Marked progression of cartilage thinning is associated with high levels of osteitis at baseline. A) Coronal T2 FS image of the wrist at baseline (2009) showing bone oedema at the scaphoid and radius with an early erosion at the ulnar aspect of the joint (lower circle). Florid bone oedema is also seen involving the hamate (upper circle). B) Coronal PD ASY SENSE sequence showing asymmetrical reduction in radioscaphoid cartilage (lower circle) and normal cartilage space at the triquetrum-hamate joint (upper circle). C) and D) show equivalent sequences from the same patient after three years (2012) indicating that bone oedema has subsided but there has been marked progression in cartilage thinning at both radioscaphoid and triquetrum-hamate joints.