Anup Sadhu *
Consultant Radiologist EKO CT & MRI Scan Centre Medical College, Kolkata.*
MRI is one of the important modalities in musculoskeletal disorders.

For orthopaedic surgeons MRI is " God's gift". MRI has significantly advanced our understanding of the early pathology of RA. One of the possible practical applications of MRI in early RA is to help differentiate this condition from other inflammatory arthropathies. Bone marrow oedema at the articular margin was found to be a useful differentiating feature being present in approximately 60% of patients with poor prognosis (insidious onset). Intrasynovial inflammation may characterize those with poor prognosis and extrasynovial capsular inflammation may be a marker of good prognosis associated with remission. MRI is an exciting imaging modality and is particularly suitable for application to musculoskeletal medicine.

Scoring systems have been developed in MRI analogous to the radiological scoring and are being standardised so that they can be used universally to measure joint inflammation and damage. MRI has clinical application in the diagnosis of inflammatory arthritis and in the prediction of prognosis which could influence management decisions in early disease. It is also likely to assume crucial importance in monitoring response to disease-modifying agent so that efficacy can be assessed within weeks of starting therapy.

MRI is unlikely to replace plain radiography as this remains a better tool for imaging multiple joint areas in established disease. However, MRI is emerging as an important imaging technique in the context of early arthritis and promises to be a useful addition to the radiologist's armamentarium.
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