M. del Carmen Larios-Forte, Radiology and Research Division, Hospital Regional Monterrey, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Nuevo León, México Mario A. Garza-Elizondo, Rheumatology Department, Internal Medicine Division, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo Leon, México Cassandra M. Skinner-Taylor, Rheumatology Department, Internal Medicine Division, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo Leon, Nuevo León, México Jorge A. Esquivel-Valerio, Servicio de Reumatología, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Mexico David Vega-Morales, Rheumatology Department, Internal Medicine Division, Hospital Universitario ?Dr. José Eleuterio González,? Universidad Autónoma de Nuevo Leon, Nuevo León, México Dionicio A. Galarza-Delgado, Rheumatology Department, Internal Medicine Division, Hospital Universitario ?Dr. José Eleuterio González,? Universidad Autónoma de Nuevo Leon, Nuevo León, México Diana E. Flores-Alvarado, Rheumatology Department, Internal Medicine Division, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo Leon, Nuevo León, México Rodrigo E. Elizondo-Omaña, Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico Alejandro Quiroga-Garza, Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico


Introduction: The Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT) and Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS), with the EULAR-OMERACT-2005 MR-Atlas, demonstrate characteristics and lesion degrees (synovitis, erosions, bone marrow edema [BME]) in rheumatoid arthritis (R.A.) clinical diagnosis for follow-up and treatment response. Our study’s objective was to use RAMRIS in patients from three R.A. phases to detect lesions according to their tissue characterization (fluid levels in tissue) using different magnetic resonance imaging (MRI) sequences. Methods: Sixty contrast-enhanced MRIs from R.A. patients (clinical suspect arthralgia [CSA] – 38%, early R.A. [ERA] – 37%, and established [R.A.] – 25%) were evaluated according to the American College of Rheumatology (ACR-EULAR)-2010 criteria. R.A. lesions evaluation was performed with RAMRIS/Atlas/scoring; our analysis added the presence of lesions in the thumb and wrist (tenosynovitis, synovitis, erosions, and BME), proposing an “extended RAMRIS.” Results: Overall, 83% (50/60) women, mean 42 ± 13.5 (19-70) years-of-age, from 1731 evaluated sites, 964 lesions were identified. Synovitis 46% (445/964) was most frequently found in the carpal bones 72% (321/445). Extended RAMRIS demonstrated tenosynovitis and erosions in 1st carpometacarpal, 1st metacarpophalangeal, and hand-wrist tenosynovitis. Gadolinium contrast showed synovial and erosions enhancement indicating active lesions, most predominantly in ERA. Conclusions: Extended RAMRIS score was not statistically different (p = 0.43) from RAMRIS-2005. However, it considers all hand-wrist bone joint sites and tendon lesions needed for assessing a more accurate degree of disease development. A proposed extended RAMRIS should be considered.



Keywords: Rheumatoid arthritis. Magnetic resonance imaging. Outcome measures in rheumatoid arthritis clinical trials-rheumatoid arthritis magnetic resonance imaging score. Extended rheumatoid arthritis magnetic resonance imaging score.