Growing Need for Diagnostic Precision in Rheumatoid Arthritis: Proposal of MR Imaging Criteria for Early Diagnosis
The recent and revolutionary paradigm shift involving novel therapeutics for the treatment of rheumatoid arthritis (RA) has called for changes in the early diagnosis of RA. Physicians now need to diagnose RA earlier, and with greater accuracy, in order to initiate effective definitive treatment as e...
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2020-07-22.
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| LEADER | 03081 am a22002053u 4500 | ||
|---|---|---|---|
| 001 | intechopen_books_7539 | ||
| 042 | |a dc | ||
| 100 | 1 | 0 | |a Takeda, Akira |e author |
| 700 | 1 | 0 | |a Sugimoto, Hideharu |e author |
| 245 | 0 | 0 | |a Growing Need for Diagnostic Precision in Rheumatoid Arthritis: Proposal of MR Imaging Criteria for Early Diagnosis |
| 260 | |b IntechOpen, |c 2020-07-22. | ||
| 500 | |a https://mts.intechopen.com/articles/show/title/growing-need-for-diagnostic-precision-in-rheumatoid-arthritis-proposal-of-mr-imaging-criteria-for-ea | ||
| 520 | |a The recent and revolutionary paradigm shift involving novel therapeutics for the treatment of rheumatoid arthritis (RA) has called for changes in the early diagnosis of RA. Physicians now need to diagnose RA earlier, and with greater accuracy, in order to initiate effective definitive treatment as early as possible. However, due to the complexity and diverseness of RA, we still do not have comprehensive diagnostic criteria for RA readily available. To find a solution to this challenge, we aimed to develop practically useful criteria which integrate gadolinium (Gd) contrast-enhanced magnetic resonance imaging (MRI) findings with clinical manifestations of the disease. These diagnostic criteria we propose, the "diagnostic criteria for early RA with MRI findings," are composed of two domains. The first domain consists of clinical findings suggestive of RA, which include both entry criteria-i.e., polyarthralgia of hands (joint pain of three or more joint areas confirmed by a physician), and exclusion criteria-i.e., exclusion of other rheumatic conditions including systemic lupus erythematosus (SLE), dermatomyositis and polymyositis (PM/DM), mixed connective tissue disease (MCTD), primary Sjögren's syndrome (SS), and Behçet's disease (BD). The second domain constitutes MRI criteria, which represent Gd-enhanced MRI findings indicating bilateral synovial enhancement seen in any joints of the proximal interphalangeal (PIP), metacarpophalangeal (MCP), or wrist joints. RA is defined by fulfilling all conditions of both domains. Our prospective study demonstrated that these criteria for the diagnosis of early RA, incorporating MRI findings with physical manifestations, can successfully distinguish patients with RA from those with other mimicking conditions, showing a sensitivity of 96%, specificity of 86%, and accuracy of 92%. When a case does not meet the criteria, RA can be ruled out with a high negative predictive value of 95%. We believe our "diagnostic criteria for early RA with MRI findings" can greatly help to solve unmet diagnostic needs in the early treatment of RA. | ||
| 540 | |a https://creativecommons.org/licenses/by/3.0/ | ||
| 546 | |a en | ||
| 690 | |a Connective Tissue Disease - Current State of the Art | ||
| 655 | 7 | |a Chapter, Part Of Book |2 local | |
| 786 | 0 | |n https://www.intechopen.com/books/7539 | |
| 787 | 0 | |n ISBN:978-1-78985-698-9 | |
| 856 | \ | \ | |u https://mts.intechopen.com/articles/show/title/growing-need-for-diagnostic-precision-in-rheumatoid-arthritis-proposal-of-mr-imaging-criteria-for-ea |z Get Online |