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The role of magnetic resonance imaging in the diagnosis and prognosis of rheumatoid arthritis.
MedLine Citation:
PMID:  21120965     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:: To systematically evaluate the literature addressing the role of MRI in the diagnosis and prognosis of early undifferentiated inflammatory arthritis and RA. METHODS:: We performed a systematic literature review of the performance characteristics of MRI for diagnosing and prognosticating RA. We searched Ovid, supplementing this with manual searches of bibliographies, journals, meeting proceedings, and ClinicalTrials.gov website. To identify Diagnostic studies, we included studies of any duration that prospectively examined whether MRI findings predicted RA diagnosis and reported adequate information to calculate sensitivity and specificity. To identify Prognostic studies, we included prospective studies with at least 12 month follow-up that measured both baseline MRI findings and clinical and/or radiographic outcomes. RESULTS:: In "Diagnostic Studies" (N=11), sensitivity and specificity of MRI findings for RA diagnosis ranged from 20-100% and 0-100%, respectively, depending upon criteria used. MRI diagnostic performance improved when lower quality or longer disease duration studies were excluded. In "Prognostic Studies" (N=17), MRI findings did not predict clinical remission and the ability to predict radiographic progression varied significantly (range 18-100% for sensitivity and 5.9-97% for specificity). Restricting the analysis to specific MRI findings or earlier disease improved MRI prognostic performance. The only prognostic study reporting 100% of a priori quality criteria found MRI bone edema the strongest predictor of radiographic progression. CONCLUSION:: Data evaluating MRI for the diagnosis and prognosis of early RA are currently inadequate to justify widespread use of this technology for these purposes, although MRI bone edema may be predictive of progression in certain RA populations.
Authors:
Lisa G Suter; Liana Fraenkel; R Scott Braithwaite
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-11-30
Journal Detail:
Title:  Arthritis care & research     Volume:  -     ISSN:  2151-4658     ISO Abbreviation:  -     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-12-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Yale School of Medicine, New Haven, CT & VA Connecticut Healthcare System, West Haven, CT.
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