Magnetic Resonance Imaging Appearance of the Hands and Feet in Patients with Early Rheumatoid Arthritis

NATHALIE BOUTRY, ANNE LARDÉ, FRANCK LAPÈGUE, ELIZABETH SOLAU-GERVAIS, RENÉ-MARC FLIPO, and ANNE COTTEN

ABSTRACT.

Objective. To describe the magnetic resonance (MRI) imaging findings of the feet in patients with early rheumatoid arthritis (RA), and to compare MRI appearance of the feet with that of the hands.

Methods. Thirty consecutive patients (18 women, 12 men; age range 19-64 yrs) with early RA underwent MRI of hands and feet. Axial fat suppressed gadolinium enhanced T1 weighted spin-echo and gadolinium enhanced 3-dimensional gradient-echo (FLASH) images were obtained.

Results. In the hands, MRI findings suggested active synovitis of the wrist and metacarpophalangeal (MCP) joints in 28 (93%) and 27 (90%) patients, respectively. In the feet, active synovitis was observed in 29 (97%) patients. Bone erosions were seen in the wrist joints in 24 (80%) patients. Observers found as many bony changes in the MCP as in the metatarsophalangeal joints [23 (77%) patients]. MRI detected tenosynovitis in 16 (53%) patients in the hands, and in 18 (60%) patients in the feet. Bursitis located between or beneath the metatarsal heads was a common MRI finding [19 (63%) patients].

Conclusion. Additional MRI of the feet may be useful when evaluation of the hands does not help identify early RA. (J Rheumatol 2003;30:671-9)

Key Indexing Terms:

RHEUMATOID ARTHRITIS
MAGNETIC RESONANCE IMAGING
HAND ARTHRITIS

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From the Department of Musculoskeletal Radiology and Department of Rheumatology, Hopital Roger Salengro, Lille, France.

N. Boutry, MD; A. Lardé, MD; F. Lapègue, MD; A. Cotten, MD, Department of Musculoskeletal Radiology; E. Solau-Gervais, MD, R-M. Flipo, MD, Department of Rheumatology.

Address reprint requests to Dr. N. Boutry, Radiologie Osteo-Articulaire, Hopital Roger Salengro, Boulevard du Pr. J. Leclerq, 59037 Lille cedex, France.

Submitted January 31, 2002; revision accepted September 19, 2002.

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