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📌Additional Features Suggestive of Rheumatoid Arthritis (RA)
1. Rice Bodies
- Rice bodies consist of sloughed fibrinous material and necrotic debris. These rod-shaped (1–3 mm) intermediate T1 and T2 signal bodies may be seen in the joints or involved bursae.
- Although rice bodies can also be seen in tuberculous arthritis, they are most frequently encountered in RA and are less common in other inflammatory arthritides.
2. Synovial Cysts
- Synovial cysts are synovial-lined fluid collections that may have long extensions from the joint into the adjacent soft tissues. In the knee, these cysts most commonly originate from popliteal Baker cysts.
- Synovial cysts may also gain access to the medullary cavity of the bones through erosions and create lytic, endosteal eroding lesions that will image as low T1, high T2 central fluid signal with peripheral rim enhancement, as would be expected of a cyst.
- While these cysts are not specific and may develop with any long-standing large joint effusion, they are most common in RA in the context of a polyarthropathy.
3. Low T2-Signal Synovitis
- Most inflammatory synovitis demonstrates low to intermediate T1 and intermediate to increased T2 signal.
- However, chronic RA may result in fibrosis within the pannus, which shows low signal on both T1 and T2 imaging.
References
- Magn Reson Imaging Clin N Am 22 (2014) 703–724
"Visualizing MSK Radiology: A Practical Guide to Radiology Mastery"
© 2022 MSK MRI Jee Eun Lee All Rights Reserved.
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#RheumatoidArthritis, #RiceBodies, #SynovialCysts, #LowT2Signal, #MRI, #InflammatoryArthritis, #Radiology, #Synovitis, #ChronicRA, #MedicalImaging
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