Detection of joint pathology by magnetic resonance imaging in patients with early rheumatoid arthritis

Magnetic resonance imaging (MRI) permits the visualization of anatomicalstructures not appreciated by conventional radiographic imaging, and mayassess inflammatory disease and its progression with greater sensitivitythan conventional radiography. In this study of 30 patients with earlyrheumatoid arthritis (RA), which could be considered as a pilot studybecause of the relatively small number of patients, we compare MRI of theknee and the fifth metatarsophalangeal joint with clinical and radiographicfindings. A parallel study of 10 healthy individuals served as a referencegroup. In all but one of the 30 patients, MRI revealed some kind of jointabnormality, whereas conventional radiography was normal in 14 patients.The present study thus suggests that MRI may detect inflammatory and/ordestructive joint changes in patients with early RA, and that these changesmay occur in the absence of clinical symptoms or signs and/or radiographicsigns in the examined joint. If these data prove to be confirmed in furthercontrolled studies, MRI may be of importance both for the assessment ofprognosis and for the decision to treat in the early critical stages of RA.