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Using Extremity Magnetic Resonance Imaging to Assess and Monitor Early Rheumatoid Arthritis:
the Optimal Joint Combination to Be Scanned in Clinical Practice
EWA OLECH, JANE E. FREESTON, PHILIP G. CONAGHAN, ELIZABETH M.A. HENSOR, PAUL EMERY, and DAVID YOCUM
ABSTRACT. Methods. In 44 patients, eMRI of 1 hand identified 77% who were erosive, 2 hands 89%, and 2 hands and feet 91%. Results. eMRI identified 4 times as many erosions as radiography. At 6 months, eMRI of 1 hand identified an increase in erosions in 50% subjects, 2 hands in 55%, and 2 hands and feet in 55%. When only subjects with a change in erosion score above the smallest detectable difference were considered, these numbers were 30%, 25%, and 20%, respectively. Conclusion. eMRI provides superior erosion identification compared to radiography. Imaging 2 hands can be used as a screening tool and 1 hand to monitor erosions over time. (J Rheumatol First Release Mar 1 2008) Key Indexing Terms:
EXTREMITY MAGNETIC RESONANCE IMAGING
From the University of Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma; Stanford University, Palo Alto, California, USA; and the Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK. E. Olech, MD, Clinical Assistant Professor of Medicine, University of Oklahoma Medical Research Foundation; J.E. Freeston, MA, MB, BChir, MRCP, Specialist Registrar in Rheumatology; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine; E.M.A. Hensor, PhD, Statistician; P. Emery, MA, MD, FRCP, Professor of Rheumatology, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; D. Yocum, MD, Clinical Professor of Medicine, Stanford University. Dr. Olech and Dr. Freeston contributed equally to this report. Address reprint requests to Dr. E. Olech, Clinical Pharmacology, Oklahoma Medical Research Foundation, 825 NE 13th Street, Oklahoma City, OK 73104. E-mail: Ewa-Olech@omrf.ouhsc.edu Accepted for publication November 29, 2007.
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