• Info
      • Age: 63
      • Sex: Male
      • Medical history:
        • Pain in the MCP joints but no swelling
        • Morning stiffness of about 30 minutes
      • Clinical findings:
        • ACPA  and RF-positive
        • CRP 3.5 mg/l
  • 1: Pain in the MCP joints
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  • <p>Are there abnormalities seen on these X-rays?</p>

Rheumatoid arthritis with incipient erosive destruction

Those who have looked closely will have already recognized the erosion in the head of the third metacarpal bone on the X-ray image. This is shown here only as a faint cysitic lesion without a clear interruption of the cortex. The oblique projection was very helpful here. Unfortunately, these are rarely done anymore.

The MRI shows the active inflammation of the joints very clearly. However, the erosion is also relatively difficult to recognize on the T1-weighted sequence with a slice thickness of 3 mm. Therefore, the VIBE sequence (last sequence in this case) is very helpful, which offers 0.8 mm slice thickness and better depicts the erosive destruction.