RHEUMATOID-ARTHRITIS - EVALUATION OF WRIST EXTENSOR TENDONS WITH CLINICAL EXAMINATION VERSUS MR-IMAGING - A PRELIMINARY-REPORT

To determine whether magnetic resonance (MR) imaging can improve asses sment of the extensor tendons of the wrist and their propensity to rup ture, the dorsal tendons in 23 wrists in 20 patients with rheumatoid a rthritis were clinically assessed and then examined with MR imaging. C linical and MR imaging evaluations were performed blindly and independ ently. The six extensor tendon compartments were assessed with MR imag ing for presence of pannus, synovial effusion, and tendon involvement or rupture. Clinical scores of systemic disease, dorsal tendon sheath swelling, and risk of tendon rupture ranged from 0 to 3 in each catego ry; the overall score was not associated with any MR imaging category. Clinical assessment of enlargement of the dorsal tendon sheath and cl inical risk of rupture correlated poorly with findings on MR images. A ll eight wrists with clinically minimal risk of rupture had pannus, ef fusions, and tendon involvement on MR images; the findings were simila r in the wrists with moderate (grade 2) risk of rupture. MR imaging de picts involvement of the dorsal tendon sheath and dorsal tendons that cannot be assessed with other radiologic or clinical means.