MedWire News: Magnetic resonance imaging (MRI) should be routinely used to determine those patients most likely to benefit from early and aggressive rheumatoid arthritis (RA) management, say scientists.
"In this study we confirmed the role of MRI bone marrow edema as an independent predictor of radiographic progression," explain Espen Haavardsholm (Diakonhjemmet Hospital, Oslo, Norway) and fellow researchers.
Haavardsholm and colleagues used radiographic and MRI techniques to study the hands and wrists of 84 consecutive patients who had been diagnosed with RA less than 1 year before being enrolled in the study.
As expected, disease symptoms improved over a follow-up period of 1 year during which patients were given standard care. At the end of this period, radiographic examination of both hands and wrists revealed erosive disease progression in 48% of patients, while MRI of the dominant wrist identified such progression in 66% of patients.
Further research revealed that a finding of bone marrow edema with MRI at the start of the study significantly and independently predicted erosive progression as shown by both conventional radiographic and MRI techniques.
"These findings, taken together with results from previous smaller studies, suggest that MRI scans of the dominant wrist may assist the clinicians in their considerations of which patients need early and aggressive treatment to avoid subsequent joint damage," conclude the investigators.
Writing in the Annals of the Rheumatic Diseases they add: "MRI bone marrow edema should be recognized as an important prognostic factor in early RA."
http://www.medwire-news.md/437/75323/Bone_Health/MRI_predicts_need_for_aggressive_RA_therapy.html
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