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- Category: Vol. 77, December 2009
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Validity of Magnetic Resonance Imaging in Early Rheumatoid Arthritis,KHALED FAWZY Z. HASSAN and INASSE IBRAHIM GABALLAH
Abstract
Aim of Study: To assess the diagnostic value of magnetic resonance (MR) imaging in patients with possible early-stage RA in whom the clinical diagnosis is equivocal and who present with polyarthralgia without radiographic evidence of RA.
Patients and Methods: This study comprised 81 patients (20 men and 61 women; mean age, 44±12.7 years), who attended or were referred to the Rheumatology Clinic of Abha Private Hospital. Patients presented with persistent polyarthral-gia with possible early-stage rheumatoid arthritis (RA) and without radiographic evidence of RA. Postero-anterior and oblique hand radiographs in all patients were obtained and interpreted. Participant patients underwent contrast-enhanced MR imaging as part of their diagnostic work-up. To confirm the final diagnosis, patients were instructed to do follow-up visits to the Rheumatology Clinic for at least one year after the MR imaging. A total of 11 patients were excluded from our study as they did not continue their one-year follow-up visits to the Rheumatology Clinic after having the MR imaging.
Results: The confirmed diagnoses of 70 patients were that 38 patients had RA, while 32 had non-RA diseases. By applying the MR imaging criterion, 38 patients were classified as having RA and 32 were classified as having a non-RA condition. The sensitivity of the MR imaging proved to be 97.4%, while its specificity was 90.6%. Positive predictive value was 92.5% while the negative predictive value was 96.7%. Its diagnostic accuracy was 94.3%.
Conclusions: The MR imaging criterion shows excellent validity with high sensitivity, specificity, predictive values and accuracy for the diagnosis of early-stage RA.
Recommendation: MR imaging be added as a useful tool for the evaluation of patients suspected of having early-stage RA.