Computed tomography (CT) scan with two radiation sources reveals tophi in patients with chronic gout. However, the study by Diekhoff et al. Did not consider other information that could be obtained using the same image, for example, bone marrow edema (OCM) detection using a virtual bone marrow image (VBMI). The purpose of this study was to evaluate the possibility of determining OKM using VBMI in patients with acute arthritis using magnetic resonance imaging (MRI) as a standard.

This retrospective study included 11 patients. These patients underwent both MRI and CT with two sources of radiation (average interval - 40 days). Two decryption specialists working with anonymized data independently determined the presence of OKM in the MRI image (standard) and VBMI. Statistical analysis was performed using the correlation coefficient φ and Cohen's kappa coefficient.

According to MRI and VBMI, bone inflammation was detected in two patients with a definitive diagnosis of rheumatoid arthritis and in one patient with septic arthritis. However, in each case, inflammation of individual bones was detected using MRI, but not using VBMI. In addition, in three patients with a final diagnosis of rheumatoid arthritis, there was a lack of OCM, which was true, and a good correlation was observed between the two methods (φ = 0.8; κ = 0.8). Reliability in the study by different experts was extremely high for both methods (κ = 0.9).

It was concluded that VBMI can be used to detect bone inflammation in patients with inflammatory arthritis. Nevertheless, further research is required in larger target populations in order to more accurately determine the correctness and additional advantages of this method, as well as indications for its use.