Periarticular Bone Findings in Rheumatoid Arthritis: T2-Weighted Versus Contrast-Enhanced T1-Weighted MRI
Lawrence Yao1,
Michael Magalnick2,
Mildred Wilson2,
Peter Lipsky2 and
Raphaela Goldbach-Mansky2
1 Diagnostic Radiology Department, National Institutes of Health, 10 Center
Drive, Room 1C640, Bethesda, MD 20892-1182.
2 National Institute of Arthritis, Musculoskeletal, and Skin Diseases, National
Institutes of Health, Bethesda, MD.

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Fig. 1A 43-year-old woman with rheumatoid arthritis. Fat-suppressed
T2-weighted MR image depicts large osseous lesion at proximal aspect of lunate
(arrow). Other less hyperintense osseous abnormalities are present
elsewhere in carpus.
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Fig. 1B 43-year-old woman with rheumatoid arthritis. Corresponding
enhanced T1-weighted image similarly depicts large lesion in lunate
(arrow). Mild synovitis is more clearly evident (arrowhead)
on enhanced imaging.
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Fig. 1C 43-year-old woman with rheumatoid arthritis. Corresponding CT
image depicts large erosion along proximal lunate. Palmar subluxation of
carpus distorts axial anatomy in this case.
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Fig. 2A 74-year-old woman with rheumatoid arthritis. Fat-suppressed
T2-weighted MR image only faintly depicts subcortical abnormality at dorsal
aspect of lunate (arrow).
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Fig. 2B 74-year-old woman with rheumatoid arthritis. Corresponding
enhanced T1-weighted image clearly depicts this lesion at dorsal lunate. Mild
synovitis is also more clearly evident.
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Fig. 2C 74-year-old woman with rheumatoid arthritis. Corresponding CT
image depicts equivocal subcortical radiolucency in corresponding location
(arrow), seen only in retrospect.
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Fig. 3A 37-year-old woman with rheumatoid arthritis. Fat-suppressed
T2-weighted coronal MRI shows prominent, ill-defined marrow signal
abnormality, or edema pattern, in third metacarpal base (arrow).
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Fig. 3B 37-year-old woman with rheumatoid arthritis. Corresponding
percent enhancement image also shows this abnormality (arrow),
although it is less prominent and more focal.
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Fig. 3C 37-year-old woman with rheumatoid arthritis. Axial CT image
shows equivocal subchondral radiolucency at dorsal aspect of third metacarpal
base (arrow), seen only in retrospect.
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Fig. 3D 37-year-old woman with rheumatoid arthritis. Adjacent and
more distal CT image shows potential deepening of enthesis at ulnar aspect of
third metacarpal base (arrow), which was not interpreted as
erosion.
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Copyright © 2006 by the American Roentgen Ray Society.