Evaluation of a Simplified Version of the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) Comprising 5 Joints (RAMRIS5)

Dr. Philipp Sewerin¹, Dr. Christoph Schleich², Dr. Christian Buchbender³, Dr. Falk Miese³, Dr. Ralph Brinks⁴, Prof. Dr. Matthias Schneider⁵, Prof. Dr. Gerald Antoch⁶ and Prof. Dr. Benedikt Ostendorf¹, ¹Department of Rheumatology, Univ. Duesseldorf, Düsseldorf, Germany, ²Department of Diagnostic and Interventional Radiology, Univ. Duesseldorf, Duesseldorf, Germany, ³Department of Diagnostic and Interventional Radiology, Univ. Duesseldorf, Düsseldorf, Germany, ⁴Univ Duesseldorf, Düsseldorf, Germany, ⁵Department of Rheumatology, Univ. Duesseldorf, Duesseldorf, Germany, ⁶Department Diagnostic and Interventional Radiology, Univ. Duesseldorf, Düsseldorf, Germany

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: diagnostic imaging and rheumatoid arthritis (RA), MRI

Session Information

Title: Imaging of Rheumatic Diseases: Magnetic Resonance Imaging (MRI)

Session Type: Abstract Submissions (ACR)

Background/Purpose

Semi-quantitative measurement of inflammatory pathologies of the hand in magnetic resonance images (MRI) is a mandatory, but time-consuming task for MRI controlled studies in Rheumatoid Arthritis (RA). The objective of this study was to evaluate a simplified version of the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) reduced to five joints of the hand (RAMRIS5).

Methods

94 patients with rheumatoid arthritis (62 female; age 59 ±12 years, range 25 – 83 years; disease duration 60 ± 90 months (median: 22 months, first quartile: 7 months, third quartile: 66 months) from the REMISSION PLUS study cohort who had complete files on C-reactive protein (CRP) levels and Disease Activity Score of 28 joints (DAS28) and complete MRI of the clinical dominant hand at baseline and after one year under anti-rheumatic therapy (follow-up time 12.5 ± 1.1 months) in a dedicated extremity MRI scanner at 0.2T were included in this retrospective study. MR images were scored according the RAMRIS criteria by two readers in consensus. Spearman correlations of the RAMRIS sum-score, subscores for RAMRIS of the metacarpophalangeal joints (RAMRISMCP), wrist (RAMRISWrist) and a reduced score comprising the MCP 2 and 3, capitate bone, triquetral bone, distal ulna were assessed. Additionally, Spearman correlations of MRI scores, CRP levels and DAS28 were calculated.

Results

There was a strong correlation between RAMRIS5 and the RAMRIS sum-score for all patients (r = 0.87, p< 0.001) at baseline and follow up (r = 0.87, p< 0.001). Among the subscores there was a significant correlation between RAMRIS5 and RAMRISMCP (baseline: r = 0.66, p < 0.001; follow-up: r = 0.74, p < 0.001) as well as between RAMRIS5 and RAMRISwrist (baseline: r = 0.72, p < 0.001, follow-up: r = 0.69, p < 0.001) at baseline and follow up. The correlation between RAMRIS5 and CRP (baseline: r = 0.21, p < 0.05; follow-up: r = 0.03, p = 0.76) or DAS28 (baseline: r = 0.17, p = 0.11; follow-up: 0.31, p < 0.01) were weak, similarly as observed for conventional RAMRIS (for CRP baseline: r = 0.29, p < 0.01; follow-up: r = 0.10, p = 0.34; for DAS28 baseline: r = 0.20, p = 0.05; follow-up: r = 0.32, p < 0.01).

Conclusion

RAMRIS5, a modified shorter RAMRIS score based on five joints of the hand is a viable tool for semi-quantitative assessment and monitoring of joint damage in RA. This abbreviated score might reduce the time needed for image analysis in MRI-controlled studies in RA and facilitate the use of MRI in studies on therapy response assessment in RA.

Disclosure:

D. P. Sewerin,
None;

D. C. Schleich,
None;

D. C. Buchbender,
None;

D. F. Miese,
None;

D. R. Brinks,
None;

P. D. M. Schneider,
None;

P. D. G. Antoch,
None;

P. D. B. Ostendorf,
None.

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluation-of-a-simplified-version-of-the-rheumatoid-arthritis-magnetic-resonance-imaging-score-ramris-comprising-5-joints-ramris5/