Early MR diagnosis of inflammatory rheumatic joint disease relies on the detection of the proliferating synovium. Several studies have shown that reliable visualization of the inflamed synovium is dependent upon the enhancement provided by intravenously injected paramagnetic contrast media. This presentation discusses the role of contrast-enhanced MRI in the assessment of inflammatory rheumatic joint disease. It is concluded that the method may aid in early diagnosis, and that it has a great potential in the assessment of disease severity and inflammatory activity.