ISSN:
1352-8661
Keywords:
rheumatoid arthritis
;
synovitis
;
arthritis
;
magnetic resonance imaging
;
cartilage
;
knee
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
,
Physics
Notes:
Abstract To investigate whether characterization and reliable staging of pannus-induced cartilage destructions in the knee could be achieved by magnetic resonance imaging (MRI), we examined 13 patients with arthritis, 2 patients with osteoarthritis (OA) and 5 healthy controls. A regional staging of bone and cartilage erosions was performed by two independent observers. In each of six regions, pannus-induced cartilage erosions were staged 0 (not present), 1 (present, but not penetrating), or 2 (penetrating). Pannus-induced cartilage erosions were demonstrated by MRI in 11 patients with arthritis and in no controls or OA patients. In the 11 patients, synovial masses overlying joint cartilage and a corresponding thinning of the cartilage, reflecting degradation, could be precisely delimited following gadolinium-DTPA I.V. Eight patients had bone erosions on MRI, either marginal caused by direct synovial invasion and/or in continuity with cartilage destructions caused by overlying pannus. By contrast, only two patients had radiographic erosions. The kappa values of interobserver variation with respect to regional presence or absence of bone and cartilage erosions were 0.94 and 0.92, respectively, indicating almost full concordance. This study suggests that MRI allows early description and reliable staging of pannus-induced cartilage and bone erosions. The destructions can be assessed by MRI at a time when plain radiographs are normal. The different pathways of joint destruction by pannus could be demonstrated. Description and staging of pannus-induced cartilage erosions by MRI could be clinically useful for early assessment of disease severity and for determination of progression in rheumatoid arthritis, particularly in early/radiologically nonerosive disease.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01753064
