Axial T1 fat-saturated magnetic resonance imaging (MRI) of the foot obtained with gadolinium contrast administration demonstrated marginal erosions at the great toe interphalangeal joint, associated synovitis, and bone marrow enhancement (black arrows). Erosive changes involving the fifth metatarsophalangeal joint were present with bone marrow enhancement in the proximal phalanx (solid white arrow). Enhancing inflammatory changes in the second and fourth toe plantar soft tissues were present (dashed white arrows).