MRI AND X-RAY DIAGNOSTICS OF EARLY RHEUMATOID AND EARLY UNCLASSIFIED (UNDIFFERENTIATED) ARTHRITIS.

5. [THU0503]   MRI AND X-RAY DIAGNOSTICS OF EARLY RHEUMATOID AND EARLY UNCLASSIFIED (UNDIFFERENTIATED) ARTHRITIS.
I. Rapoport*¹, E. L. Luchikhina², A. V. Smirnov^1
1Radiology Department, ²Early Arthritis Research Unit, Institute of Rheumatology, Moscow, Russian Federation

Background: Invention of novel medicines – biologics – for the treatment of Rheumatic diseases as well as deeper understanding of pathogenesis processes that confirmed necessity of earliest rational treatment led to the necessity of early and accurate diagnostics of rheumatic diseases, in particularity, arthritis. MRI is a method that proposed to be widely used at early diagnostic stage, for evaluation, classification and prognosis issues.

Objectives: To check differences in MRI and X-ray data between 2 groups of patients with early arthritis: early rheumatoid arthritis (ERA) and early unclassified arthritis (EUA), in order to define possibilities of usage of MRI in early arthritis diagnostic evaluation.

Methods: 110 patients with early (less then 2 years from symptoms beginning) rheumatoid arthritis, defined by last ARA criteria, and 101 patient with EUA, defined as patient with arthritis/arthralgias, excluding patients with ERA and other exact diagnosis defined at the moment of initial evaluation. Mean age of ARA patients was 49.5±13.5 years, EUA patients – 42.08±14.4 years.

X-ray and MRI were done at initial visit to the clinic. Plain X-ray was done by usual technique, evaluated by Sharp/Van Der Heijde modification score. MRI was done at 0.2T Artoscan-C MRI, Esaote, Italy, evaluated by OMERACT-RAMRIS standard reference atlas. DAS28 score was high, ERA – 5.7±1.07, EUA – 3,5±0.8 (medium)

Results: In the tables below 

Conclusion: there is a statistically significant difference in erosion scores at both: MRI and X-ray imaging results, between ERA and EUA groups. Everything: erosion score, BMO, synovitis, even joint narrowing was less in patients with EUA, them with ERA. It means, that low-field (0.2) MRI can be used as an additional method of diagnostics, to traditional X-ray, and gives a lot of important data (BMO, synovitis score) that can help in early diagnostics and differentiation of arthritis at initial evaluation by physician.

Disclosure of Interest: Authors would like to thank GE Healthcare Russia and CIS, MR Division, for supporting presentation of these clinical findings to EULAR community and encouragement of further research activities.