Bilateral MRI More Accurately Characterizes RA vs Unilateral MRI

hand MRI
hand MRI
Investigators sought to determine whether bilateral magnetic resonance imaging of the hands is more optimal than unilateral magnetic resonance imaging in patients with rheumatoid arthritis.

For patients with rheumatoid arthritis (RA), magnetic resonance imaging (MRI) of bilateral hands can better characterize disease attributes compared with MRI of the unilateral hand, according to results published in the Journal of Rheumatology.

The study included 120 participants with active RA. Each participant underwent clinical assessment, radiograph, and MRI of bilateral hands. The researchers scanned bilateral hands simultaneously on 3.0 T whole-body MRI, scoring hands for synovitis, osteitis, and bone erosion according to the RA MRI scoring (RAMRIS) system.

When the researchers analyzed the MRI of dominant unilateral hand, it caused misdiagnosis of MRI synovitis and osteitis in 5% of wrists and 3 MRI features in 5% to 14% of metacarpophalangeal joints (McNemar test, all P <.05).

When the researchers analyzed the MRI of the clinically more severe hand, it resulted in misdiagnosis of MRI synovitis in 5% of wrists and 3 MRI features in 7% to 15% of metacarpophalangeal joints (all P <.05).

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The researchers used scatter plots and linear regression analyses to show differences in RAMRIS between the dominant or selected hand (Y values) and nondominant or nonselected hand (X values). All linear models were significantly different from a Y=X linear model, which indicated that the dominant or clinically more severe hand could not represent the contralateral hand to evaluate RAMRIS.

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Mo Y, Yang Z, He H, et al. Magnetic resonance imaging of bilateral hands is more optimal than MRI of unilateral hands for rheumatoid arthritis. [published online May 1, 2018]. J Rheumatol. doi: 10.3899/jrheum.171044