Figure 3

Proposed series of events leading to bone erosion. The advent of magnetic resonance imaging (MRI) in early rheumatoid arthritis (RA) allows the demonstration of the early appearance of MRI bone oedema, histologically an osteitis, suggesting that the path to bone destruction in RA should be viewed as a close integration of synovitis and erosion. Modifying factors such as the position of joint collateral ligaments, the degree of synovitis, and bone mineral density may modify erosion formation.