Magnetic resonance imaging, radiography, and scintigraphy of the finger joints: one year follow up of patients with early arthritis
Magnetic resonance imaging, radiography, and scintigraphy of the finger joints: one year follow up of patients with early arthritis
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DOI：
10.1136/ard.59.7.521
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发表时间：
2000-07-01
影响因子：
27.4
通讯作者：
Lorenzen, I
中科院分区：
文献类型：
--
作者：
Klarlund, M;Ostergaard, M;Lorenzen, I
目的对随访1年的类风湿关节炎（RA）或疑似RA患者第2 ~ 5掌指关节（MCP）和近端指间关节（PIP）滑膜肥大、腱鞘炎和糜烂情况进行磁共振成像评价。此外，将结果与x线片、骨显像和临床表现进行比较。患者和方法：55例患者在基线时接受检查，其中34例随访一年。21名患者在基线时已经达到了美国风湿病学会（ACR）的RA标准，5名患者在随访一年后才达到标准，而8名患者维持了早期未分类多发性关节炎的原始诊断。在基线和一年时评估以下MRI变量：滑膜肥大评分、糜烂数量和腱鞘炎评分。结果：mri比x线检查更早、更频繁地发现相同关节的糜烂进展；基线时MRI与x线摄影比值为28:4。侵蚀只发生在基线时的RA患者或一年后达到ACR标准的患者。在一年的随访中，MR滑膜肥大、腱鞘炎和显影示踪剂积累的评分与基线相比没有显著变化；肿胀和压痛关节计数明显下降（p < 0.05）。结论：mri检出的糜烂程度高于x线摄影。磁共振滑膜肥大和显像评分与临床评估的肿胀和压痛关节计数随时间的变化不一致。虽然关节疾病活动可以通过传统的临床方法评估为静止，但通过MRI进行更详细的评估可能显示滑膜内仍然存在病理状况。
Objectives-To evaluate synovial membrane hypertrophy, tenosynovitis, and erosion development of the 2nd to 5th metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints by magnetic resonance imaging in a group of patients with rheumatoid arthritis (RA) or suspected RA followed up for one year. Additionally, to compare the results with radiography, bone scintigraphy, and clinical findings.Patients and methods-Fifty five patients were examined at baseline, of whom 34 were followed up for one year. Twenty one patients already fulfilled the American College of Rheumatology (ACR) criteria for RA at baseline, five fulfilled the criteria only after one year's follow up, whereas eight maintained the original diagnosis of early unclassified polyarthritis. The following MRI variables were assessed at baseline and one year: synovial membrane hypertrophy score, number of erosions, and tenosynovitis score.Results-MRI detected progression of erosions earlier and more often than did radiography of the same joints; at baseline the MRI to radiography ratio was 28:4. Erosions were exclusively found in patients with RA at baseline or fulfilling the ACR criteria at one year. At one year follow up, scores of MR synovial membrane hypertrophy, tenosynovitis, and scintigraphic tracer accumulation had not changed significantly from baseline; in contrast, swollen and tender joint counts had declined significantly (p < 0.05).Conclusions-MRI detected more erosions than radiography. MR synovial membrane hypertrophy and scintigraphy scores did not parallel the changes seen over time in clinically assessed swollen and tender joint counts. Although joint disease activity may be assessed as quiescent by conventional clinical methods, a more detailed evaluation by MRI may show that a pathological condition is still present within the synovium.