MRI in early rheumatoid arthritis: synovitis and bone marrow oedema are independent predictors of subsequent radiographic progression

Boyesen, P.; Haavardsholm, E.A.; Ostergaard, M.; Heijde, D. van der; Sesseng, S.; Kvien, T.K. (2011)

Article / Letter to editor

Objectives To determine whether MRI and conventional (clinical and laboratory) measures of inflammation can predict 3-year radiographic changes measured by the van der Heijde Sharp score in patients with early rheumatoid arthritis (RA). Methods 55 patients with RA with disease duration <1 year participated in this 3-year follow-up study. Patients were evaluated at baseline, 3, 6, 12 and 36 months by swollen and tender joint count, disease activity score based on 28-joint count, erythrocyte sedimentation rate (ESR), C reactive protein, MRI measures of synovitis, bone marrow oedema and tenosynovitis of the dominant wrist, as well as conventional x-rays of the hands and wrists. Results All measures of inflammation decreased during the follow-up period. ESR, MRI synovitis and MRI bone marrow oedema were independent predictors of 3-year radiographic progression adjusted for age, sex and anti-citrullinated protein antibodies. The 1-year cumulative measures of MRI synovitis and bone marrow oedema provided an improved explanation of variation (adjusted R-2) in radiographic change compared with the baseline MRI values (adjusted R-2 = 0.32 and 0.20 vs 0.11 and 0.04, respectively). Conclusions Both baseline and 1-year cumulative measures of MRI synovitis and bone marrow oedema independently predicted 3-year radiographic progression. These results confirm that MRI synovitis and MRI bone marrow oedema precede radiographic progression in patients with early RA.

• disease-activity score reliability multireader

• All authors: Boyesen, P.; Haavardsholm, E.A.; Ostergaard, M.; Heijde, D. van der; Sesseng, S.; Kvien, T.K.
• Date: 2011-03-31
• Journal: Annals of the Rheumatic Diseases
• Volume: 70
• Issue: 3
• Pages: 428 - 433
• DOI: doi:10.1136/ard.2009.123950