RESEARCH - MRI of large intraosseous lesions in patients with inflammatory arthritis

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AJR Am J Roentgenol. 2004 Nov;183(5):1453-63.

MRI of large intraosseous lesions in patients with inflammatory arthritis.

Tehranzadeh J, Ashikyan O, Dascalos J, Dennehey C.

Department of Radiological Sciences, University of California, Irvine, 101

The City Drive S, Route 140, Orange, CA 92868, USA.

OBJECTIVE: The purpose of our study was to evaluate on MRI the occurrence of

large cystlike intraosseous lesions in patients with inflammatory arthritis.

SUBJECTS AND METHODS: We prospectively reviewed contrast-enhanced MR images

of 128 hands and wrists in 44 patients with clinical presentation of

inflammatory arthritis. Large lesions (> or = 1 cm) found on MR images were

further evaluated for the presence of a cortical break and intraarticular

extension. These data were correlated with clinical and laboratory findings

and the duration of arthritis. RESULTS: We found 26 patients with rheumatoid

arthritis, seven with psoriatic arthritis, two with systemic lupus

erythematosus, one with HIV-associated arthritis, one with mixed connective

tissue disorder, one with paraneoplastic-associated arthritis, one with

inflammatory bowel disease arthritis, and five patients with early

unclassified inflammatory arthritis. Twelve patients had 16 large

intraosseous lesions, none of which were detected on available radiographs

(availability of radiographs for large erosions was 75%). A cortical break

with intraarticular extension of the large lesions was seen in 12 cases.

Four lesions were not intraarticular.

CONCLUSION: Even large intraosseous lesions may be occult on radiography.

MRI is a superior technique for detecting these lesions in the small joints

of the hand and wrist in inflammatory arthritis. Although large intraosseous

erosions often communicate with joints, we observed four large purely

intraosseous enhancing lesions without intraarticular connection. Patients

with large erosions have a longer duration of inflammatory arthritis.

PMID: 15505320

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=15505320 & itool=iconabstr & query_hl=9 & itool=pubmed_DocSum

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