MRI evidence of persistent joint inflammation and progressive joint damage despite clinical remission during treatment of early rheumatoid arthritis
Similar to ultrasound in RA, MRI appears to "over-read" inflammation (synovitis) and damage (erosions) in the joints than may be apparent on clinical assessment (joint examination and blood tests for inflammation). Interestingly, such radiological findings seem to correlate far better with patients' pain, physical function and general well-being, while the conventional clinical measures of disease activity seem to fall short.
To put it plainly, patients can better gauge what's going on with their RA (and whether the medicines they are currently receiving are helping) than what the attending doctors can figure out with their examination skills and lab tests. And how they feel and function can better predict how they'll eventually turn out years later (disabled or otherwise), than whatever prognostication construct is currently at the rheumatologists' disposal.
Ouch. More evidence that the "How ya doin'?" score is trumping our laboriously devised and validated disease activity scores.