The results of a recent study suggest that contrast-enhanced MRI may help physicians determine whether patients have rheumatoid or psoriatic arthritis in the hand and wrist, and aid them in choosing therapies that are best suited for each condition.
As our study suggests, the use of contrast-enhanced MRI could play an important role in differentiating psoriatic arthritis from rheumatoid arthritis, Nina F. Schwenzer, MD, the lead author of the study, stated in an American Roentgen Ray Society press release.
The study appears in the March issue of the American Journal of Roentgenology.
Diagnosing RA, PsA
Schwenzer noted that it is difficult to distinguish rheumatoid arthritis (RA) from psoriatic arthritis (PsA) because the symptoms are similar, and current diagnostic tests are not always sufficient.
Schwenzer and her colleagues from the University Hospital of Tubingen in Tubingen, Germany studied 45 patients with either RA or PsA who underwent imaging using contrast-enhanced MRI. Researchers presume that the uptake of contrast media in PsA and RA is different, Schwenzer noted in the release.
Difference in perfusion
Our study revealed a significant difference in perfusion between those patients with rheumatoid arthritis and psoriatic arthritis after 15 minutes, Schwenzer stated in the release. However, since it was a small group of patients and there was an overlap in perfusion values between both types of arthritis, a diagnosis could not be led by contrast-enhanced MRI alone. Our results are nonetheless promising though.
She added, In the past, the treatment strategy for patients with psoriatic arthritis was based on that for patients with rheumatoid arthritis. Recent research indicates that the therapeutic management, including medication and therapy monitoring, has to be adapted for each type of arthritis.
Schwenzer NF, Kötter I, Henes JC, et al. The role of dynamic contrast-enhanced MRI in the differential diagnosis of psoriatic and rheumatoid arthritis. AJR Am J Roentgenol. 2010. March; 194: 715-720.