(a)
(b)
(c)
(d)
Figure 1: Baseline coronal (a) and axial (c) MR images of the second metacarpophalangeal joint show synovitis and osteitis but no erosion. At 24 weeks (c, d) the synovitis has decreased, and the osteitis has converted to erosion. Cartilage loss had also developed in this joint at 24 weeks (better seen on an adjacent MRI slice not shown). Without an additional time point prior to 24 weeks, however, it is not possible to determine whether the erosion developed prior to the decrease in inflammation or despite it. Further, without a time point after 24 weeks, it is not possible to determine whether the degree of residual synovitis present at 24 weeks is sufficient to drive further progression in joint damage in this case.