 Good morning everybody. My name is Dr. Gauravathri, Jr. resident, P.J.M.S. Rottak. The topic of my paper presentation is role of MRI in differentiating various causes of large joint monoarthritis. Introduction. Arthritis means joint inflammation. It can involve one joint on multiple joints or may start as monoarticular and then involve multiple joints. It may also be a part of systemic disease manifestation. As symptoms of many diseases of monoarthritis overlap, the diagnosis poses a problem. Patients of monoarthritis may present with joint line tenderness, painful and restrictive joint movement, redness, increase in local temperature, joint function, loss, etc. Early diagnosis of acute monoarthritis is mandatory as cartilage destruction can be there in very quick succession. Rheumatological arthritis and tubercular arthritis both are causes of chronic arthritis but both present with pain and restrictive joint activity. The involvement of multiple joints may or not always true whole truth for rheumatic arthritis as an oligoarticular variant is also common. Similarly, transient sinusitis and septic arthritis are common causes of acute monoarthritis and both present as hip pain, limb, fever and irritability. But, sequelae of both are very different. Septic arthritis is known for destructive nature while transient arthritis has no such sequelae. MRI has better application in diagnosing, evaluating the extent and preoperative planning and follow up chronic monoarthritis. Various changes detected on MRI are joint diffusion, perisannabal edema, bone marrow edema, bone erosion, signable proliferation, soft tissue collection, ligament, tendon and muscle. Based on changes in these tissues, various differential diagnosis can be suggested and a diagnosis is made. Contrast MRI is increasingly used in diagnosis of large joint arthritis. It can easily differentiate joint diffusion from signable proliferation. Signable inflammation shows an enhancement owing to the vascularity increase in arthritis and there is high correlation between degree of signable inflammation and vascularity of biopsy and post-contrast enhancement. Ames and objectives to evaluate role of magnetic resonance imaging in clinically diagnosed large joint monoarthritis material methods. The study was conducted on 50 patients referred from different inpatient and outpatient departments of PGMS Rottach for clinically diagnosed large joint monoarthritis. The relevant clinical parameters were recorded followed by MR imaging. Parameters that were taken on MRI were presence of joint diffusion, signable thickening, perisannabal edema, bone erosion, lymph nodes if they are present or not, bone marrow edema, soft tissue, collection, present or not. So P-value of bone erosion among various types of monoarthritis was 0.09 which is not significant in our study. P-value of signable thickness among various types of arthritis was 0.03 which is significant. P-value for bone erosions among various types of arthritis was 0.09 which is not significant. P-value of perisannabal edema among various types of arthritis was 0.99 which is not significant. P-value for diffusion was 0.76 which was also not significant. In our study, the most common joint affected one knee joint with 35 patients, 70% followed by hip joint, then shoulder, ankle and elbow. Septic arthritis patients presented clinically with pain, fever, tenderness and rhythm. 100% of septic arthritis showed joint diffusion followed by signable thickening, lymph nodes, bone marrow edema, bone erosions and perisannabal edema. In our study, features of tubercular arthritis were as follows. Signable thickening was the most common thing, 60% grade 3 and 20% grade 2. Then joint effusion, perisannabal edema, bone marrow edema, bone erosions and lymph nodes were 100% absent. There were three patients of tubercular arthritis. The features of MRI in our study in these patients was signable thickening, 66% was grade 3, 33% grade 2. Joint effusion, 100% were mild. Bone marrow edema, 66% grade 1, 33% grade 0. Bone erosions, 33% grade 0, 1 and 2 each. And perisannabal edema, 100% were grade 2. There were two cases of lipoma or borserans. MRI features in these cases were found like signable thickening, which was grade 3 in 100%. Joint effusion, moderate 100%, erosions, 50% absent and 50% were grade 1. Bone marrow edema, 50% were grade 1, 50% cases absent. Perisannabal edema, there were 100% absence, lymph nodes present in 100% cases and subcondulces 50%. Tubercular rheumatoid 30 showed a higher grade of signable thickening as compared to septic or non-specific. P-value for signable thickening among various types of arthritis was 0.03, which is statistically significant. Infective cases showed diffusion more commonly. P-value for diffusion among various types of arthritis was 0.76, which was not statistically significant. Infective cases had higher chances of having perisannabal edema as compared to non-invasive one. P-value for Tubercular ankle, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L, APL-A-L all revealed. Signable thickening of grade 3, enhancing bone erosion with bone marrow edema. Radiograph of ankle is normal. The patient had a cavity-treat lung lesion and the bronknival was revealed. Tubercular mycobacteria. The final diagnosis was tubercular arthritis. Figure 2. 45-year-old male with right ankle swelling and tinges revealed, the findings revealed, the findings revealed, the findings revealed, asymmetric sonovial thickening, and enhancing bone erosion, tinoceinobitis. Following sonovial biopsy, a diagnosis for rheumatoid was made, patient was given methotrexid and was relieved. Figure 3. 48-year-old female presented with pain in right knee of 3 months duration. The imaging findings were multiple loose bodies, massive joint diffusion, sonovial thickening, final diagnosis was sonovial osteocontromatosis secondary to osteoarthritis. So these are the references. Thank you everybody.