Mixed connective tissue disease (MCTD) constitutes a distinct entity, presenting combined clinical findings of four systemic disorders: systemic lupus erythymatosous (SLE), systemic sclerosis (SSc), rheumatoid arthritis (RA) and polymyositis/dermatomyositis (PM/DM) [1]. As MCTD in children shows similarities to juvenile idiopathic arthritis (JIA), discrimination between these two entities, with respect to both clinical presentation and imaging features, can be difficult. MRI is the modality of choice in the imaging of inflammatory arthritic diseases [2]. In contrast to the quickly expanding research on MRI in JIA, MCTD-specific...

Clinical presentation The term Mixed Connective Tissue Disease was initialised by Sharp et al. in 1972 [4]. They described a distinct systemic entity, which is characterised by high serum titres of auto-antibodies to nuclear RNP, along with the appearance of common clinical features of other systemic disorders, such as SLE, SSc, RA and PM/DM [4]. Thus, MCTD constitutes a clinical syndrome, commonly presenting itself with Raynaud’s phenomenon, arthralgias (with or without arthritis), sclerodactyly, edematous fingers/hands and muscle disorders [5]. The disease appears to have a...

Patients (n=5) To acquire information on our learning objectives for this educational poster, we evaluated wrist contrast-enhanced MRI datasets of five MCTD -clinically and laboratory- confirmed patients, using the Alarcón-Segovia criteria [1]. All MR examinations were performed at open-bore 1.0 Tesla scanner using a phased-array coil, with the patients placed in supine position. Coronal/axial T1- and T2-weighted images before intravenous contrast (gadolinium) administration were acquired. After intravenous contrast administration, coronal and axial (with fat saturation) sequences were obtained to enable assessment of synovial enhancement. Four...

MRI findings in MCTD patients are similar to those seen in JIA: common presence of synovial hypertrophy and tenosynovitis, while bone marrow edema and bone erosions were rarely seen. The most frequent sites of involvement were distal radius/ulna, radiocarpal and midcarpal region, while carpometacarpal region was mostly spared. In our experience, unique findings for MCTD include extensive synovial hypertrophy and involvement of the flexor tendons, present in the majority of our MCTD patients, while only occurring in clinically very severely affected JIA patients. Furthermore, besides...

Alarcon-Segovia D, Villareal M: Classification and diagnostic criteria for mixed connective tissue disease; in Kasukawa R, Sharp GC, (eds): Mixed connective tissue disease and antinuclear antibodies. Amsterdam, Elsevier, 1987, pp 33-40. Cimmino MA, Bountis C, Silvestri E, Garlaschi G, Accardo S: An appraisal of magnetic resonance imaging of the wrist in rheumatoid arthritis. Semin Arthritis Rheum 2000;30:180-195. Magni-Manzoni S, Malattia C, Lanni S, Ravelli A: Advances and challenges in imaging in juvenile idiopathic arthritis. Nat Rev Rheumatol 2012;8:329-336. Sharp GC, Irvin WS, Tan EM, Gould...