From the Guidelines
Periarticular foci on MRI typically do not need to be reimaged unless there are specific clinical concerns or changes in symptoms, as stated by the American College of Rheumatology and European League Against Rheumatism 1. The decision to reimage should be based on the radiologist's recommendation, the clinical context, and the patient's symptoms rather than routine follow-up. Some key points to consider when deciding whether to reimage periarticular foci on MRI include:
- The presence of specific clinical concerns or changes in symptoms, such as increasing pain, decreased range of motion, or swelling
- The identification of benign findings, such as bone islands, small cysts, or normal vascular channels, which generally do not require reimaging
- The presence of indeterminate or suspicious findings, which may warrant follow-up imaging
- The use of MRI as the preferred modality for follow-up, due to its excellent soft tissue contrast and ability to detect subtle changes in lesions over time According to the most recent and highest quality study, the American College of Rheumatology and European League Against Rheumatism agree that the decision to repeat MRI to assess disease activity or monitor for disease response depends on the clinical circumstances 1. The Spondyloarthritis Research Consortium of Canada method has been utilized as a scoring system for quantification and follow-up of lesions at the sacroiliac joints on MRI, which may be helpful in guiding the decision to reimage 1. Ultimately, the decision to reimage periarticular foci on MRI should be made through shared decision-making between the clinician and patient, considering the risks of missed pathology versus unnecessary imaging.
From the Research
Periarticular Foci on MRI
- The need to reimage periarticular foci on MRI is not directly addressed in the provided studies 2, 3, 4, 5, 6.
- However, the studies discuss the importance of imaging in diagnosing and characterizing periarticular bone changes in various conditions, such as osteoarthritis 2, rheumatoid arthritis 3, and axial spondyloarthritis 6.
- The use of MRI and other imaging techniques, such as µCT scans and X-ray diffraction, can help identify and characterize periarticular bone lesions and calcifications 3, 4, 5.
- The studies suggest that specific imaging findings, such as bone marrow edema and sclerosis, can be relevant for diagnosing certain conditions, such as axial spondyloarthritis 6.
- However, there is no clear evidence to suggest that periarticular foci on MRI need to be reimaged in general, and the decision to reimage would likely depend on the specific clinical context and diagnosis 2, 3, 4, 5, 6.