Semin Musculoskelet Radiol 2004; 08: 287-299 DOI: 10.1055/s-2004-861576
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001 USA.
Magnetic Resonance Imaging of the Synovium in Rheumatoid Arthritis
Mikkel Østergaard1,2, Bo Ejbjerg2,3
1 Department of Rheumatology, Copenhagen University Hospitals at Herlev, Hvidovre and Rigshospitalet 2 Danish Research Centre of Magnetic Resonance, Copenhagen University Hospital at Hvidovre 3 Department of Radiology, Copenhagen University Hospital at Hvidovre, Denmark

ABSTRACT

Early diagnosis, followed by early initiation and optimal adjustments of aggressive therapies, are acknowledged as essential to optimize long-term clinical and radiological outcome in rheumatoid arthritis (RA). This requires sensitive methods for detection and monitoring of the primary feature of RA-the synovitis. In comparison with conventional methods, magnetic resonance imaging (MRI) offers assessment of the rheumatoid synovium with improved sensitivity to early pathology and to change. Various aspects such as volume, vascularity, and edema can be assessed by different metrological approaches. MRI findings are of prognostic value to the long-term radiological outcome. This article reviews current knowledge on MRI for assessment of the synovium in RA, focusing on the validity of MRI measures of synovitis. Future perspectives and suggested research priorities are described. The rationale is provided for MRI becoming the new gold standard for assessment of RA joints and for MRI assessments of synovitis being reliable and valid measures of rheumatoid disease activity.

KEYWORDS

Rheumatoid arthritis - synovitis - magnetic resonance imaging