Skip to main content


Log in

Magnetic resonance imaging in early rheumatoid arthritis: a multicenter, prospective study

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript


To identify the magnetic resonance imaging (MRI) features of hands and wrists in early rheumatoid arthritis (RA). A total of 129 early arthritis patients (≤1 year) were enrolled in the study. At presentation, MRI of the hands was performed, with clinical and laboratory analyses. After a 1-year follow-up, clinical diagnosis of early RA or non-RA was confirmed by two rheumatologists. The characteristics of MRI variables at baseline in RA patients not fulfilling ACR 1987 criteria [RA-87(−)] were compared with those fulfilling ACR1987 criteria [RA-87(+)] and non-RA. In the 129 early arthritis patients, 90 were diagnosed with RA in a 1-year follow-up. There were 47.8 % (43/90) of the RA patients not fulfilling ACR 1987 criteria [RA-87(−)]. The scores of synovitis in RA-87(−) patients were similar with those in RA-87(+) [Synovitis score, 14.0 (IQR, 4.0–25.0) vs. 14.0 (IQR, 10.0–25.0), p > 0.05]. Compared with those in non-RA, RA-87(−) patients had higher synovitis scores and occurrence of synovitis in proximal interphalangeal (PIP) joints [synovitis score, 14.0 (IQR, 4.0–25.0) vs. 6.0 (IQR, 2.0–14.5), p = 0.046; occurrence of PIP synovitis: 53.5 vs. 27.3 %, p = 0.02]. There was no significant difference of bone marrow edema, bone erosion, and tenosynovitis between RA-87(−) and non-RA. Synovitis in PIP joints was independent predictor for RA-87(−) [OR, 3.1 (95 %CI 1.2–8.1)]. High synovitis scores and synovitis in PIP joints on MRI were important in early RA, especially those not fulfilling ACR 1987 criteria.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others


  1. Boers M (2003) Understanding the window of opportunity concept in early rheumatoid arthritis. Arthritis Rheum 48:1771–1774

    Article  PubMed  Google Scholar 

  2. Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  CAS  PubMed  Google Scholar 

  3. van der Linden MP, Knevel R, Huizinga TW et al (2011) Classification of rheumatoid arthritis: comparison of the 1987 American College of Rheumatology criteria and the 2010 American College of Rheumatology/European League Against Rheumatism criteria. Arthritis Rheum 63:37–42

    Article  PubMed  Google Scholar 

  4. Kosta PE, Voulgari PV, Zikou AK, Drosos AA, Argyropoulou MI (2011) The usefulness of magnetic resonance imaging of the hand and wrist in very early rheumatoid arthritis. Arthritis Res Ther 13:R84

    Article  PubMed Central  PubMed  Google Scholar 

  5. Olech E, Crues JV 3rd, Yocum DE, Merrill JT (2010) Bone marrow edema is the most specific finding for rheumatoid arthritis (RA) on noncontrast magnetic resonance imaging of the hands and wrists: a comparison of patients with RA and healthy controls. J Rheumatol 37:265–274

    Article  PubMed  Google Scholar 

  6. Bøyesen P, Haavardsholm EA, Ostergaard M, van der Heijde D, Sesseng S, Kvien TK (2011) MRI in early rheumatoid arthritis: synovitis and bone marrow oedema are independent predictors of subsequent radiographic progression. Ann Rheum Dis 70:428–433

    Article  PubMed  Google Scholar 

  7. Suter LG, Fraenkel L, Braithwaite RS (2011) Role of magnetic resonance imaging in the diagnosis and prognosis of rheumatoid arthritis. Arthritis Care Res (Hoboken) 63:675–688

    Article  Google Scholar 

  8. Østergaard M, Edmonds J, McQueen F et al (2005) An introduction to the EULAR-OMERACT rheumatoid arthritis MRI reference image atlas. Ann Rheum Dis 64(Suppl 1):i3–i7

    Article  PubMed Central  PubMed  Google Scholar 

  9. Haavardsholm EA, Østergaard M, Ejbjerg BJ, Kvan NP, Kvien TK (2007) Introduction of a novel magnetic resonance imaging tenosynovitis score for rheumatoid arthritis: reliability in a multireader longitudinal study. Ann Rheum Dis 66:1216–1220

    Article  PubMed Central  PubMed  Google Scholar 

  10. Tamai M, Kawakami A, Uetani M et al (2006) Early prediction of rheumatoid arthritis by serological variables and magnetic resonance imaging of the wrists and finger joints: results from prospective clinical examination. Ann Rheum Dis 65:134–135

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Baan H, Bezooijen R, Avenarius JK, Dubbeldam R, Drossaers-Bakker WK, van de Laar MA (2011) Magnetic resonance imaging of the rheumatic foot according to the RAMRIS system is reliable. J Rheumatol 38:1003–1008

    Article  PubMed  Google Scholar 

  12. Boutry N, Hachulla E, Flipo RM, Cortet B, Cotten A (2005) MR imaging findings in hands in early rheumatoid arthritis: comparison with those in systemic lupus erythematosus and primary Sjogren’s syndrome. Radiology 236:593–600

    Article  PubMed  Google Scholar 

  13. Duer-Jensen A, Hørslev-Petersen K, Hetland ML et al (2011) Bone edema on magnetic resonance imaging is an independent predictor of rheumatoid arthritis development in patients with early undifferentiated arthritis. Arthritis Rheum 63:2192–2202

    Article  PubMed  Google Scholar 

Download references


We thank Prof. Hong-Yuan Wang for assistance with statistical analysis. This work was supported by a grant from the National Science & Technology Pillar Program [Grant number 2008BAI59B01] and Significant New Drugs Creation of Special Technology Major Project (2012zx09303001).

Author information

Authors and Affiliations


Corresponding authors

Correspondence to Yin Su or Zhan-Guo Li.

Ethics declarations



Additional information

Ru Li and Xia Liu contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, R., Liu, X., Ye, H. et al. Magnetic resonance imaging in early rheumatoid arthritis: a multicenter, prospective study. Clin Rheumatol 35, 303–308 (2016).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: