MRI
What are the earliest MR findings in rheumatoid arthritis?
Synovial hypertrophy and enhancement (synovitis) as well as bone marrow oedema are the earliest findings before the pannus eroding the bones.
There are multiple small erosions seen at carpal bones and radial styloid process associated with marrow oedema of carpal bones (especially the lunate and triquetral bones and scapholunate dissociation), ulnar subluxation and synovial hypertrophy and enhancement of the wrist joint. Also there is tear of the triangular fibrocartilage allow joint effusion to extend proximally.
Diagnosis: Rheumatoid arthritis of the wrist joint.