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Psoriatic Arthritis and Rheumatoid Arthritis: Findings in Contrast-Enhanced MRI

Helmut Schoellnast1, Hannes A. Deutschmann1, Josef Hermann2, Gottfried J. Schaffler1, Pia Reittner1, Fritz Kammerhuber3, Dieter H. Szolar4 and Klaus W. Preidler4

1 Department of Radiology, Medical University Graz, Graz, Austria.
2 Department of Internal Medicine, Medical University Graz, Graz, Austria.
3 Division of Radiology, Hospital of Barmherzige Brueder, Graz, Austria.
4 Diagnostikum Graz Sued West, Weblinger Guertel 25, 8054 Graz, Austria.


Figure 1
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  		Fig. 1A —52-year-old man with clinically proven psoriasis. Coronal T1-weighted spin-echo fat-saturated MR image after administration of contrast agent (TR/TE, 620/20) reveals periosteal enhancement of proximal phalanx of third digit (arrows) as sign of periostitis.

 

Figure 2
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  		Fig. 1B —52-year-old man with clinically proven psoriasis. Radiograph obtained 2 months after MRI shows proximal phalanx of third digit (arrows) without evidence of preceding periostitis. Note that radiographs are provided for case illustration. Systematic comparison between MRI and radiographs was not performed because of lack of radiographs in temporal proximity to MRI examination.

 

Figure 3
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  		Fig. 2A —74-year-old woman with clinically proven rheumatoid arthritis. Coronal T1-weighted spin-echo MR image shows focal decreased signal intensity in head of metacarpal bone of third ray consistent with bare-area bone erosion (arrow).

 

Figure 4
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  		Fig. 2B —74-year-old woman with clinically proven rheumatoid arthritis. Dorsovolar (B) and oblique (C) radiographs obtained 8 days before MRI show no evidence of bone erosion (arrows) in head of metacarpal bone of third ray. Note that radiographs are provided for case illustration. Systematic comparison between MRI and radiographs was not performed because of lack of radiographs in temporal proximity to MRI examination.

 

Figure 5
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  		Fig. 2C —74-year-old woman with clinically proven rheumatoid arthritis. Dorsovolar (B) and oblique (C) radiographs obtained 8 days before MRI show no evidence of bone erosion (arrows) in head of metacarpal bone of third ray. Note that radiographs are provided for case illustration. Systematic comparison between MRI and radiographs was not performed because of lack of radiographs in temporal proximity to MRI examination.

 

Figure 6
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  		Fig. 3A —47-year-old man with clinically proven rheumatoid arthritis. Coronal T1-weighted, turbo spin-echo, fat-saturated MR image after administration of contrast material (TR/TE, 620/20) reveals soft-tissue swelling and contrast enhancement of synovial membrane of proximal interphalangeal joint of fourth ray as sign of synovitis (arrows).

 

Figure 7
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  		Fig. 3B —47-year-old man with clinically proven rheumatoid arthritis. Radiograph obtained 10 days before MRI shows soft-tissue swelling (arrows) and narrowing of joint space of proximal interphalangeal joint of fourth ray as typical finding of arthritis. Note that radiographs are provided for case illustration. Systematic comparison between MRI and radiographs was not performed because of lack of radiographs in temporal proximity to MRI examination.

 

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