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Can MRI substitute for biopsy in eosinophilic fasciitis?
  1. M Ronneberger1,
  2. R Janka2,
  3. G Schett1,
  4. B Manger1
  1. 1
    Department of Medicine III, University of Erlangen-Nuremberg, Erlangen, Germany
  2. 2
    Radiological Institute, University of Erlangen-Nuremberg, Erlangen, Germany
  1. Correspondence to M Ronneberger, Department of Medicine III, University Erlangen-Nuremberg, Krankenhausstrasse 12, D-91054 Erlangen, Germany; monika.ronneberger{at}

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In the April 2008 issue of Annals of the Rheumatic Diseases, Dybowski et al reported a patient with eosinophilic fasciitis (EF), for whom ultrasound and MRI provided seminal findings in the diagnostic procedure, whereas laboratory tests could not sufficiently confirm the diagnosis.1

Here, we report two cases where MRI generated results equal or even superior to biopsy. Patient 1 was a 35-year-old woman with severe pain and symmetric swelling of lower legs and forearms. In addition to 3 months of increasing tenderness in those areas, she had general myalgias and morning stiffness in the wrists and ankles of short duration. Clinical examination revealed the typical “groove sign”, characterised by marked retractions of the subcutaneous tissue above the superficial veins upon elevation of the limbs (fig 1A). Forearms and lower legs …

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