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Magnetic resonance imaging (MRI) detection of synovitis and bone lesions of the wrists and finger joints in early-stage rheumatoid arthritis: comparison of the accuracy of plain MRI-based findings and gadolinium-diethylenetriamine pentaacetic acid-enhanced MRI-based findings

  • Original Article
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Modern Rheumatology

Abstract

Objective

To explore whether synovitis and bone lesions in the wrists and finger joints visualized by plain magnetic resonance imaging (MRI)-based findings correspond exactly or not to those judged by gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA)-enhanced MRI-based findings.

Methods

Magnetic resonance imaging of the wrists and finger joints of both hands were examined in 51 early-stage rheumatoid arthritis (RA) patients whose median disease duration from the onset of articular manifestations to entry was 5 months, by both plain (T1 and short-time inversion recovery images) and Gd-DTPA-enhanced MRI (post-contrast fat-suppressed T1-weighted images) simultaneously. We focused on 15 sites per hand, to examine the presence of synovitis and bone lesions (bone edema and bone erosion). Gd-DTPA-enhanced MRI-based findings were considered “true” lesions, and we evaluated the accuracy of plain MRI-based findings in comparison to Gd-DTPA-enhanced MRI-based findings.

Results

Synovitis, judged by plain MRI-based findings, appeared as false-positive at pretty frequency; thus, the specificity, positive predictive value and accuracy of the findings were low. The rate of enhancement (E-rate) in false-positive synovitis sites was significantly low compared with true-positive synovitis sites where Gd-DTPA enhancement appears. In contrast to synovitis, the false-positivity of bone lesions, judged by plain MRI-based findings, was very low compared with Gd-DTPA-enhanced MRI-based findings.

Conclusion

Synovitis judged by plain MRI-based findings is sometimes considered false-positive especially in sites where synovitis is mild. However, plain MRI is effective in identifying bone lesions in the wrist and finger joints in early-stage RA.

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Abbreviations

ACR:

American College of Rheumatology

CRP:

C-reactive protein

E-rate:

Rate of enhancement

Gd-DTPA:

Gadolinium–diethylenetriamine pentaacetic acid

HLA-DRB1*SE:

HLA-DRB1*shared epitope

RA:

Rheumatoid arthritis

UA:

Undifferentiated arthritis

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Acknowledgments

This study was supported in part by a Grant from The Ministry of Health, Labour and Welfare, Japan.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Mami Tamai, Atsushi Kawakami, Naoki Iwamoto, Makoto Kamachi & Hideki Nakamura

  2. Center for Health and Community Medicine, Nagasaki University, 1-14 Bunkyo-machi, Nagasaki, 852-8521, Japan

    Mami Tamai

  3. Department of Radiology and Radiation Research, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Masataka Uetani & Aya Fukushima

  4. Department of Medical Gene Technology, Atomic Bomb Disease Institute, Nagasaki University School of Health Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Kazuhiko Arima

  5. Department of Rheumatology, Isahaya Healthy Insurance General Hospital, 24-1 Eisyohigashi-machi, Isahaya, 854-8501, Japan

    Keita Fujikawa

  6. Department of Rheumatology, Japanese Red Cross Nagasaki Genbaku Hospital, 3-15 Mori-machi, Nagasaki, 852-8511, Japan

    Toshiyuki Aramaki

  7. Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University, 67 Asahi-machi, Kurume, 830-0011, Japan

    Hiroaki Ida

  8. Department of Rehabilitation Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Tomoki Origuchi

  9. Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Kiyoshi Aoyagi

  10. Sasebo City General Hospital, 9-3 Hirase-machi, Sasebo, 857-8511, Japan

    Katsumi Eguchi

Authors
  1. Mami Tamai
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  2. Atsushi Kawakami
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  3. Masataka Uetani
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  4. Aya Fukushima
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  5. Kazuhiko Arima
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  6. Keita Fujikawa
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  7. Naoki Iwamoto
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  8. Toshiyuki Aramaki
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  9. Makoto Kamachi
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  10. Hideki Nakamura
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  11. Hiroaki Ida
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  12. Tomoki Origuchi
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  13. Kiyoshi Aoyagi
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  14. Katsumi Eguchi
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Corresponding author

Correspondence to Mami Tamai.

Additional information

M. Tamai and A. Kawakami contributed equally to this work.

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Tamai, M., Kawakami, A., Uetani, M. et al. Magnetic resonance imaging (MRI) detection of synovitis and bone lesions of the wrists and finger joints in early-stage rheumatoid arthritis: comparison of the accuracy of plain MRI-based findings and gadolinium-diethylenetriamine pentaacetic acid-enhanced MRI-based findings. Mod Rheumatol 22, 654–658 (2012). https://doi.org/10.1007/s10165-011-0575-8

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  • DOI: https://doi.org/10.1007/s10165-011-0575-8

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