Value of MRI of hands in diagnosis of early rheumatoid arthritis and bone joint injury

Objective To explore the value of MRI of both hands in the diagnosis of early RA,bone and joint damage in RA. Methods A total of 111 patients with early RA (disease duration less than 1 year) was recruited.All the clinical and laboratory parameters in all the patients were recorded.BMD of femur and lumbar vertebrae in RA were detected.Radiographs for two hands were evaluated according to the Sharp's method.MRI of hands was executed in early RA patients and MRIS were used to assess changes of MRI in 37 patients. Results ①Results of X-ray examination and MRI of both hands scan showed:according to classification standard of X-ray examination,73.87% with RA was classified as Ⅰ stage and 26.13% as Ⅱ stage,whose sharp scores were all within 10 score.The manifestation of 37 patients with early RA patients on MRI scan for two hands demonstrated bone erosion in 33 cases,synovitis in 31 cases,bone marrow edema in 21 cases and tendinitis in 11 cases.Positive rate of either indicator among above manifestations on MRI was 36 cases.②Results of bivariable correlation analysis showed that tendinitis score was positively correlated with bone marrow edema score (P<0.05) and synovitis score (P<0.05).③Correlation analysis found bone erosion score of MRI scan positively correlated with sharp score (P<0.05) and negatively correlated with BMD at greater trochanter (P<0.05),total hip (P<0.05).Tendinitis score of MRI scan positively correlated with CRP (P<0.05),swollen joint count (P<0.05) and tender joint count (P<0.05). Conclusion The positive rate is higher on MRI scan than that in X-ray examination.MRI scan has good diagnostic value in early RA.Manifestations of MRI scan are correlated with BMD and sharp score,and tendinitis on MRI scan may have a certain diagnostic value.