Early changes in joint damage due to rheumatoid arthritis (RA) and inflammation detected with MRI predict changes in joint damage evident on subsequent X-rays, a recent study found. These findings support the use of MRI as a valid method for monitoring structural damage in short-duration randomized controlled trials (RCTs). Pooled data from 4 RCTs involving 1,022 RA hands and wrists in early and established RA were analyzed. Researchers found:

• Progression of MRI erosion scores at weeks 12 and 24 predicted progression of X-ray erosions at weeks 24 and 52, with areas under the curve (AUCs) of 0.64 and 0.74, respectively.
• 12-week and 24-week changes in MRI osteitis scores were similarly predictive of 24-week and 52-week X-ray erosion progressions; pooled AUCs were 0.78 and 0.77, respectively.
• MRI changes in synovitis at weeks 12 and 24 also predicted progression of X-ray joint damage (erosion and joint-space narrowing) at weeks 24 and 52 (AUCs=0.72 and 0.65, respectively).