Correlation of structural abnormalities of the wrist and metacarpophalangeal joints evaluated by high‐resolution peripheral quantitative computed tomography, 3 T esla magnetic resonance imaging and conventional radiographs in rheumatoid arthritis

Aim In rheumatoid arthritis ( RA ) hands, we applied high‐resolution peripheral quantitative computed tomography ( HR ‐p QCT ) and 3  T esla (3  T ) magnetic resonance imaging ( MRI ), which are new methods for erosion detection and bone marrow edema ( BME ) quantification. We compared the erosion measurements between these techniques with conventional radiographs ( CR ) in order to examine their significance for evaluating structural abnormalities. Methods In 16 RA patients, HR ‐p QCT of metacarpophalangeal and wrist joints, 3  T MRI of wrist joints, as well as CR in both hands and feet were performed. Ten patients had 1‐year follow‐up CR . CR s were graded according to the modified Sharp score ( MSS ). Bone erosions were evaluated in HR ‐p QCT and MRI . BME pattern was quantified from MRI for volume, signal change and total burden. Results The erosion detection sensitivity of MRI was 85.7% and CR was 60.9% when HR ‐p QCT was considered as a reference method. The smallest dimensions of erosion detected by HR ‐p QCT , MRI and CR were 0.09, 0.14 and 0.66 cm, respectively. Baseline total MSS was correlated with HR ‐p QCT erosion measures, MRI erosion measures and MRI BME volume ( P  < 0.05). The mean difference between baseline and 1‐year follow‐up MSS (delta MSS ) was 1.2. A trend was observed toward a correlation between delta MSS and MRI BME volume and burden. Conclusion This study demonstrates that HR ‐p QCT detects more and smaller bone erosions compared to MRI and CR . In addition, 3  T MRI can provide quantitative measurement of BME . Combination of HR ‐p QCT and MRI modalities may provide powerful tools to evaluate joint inflammation and bone damage in RA .