Learning objectives
In the days of diagnostic ultrasound and magnetic resonance imaging (MRI),
the mainstay of assessment of radiological changes in arthritis nonetheless remains the plain radiograph,
usually of the hands and feet.
Interpreting radiographs of patients with arthritis can be a daunting task.
Shortening of radiological training and the need to encompass more and more complex cross sectional interpretation within that training time results in more limited exposure of trainee radiologists to the basic plain radiograph.
Our aims are to illustrate through a pictorial review the...
Background
Arthritis may be a serious medical condition,
more prevalent in women and increasingly relevant in an ageing population. It may be debilitating with a broad range of aetiology.
These can be broadly categorised into inflammatory,
chondropathic and depositional causes,
summarised in table 1.
The most common type of arthritis is osteoarthritis,
which affects approximately 8 million people in the United Kingdom (UK)2.
A timely diagnosis is essential as it aids the clinician in initiating and guiding management.
ARTHRITIDES
INFLAMMATORY
CHONDROPATHIC
DEPOSITIONAL
Rheumatoid and other connective...
Imaging findings OR Procedure Details
IMAGING FINDINGS
Alignment
1. Joint deformities
Subluxation or dislocation e.g.
Boutonniere deformity - RA (Fig. 1),
lateral subluxation ( Fig. 2 ) in OA,
Z-deformity in RA ( Fig. 3 ),
ulnar deviation ( mainly MCP joints) ( Fig. 4 ) in inflammatory arthritis,
swan-neck deformity with PIP hyperextension and DIP flexion (fig.5)
In patients with SLE joint MCP jointsulnar deviationis not associated with erosive changes,
as in rheumatoid arthritis (fig 37)
Bone changes
1. Mineralisation
Normal mineralisation in all arthritides apart from RA (...
Conclusion
Several arthritides have clinical manifestations involving the hands and feet.
The plain radiograph remains the first imaging modality in the assessment of arthritis.
Accurate interpretation of the bone and soft tissue changes,
sound understanding of the patterns of disease and correlation with clinical history and laboratory investigations will aid in appropriate diagnosis and onward clinical management.
The key features of all arthritides can be seen in Fig. 395
References
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Davies,
S et al.
The major polyarthritides.
Chapman & Nakielny's Aids to Radiological Differential Diagnosis: Expert Consult 6e.
20 Nov 2013: Pg 51.
2.
Arthritis.
NHS Choices.
Accessed on 19th April 2017 from: http://www.nhs.uk/Conditions/Arthritis/Pages/Introduction.aspx
3.
Weissleder,
R et al.
Arthritis.
Primer of Diagnostic Imaging.
5e.
9 Sep 2011: Pg.
323
4.
Batlle JA,
et al.
Radiographic Assessment of Arthritis: A Pictorial Review.
European Society of Radiology.
ECR 2011.
DOI: 10.1594/ecr2011/C-0065
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5.
Brower,
A,
Flemming,
D.
Arthritis...