ABSTRACT
An increasingly aggressive therapeutic strategy, improved treatment options, and encouraging
preliminary results have attracted growing attention to the potential of magnetic
resonance imaging (MRI) in the diagnosis, prognostication, and monitoring of rheumatoid
arthritis (RA). MRI offers multiplanar imaging with unprecedented soft tissue contrast
and high spatial resolution. Synovitis, the primary joint lesion in RA, can be detected
and monitored. By contrast, conventional radiography shows only the late signs of
preceding synovitis. Other soft tissue changes, such as tenosynovitis, tendonitis,
enthesitis, joint effusions, and ligament and tendon tears, can be visualized. Unfortunately,
the image resolution in most clinically available MR units is insufficient for evaluation
of wrist joint cartilage. Preliminary data suggest that MRI is a valuable tool in
the diagnosis and prognostication of RA. The superior sensitivity of MRI may be of
major significance in both clinical trials and practice. In trials, MRI may allow
reductions in the trial size and length because of its more sensitive separation of
responders from nonresponders. Thus, although thorough validation is awaited, particularly
concerning the reproducibility and prognostic value, MRI seems to be a very promising
method for assessment of both established and early RA.
KEYWORD
Magnetic resonance imaging - wrist - rheumatoid arthritis
