PT - JOURNAL ARTICLE AU - Frances Humby AU - Arti Mahto AU - Muaaze Ahmed AU - Andrew Barr AU - Stephen Kelly AU - Maya Buch AU - Costantino Pitzalis AU - Philip G. Conaghan TI - The Relationship Between Synovial Pathobiology and Magnetic Resonance Imaging Abnormalities in Rheumatoid Arthritis: A Systematic Review AID - 10.3899/jrheum.161314 DP - 2017 Sep 01 TA - The Journal of Rheumatology PG - 1311--1324 VI - 44 IP - 9 4099 - http://www.jrheum.org/content/44/9/1311.short 4100 - http://www.jrheum.org/content/44/9/1311.full SO - J Rheumatol2017 Sep 01; 44 AB - Objective. Magnetic resonance imaging (MRI) has been increasingly recognized as a critical tool for the assessment of patients with rheumatoid arthritis (RA) and is able to reliably identify synovitis, bone marrow edema, bone erosion, and joint space narrowing (JSN)/cartilage loss. Understanding the exact relationship between each MRI feature and local synovial pathobiology is critical to dissect disease pathogenesis as well as develop future predictive models.Methods. A systematic review was performed of the current published literature examining the relationship between MRI abnormalities and synovial pathobiology in patients with RA.Results. Eighteen studies were identified; most focused on validation of MRI as a tool to detect and quantify synovitis, with a significant relationship demonstrated. Additionally, from the limited data available, a critical role seems likely for synovial pathways, at least in driving joint damage. However, there was a lack of data examining the relationship between synovial pathobiology and bone marrow abnormalities and JSN.Conclusion. Although understanding the interrelationship of these disease biomarkers offers the potential to enhance the predictive validity of modern imaging with concomitant synovial pathobiological analysis, further studies integrating MRI with synovial tissue analysis in well-controlled cohorts at distinct disease stages before and after therapeutic intervention are required to achieve this.