Magnetic resonance imaging in coccidioidal arthritis.
OBJECTIVE
The authors assessed the MRI findings of appendicular coccidioidal arthritis.


METHODS
T1- and T2-weighted MR images of affected joints, both with and without intravenous gadopentetate dimeglumine, were performed in nine adult patients (ten studies) and evaluated by three masted readers, using a four-point certainty scale for: synovial abnormality, articular cartilage loss, subarticular bone loss, abnormal marrow signal, enhancement of osseous and articular structures, and assessment of disease activity. Findings were correlated with biopsy results or clinical course.


RESULTS
Eight patients had active and one had inactive arthritis, involving the knee (five patients), ankle (two patients), and elbow (one patient). Synovial complex was the most common finding in active arthritis (P < 0.025). Cartilage and subarticular bone loss were seen 56% and 89% of patients with active disease, respectively. Abnormal marrow signal was uncommon (two patients). All cases showed synovial and/or osseus enhancement.


CONCLUSIONS
MRI findings in coccidiodal arthritis are described. Enhancement of thickened synovium and erosions was seen after intravenous gadopentetate.
Department of Radiology, University of Arizona Health Sciences Center, Tucson 85724, USA.
P J
PJ
Lund
K M
KM
Chan
E C
EC
Unger
T N
TN
Galgiani
M J
MJ
Pitt
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001170:Arthritis, Infectious / Q000175:diagnosis*; D003047:Coccidioidomycosis / Q000175:diagnosis*; D003287:Contrast Media; D004338:Drug Combinations; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D007596:Joints / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives; D013583:Synovial Membrane / Q000473:pathology
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA