TY - JOUR T1 - Magnetic Resonance Imaging Bone Edema at Enrollment Predicts Rapid Radiographic Progression in Patients with Early RA: Results from the Nagasaki University Early Arthritis Cohort JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.150988 SP - jrheum.150988 AU - Yoshikazu Nakashima AU - Mami Tamai AU - Junko Kita AU - Toru Michitsuji AU - Toshimasa Shimizu AU - Shoichi Fukui AU - Masataka Umeda AU - Ayako Nishino AU - Takahisa Suzuki AU - Yoshiro Horai AU - Akitomo Okada AU - Takayuki Nishimura AU - Tomohiro Koga AU - Shin-ya Kawashiri AU - Naoki Iwamoto AU - Kunihiro Ichinose AU - Yasuko Hirai AU - Kazuhiko Arima AU - Satoshi Yamasaki AU - Hideki Nakamura AU - Tomoki Origuchi AU - Shoichiro Takao AU - Masataka Uetani AU - Kiyoshi Aoyagi AU - Katsumi Eguchi AU - Atsushi Kawakami Y1 - 2016/05/01 UR - http://www.jrheum.org/content/early/2016/04/22/jrheum.150988.abstract N2 - Objective To clarify whether magnetic resonance imaging (MRI) bone edema predicts the development of rapid radiographic progression (RRP) in the Nagasaki University Early Arthritis Cohort of patients with early-stage rheumatoid arthritis (RA). Methods Patients with early-stage RA (n = 76) were enrolled and underwent 1.5-T MRI of both wrists and finger joints. Synovitis, bone edema, and bone erosion were evaluated using the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring (RAMRIS). RRP was defined as an annual increment > 3 at 1 year by the Genant-modified Sharp score of plain radiographs. A multivariate logistic regression analysis was performed to establish the risk factors for RRP. Results Median disease duration at enrollment was 3 months. RRP was found in 12 of the 76 patients at 1 year. A univariate analysis revealed that matrix metalloprotease-3, RAMRIS bone edema score, and RAMRIS bone erosion score were associated with RRP. Multivariate logistic regression analyses demonstrated that the RAMRIS bone edema score at enrollment (5-point increase, OR 2.18, 95% CI 1.32–3.59, p = 0.002) was the only independent predictor of the development of RRP at 1 year. A receiver-operating characteristic analysis identified the best cutoff value for RAMRIS bone edema score as 5. RRP was significantly rare among the patients with a RAMRIS bone edema score < 5 at enrollment (2 from 50 patients). Conclusion Our findings suggest that MRI bone edema is closely associated with the development of RRP in patients with early-stage RA. Physicians should carefully control the disease activity when MRI bone edema is observed in patients with early RA. ER -