| Objective: To observe the manifestation of wrist joints'synovitis changes, bone erosion and articular cavity effusion in MRI. Meanwhile, to explore the correlation between MRI manifestations and serological testing index.Material and Method: Take 30 patients with definite RA according to clinical symptom and serological testing results but with no bone destruction in wrist joints according to the examination of X-ray as research object. Carry out routine scan and enhanced scan on functioning wrist or side wrist with serious clinic symptom on 3.0T MRI. The routine scan consists of the coronal and sagittal T1-weighted imaging scan, the coronal T2-weighted imaging scan, and the coronal and sagittal T2-weighted fat suppression scan.The enhanced scan consists of the coronal and sagittal T1WI fat suppression scan. 22 patients in this group simply take routine scan, while the rest take both. At the same time, the parts and number of lesion in bone erosion found by MRI should be counted as well as whether there exists articular effusion. In addition, the gcs of synovitis should be done with the Ostergaard semiquantitive method which is recommended by the OMERACT. Besides, materials about the patient should be recorded. The sensitivity of the early-RA's pathology manifestation in X-ray and MRI imaging should be collected and analyzed. Correlation research between gcs of synovitis and bone erosion in MRI imaging should be carried out. On the basis of the result, the correlation analysis between the serological testing results and the two mentioned above ought to be on as well.Each patient takes the examination of X- ray and MRI within the same day. First they take the X-ray examination. Those who have no definite bone destruction take MRI examination later. The interval between serological tests and image radiology examination is within 36 hours.Results: In these 30 patients, the X-ray examination showed that six of them had positive change, five with esteo porosis, and among them one with combined swell in proximal interphalangeal joints. The last one had swell simply in netacarpophalangeal joints. The MRI found out that 21 patients had bone erosion or bone marrow edema. There were 49 parts with bone erosion, including one in one patient's proximal interphalangeal joints, eleven in eleven patients'netacarpophalangeal joints, and thirty seven in eighteen patients'wrist joints. What's more, two patients had both bone erosion and combined metacarpal bone marrow edema. Apart from the above, nine patients had neither of the problems. All the patients'synovium in wrist joint thickened in varying degrees, including eight in metacarpophalangeal joints, ten in proximal interphalangeal joints and four in both. After the measurement and grade of all the patients'proximal phalangeal joints, metacarpophalangeal joints and wrist joints, the results illustrated that the gcs of synovium between the bone erosion group and the normal group had great difference. And the correlation between the gcs of synovium in wrist joints and the serological testing results in clinic(RF, IgA, IgG, IgM)Presented statistical significance(p<0.05),but as to CRP, no obvious correlation existed (r= 0.20, p>0.05).When took the statistical analysis to the serological testing in bone erosion group and the normal group, the results justified that the divergence of CRP, IgA, IgG showed statistical significance(p <0.05). But the divergence between RF and IgM meant no statistical significance (p>0.05). Moreover, all the patients had articular effusion in varying degrees.Conclusion: MRI can reveal the pathology of the wrist joints with RA. It is superior to the traditional X-ray examination in finding out the problems of bone erosion, synovitis and articular cavity effusion. The usage of MRI can do semi-quantitive gcs to early-RA .The gcs of Early-RA in MRI and bone erosion have deep correlation with the serological manifestation, which can provide a platform to do further diagnosis and research of its motion level of Early-RA.
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