Skeletal Radiology

, Volume 42, Issue 2, pp 255–260 | Cite as

3 T DCE-MRI assessment of synovitis of the interphalangeal joints in patients with erosive osteoarthritis for treatment response monitoring

  • L. Jans
  • T. De Coninck
  • R. Wittoek
  • V. Lambrecht
  • W. Huysse
  • G. Verbruggen
  • K. Verstraete
Scientific Article

Abstract

Objective

To study the value of 3 T dynamic contrast-enhanced (DCE)-MRI for assessment of synovitis of the interphalangeal joints in patients with erosive osteoarthritis (EOA) for treatment response monitoring.

Materials and methods

The interphalangeal joints of fingers two to five were examined at 3 T MRI in nine patients with EOA. Two musculoskeletal radiologists recorded erosions, bone marrow oedema (BME), synovitis and osteophytes. Interobserver reliability was calculated using κ statistics. In six patients, DCE-MRI time intensity curves of synovitis in two affected joints were analysed. The maximum upslope, absolute and relative enhancement of synovitis were compared with MRI after 12 months of anti-tumour necrosis factor treatment. Intraobserver reproducibility was calculated using intra-class correlation coefficient.

Results

Interobserver reliability was ‘good’ for detection of erosions (κ = 0.70), BME (κ = 0.77) and synovitis (κ = 0.77), but ‘poor’ for osteophytes (κ = 0.12). Post-treatment DCE-MRI showed decreasing maximum upslope (p = 0.002) and absolute (p = 0.002) and relative (p = 0.01) enhancement compared to the initial scan. Intraobserver reproducibility of DCE-MRI was ‘almost perfect’ or ‘strong’ for all parameters.

Conclusions

3 T DCE-MRI demonstrates changes in time intensity curves of synovitis in EOA of the interphalangeal joints in a longitudinal study, indicating this technique is promising for monitoring therapy response.

Keywords

MRI Dynamic contrast-enhanced Erosive osteoarthritis Interphalangeal joint Synovitis 

Notes

References

  1. 1.
    Banks SE. Erosive osteoarthritis: a current review of a clinical challenge. Clin Rheumatol. 2010;29:697–706.PubMedCrossRefGoogle Scholar
  2. 2.
    Resnick D, et al. Degenerative disease of extrapinal locations. In: Resnick D, editor. Diagnosis of bone and joint disorders, 4th ed. Philadelphia: Saunders; 2002. p. 1271–381.Google Scholar
  3. 3.
    Verbruggen G, Wittoek R, Vander Cruyssen B, Elewaut D. Morbid anatomy of ‘erosive osteoarthritis’ of the interphalangeal finger joints: an optimised scoring system to monitor disease progression in affected joints. Ann Rheum Dis. 2010;69:862–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Grainger AJ, Farrant JM, O’Connor PJO, et al. MR imaging of erosions in interphalangeal joint osteoarthritis: is all osteoarthritis erosive? Skeletal Radiol. 2007;36:737–45.PubMedCrossRefGoogle Scholar
  5. 5.
    Wittoek R, Jans L, Lambrecht V, Carron P, Verstraete K, Verbruggen G. Reliability and construct validity of ultrasonography of soft tissue and destructive changes in erosive osteoarthritis of the interphalangeal finger joints: a comparison with MRI. Ann Rheum Dis. 2011;70:278–83.PubMedCrossRefGoogle Scholar
  6. 6.
    Vlychou M, Koutroumpas A, Malizos K, et al. Ultrasonographic evidence of inflammation is frequent in hand of patients with erosive osteoartritis. Osteoarthritis Cartilage. 2009;17:1283–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Szkudlarek M, Klarlund M, Narvestad E, et al. Ultrasonography of the metacarpophalangeal and proximal interphalangeal joints in rheumatoid arthritis: a comparison with magnetic resonance imaging, conventional radiography and clinical examination. Arthritis Res Ther. 2006;8:R52.PubMedCrossRefGoogle Scholar
  8. 8.
    Verstraete KL, Dierick A, De Deene Y, et al. First-pass images for musculoskeletal lesions: a new and useful diagnostic application of dynamic contrast-enhanced MRI. Magn Reson Imaging. 1994;12:687–702.PubMedCrossRefGoogle Scholar
  9. 9.
    Schraml C, Schwenzer NF, Martirosian P, et al. Assessment of synovitis in erosive osteoarthritis of the hand using DCE-MRI and comparison with that in its major mimic, the psoriatic arthritis. Acta Radiol. 2011;18:804–9.Google Scholar
  10. 10.
    Tan AL, Grainger AJ, Tanner SF, et al. High-resolution magnetic resonance imaging for the assessment of hand osteoarthritis. Arthritis Rheum. 2005;52:2355–65.PubMedCrossRefGoogle Scholar
  11. 11.
    Kirkhus E, Bjornerud A, Thoen J, et al. Contrast-enhanced dynamic magnetic resonance imaging of the finger joints in osteoarthritis and rheumatoid arthritis: an analysis based on pharmacokinetic modelling. Acta Radiol. 2006;47:845–51.PubMedCrossRefGoogle Scholar
  12. 12.
    Altman R, Alarcon G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum. 1990;33:1601–10.PubMedCrossRefGoogle Scholar
  13. 13.
    Ostergaard M, Peterfy C, Conaghan P, et al. OMERACT rheumatoid arthritis magnetic tesonance imaging studies. Core set of MRI acquisitions, joint pathology definition, and the OMERACT RA-MRI scoring system. J Rheumatol. 2003;30:1385–6.PubMedGoogle Scholar
  14. 14.
    Verbruggen G, Veys EM. Numerical scoring systems for the anatomic evolution of osteoarthritis of the finger joints. Arthritis Rheum. 1996;39:308–20.PubMedCrossRefGoogle Scholar
  15. 15.
    Verstraete KL, De Deene Y, Roels H, Dierick A, Uyttendaele D, Kunnen M. Benign and malignant musculoskeletal lesions: dynamic contrast-enhanced MR imaging parametric first-pass images depict tissue vascularization and perfusion. Radiology. 1994;192:835–43.PubMedGoogle Scholar
  16. 16.
    Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.PubMedCrossRefGoogle Scholar
  17. 17.
    Shrout PE, Fleiss JL. Intraclass correlations; uses in assessing rater reliability. Psychol Bull. 1979;86:420–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Workie DW, Dardzinski BJ, Graham TB, Laor T, Bommer WA, O’Brien KJ. Quantification of dynamic contrast-enhanced MR imaging of the knee in children with juvenile rheumatoid arthritis based on pharmacokinetic modelling. Magn Reson Imaging. 2004;22:1201–10.PubMedCrossRefGoogle Scholar

Copyright information

© ISS 2012

Authors and Affiliations

  • L. Jans
    • 1
    • 3
  • T. De Coninck
    • 1
  • R. Wittoek
    • 2
  • V. Lambrecht
    • 1
  • W. Huysse
    • 1
  • G. Verbruggen
    • 2
  • K. Verstraete
    • 1
  1. 1.Department of Radiology and Medical ImagingGhent University HospitalGentBelgium
  2. 2.Department of RheumatologyGhent University HospitalGentBelgium
  3. 3.Ghent University HospitalGentBelgium

Personalised recommendations