Magnetic resonance imaging of wrist and finger joints in healthy subjects occasionally shows changes resembling erosions and synovitis as seen in rheumatoid arthritis
Magnetic resonance imaging of wrist and finger joints in healthy subjects occasionally shows changes resembling erosions and synovitis as seen in rheumatoid arthritis
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DOI：
10.1002/art.20135
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发表时间：
2004-04-01
影响因子：
--
通讯作者：
Ostergaard, M
中科院分区：
文献类型：
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作者：
Ejbjerg, B;Narvestad, E;Ostergaard, M
目的探讨在磁共振成像（MRI）上健康人掌指关节（MCP）和腕关节出现类风湿性关节炎糜烂和滑膜炎样改变的可能性，并将MRI表现与常规影像学、临床和生化表现进行比较。对优势腕关节和第二至第五MCP关节进行了对比增强MRI和常规X线摄影，并进行了标准临床评估和生化分析。根据最新的OMERACT（流变学临床试验结果测量）建议，对滑膜炎，糜烂和骨髓水肿进行了评价。结果常规X线摄影显示，224个MCP关节骨中有1个（0.4%）和420个腕关节骨中有1个（0.2%）出现糜烂样改变。MRI显示224个MCP关节骨中有5个（2.2%）和420个腕关节骨中有7个（1.7%）出现低度侵蚀样改变，但其中仅8.3%的病变内检测到增强后增强。MRI显示112个MCP关节中的10个（8.9%）和84个评估的腕关节区域中的8个（9.5%）出现了低度滑膜炎样变化，而动态MRI仅检测到极轻微的早期滑膜增强。3例受试者血清C反应蛋白水平升高，这些受试者显示44.5%的滑膜炎样变化和41.7%的糜烂样变化。骨髓水肿样变化没有发现在任何joint.ConclusionChanges类似轻度滑膜炎或小骨侵蚀偶尔发现在MCP和健康对照的腕关节。在动态MRI上滑膜炎的体征、骨侵蚀样改变内的增强和骨髓水肿的体征在健康对照组中很少出现或不存在。因此，这些迹象可能被证明是非常具体的区别关节炎和正常关节。
ObjectiveTo explore the presence of changes resembling rheumatoid arthritis erosions and synovitis in metacarpophalangeal (MCP) and wrist joints of healthy individuals on magnetic resonance imaging (MRI) and to compare the MRI findings with conventional radiographic, clinical, and biochemical findings.MethodsTwenty‐eight healthy individuals were studied. Contrast‐enhanced MRI and conventional radiography of the dominant wrist and second through fifth MCP joints were performed, coupled with standard clinical assessments and biochemical analyses. MR images were evaluated according to the latest OMERACT (Outcome Measures in Rheumatology Clinical Trials) recommendations with respect to synovitis, erosions, and bone marrow edema.ResultsConventional radiography revealed erosion‐like changes in 1 of 224 MCP joint bones (0.4%) and in 1 of 420 wrist joint bones (0.2%). MRI depicted low‐grade erosion‐like changes in 5 of 224 MCP joint bones (2.2%) and in 7 of 420 wrist joint bones (1.7%), but postcontrast enhancement within the lesion was detected in only 8.3% of these. MRI depicted low‐grade synovitis‐like changes in 10 of 112 MCP joints (8.9%) and in 8 of 84 assessed wrist areas (9.5%), while only minimal early synovial enhancement was detected by dynamic MRI. Three subjects had elevated serum levels of C‐reactive protein, and these subjects displayed 44.5% of the synovitis‐like changes and 41.7% of the erosion‐like changes. Bone marrow edema–like changes were not found in any joints.ConclusionChanges resembling mild synovitis or small bone erosions are occasionally found in the MCP and wrist joints of healthy controls. Signs of synovitis on dynamic MRI, enhancement within bone erosion–like changes, and signs of bone marrow edema appear rarely or are absent in healthy controls. These signs may thus prove to be very specific in the distinction between arthritic and normal joints.