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Logo of annrheumdAnnals of the Rheumatic DiseasesCurrent TOCInstructions for authors
Ann Rheum Dis. Feb 2005; 64(Suppl 1): i48–i55.
PMCID: PMC1766831

Pitfalls in scoring MR images of rheumatoid arthritis wrist and metacarpophalangeal joints

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Selected References

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  • Østergaard Mikkel, Peterfy Charles, Conaghan Philip, McQueen Fiona, Bird Paul, Ejbjerg Bo, Shnier Ron, O'Connor Philip, Klarlund Mette, Emery Paul, et al. OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Core set of MRI acquisitions, joint pathology definitions, and the OMERACT RA-MRI scoring system. J Rheumatol. 2003 Jun;30(6):1385–1386. [PubMed]
  • Peterfy CG, Linares R, Steinbach LS. Recent advances in magnetic resonance imaging of the musculoskeletal system. Radiol Clin North Am. 1994 Mar;32(2):291–311. [PubMed]
  • Ejbjerg Bo, Narvestad Eva, Rostrup Egill, Szkudlarek Marcin, Jacobsen Søren, Thomsen Henrik S, Østergaard Mikkel. Magnetic resonance imaging of wrist and finger joints in healthy subjects occasionally shows changes resembling erosions and synovitis as seen in rheumatoid arthritis. Arthritis Rheum. 2004 Apr;50(4):1097–1106. [PubMed]
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Figures and Tables

Figure 1
 T1 weighted (T1w) coronal image of the wrist in a patient with RA in whom a metal screw was used for surgical fixation of the distal radioulnar joint.
Figure 2Figure 2
 (A) T1 weighted coronal image of the scaphoid where the radial border is blurred because of adjacent synovial membrane with lower signal, "averaging" with high signal of bone marrow. (B) T1 weighted axial image showing the scaphoid margin is ...
Figure 3
 T2 weighted fat saturated (T2w FS) axial image of the wrist showing movement artefact.
Figure 4
 T2 weighted axial image of the distal radius and ulna. Fat saturation is complete for the ulna but not for the radius, where "shine through" of marrow fat is apparent (thin arrow). This appearance mimics bone oedema. Fat in subcutaneous tissues ...
Figure 5
 Palmar interosseous ligaments of the wrist (Reprinted from Taleisnik, J. The Wrist, Figure 2-18, copyright 1985, with permission from Elsevier Inc.).
Figure 6Figure 6
 (A) T1 weighted coronal image of the wrist from a patient with early RA. The interosseous ligament between the capitate and hamate blurs the inner borders of these bones distally (arrow). This appearance can mimic erosion (but erosion may also ...
Figure 7
 Short tau inversion recovery (STIR) coronal image of the wrist reveals an interosseous ligament between the capitate and scaphoid (thin arrow). There is also bone oedema within the distal capitate (wide arrow).
Figure 8
 Interosseous ligaments as they attach to the metacarpal head and the base of the proximal phalanx.
Figure 9
 Short tau inversion recovery (STIR) coronal image of the carpus showing a nutrient vessel within the triquetrum and two nutrient foramina within the lunate mimicking erosions (thin arrows). True erosions with surrounding bone oedema are shown ...
Figure 10Figure 10
 (A) T1 weighted coronal image of the wrist from a patient with early RA (six months from onset). (B) T1 weighted coronal image of the same region six years later showing gross deformity of the joint with erosion and distal migration of the lunate ...
Figure 11Figure 11Figure 11
 (A) T1 weighted coronal image of the wrist. The central lesion in the lunate might be localised bone oedema or erosion—an axial view is required. (B) T1 weighted axial image reveals several erosions. (C) T2 weighted fat saturation axial ...
Figure 12Figure 12
 (A) T1 weighted coronal image of the wrist in a patient with early RA. Bone oedema is seen at the pole of the triquetrum with blurring of the dark cortical line, raising the possibility of an adjacent erosion. Bone oedema is also present more ...
Figure 13
 T1 weighted axial image of the wrist showing reduced signal within the capitate, hamate, and trapezoid due to proximity of the bony border adjacent to the metacarpal bases.
Figure 14Figure 14
 (A) T1 weighted axial image of the wrist from a normal control subject. (B) Postcontrast (gadolinium-DTPA) image of the same region revealing a thin rim of enhancing synovial membrane adjacent to the palmar aspect of the ulna (arrow).
Figure 15Figure 15
 (A) T1 weighted axial image of the wrist. (B) Postcontrast T1 weighted axial image of the same region showing increased signal in the region of the flexor tendons (long arrow) plus low grade synovitis within the intercarpal joint (short arrow). ...
Figure 16
 Short tau inversion recovery (STIR) coronal image of the fingers of a patient with rheumatoid arthritis covering the second to fifth metacarpophalangeal and proximal interphalangeal joints. Bright signal over the proximal phalanx of the third ...

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