POS1363 MRI HAND FINDINGS IN PATIENTS WITH EARLY INFLAMMATORY ARTHRITIS: A CROSS-SECTIONAL STUDY

Le résumé fourni par la source

Background: MRI is useful in assessing inflammatory soft tissue and bone involvement, including synovitis, tenosynovitis, osteitis, and erosions, in patients with early inflammatory arthritis (EIA). Over 90% of patients with EIA show MRI evidence of synovitis, and 70-80% have tenosynovitis [1]. It serves as a diagnostic tool, identifies poor prognostic markers and provides a semi-quantitative approach to evaluate patient outcomes. With the evolving emphasis on early diagnosis and treat-to-target strategies in RA management, there is a growing need to better understand MRI findings in EIA patients. This understanding is crucial for discerning predictive patterns and enabling more precise diagnostic and prognostic applications. Objectives: To describe the MRI findings in patients with EIA and to determine whether there is any difference between seropositive and seronegative EIA. Methods: All consecutive patients with EIA seen between June 2023 and December 2023 were assessed. EIA was defined as onset of symptoms in the past 6 months and lack of overt clinical synovitis but MRI evidence of inflammation. Demographic information, clinical features, serological parameters, rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (anti-CCP) levels, laboratory results (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP]), and MRI findings were collected for each patient. MRI scans were assessed by a radiologist who was blinded to the patient’s clinical information and diagnosis. The radiologist evaluated the bone marrow edema, synovitis, erosions, triangular cartilage lesions, tenosynovitis, joint space narrowing, and ganglion cysts. Results: A total of 45 patients were evaluated, of which 36 were female, with a median age of 49 years(IQR: 40.5-59.5). The median symptom duration before diagnosis was 3 months(IQR:1.3-6). Oligoarticular joint pain was the most common pattern observed in 42%, followed by palindromic in 35% and additive in 22%. RF was positive in 13 patients (29%), and 18 (40%) tested positive for anti-CCP antibodies. Raised ESR was observed in 44%, and 37% had elevated CRP levels. The most prevalent MRI finding was synovitis in 34(75%), followed by tenosynovitis in 25(55%), flexor tenosynovitis in 22(48%) and extensor tenosynovitis in 17(37%) patients. Bone marrow edema was found in 15(33%), predominantly in the carpal bones (16%). Erosions were detected in 29% of the patients (Figure 1). Triangular cartilage lesions were observed in 7(15.5%), joint space narrowing in 2(4%), and ganglion cysts in 11 patients(4%). A comparison of MRI findings in the seropositive and seronegative groups showed that seropositive patients had significantly higher CRP levels and subclinical PIP synovitis. There were no significant differences in bone marrow edema, erosion, triangular cartilage lesions, or ganglion cysts (Figure 2). Conclusion: This study provides valuable insights into the diagnostic utility of MRI for detecting subclinical synovitis and erosions within the first six months of inflammatory arthritis. Additionally, it advances our understanding of the ability of MRI to distinguish inflammatory patterns across different forms of arthritis. Notably, seropositive patients exhibited elevated CRP levels and subclinical synovitis in the PIP joints compared with seronegative patients. Identifying the distribution patterns in MRI from this study can be utilized in future neural network analyses and deep machine learning, offering potential diagnostic and prognostic implications. We are recruiting more patients over the next 6 months and then intend to follow up this cohort for long term. REFERENCES: [1] McQueen FM, Stewart N, Crabbe J, Robinson E, Yeoman S, Tan PL, et al. Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals a high prevalence of erosions at four months after symptom onset. Ann Rheum Dis. 1998 Jun; 57(6):350–6. Acknowledgements: NIL. Disclosure of Interests: None declared.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.