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Machado, P.M.M.C.; Koevoets, R.; Bombardier, C.; Heijde, D.M. van der (2011)

The Value of Magnetic Resonance Imaging and Ultrasound in Undifferentiated Arthritis: A Systematic Review

Article / Letter to editor
Objective. To perform a systematic literature review of the diagnostic and prognostic value of magnetic resonance imaging (MRI) and ultrasound (US) in patients with undifferentiated peripheral inflammatory arthritis (UPIA), and to assess if MRI and US should be done at baseline and repeated, and if so, at what interval. Methods. Medline, Embase, the Cochrane Library, and abstracts presented at the 2007 and 2008 meetings of the American College of Rheumatology and European League Against Rheumatism meetings were searched for diagnostic and prognostic studies of any duration examining the ability of MRI/US to predict outcome of patients with UPIA. Sensitivity, specificity, predictive values, and positive/negative likelihood ratios (LR+/LR-) were calculated. When available, odds ratios were extracted. Quality was appraised using validated scales. Results. Regarding MRI, 11 out of 2595 screened references were included: 2 described pure undifferentiated arthritis (UA) populations and 9,...Show moreObjective. To perform a systematic literature review of the diagnostic and prognostic value of magnetic resonance imaging (MRI) and ultrasound (US) in patients with undifferentiated peripheral inflammatory arthritis (UPIA), and to assess if MRI and US should be done at baseline and repeated, and if so, at what interval. Methods. Medline, Embase, the Cochrane Library, and abstracts presented at the 2007 and 2008 meetings of the American College of Rheumatology and European League Against Rheumatism meetings were searched for diagnostic and prognostic studies of any duration examining the ability of MRI/US to predict outcome of patients with UPIA. Sensitivity, specificity, predictive values, and positive/negative likelihood ratios (LR+/LR-) were calculated. When available, odds ratios were extracted. Quality was appraised using validated scales. Results. Regarding MRI, 11 out of 2595 screened references were included: 2 described pure undifferentiated arthritis (UA) populations and 9, mixed populations. Bone edema (LR+4.5) and combination of a distinct MRI synovitis and erosion pattern (LR+4.8) increased probability of developing rheumatoid arthritis (RA). Absence of MRI synovitis (LR-0.2) and absence of a distinct synovitis pattern (LR-0) decreased probability of developing RA. Regarding US, 2 out of 2111 references were included, both mixed populations; no data could be extrapolated for UPIA. Conclusion. MRI bone edema and combined synovitis and erosion pattern seem useful in predicting development of RA from UPIA. The value of US in UPIA remains to be determined. The absence of MRI synovitis seems useful in excluding development of RA. No data were found about the value of repeating MRI/US. Studies evaluating MRI/US in UPIA are scarce, but current knowledge strongly encourages further testing in UA. (J Rheumatol 2010;38 Suppl 87:31-37; doi:10.3899/jrheum.101072)Show less
ANKYLOSING SPONDYLITIS DISEASE ACTIVITY RESPONSE CRITERIA OUTCOME ASSESSMENT UNDIFFERENTIATED ARTHRITIS early rheumatoid-arthritis finger joints diagnostic-accuracy follow-up hand classification scintigraphy radiography prediction criteria
All authors
Machado, P.M.M.C.; Koevoets, R.; Bombardier, C.; Heijde, D.M. van der
Date
2011-03-31
Journal
Journal of Rheumatology
Volume
38
Pages
31 - 37