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ERAMRS: a new MR scoring system for early rheumatoid arthritis of the wrist

Fan Xiao1, James F Griffith2, Andrea L Hilkens1

  • 1Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong.

European Radiology
|March 16, 2019
PubMed
Abstract

Insights

A new scoring system, Early Rheumatoid Arthritis Magnetic Resonance Score (ERAMRS), effectively assesses wrist inflammation in early rheumatoid arthritis (ERA) using MRI. ERAMRS demonstrated superior correlation with clinical and serological markers compared to other MR scoring systems.

Area of Science:

  • Rheumatology
  • Radiology
  • Medical Imaging

Background:

  • Early rheumatoid arthritis (ERA) diagnosis and monitoring rely on clinical and serological assessments.
  • Magnetic Resonance Imaging (MRI) offers detailed visualization of inflammatory changes in ERA, but standardized scoring systems are crucial for clinical application.

Purpose of the Study:

  • To develop and validate the Early Rheumatoid Arthritis Magnetic Resonance Score (ERAMRS), a novel semi-quantitative system for assessing wrist inflammation on MRI in ERA.
  • To compare the performance of ERAMRS against established MRI scoring systems (RAMRIS, McQueen) and clinical/serological measures.

Main Methods:

  • 106 treatment-naïve ERA patients underwent 3-T MRI of the wrist.
  • Clinical assessments included Disease Activity Score-28 and Health Assessment Questionnaire.
  • Serological markers (ESR, CRP) were measured.
  • MRI data was scored using ERAMRS, RAMRIS, and McQueen systems.

Main Results:

  • ERAMRS showed the highest correlation with clinical disease activity (r=0.476) and serological parameters (r=0.562).
  • The RAMRIS system exhibited lower correlations with clinical (r=0.369) and serological (r=0.436) measures.
  • ERAMRS outperformed the RAMRIS synovitis subscore in correlating with clinical and serological assessments.

Conclusions:

  • The ERAMRS system is a clinically relevant and user-friendly tool for evaluating wrist inflammation in ERA via MRI.
  • ERAMRS demonstrates improved clinical relevance due to its superior correlation with established clinical and serological assessments of inflammation.
Keywords:
Clinical correlationEarly rheumatoid arthritisMagnetic resonance imagingSemi-quantitative scoring system

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