Keywords:
Arthritides, Education, Conventional radiography, Musculoskeletal system, Musculoskeletal joint, Musculoskeletal bone
Authors:
H. D. Peiris, C. Lord, V. T. Skiadas, M. Sampson; Southampton/UK
DOI:
10.1594/essr2017/P-0276
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 tissue diseases
|
Seronegative arthritides
|
Degenerative
|
Metabolic
|
Gout
|
|
Rheumatoid arthritis (RA)
|
Ankylosing spondylitis
|
Osteoarthritis
|
Crystal pyrophosphate deposition disease (CPPD)
|
|
Systemic lupus erythematosus (SLE)
|
Psoriatic arthropathy
|
Hyperparathyroidism
|
Amyloidosis
|
|
Scleroderma
|
Reiter’s syndrome
|
|
The workhorse for radiological diagnosis rests primarily on the accurate interpretation of hand and feet radiographs.
This involves interrogating radiographs based principally on the distribution of changes and identifying if the disease process is predominantly bone-forming,
erosive or both.
It is also important to consider other factors such as patient demographics (age,
gender),
extra-articular manifestations and laboratory investigations.
The ‘ABCDS’ method is the main diagnostic aide memoire to facilitate differentiating various forms of arthritides.
These features will be described in the ‘imaging findings’ section.
Framework for the interpertation of arthritides plain films
A
|
Alignment
|
B
|
Bone changes
|
C
|
Cartilage
|
D
|
Distribution
|
S
|
Soft tissues
|