The portable devices can be used to identify features that can be influenced by early tumor necrosis factor (TNF) blockade. There is evidence that patients who start early on anti-TNF treatments can achieve remission compared with patients treated with disease-modifying antirheumatic drugs.
“It’s crucial to start early to get patients into remission,” Dr. Emery said.
An advantage of MRI over traditional x-ray is that there are fewer chances to miss bone erosion in MRI images. A slight hand turn on two-dimensional x-rays can hide bone erosion, said Dr. Emery. He admitted that there are issues with false positives based on examining MRI images, but he suggested this is more of a training issue than a functional problem.
When, and if, peripheral MRIs come into mainstream use among rheumatologists, there is also the issue of who should read the images. Some in the radiology community have argued they should take on the task of examining MRI images, but other experts contend that rheumatologists should be able to read their own MRI images.
The peripheral MRI debate may just be beginning. As more studies on the subject emerge, experts may revisit the discussion. For now, many experts are taking a wait and see approach, leaning to the idea the peripheral MRIs may not yet be ready for widespread use.
Greg Lavine is a freelance journalist based in Maryland.
