Background/Purpose: It is recommended by an EULAR imaging taskforce that MR-detected inflammation is useful in the diagnostic process of Rheumatoid Arthritis. This recommendation is based on the sensitivity of MR to detect inflammation. The specificity is unknown, but knowledge on the prevalence of MR-detected inflammation in symptom-free persons is pivotal when considering MR for diagnostic purposes. This prompted us to perform this study.

Methods: From November 2013-December 2014 196 symptom-free persons were recruited from the general population. Inclusion criteria were: no history of inflammatory arthritis, no joint symptoms during the last month and no clinically detectable arthritis at physical examination. Contrast-enhanced 1.5T MR-images of the dominant MCP, wrist and MTP joints were made and scored by two readers according to RAMRIS. At categorisation, MR-inflammation was considered present if both readers scored positive.

Results: Of 193 persons scanned (age range 19-89 years), only 28% had no single inflammatory-feature. Higher age correlated with higher inflammation-scores (p<0.001). Individual lesions were mostly grade-1. Preferential locations for synovitis were MCP-3 (14% in persons aged 40-59 years, 17% if aged ≥60 years). MCP-2 (8%, 19% respectively), wrist joints (8-35% if aged ≥40 years) and MTP-1 (11-13% if aged ≥40 years). BME was frequent at all ages in the lunate (6-27%) and MTP-1 (10-23%). Tenosynovitis was infrequent, except for extensor carpi ulnaris (9% in persons aged 40-59 years; 12% if aged ≥60 years).

Conclusion: MR-detected inflammation is prevalent in the absence of symptoms, especially at higher age and at preferential locations. Tables with RAMRIS-based and age, location and inflammation-type dependent prevalences were constructed.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/studying-mr-detected-inflammation-in-symptom-free-persons-from-the-general-population-to-generate-ramris-based-reference-values/