Using extremity magnetic resonance imaging to assess and monitor early rheumatoid arthritis: the optimal joint combination to be scanned in clinical practice.

OBJECTIVE To identify the optimal combination for detecting erosions in early rheumatoid arthritis using extremity magnetic resonance imaging (eMRI). METHODS In 44 patients, eMRI of 1 hand identified 77% who were erosive, 2 hands 89%, and 2 hands and feet 91%. RESULTS eMRI identified 4 times as many erosions as radiography. At 6 months, eMRI of 1 hand identified an increase in erosions in 50% subjects, 2 hands in 55%, and 2 hands and feet in 55%. When only subjects with a change in erosion score above the smallest detectable difference were considered, these numbers were 30%, 25%, and 20%, respectively. CONCLUSION eMRI provides superior erosion identification compared to radiography. Imaging 2 hands can be used as a screening tool and 1 hand to monitor erosions over time.

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