MR imaging of tuberculous arthritis: Clinical and experimental studies

Signal-intensity characteristics of magnetic resonance (MR) images were assessed in five patients and in 10 rabbits with tuberculous arthritis. MR imaging findings were compared with histologic findings in the animal study. In both of clinical and experimental cases, tuberculous lesions showed both intermediate and high signal intensity on T2-weighted images, while they showed heterogeneously intermediate signal intensity on T1-weighted images. As T2-weighted images were compared with pathologic specimens, intermediate signal intensity corresponded to caseous necrosis, whereas high signal intensity related to granulomas or effusion. Postcontrast T1-weighted images showed enhancement at the peripheries rather than the centers of tuberculous lesions. These results indicate that tuberculous arthritis should be included in the differential diagnosis when intra-articular lesions with low or intermediate signal intensity are found on T2-weighted images.