Integrated imaging of metastatic monoarticular arthropathy

Metastatic monoarticular arthropathy (MMA) is poorly described in the radiologic literature. The authors reviewed their experience (16 cases) and reports in the literature (31 cases). All patients underwent plain radiography (negative or nonspecific in 25) and 28 underwent skeletal scintigraphy (normal in four). Four patients underwent CT or MR imaging, which demonstrated juxta-articular osteolysis or soft-tissue changes suggestive of malignancy. They conclude that MMA should be suspected in any patient with monoarticular symptoms refractory to therapy or with a history of malignancy. If radiographs are normal or nonspecific, skeletal scintigraphy should be performed. If skeletal scintigraphy is positive, MR imaging or CT is recommended to exclude malignancy