MUSCULOSKELETAL IMAGING: Arthritis of the Proximal Joints
Case Author: Kirkland W. Davis, MD, University of Wisconsin of School of Medicine, and Public Health
History
55-year-old man with sciatica.
Imaging Findings
Coronal T1-weighted MR image of hips (A) and coronal fat-suppressed T2-weighted MR image of the left hip (B) show large intraarticular erosions of the femurs and acetabula. Prominent material of intermediate to low signal intensity distends both joints. No bone marrow edema is associated with the erosions, but edema is present in the surrounding muscles.
- Amyloid arthropathy
- Hemophilic arthropathy
- Pigmented villonodular synovitis (PVNS)
- Synovial chondromatosis
- Tophaceous gout
Diagnosis
Amyloid arthropathy
Teaching Points
Tophaceous gout is an extraarticular process; occasional intraosseous tophi may be seen. On MR images, low-signal-intensity masses associated with arthritis include tophi (gout), hemosiderin (pigmented villonodular synovitis [PVNS], hemophilic arthropathy), Β2 microglobulin (amyloid arthropathy), and rheumatoid nodules, among others. Pigmented villonodular synovitis (PVNS) is rarely polyarticular.
Suggested Readings
Sheldon PJ, Forrester DM, Learch TJ. Imaging of intra-articular masses. RadioGraphics 2005; 25:105–119
This page is updated with new content weekly. It was last updated on August 14, 2017.