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Patients with rheumatoid and psoriatic arthritis undergoing MRI show differences in synovial enhancement 15 minutes after contrast injection, suggesting that this method may be helpful in differentiating between the diseases.

This research was published in the March issue of the American Journal of Roentgenology.

Nina F. Schwenzer, M.D., of the University Hospital of Tübingen in Germany, and colleagues analyzed data from 45 individuals, 31 with rheumatoid arthritis and 14 with psoriatic arthritis. All underwent dynamic contrast-enhanced magnetic resonance imaging ( MRI ) of the most clinically noticeable hand or wrist.

The researchers found that the groups showed no difference in the relative enhancement rate at 35 seconds, 52 seconds, or three minutes after injection of contrast. No significant difference was seen between the groups in the rate of early enhancement at 35 and 52 seconds, either. However, the groups did show a significant difference in relative enhancement rate after 15 minutes. Associations were found between inflammatory parameters and dynamic contrast-enhanced parameters in those with rheumatoid arthritis, but not psoriatic arthritis.

"It has been suggested that the inflamed synovial membrane of psoriatic arthritis differs slightly from rheumatoid synovium. Histopathologic studies showed a greater number of synovial vessels per square millimeter, in contrast to rheumatoid arthritis, and a marked thickening in the walls of capillaries and small arteries with inflammatory perivascular infiltrates. Consequently, the uptake of contrast media in psoriatic arthritis and rheumatoid arthritis is presumed to be different," the authors write.

Source: American Journal of Roentgenology

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