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Tenosynovitis/Rheumatoid Arthritis

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<v ->One of the common causes of tenosynovitis

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is rheumatoid arthritis.

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This is an interesting case just to explore that.

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We all would recognize flexor tenosynovitis,

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but how many of you would recognize

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these little fluid collections here,

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and here,

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as tenosynovitis about the interosseous muscles?

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That's a common, but subtle finding in the hand

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in patients with rheumatoid arthritis,

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and it can be symptomatic.

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In this particular patient,

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who has rheumatoid with chronic disease,

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we see an extensor tenosynovitis

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composed mainly of fibrous tissue with low signal.

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Here in the sagittal plane,

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all of this is fibrous adhesions in the tendon sheath.

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You can see that in the axial plane, as well.

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And here in the coronal plane

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we can see it as well as extensive bone and joint disease.

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This is chronic tenosynovitis.

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Now, when you have chronic tenosynovitis,

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you can develop those rice bodies.

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I'll show you more examples later on,

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but here's an example of flexor tenosynovitis,

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in rheumatoid, with rice bodies, those areas of low signal.

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And you'll note, as I mentioned earlier,

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when you do get a lineum in those cases,

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the synovium enhances,

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but most of these rice bodies do not enhance.

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So you'll see a background of low signal intensity

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in these cases.

Report

Faculty

Donald Resnick, MD

Professor Emeritus, Department of Radiology

University of California, San Diego

Carlos H. Longo, MD

Head of Radiology

Hospital Beneficência Portuguesa de São Paulo

Abdalla Skaf, MD

Head of the Department of Diagnostic Imaging Hospital HCor / Medical director of ALTA diagnostics (DASA group)

HCOR / DASA / TELEIMAGEM

Rodrigo Aguiar, MD, PhD

Professor of Radiology

Federal University of Paraná - Brazil

Marcelo D’Abreu, MD

Head of Radiology

Hospital Mae de Deus

Tags

Musculoskeletal (MSK)

MSK

MRI

Hand & Wrist