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Magnetic resonance imaging in coccidioidal arthritis
P J Lund1, K M Chan, E C Unger
1Department of Radiology, University of Arizona Health Sciences Center, Tucson 85724, USA.
Skeletal Radiology
|October 1, 1996
Summary
Magnetic resonance imaging (MRI) reveals key findings in coccidioidal arthritis, showing synovial thickening and erosions with contrast enhancement. This helps assess active disease, cartilage loss, and bone damage in affected joints.
Area of Science:
- Radiology
- Infectious Diseases
- Rheumatology
Background:
- Coccidioidal arthritis is a fungal infection affecting joints.
- Accurate diagnosis and assessment of disease activity are crucial for effective treatment.
Purpose of the Study:
- To evaluate the magnetic resonance imaging (MRI) findings in patients with appendicular coccidioidal arthritis.
- To correlate MRI findings with clinical outcomes and biopsy results.
Main Methods:
- Retrospective review of MRI scans (T1- and T2-weighted, with and without contrast) from nine adult patients (ten studies).
- Evaluation by three experienced readers using a standardized scale for synovial abnormality, cartilage loss, bone loss, marrow signal, and enhancement.
- Correlation of imaging findings with biopsy or clinical course.
Main Results:
- Active arthritis was present in eight patients, involving knees, ankles, and elbows.
- Synovial complex (thickening and enhancement) was the most common finding in active disease (P < 0.025).
- Significant cartilage loss (56%) and subarticular bone loss (89%) were observed in active cases; abnormal marrow signal was uncommon.
Conclusions:
- MRI effectively characterizes appendicular coccidioidal arthritis.
- Intravenous gadopentetate enhancement highlights thickened synovium and erosions, aiding in disease assessment.