ABSTRACT
To determine the joint damage progression using magnetic resonance imaging [MRI], and to investigate the predictive value of early MRI in rheumatoid arthritis [RA] patients. We studied forty RA female patients. Their mean age was 42.7 [ +/- 10.6] years. Patients underwent clinical, laboratory and functional assessments over 12 months. Standard plain radiography and MRI of the hands and wrists were done for all patients at baseline and after 12 months. All clinical and laboratory variables reflecting disease activity showed low activity after one year of treatment [p<0.05]. At one year, MRI erosions were found in 62.5% of patients [25 of 40] compared with 42.5% at baseline [p<0.05]. MRI findings reflecting inflammation [bone marrow edema and synovitis] regressed after one year [p<0.05]. We have analyzed baseline variables for prediction of MRI erosions at one year including positive RF, plain radiological erosions, baseline MRI erosion, bone marrow edema and synovitis. Positive RF and synovitis were predictor risk factors for MRI erosive progression at one year [p<0.05]. On the other hand, plain radiological erosions were not statistically significant as predictor risk factor in these patients [p>0.05]. Baseline MRI erosion and bone marrow edema were strong predictors for MRI erosive progression [the odds ratio [95%CI] were 5.92 [3.06-9.03] and 12.85 [3.41-21.22], respectively] [p<0.001]. The results of this study suggest that MRI is a useful tool to investigate disease processes in RA. It can be used in clinical practice in determining the prognosis, and selecting patients who need aggressive therapy to avoid subsequent joint damage