Magnetic resonance imaging of Jaccoud's arthropathy in systemic lupus erythematosus

Joint Bone Spine. 2010 May;77(3):241-5. doi: 10.1016/j.jbspin.2009.10.013. Epub 2010 Mar 30.

Abstract

Objective: To perform a detailed magnetic resonance imaging (MRI) analysis of the hands of patients with Jaccoud's arthropathy (JA) secondary to systemic lupus erythematosus (SLE).

Methods: The hand with more expressive deformities compatible with JA from a group of SLE patients was examined by 1.5-T MRI. The protocol included coronal, sagittal, and axial turbo-spin-echo images before and after the administration of contrast medium. The presence of synovitis, edema, erosion, cysts, and tenosynovitis in the carpometacarpal, metacarpophalangeal, and proximal interphalangeal joints were scored based on a modified Outcome Measures in Rheumatology recommendations.

Results: Twenty SLE patients, (19 women and one man) with median age of 44.7 years (range: 20-76 years), median disease duration of 14.7 years (range: 5-26 years), and median arthritis duration of 13.7 years (range: 4-26 years) were studied. Of the 300 joints evaluated, 202 (67.3%) had some degree of synovitis. Sixteen out of 300 examined joints (5.3%) small areas of erosion were seen in 10 out of the 20 patients (50%). Subchondral bone edema was found in eight out of the 20 (40%) patients or a total of 18 joints (6%). A total of 200 compartments tendons were evaluated, and changes were found in 77 (38.5%) of them. In four out of the 20 patients, the MRI revealed bone cysts.

Conclusions: The MRI seems to be a non-invasive diagnostic tool in patients with JA secondary to SLE, and may contribute to understanding the mechanism involved in the development of this deformity.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Arthritis / etiology
  • Arthritis / pathology*
  • Bone Cysts / etiology
  • Bone Cysts / pathology
  • Carpal Joints / pathology
  • Edema / etiology
  • Edema / pathology
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / pathology*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Metacarpophalangeal Joint / pathology
  • Middle Aged
  • Tenosynovitis / etiology
  • Tenosynovitis / pathology
  • Young Adult