Multicentric reticulohistiocytosis

Dr Henry Knipe and A.Prof Frank Gaillard et al.

Multicentric reticulohistiocytosis (MRH) also known as lipoid dermatoarthritis, is a rare systemic disorder.

MRH is considered a form of granulomatous disease 10 characterised by infiltration of multinucleated histiocytes into various tissues, primarily affecting skin and synovium, which results in an erosive, deforming polyarthritis. 

There is a recognised associated with various malignancies (up to 25% of cases 9):

It can have similar plain film findings as gout and rheumatoid arthritis (RA), although it is, unlike these two other conditions, associated with joint space widening.

Features are bilateral and symmetric and include:

  • sharply demarcated marginal erosions: can  have a strikingly bilateral symmetrical distribution and often sharply circumscribed and rapidly progressive
  • nodular soft tissue swelling: may be appreciated as prominent, uncalcified nodules of skin, subcutaneous tissue and tendon sheaths
  • predisposition for interphalangeal joints
  • there can be a tendency toward early and severe atlanto-axial involvement
  • no or mild periarticular osteopaenia (unlike RA)
  • often a disproportion between severity of joint destruction and mildness of symptoms regardless of therapy.
  • absent or minimal periosteal reaction
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Article information

rID: 1694
Section: Gamuts
Tag: cases
Synonyms or Alternate Spellings:
  • Multicentric reticulo-histiocytosis
  • Multi centric reticulohistiocytosis (MRH)
  • Lipoid dermatoarthritis
  • MCRH
  • MRH

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Cases and figures

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    Case 1
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    Case 2: involving hands and feet
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