MRI-detected erosions as defined by the Rheumatoid Arthritis MRI Scoring System (RAMRIS) criteria [26] can be observed in the metacarpophalangeal and metatarsophalangeal joints of symptom-free individuals in the general population and in different types of rheumatologic diseases and are thus nonspecific [27]. Although synovial hypertrophy can be appreciated on unenhanced sequences, the use of IV gadolinium aids in the evaluation of synovitis because it helps differentiate joint effusion from synovium, which may demonstrate similar signal characteristics on unenhanced sequences [23,28]. MRI Area of Interest Without IV Contrast Regarding the diagnosis of RA, the 2013 EULAR task force recommendations on the use of imaging of the joints in RA state that when there is diagnostic doubt following radiographs, either US or MRI can be used to improve certainty of diagnosis of RA above clinical criteria as well as to detect early joint damage before it is radiographically visible [13]. Both MRI and US outperform clinical evaluation in the detection of inflammation and structural damage and provide prognostic information concerning radiographic progression [18-20]. The evidence is inconclusive as to whether MRI or US should be considered the preferred method for evaluation of RA [18]. MRI area of interest without IV contrast can show cortical erosions, bone edema, synovial hypertrophy, and soft tissue abnormalities such as tenosynovitis and dactylitis. Cortical irregularity from inflammatory enthesitis and periostitis and increased fluid signal in the subjacent bone marrow may be seen on MRI without IV contrast [27]. Entheseal the diagnosis of seronegative spondyloarthropathy [26].
Chronic Extremity Joint Pain Suspected Inflammatory Arthritis Crystalline Arthritis or Erosive Osteoarthritis PCAs. MRI-detected erosions as defined by the Rheumatoid Arthritis MRI Scoring System (RAMRIS) criteria [26] can be observed in the metacarpophalangeal and metatarsophalangeal joints of symptom-free individuals in the general population and in different types of rheumatologic diseases and are thus nonspecific [27]. Although synovial hypertrophy can be appreciated on unenhanced sequences, the use of IV gadolinium aids in the evaluation of synovitis because it helps differentiate joint effusion from synovium, which may demonstrate similar signal characteristics on unenhanced sequences [23,28]. MRI Area of Interest Without IV Contrast Regarding the diagnosis of RA, the 2013 EULAR task force recommendations on the use of imaging of the joints in RA state that when there is diagnostic doubt following radiographs, either US or MRI can be used to improve certainty of diagnosis of RA above clinical criteria as well as to detect early joint damage before it is radiographically visible [13]. Both MRI and US outperform clinical evaluation in the detection of inflammation and structural damage and provide prognostic information concerning radiographic progression [18-20]. The evidence is inconclusive as to whether MRI or US should be considered the preferred method for evaluation of RA [18]. MRI area of interest without IV contrast can show cortical erosions, bone edema, synovial hypertrophy, and soft tissue abnormalities such as tenosynovitis and dactylitis. Cortical irregularity from inflammatory enthesitis and periostitis and increased fluid signal in the subjacent bone marrow may be seen on MRI without IV contrast [27]. Entheseal the diagnosis of seronegative spondyloarthropathy [26].