Clinical Study On MRI Of The Wrist In Rheumatoid Arthritis

Objective To observe the appearances of rheumatoid arthritis(RA) , assess the role of MRI in diagnosis and and evaluate disease prognosis of rheumatoid arthritis.Methods 43 patients, fulfilled 1987 American Rheumatism Assosiation ( ARA) revised criteria , and 10 age-matched healthy controls entered the study . In 43 patients , all had pannus on MRI of wrists , 37 patients had joint effusion, 21 patients had bone marrow edema, 38 patients had marked enhanced pannus of signal intensity , and 30 patients had bone erosions. T1-weighted spin echo , short time inversion recovery ( STIR ) of both wrists, gadolinium contrast material -enhanced sequences of dominant wrists were performed in the coronal planes . MRI ,the plain wrist radiographs ,clinical date .included swollen joint ,patient global assessment (AIMS) , and laboratory examinations included ESR ,RF ,APF,AKA were obtained at the same time . Functional disability was assessed using the Health Assessment Questionnaire Disability Score ( HAQ score) .Results There were significant difference in the ESR ^ HAQ -. pain joint count as well as AIMS between patients with bone marrow edema and patients without bone marrow edema (t=5.18> p=0.000; t=5.70, p=0.000; t=3.14, p=0.001;t=5.49> p=0.000) , which is the same as patients with joint effusion and patients without joint effusion (t=6.47> p=0.000; t=7.74>p=0.000; t=6.81, p=0.000; t=4.93, p=0.000) ,and patients with marked enhanced pannus of signal intensity and patients without marked enhanced pannus of signal intensity after injection of contrast material (t=6.14, p=0.000; t=7.49, p=0.000; t=6.72, p=0.000; t=4.32, p=0.001). There were significant difference in the pain of metatarsal phalange joint, and APF between patients with MR1 bone marrow edema of wrists and patients without MR1 bone marrow edema of wrists ( x 2=10.38 p=0.001; x2=5.06 p=0.024) .Number of patients with MRI erosion of wrists is associated with number of patients with MRI bone marrow edema of wrists ( x2=8.35, p=0.004) .Conclusion MRI scans of wrists ,as a maker of joint disease activity in rheumatoid arthritis,can provide imaging basis in diagnosis rheumatoid arthritis ,and select patients for more or less aggressive treatment . MR1 may have a role in the assessment of disease prognosis.