HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hsu, C.-Y. Articles by Shih, T. T.-F. Search for Related Content PubMed PubMed Citation Articles by Hsu, C.-Y. Articles by Shih, T. T.-F. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Tuberculous Infection of the Wrist: MRI Features

¹ Department of Medical Imaging, National Taiwan University Hospital, 7, Chung-Shan S. Rd. Taipei, Taiwan.
² Department of Radiology, National Taiwan University, School of Medicine, Taipei, Taiwan.

Abstract

OBJECTIVE. The objective of our study was to define the MRI features of tuberculous infection of the wrist.

MATERIALS AND METHODS. We present the MRI findings of eight patients with tuberculous infection of the wrist. Spin-echo T1-weighted, gradient-echo T2^*-weighted, and fast spin-echo T2-weighted sequences were performed for all patients. Gadolinium-enhanced MR images were obtained in seven patients. All images were evaluated for the characteristics of tuberculous infection of the wrist, including the presence of synovial thickening around the joints and tendons, signal intensity of the thickened tenosynovium and synovium on the T2-weighted images, synovial fluid collection in the tendon sheath, small low-signal and nonenhanced foci in the synovial fluid, bone erosion, osteomyelitis, and encasement of the median nerve.

RESULTS. The tuberculous infection involved the right (n = 6) and left (n = 2) wrists. All patients had synovial thickening around the flexor and extensor tendons with synovial fluid collection in the tendon sheath. The thickened tenosynovium and synovium revealed low signal intensity on T1-weighted images, intermediate to low signal intensity on T2- and T2^*-weighted images, and enhancement on contrast-enhanced MR images. The synovial fluid showed intermediate to low signal on T1-weighted images and homogeneous or heterogeneous high signal intensity on T2- and T2^*-weighted images. Multiple small foci of low signal intensity and nonenhancement scattered in the synovial fluid were present in seven patients. Bone erosion occurred in seven patients, osteomyelitis was seen in six patients, and encasement of the median nerve was found in three patients.

CONCLUSION. Characteristic MRI findings of tuberculous infection of the wrist include synovial thickening around the flexor and extensor tendons and synovial fluid collection that contains small low-signal and nonenhanced foci in the tendon sheath. Bone erosion, osteomyelitis, and median nerve encasement are also frequently present. These characteristic manifestations are helpful in diagnosing this disease entity.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				R S CHERIAN, M BETTY, M T MANIPADAM, V M CHERIAN, P M POONNOOSE, A T OOMMEN, and R A CHERIAN The "dot-in-circle" sign -- a characteristic MRI finding in mycetoma foot: a report of three cases Br. J. Radiol., August 1, 2009; 82(980): 662 - 665. [Abstract] [Full Text] [PDF]

				C. C. Roberts, P. T. Liu, and F. S. Chew Imaging evaluation of tendon sheath disease: self-assessment module. Am. J. Roentgenol., March 1, 2007; 188(3 Suppl): S10 - S12. [Abstract] [Full Text] [PDF]

				J TEH and G Whiteley MRI of soft tissue masses of the hand and wrist Br. J. Radiol., January 1, 2007; 80(949): 47 - 63. [Full Text] [PDF]