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RAMRIS MRI Scoring — SCE Rheumatology MCQ

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HardMusculoskeletal ImagingRAMRIS MRI ScoringSCE Rheumatology

A multicentre early rheumatoid arthritis trial uses the updated OMERACT RAMRIS to score MRI of the wrist and second to fifth metacarpophalangeal joints. Which description of the scoring framework is correct?

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Correct answer: E — Synovitis is scored 0–3, osteitis 0–3 and erosion 0–10; tenosynovitis and joint-space narrowing may also be added.

RAMRIS is the OMERACT semiquantitative MRI outcome measure for rheumatoid arthritis. Its original domains are synovitis, bone marrow oedema—termed osteitis—and bone erosion at predefined wrist and MCP sites. Synovitis and osteitis are each graded 0–3, whereas erosion is graded 0–10 according to the proportion of assessed bone volume eroded. Updated recommendations provide additional scores for tenosynovitis and joint-space narrowing. Therefore, E is correct. A and C transpose the domain scales, while C also substitutes spondyloarthritis features. D incorrectly omits osteitis and adds radiographic features not forming RAMRIS domains. E incorrectly excludes joint synovitis and erosion and treats tendon rupture as a RAMRIS damage domain.

Reference: Østergaard M et al. The OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging (MRI) Scoring System: Updated Recommendations by the OMERACT MRI in Arthritis Working Group. Journal of Rheumatology. 2017;44:1706–1712. https://pubmed.ncbi.nlm.nih.gov/28811353/