Early RA Shows as MRI Hand Tenosynovitis

"Flexor tenosynovitis is a strong predictor for early RA in MRI of the hand."—Iris Eshed, MD

Iris Eshed, MD, and colleagues from Sheba Medical Center in Tel Hashomer, Israel, evaluated the potential role of MRI of finger and wrist joints for identifying early RA in a study of 99 patients with unspecified arthritis or suspected RA and negative x-ray findings. They evaluated MRI parameters as a stand-alone tool and also in combination with ACR criteria and with serum markers such as rheumatoid factor (RF) and anti-CCP antibodies.

MRI plus either RF or anti-CCP finds most early RA cases

The researchers analyzed MRI images of the hand and wrist for synovitis, erosions, and tenosynovitis. After 6 to 42 months of clinical follow-up, the MRI findings were correlated with “gold standard” clinical diagnosis (early RA, n=58, or non-RA, n=41) made by a rheumatologist.

Stepwise logistic regression showed that of all evaluated MR findings, tenosynovitis of the flexor tendons was the most powerful predictor for early RA (sensitivity=60.3%, specificity=73.2%).

Positive serum rheumatoid factor (RF) plus tenosynovitis increased early RA sensitivity to 82.8% and specificity to 63.4%.

Anti-CCP plus flexor tenosynovitis increased sensitivity to 78.9% and specificity to 73%.

“Flexor tenosynovitis is a strong predictor for early RA in MRI of the hand. Combining this finding with positive serum anti-CCP values or alternatively with positive RF values produces an even stronger predictor for early RA,” Dr. Eshed concluded.

Reference

1. Eshed I, Feist E, Backhaus M, et al. Tenosynovitis of the flexor tendons of the hand detected by MRI: an indicator for early rheumatoid arthritis. Presented at: Radiological Society of America 2008 meeting, Chicago, November 30, 2008. Presentation no. SSA14-01.

Early RA Shows as MRI Hand Tenosynovitis | Arthritis Information