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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.


Figure 1
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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.

 

Figure 2
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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.

 

Figure 3
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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.

 

Figure 4
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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).

 

Figure 5
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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.

 

Figure 6
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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.

 

Figure 7
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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).

 

Figure 8
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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.

 

Figure 9
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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.

 

Figure 10
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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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