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Arthropathy in Behçet Disease: MR Imaging Findings in Two Cases¹

¹ From the Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea. Received December 4, 2001; revision requested February 18, 2002; revision received April 10; accepted May 24. Address correspondence to H.S.K. (e-mail: kanghs@radcom.snu.ac.kr).

View larger version (155K): [in a new window]   Figure 1a. Case 1. A 31-year-old man with Behçet disease and left knee and ankle pain. (a) Transverse T1-weighted spin-echo MR image (600/20 [repetition time msec/echo time msec]) of the left knee shows intermediate signal intensity (arrow) in the distal semimembranosus muscle near the musculotendinous junction. (b) Transverse T2-weighted spin-echo MR image (2,000/70) of the same area as in a shows a slightly higher signal intensity (arrow). (c) Gadolinium-enhanced sagittal T1-weighted fat-suppressed spin-echo MR image (800/20) shows diffuse enhancement of the distal portion of the semimembranosus muscle (arrow). (d) Sagittal T2*-weighted gradient-recalled-echo MR image (600/18, 20° flip angle) of the left ankle shows high-signal-intensity fluid collections in the subtalar (solid arrow) and tibiotalar (open arrow) joints.

View larger version (143K): [in a new window]   Figure 1b. Case 1. A 31-year-old man with Behçet disease and left knee and ankle pain. (a) Transverse T1-weighted spin-echo MR image (600/20 [repetition time msec/echo time msec]) of the left knee shows intermediate signal intensity (arrow) in the distal semimembranosus muscle near the musculotendinous junction. (b) Transverse T2-weighted spin-echo MR image (2,000/70) of the same area as in a shows a slightly higher signal intensity (arrow). (c) Gadolinium-enhanced sagittal T1-weighted fat-suppressed spin-echo MR image (800/20) shows diffuse enhancement of the distal portion of the semimembranosus muscle (arrow). (d) Sagittal T2*-weighted gradient-recalled-echo MR image (600/18, 20° flip angle) of the left ankle shows high-signal-intensity fluid collections in the subtalar (solid arrow) and tibiotalar (open arrow) joints.

View larger version (117K): [in a new window]   Figure 1c. Case 1. A 31-year-old man with Behçet disease and left knee and ankle pain. (a) Transverse T1-weighted spin-echo MR image (600/20 [repetition time msec/echo time msec]) of the left knee shows intermediate signal intensity (arrow) in the distal semimembranosus muscle near the musculotendinous junction. (b) Transverse T2-weighted spin-echo MR image (2,000/70) of the same area as in a shows a slightly higher signal intensity (arrow). (c) Gadolinium-enhanced sagittal T1-weighted fat-suppressed spin-echo MR image (800/20) shows diffuse enhancement of the distal portion of the semimembranosus muscle (arrow). (d) Sagittal T2*-weighted gradient-recalled-echo MR image (600/18, 20° flip angle) of the left ankle shows high-signal-intensity fluid collections in the subtalar (solid arrow) and tibiotalar (open arrow) joints.

View larger version (108K): [in a new window]   Figure 1d. Case 1. A 31-year-old man with Behçet disease and left knee and ankle pain. (a) Transverse T1-weighted spin-echo MR image (600/20 [repetition time msec/echo time msec]) of the left knee shows intermediate signal intensity (arrow) in the distal semimembranosus muscle near the musculotendinous junction. (b) Transverse T2-weighted spin-echo MR image (2,000/70) of the same area as in a shows a slightly higher signal intensity (arrow). (c) Gadolinium-enhanced sagittal T1-weighted fat-suppressed spin-echo MR image (800/20) shows diffuse enhancement of the distal portion of the semimembranosus muscle (arrow). (d) Sagittal T2*-weighted gradient-recalled-echo MR image (600/18, 20° flip angle) of the left ankle shows high-signal-intensity fluid collections in the subtalar (solid arrow) and tibiotalar (open arrow) joints.

View larger version (106K): [in a new window]   Figure 2a. Case 2. A 35-year-old woman with Behçet disease and a painful mass on the left wrist. (a) Transverse US scan of the wrist reveals hypoechoic areas (arrows) around the flexor digitorum tendon sheaths. (b) Transverse T1-weighted spin-echo MR image (500/15) at the level of the lunate shows low signal intensities surrounding the flexor digitorum tendons (solid arrows) and convex bowing of the flexor retinaculum (open arrows). (c) Transverse T2-weighted spin-echo MR image (1,800/90) of the same areas as in b shows high signal intensities (arrows). (d) Gadolinium-enhanced T1-weighted spin-echo MR image (500/15) shows enhancement (arrows) of the previously hypointense areas around the flexor digitorum tendon sheaths.

View larger version (115K): [in a new window]   Figure 2b. Case 2. A 35-year-old woman with Behçet disease and a painful mass on the left wrist. (a) Transverse US scan of the wrist reveals hypoechoic areas (arrows) around the flexor digitorum tendon sheaths. (b) Transverse T1-weighted spin-echo MR image (500/15) at the level of the lunate shows low signal intensities surrounding the flexor digitorum tendons (solid arrows) and convex bowing of the flexor retinaculum (open arrows). (c) Transverse T2-weighted spin-echo MR image (1,800/90) of the same areas as in b shows high signal intensities (arrows). (d) Gadolinium-enhanced T1-weighted spin-echo MR image (500/15) shows enhancement (arrows) of the previously hypointense areas around the flexor digitorum tendon sheaths.

View larger version (107K): [in a new window]   Figure 2c. Case 2. A 35-year-old woman with Behçet disease and a painful mass on the left wrist. (a) Transverse US scan of the wrist reveals hypoechoic areas (arrows) around the flexor digitorum tendon sheaths. (b) Transverse T1-weighted spin-echo MR image (500/15) at the level of the lunate shows low signal intensities surrounding the flexor digitorum tendons (solid arrows) and convex bowing of the flexor retinaculum (open arrows). (c) Transverse T2-weighted spin-echo MR image (1,800/90) of the same areas as in b shows high signal intensities (arrows). (d) Gadolinium-enhanced T1-weighted spin-echo MR image (500/15) shows enhancement (arrows) of the previously hypointense areas around the flexor digitorum tendon sheaths.

View larger version (106K): [in a new window]   Figure 2d. Case 2. A 35-year-old woman with Behçet disease and a painful mass on the left wrist. (a) Transverse US scan of the wrist reveals hypoechoic areas (arrows) around the flexor digitorum tendon sheaths. (b) Transverse T1-weighted spin-echo MR image (500/15) at the level of the lunate shows low signal intensities surrounding the flexor digitorum tendons (solid arrows) and convex bowing of the flexor retinaculum (open arrows). (c) Transverse T2-weighted spin-echo MR image (1,800/90) of the same areas as in b shows high signal intensities (arrows). (d) Gadolinium-enhanced T1-weighted spin-echo MR image (500/15) shows enhancement (arrows) of the previously hypointense areas around the flexor digitorum tendon sheaths.