European Radiology

, Volume 21, Issue 7, pp 1499–1508 | Cite as

Synovitis maps for the assessment of inflammatory diseases of the hand

  • Christoph Karlo
  • Marco Zanetti
  • Paul Stolzmann
  • Isabelle Steurer-Dober
  • Florian Brunner
  • Jürg Hodler
  • Christian W. A. Pfirrmann



To compare accuracy and review times of FLASH-MRI-derived synovitis maps (SM) with conventional MR images (cMRI) in the assessment of articular synovitis and tenosynovitis of the hand.


80 hands in 40 patients (mean age, 48 years; range, 15–72 years) were assessed for synovitis on cMRI and SM by two readers independently. Reporting times and diagnostic confidence (scale: 1 = least, 5 = most confident) were measured. Results from an assessment of a panel of senior musculoskeletal radiologists served as the standard of reference.


Sensitivity and specificity for the detection of articular synovitis were 0.91/1.00 (R1) and 1.00/0.67 (R2) on cMRI and 0.87/0.75 (R1) and 0.91/0.45 (R2) on SM and for the detection of tenosynovitis 0.95/0.63 (R1) and 0.67/0.79 (R2) on cMRI and 0.67/0.89 (R1) and 0.38/1.00 (R2) on SM. Mean review times (cMRI/SM, sec) were 142/37 (R1) and 167/25 (R2). Mean diagnostic confidence (cMRI/SM) was 3.7/3.4 (R1) and 3.2/3.5 (R2) for articular synovitis and 4.0/4.0 (R1), 3.3/3.7 (R2) for tenosynovitis.


Synovitis maps provide a comparable diagnostic accuracy to conventional MR images in the assessment of articular synovitis and tenosynovitis of the hand. Because of short review times, synovitis maps provide a fast overview of locations with synovial enhancement.


Synovitis maps FLASH MRI Tenosynovitis Tram line 



Prof. J. Hodler is a member of the Siemens MSK advisory board. All other authors have nothing to disclose.


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Copyright information

© European Society of Radiology 2011

Authors and Affiliations

  • Christoph Karlo
    • 2
    • 4
  • Marco Zanetti
    • 1
  • Paul Stolzmann
    • 1
  • Isabelle Steurer-Dober
    • 1
    • 2
  • Florian Brunner
    • 3
  • Jürg Hodler
    • 1
  • Christian W. A. Pfirrmann
    • 1
  1. 1.Department of RadiologyUniversity Hospital BalgristZurichSwitzerland
  2. 2.Department of RadiologyKantonsspital LuzernLuzernSwitzerland
  3. 3.Department of RheumatologyUniversity Hospital BalgristZurichSwitzerland
  4. 4.Department of RadiologyUniversity Hospital ZurichZurichSwitzerland

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