Answer:
Rheumatoid Arthritis of the Wrist Joint.
Findings:
Subchondral TIRM hyperintensities in the ulnar styloid process and distal radius. Bone marrow edema is seen in the scaphoid , lunate and triquetrum . Contrast enhancement in the ulnar styloid process, scaphoid, lunate and triquetrum reflecting Erosions. Synovial thickening with soft tissue enhancement in the radio ulnar joint , radiocarpal joints and intercarpal joints , reflecting small pannus formation. Synovial inflammation around the extensor carpi ulnaris tendon.
Discussion:
Bone Marrow erosions are a cardinal features in RA A Pre erosive lesion has 6 fold increase for erosion occurrence 1 and 6 yrs later. Increased synovial hyperemia due to angiogenesis is important in pathogenesis of RA. Contrast MRI is useful in early detection of erosions as well as synovial involvement. OMERACT (Outcome Measures in Rheumatoid Arthritis Clinical Trials) have specified the Core set of MR sequences – FS TIW Pre and Post Contrast -Synovitis FS T2WI -Bone Marrow edema
Reference:
Kari Palosari et al -Rheumatology May 2006
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai
Rheumatoid Arthritis of the Wrist Joint.
Findings:
Subchondral TIRM hyperintensities in the ulnar styloid process and distal radius. Bone marrow edema is seen in the scaphoid , lunate and triquetrum . Contrast enhancement in the ulnar styloid process, scaphoid, lunate and triquetrum reflecting Erosions. Synovial thickening with soft tissue enhancement in the radio ulnar joint , radiocarpal joints and intercarpal joints , reflecting small pannus formation. Synovial inflammation around the extensor carpi ulnaris tendon.
Discussion:
Bone Marrow erosions are a cardinal features in RA A Pre erosive lesion has 6 fold increase for erosion occurrence 1 and 6 yrs later. Increased synovial hyperemia due to angiogenesis is important in pathogenesis of RA. Contrast MRI is useful in early detection of erosions as well as synovial involvement. OMERACT (Outcome Measures in Rheumatoid Arthritis Clinical Trials) have specified the Core set of MR sequences – FS TIW Pre and Post Contrast -Synovitis FS T2WI -Bone Marrow edema
Reference:
Kari Palosari et al -Rheumatology May 2006
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai