48-year-old female patient with pain and positive serologies (CCP, RF, RNP) but without definite diagnosis of CTD. Right hand with possible synovitis. There is an erosion about the radial aspect of the first metacarpal head with increased fluid about the first metacarpophalangeal joint and enhancement of the synovium on postcontrast imaging consistent with synovitis. Increased fluid on T2-weighted images is also noted about the remaining metacarpophalangeal joints, most predominately the second and third. There is synovial enhancement at the third and, to a lesser degree, the second metacarpophalangeal joints consistent with synovitis. Inflammation is also noted in the soft tissues radial to the second metacarpophalangeal joint. Fluid and enhancement surrounding the extensor tendon overlying the third metacarpophalangeal joint is consistent with tenosynovitis.The visualized tendinous structures are otherwise intact.
1. Synovitis of multiple metacarpophalangeal joints, most predominately the first and third, with underlying erosions at the first MCP.2. Tenosynovitis of the extensor tendon overlying the third MCP.