|ECR 2018 / C-0415|
|Evaluation of temporomandibular (tmj) and atlanto-axial (aaj) joints with open gantry low field mr without contrast in patients with early and long rheumatoid arthritis.|
In conclusion, the presence of symptomatology, even more if associated with positive autoantibodies and inflammatory indices, is related to organic alterations evident with our method (open gantry 0.28 T MRI scan without contrast with dedicated coils), such as the flattening of the disc, the erosions of the mandibular condyle and the altered articular relationships. These alterations are very important from the clinical and prognostic point of view, especially in relation to the quality of life of patients with RA, and are also the subject of pharmacological and maxillofacial targeted therapies . No statistically significant correlations were found for patients with early RA; in this group, no sufficient radiological alterations were found to allow a more detailed statistical analysis. There was no correlation with the flattening of the articular condyle, probably due to the limited study sample or to the greater importance of degenerative rather than inflammatory phenomena, at the base of the development of this alteration. Also the AAJ alterations showed little incidence; therefore a more accurate judgment can not be expressed. Another limitation of the study was represented by the non-use of the contrast agent, which is perhaps the reason for the poor identification of the synovial pannus even in patients who presented pain associated with different organic alterations evident on the MRI examination.
It would be interesting to evaluate data concerning a larger series, and possibly studies comparing the diagnostic results between high-field and low-field MRI scans.
Therefore, the study and monitoring of TMJ by this MRI method can be considered useful in patients with long RA and with positive laboratory tests and may be subject to future studies.
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Prolonged image acquisition time after contrast agent administration results in increased synovial thickness on post-contrast MRI of JIA patients: standardisation is key