EURORAD ESR

Case 12703

Rheumatoid nodule of the foot - MRI features

Author(s)
Parveen Sulthana M, Saravana Kumar S, Malathi V, Sekhar K.S

Billroth hospitals,
Department of Radiology,
Lakshmi talkies road,
Shenoy nagar,
Chennai-600 030, India;
Email:drspjkmc@gmail.com
 
Patient
female, 56 year(s)
 
 
  • Figure 1
    Coronal T1W MRI image of the foot
     

    Coronal T1W image showing a well-defined hypointense lesion (white arrow) in the medial aspect of the foot at the level of first tarsometatarsal joint.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;

    Coronal T1W image showing a well-defined hypointense lesion (white arrow) in the medial aspect of the foot at the level of first tarsometatarsal joint.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;
     
     
  • Figure 2
    Coronal STIR MR image
     

    Coronal STIR image showing a well-defined hyperintense lesion (white arrow) in the medial aspect of the foot at the level of fthe irst tarsometatarsal joint. A small central cystic change is also seen.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;

    Coronal STIR image showing a well-defined hyperintense lesion (white arrow) at the medial aspect of the foot at the level of the first tarsometatarsal joint. A small central cystic change is also seen.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;
     
     
  • Figure 3
    Sagittal STIR MR image

    Sagittal STIR image showing a well defined hyperintense lesion(white arrow) in the medial aspect of the foot at the level of first tarsometatarsal joint. A small central cystic change also seen.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;
     
     
  • Figure 4
    Sagittal T1W MR image

    Sagittal T1W image showing a hypointense lesion (white arrows) in the subcutaneous soft tissue of the medial aspect of the foot.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;
     
     
  • Figure 5
    Axial STIR and T2W MR image
     

    Axial STIR MR image showing a hyperintense lesion (white arrow) in the medial aspect of the first tarsometatarsal joint.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;

    Axial T2W MR image showing a central hyperintense signal within the lesion.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;
     
     
  • Figure 6
    Coronal T1W and STIR MR image
     

    Coronal T1W MR image showing erosions (white arrows) in the medial and middle cuneiform bones and calcaneus.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;

    Coronal STIR MR image showing erosions (white arrows) in the medial and middle cuneiform bones and calcaneus.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;
     
     
  • Figure 7
    Axial T1W and STIR MR image
     

    Axial T1W MR image showing erosions (white arrows) in the medial and middle cuneiform bones.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;

    Axial STIR MR image showing erosions (white arrows) in the medial and middle cuneiform bones.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;
     
     
  • Figure 8
    Axial T1W and STIR MR image
     

    Axial STIR MR image showing erosions (white arrow) in the lateral malleolus.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;

    Axial STIR MR image showing erosions (white arrow) in the lateral malleolus.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;
     
     
  • Figure 9
    Cytology
     

    FNAC shows numerous lymphocytes, neutrophils, histiocytes and multinucleated giant cells suggestive of chronic inflammation.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;

    FNAC shows numerous lymphocytes, neutrophils, histiocytes and multinucleated giant cells suggestive of chronic inflammation.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;
     
     
  • Figure 10
    USG of the foot
     

    Ultrasound shows a well-defined hypoechoic lesion with a central echogenic area.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;

    Ultrasound shows a well-defined hypoechoic lesion with a central echogenic area.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;

    Ultrasound shows a well-defined hypoechoic lesion with a central echogenic area.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Connective tissue disorders;
     
     
Coronal T1W image showing a well-defined hypointense lesion (white arrow) in the medial aspect of the foot at the level of first tarsometatarsal joint.
 
Coronal T1W image showing a well-defined hypointense lesion (white arrow) in the medial aspect of the foot at the level of first tarsometatarsal joint.
 
Coronal STIR image showing a well-defined hyperintense lesion (white arrow) in the medial aspect of the foot at the level of fthe irst tarsometatarsal joint. A small central cystic change is also seen.
 
Coronal STIR image showing a well-defined hyperintense lesion (white arrow) at the medial aspect of the foot at the level of the first tarsometatarsal joint. A small central cystic change is also seen.
 
Sagittal STIR image showing a well defined hyperintense lesion(white arrow) in the medial aspect of the foot at the level of first tarsometatarsal joint. A small central cystic change also seen.
 
Sagittal T1W image showing a hypointense lesion (white arrows) in the subcutaneous soft tissue of the medial aspect of the foot.
 
Axial STIR MR image showing a hyperintense lesion (white arrow) in the medial aspect of the first tarsometatarsal joint.
 
Axial T2W MR image showing a central hyperintense signal within the lesion.
 
Coronal T1W MR image showing erosions (white arrows) in the medial and middle cuneiform bones and calcaneus.
 
Coronal STIR MR image showing erosions (white arrows) in the medial and middle cuneiform bones and calcaneus.
 
Axial T1W MR image showing erosions (white arrows) in the medial and middle cuneiform bones.
 
Axial STIR MR image showing erosions (white arrows) in the medial and middle cuneiform bones.
 
Axial STIR MR image showing erosions (white arrow) in the lateral malleolus.
 
Axial STIR MR image showing erosions (white arrow) in the lateral malleolus.
 
FNAC shows numerous lymphocytes, neutrophils, histiocytes and multinucleated giant cells suggestive of chronic inflammation.
 
FNAC shows numerous lymphocytes, neutrophils, histiocytes and multinucleated giant cells suggestive of chronic inflammation.
 
Ultrasound shows a well-defined hypoechoic lesion with a central echogenic area.
 
Ultrasound shows a well-defined hypoechoic lesion with a central echogenic area.
 
Ultrasound shows a well-defined hypoechoic lesion with a central echogenic area.
 
 
 
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