Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis

A Duer, M Østergaard, K Hørslev-Petersen, J Vallø

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

 
Udgivelsesdato: 2008-Jan
OriginalsprogEngelsk
TidsskriftAnnals of the Rheumatic Diseases
Vol/bind67
Udgave nummer1
Sider (fra-til)48-51
Antal sider3
ISSN0003-4967
DOI
StatusUdgivet - 1. jan. 2008

Fingeraftryk

Magnetic resonance
Radionuclide Imaging
Magnetic resonance imaging
Bone
Differential Diagnosis
Imaging techniques
Erosion
Psoriatic Arthritis
Psoriasis
Joints

Citer dette

@article{2ed7a7b0d3c711dcb2ba000ea68e967b,
title = "Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis",
abstract = "OBJECTIVES: To investigate the value in clinical practice of hand magnetic resonance imaging (MRI) and whole body bone scintigraphy in the differential diagnosis of patients with unclassified arthritis. METHODS: 41 patients with arthritis (> or = 2 swollen joints, > 6 months' duration) which remained unclassified despite conventional clinical, biochemical and radiographic (hands and feet) examinations were studied. Patients who fulfilled the ACR criteria for rheumatoid arthritis (RA) or had radiographic bone erosions were excluded. Contrast enhanced MRI of the wrist and metacarpophalangeal joints of the most symptomatic hand and whole body bone scintigraphy were performed. Two rheumatologists agreed on the most likely diagnosis and the patients were treated accordingly. A final diagnosis was made by another specialist review 2 years later. RESULTS: Tentative diagnoses after MRI and bone scintigraphy were: RA (n = 13), osteoarthritis (n = 8), other inflammatory diseases (n = 11), arthralgias without inflammatory or degenerative origin (n = 9). Two years later 11 of 13 patients with an original tentative diagnosis of RA had fulfilled the ACR criteria while two were reclassified (one to psoriatic arthritis (RF negative + psoriasis); one to non-specific self-limiting arthritis). No patients classified as non-RA at baseline had fulfilled the ACR criteria after 2 years. The presence of MRI synovitis, MRI erosion and bone scintigraphic pattern compatible with RA showed 100{\%} specificity for a diagnosis of RA at 2 year follow-up. CONCLUSIONS: In patients with arthritis unclassified despite conventional clinical, biochemical and radiographic examinations, MRI and scintigraphy allowed correct classification as RA or non-RA in 39 of 41 patients when fulfilment of ACR criteria 2 years later was considered the standard reference.",
keywords = "Adolescent, Adult, Aged, Arthritis, Arthritis, Rheumatoid, Bone and Bones, Contrast Media, Diagnosis, Differential, Female, Follow-Up Studies, Gadolinium DTPA, Humans, Joint Diseases, Magnetic Resonance Imaging, Male, Metacarpophalangeal Joint, Middle Aged, Osteoarthritis, Rheumatic Diseases, Sensitivity and Specificity",
author = "A Duer and M {\O}stergaard and K H{\o}rslev-Petersen and J Vall{\o}",
year = "2008",
month = "1",
day = "1",
doi = "10.1136/ard.2006.063792",
language = "English",
volume = "67",
pages = "48--51",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "B M J Group",
number = "1",

}

Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis. / Duer, A; Østergaard, M; Hørslev-Petersen, K; Vallø, J.

I: Annals of the Rheumatic Diseases, Bind 67, Nr. 1, 01.01.2008, s. 48-51.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis

AU - Duer, A

AU - Østergaard, M

AU - Hørslev-Petersen, K

AU - Vallø, J

PY - 2008/1/1

Y1 - 2008/1/1

N2 - OBJECTIVES: To investigate the value in clinical practice of hand magnetic resonance imaging (MRI) and whole body bone scintigraphy in the differential diagnosis of patients with unclassified arthritis. METHODS: 41 patients with arthritis (> or = 2 swollen joints, > 6 months' duration) which remained unclassified despite conventional clinical, biochemical and radiographic (hands and feet) examinations were studied. Patients who fulfilled the ACR criteria for rheumatoid arthritis (RA) or had radiographic bone erosions were excluded. Contrast enhanced MRI of the wrist and metacarpophalangeal joints of the most symptomatic hand and whole body bone scintigraphy were performed. Two rheumatologists agreed on the most likely diagnosis and the patients were treated accordingly. A final diagnosis was made by another specialist review 2 years later. RESULTS: Tentative diagnoses after MRI and bone scintigraphy were: RA (n = 13), osteoarthritis (n = 8), other inflammatory diseases (n = 11), arthralgias without inflammatory or degenerative origin (n = 9). Two years later 11 of 13 patients with an original tentative diagnosis of RA had fulfilled the ACR criteria while two were reclassified (one to psoriatic arthritis (RF negative + psoriasis); one to non-specific self-limiting arthritis). No patients classified as non-RA at baseline had fulfilled the ACR criteria after 2 years. The presence of MRI synovitis, MRI erosion and bone scintigraphic pattern compatible with RA showed 100% specificity for a diagnosis of RA at 2 year follow-up. CONCLUSIONS: In patients with arthritis unclassified despite conventional clinical, biochemical and radiographic examinations, MRI and scintigraphy allowed correct classification as RA or non-RA in 39 of 41 patients when fulfilment of ACR criteria 2 years later was considered the standard reference.

AB - OBJECTIVES: To investigate the value in clinical practice of hand magnetic resonance imaging (MRI) and whole body bone scintigraphy in the differential diagnosis of patients with unclassified arthritis. METHODS: 41 patients with arthritis (> or = 2 swollen joints, > 6 months' duration) which remained unclassified despite conventional clinical, biochemical and radiographic (hands and feet) examinations were studied. Patients who fulfilled the ACR criteria for rheumatoid arthritis (RA) or had radiographic bone erosions were excluded. Contrast enhanced MRI of the wrist and metacarpophalangeal joints of the most symptomatic hand and whole body bone scintigraphy were performed. Two rheumatologists agreed on the most likely diagnosis and the patients were treated accordingly. A final diagnosis was made by another specialist review 2 years later. RESULTS: Tentative diagnoses after MRI and bone scintigraphy were: RA (n = 13), osteoarthritis (n = 8), other inflammatory diseases (n = 11), arthralgias without inflammatory or degenerative origin (n = 9). Two years later 11 of 13 patients with an original tentative diagnosis of RA had fulfilled the ACR criteria while two were reclassified (one to psoriatic arthritis (RF negative + psoriasis); one to non-specific self-limiting arthritis). No patients classified as non-RA at baseline had fulfilled the ACR criteria after 2 years. The presence of MRI synovitis, MRI erosion and bone scintigraphic pattern compatible with RA showed 100% specificity for a diagnosis of RA at 2 year follow-up. CONCLUSIONS: In patients with arthritis unclassified despite conventional clinical, biochemical and radiographic examinations, MRI and scintigraphy allowed correct classification as RA or non-RA in 39 of 41 patients when fulfilment of ACR criteria 2 years later was considered the standard reference.

KW - Adolescent

KW - Adult

KW - Aged

KW - Arthritis

KW - Arthritis, Rheumatoid

KW - Bone and Bones

KW - Contrast Media

KW - Diagnosis, Differential

KW - Female

KW - Follow-Up Studies

KW - Gadolinium DTPA

KW - Humans

KW - Joint Diseases

KW - Magnetic Resonance Imaging

KW - Male

KW - Metacarpophalangeal Joint

KW - Middle Aged

KW - Osteoarthritis

KW - Rheumatic Diseases

KW - Sensitivity and Specificity

U2 - 10.1136/ard.2006.063792

DO - 10.1136/ard.2006.063792

M3 - Journal article

C2 - 17289759

VL - 67

SP - 48

EP - 51

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 1

ER -