image-based diagnosis was compared with the clinical diagnosis.
RESULTS: In 59.4 % of the patients the clinical diagnosis was confirmed on image analysis. This was high for OA (80 %), moderately good for RA (67 %) but only 50 % for SpA/PsA. The major difficulty was to distinguish OA from SpA/PsA where common imaging findings are evident including periostitis (SpA/PsA 45 %, OA 40 % compared with RA 0 %; P = 0.015). Likewise, osteitis was frequently detected in SpA/PsA (79 %) and OA (80 %) and less frequently in RA (42 %) (P = 0.014).
CONCLUSION: Characterisation of inflammatory disorders of small joints merely using high-resolution MRI remains challenging especially in the differentiation between OA and PsA. These findings are likely explained by common microanatomical similarities in disease expression rather than limitations of imaging techniques.
KEY POINTS: • High-resolution MRI is increasingly used to investigate joint disease. • Osteitis and periostitis occur in psoriatic and osteoarthritis (but not rheumatoid arthritis). • In severely affected patients the amount of synovitis and erosions is similar.
Leonie S Braum; Dennis McGonagle; Anne Bruns; Sandra Philipp; Sandra Hermann; Karlfried Aupperle; Ai Lyn Tan; Torsten Diekhoff; Bernd Hamm; Kay-Geert A Hermann
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Publication Detail:
Type:  Journal Article     Date:  2013-01-09
Journal Detail:
Title:  European radiology     Volume:  23     ISSN:  1432-1084     ISO Abbreviation:  Eur Radiol     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-17     Completed Date:  2013-12-26     Revised Date:  2014-08-26    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1686-93     Citation Subset:  IM    
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MeSH Terms
Arthritis, Psoriatic / pathology*
Arthritis, Rheumatoid / pathology*
Cross-Sectional Studies
Equipment Design
Hand Joints / pathology*
Image Processing, Computer-Assisted / methods
Magnetic Resonance Imaging / methods*
Middle Aged
Osteoarthritis / pathology*
Prospective Studies
Spondylarthropathies / pathology*
Synovitis / pathology
Grant Support
NIHR/CS/009/015//Department of Health

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

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