Synovial membrane enhancement and bone erosion by magnetic resonance imaging for prediction of radiologic progression in patients with early rheumatoid arthritis

Objective: The aim of this study was to determine the prognostic factors related to radiographic progression in patients with early rheumatoid arthritis (RA) (less than I year after onset) undergoing enhanced MRI at entry. Methods: Demographic characteristics, disease duration, and enhanced MRI of the dominant wrists were recorded at entry. Duration of morning stiffness, number of swollen joints, serum rheumatoid factor (RF), erythrocyte sedimentation rate, C-reactive protein (CRP) level, and radiographs of hands and feet (Sharp/van der Heijde score) were assessed at each follow-up. Outcome was defined as damage seen on radiography. Results: One hundred fourteen patients were followed up for 10 years. Logistic regression analysis showed that high MRI score, CRP, and RF positivity were associated with radiologic progression. The MRI score at baseline was a better predictor than CRP level and RF positivity at entry. Conclusion: The assessment of synovial membrane enhancement and bone erosion by MRI of the wrist in early RA is very helpful to predict erosive outcome.