Sixty-four examinations of the wrist in patients with rheumatoid arthritis by magnetic resonance imaging using a 0.23 TESLA magnet showed a great sensitivity in detecting proliferative partly exudative or destructive synovialitis, as is common in rheumatoid arthritis. In accordance to the Larsen system for grading rheumatoid arthritis lesions by conventional x-ray, we establish a clinically relevant magnetic resonance grading system which is able to diversify the stages of destruction and inflammative activity in rheumatoid arthritis.