Correlation of structural abnormalities of the wrist and metacarpophalangeal joints evaluated by high-resolution peripheral quantitative computed tomography, 3 Tesla magnetic resonance imaging and conventional radiographs in rheumatoid arthritis

Int J Rheum Dis. 2015 Jul;18(6):628-39. doi: 10.1111/1756-185X.12495. Epub 2014 Oct 8.

Abstract

Aim: In rheumatoid arthritis (RA) hands, we applied high-resolution peripheral quantitative computed tomography (HR-pQCT) and 3 Tesla (3 T) magnetic resonance imaging (MRI), which are new methods for erosion detection and bone marrow edema (BME) quantification. We compared the erosion measurements between these techniques with conventional radiographs (CR) in order to examine their significance for evaluating structural abnormalities.

Methods: In 16 RA patients, HR-pQCT of metacarpophalangeal and wrist joints, 3 T MRI of wrist joints, as well as CR in both hands and feet were performed. Ten patients had 1-year follow-up CR. CRs were graded according to the modified Sharp score (MSS). Bone erosions were evaluated in HR-pQCT and MRI. BME pattern was quantified from MRI for volume, signal change and total burden.

Results: The erosion detection sensitivity of MRI was 85.7% and CR was 60.9% when HR-pQCT was considered as a reference method. The smallest dimensions of erosion detected by HR-pQCT, MRI and CR were 0.09, 0.14 and 0.66 cm, respectively. Baseline total MSS was correlated with HR-pQCT erosion measures, MRI erosion measures and MRI BME volume (P < 0.05). The mean difference between baseline and 1-year follow-up MSS (delta MSS) was 1.2. A trend was observed toward a correlation between delta MSS and MRI BME volume and burden.

Conclusion: This study demonstrates that HR-pQCT detects more and smaller bone erosions compared to MRI and CR. In addition, 3 T MRI can provide quantitative measurement of BME. Combination of HR-pQCT and MRI modalities may provide powerful tools to evaluate joint inflammation and bone damage in RA.

Keywords: 3 Tesla magnetic resonance imaging; conventional radiograph; erosion; high-resolution peripheral quantitative computed tomography; rheumatoid arthritis.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / diagnostic imaging*
  • Bone Marrow Diseases / diagnostic imaging
  • Disease Progression
  • Edema / diagnostic imaging
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Metacarpophalangeal Joint / diagnostic imaging*
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Reproducibility of Results
  • Severity of Illness Index
  • Time Factors
  • Tomography, X-Ray Computed*
  • Wrist Joint / diagnostic imaging*