TB Wrist Joint : MRI

Xray- Frontal radiograph of wrist shows multiple osteolytic areas with surrounding sclerosis is seen involving all carpal bones and second metatcarpal bone s/o  permeative type of bone destruction.

MRI- MRI shows Extensive areas of altered marrow signal with osteolysis are seen involving all the carpal bones and almost the entire 2nd metacarpal bone. Similar areas of involvement are seen in the proximal radius predominantly involving the dorsal aspect with large soft tissue component.

The altered areas appear hypointense on T1 and hyperintense on T2 WIs. There is involvement of base of the third and the fourth metacarpal along with metacarpophalangeal joint.

Soft tissue component with marked synovial thickening is seen in the wrist, intercarpal and metacarpophalangeal joint. The altered areas appear hypointense on T1 and hyperintense on T2WIs.

Diagnosis- Findings are s/o Tuberculosis of wrist joint

Important Point

Phemister’s triad- 

Juxtaarticular osteopenia, erosions and loss of joint space – typically seen in TB of joints