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Chiropractic Research Review

E-MRI: More Accurate than X-ray, Clinical Examination for RA?

It can be difficult to diagnose rheumatoid arthritis (RA) or predict the course it will follow in a patient, especially in its early stages. Early and aggressive treatment has been shown to be more effective than conservative care when treating RA, warranting the need for better imaging methods to determine prognosis.

One such method may be low field dedicated extremity magnetic resonance imaging (E-MRI).

Researchers recruited 25 RA patients in Denmark who fulfilled the American College of Rheumatology criteria for the condition and were experiencing their first year of the disease. Three controls with no RA symptoms were also evaluated. The 2nd-5th metacarpophalangeal (MCP) and wrist joints were examined using radiographs, clinical evaluations, and E-MRI.

E-MRI detected 9.5 times as many bone erosions as X-ray (57 compared to 6). Synovial hypertrophy was much higher in patients exhibiting signs of joint inflammation, such as tenderness and swelling. Also, E-MRI detected synovial hypertrophy in 51% of joints with no clinical signs of synovitis.

Conclusion: This study demonstrates that joint destruction begins very early in patients with RA. E-MRI allows for accurate observation of inflammatory and destructive changes in the wrists and MCP joints of rheumatoid arthritis patients. Chiropractors should consider E-MRI for early detection of RA in patients whom they suspect have the condition.

Lindegaard H, Vallø J, Hørslev-Petersen K, et al. Low field dedicated magnetic resonance imaging in untreated rheumatoid arthritis of recent onset. Annals of the Rheumatic Diseases, August 2001:60, pp. 770-776.

Chiropractic Research Review

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