Swelling and pain in the right hand symptoms started 3 months ago, initially there were no pathologic findings in conventional radiography. As an earlier radiography showed massive erosive changes in the wrist, but unclear changes in the MCP (metacarpophalangeal joint) and PIP (proximal interphalangeal joint), we performed a CT Dual Energy examination to search for further erosions and synovitis.
Rapid progressive wrist arthritis in the right hand. The CT scan revealed massive erosive destruction of the right wrist, accompanied by synovitis and joint effusion. Within the phalanges we found subcortical osteolytic changes (which were not visible in the left hand), with intact cortical structures. With Dual Energy technique, we could easily visualize the synovitic tissue. Unfortunately, even histopathologic examination was unspecific.
In rheumatic imaging, when the verification of erosive changes is the most important question in CT, synovitic tissue can still be easily detected in Dual Energy technique. As the 80/140 kV separation is quite high after iodine contrast application, it is very easy to visualize this tissue.
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The drugs and doses mentioned herein are consistent with the approval labeling for uses and/or indications of the drug. The treating physician bears the sole responsibility for the diagnosis and treatment of patients, including drugs and doses prescribed in connection with such use. The Operating Instructions must always be strictly followed when operating the CT System. The source for the technical data is the corresponding data sheets. Results may vary.