Inflammatory Arthritis
KEY FACTS
Terminology
Imaging
IMAGING
General Features
Radiographic Findings
Often normal in early stages of disease
Soft tissue swelling, juxtaarticular osteopenia, joint space narrowing, bone erosion
Joint obliteration and ankylosis, particularly of carpus
Arthritis mutilans and joint deformities (“swan neck,” “boutonniere”) less commonly seen with disease-modifying therapy
MR Findings
Shows fluid and edematous tissue (synovium, erosions, subchondral marrow, paraarticular soft tissues)
Effusions and pannus are both hyperintense and may not be readily distinguishable
Joint space narrowing, erosions, bone marrow edema graded semiquantitatively [outcome measures in rheumatology clinical trials (OMERACT) score]
Ultrasonographic Findings
Imaging Recommendations
Joints best examined in long axis, tendons in short axis
Schematic examination of each symptomatic joint
If multiple joints symptomatic, examine wrists and 3 most symptomatic other joints
Erosions usually associated with surface cortical irregularity and adjacent pannus
Use minimal transducer pressure when examining superficial joints, especially for color Doppler imaging
Inflammatory Arthritis
on the dorsum of the carpus deep to the extensor tendons 
. The distal end of the radius 
, the lunate 
, and the capitate 
are shown.
on the dorsum of the carpus deep to the extensor tendons 
. The distal end of the radius 
, the lunate 
, and the capitate 
are shown. Hypoechoic synovium is more edematous than hyperechoic synovium.
