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 (Hoboken). 2011 Mar;63(3):436-9. doi: 10.1002/acr.20395. Epub 2010 Nov 15.


Objective: To verify whether magnetic resonance imaging (MRI)-proven joint injury is sensitive as compared with joint injury determined by physical examination.

Methods: 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.

Results: 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), r(s) = 0.469).

Conclusion: Our present data suggest that MRI is not only sensitive but accurately reflects the joint injury in patients with early-stage RA.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthralgia / diagnosis
  • Arthralgia / etiology
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / diagnosis*
  • Arthritis, Rheumatoid / pathology
  • Chi-Square Distribution
  • Contrast Media
  • Early Diagnosis
  • Edema / diagnosis
  • Edema / etiology
  • Female
  • Finger Joint / pathology*
  • Gadolinium DTPA
  • Humans
  • Japan
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Pain Measurement
  • Physical Examination*
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Synovitis / diagnosis
  • Synovitis / etiology
  • Wrist Joint / pathology*
  • Young Adult


  • Contrast Media
  • Gadolinium DTPA