Rheumatoid arthritis x ray: Difference between revisions
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The hallmark of [[rheumatoid arthritis]] is:<ref name="pmid12477226">{{cite journal |vauthors=Devauchelle-Pensec V, Saraux A, Alapetite S, Colin D, Le Goff P |title=Diagnostic value of radiographs of the hands and feet in early rheumatoid arthritis |journal=Joint Bone Spine |volume=69 |issue=5 |pages=434–41 |date=October 2002 |pmid=12477226 |doi= |url=}}</ref> | The hallmark of [[rheumatoid arthritis]] is:<ref name="pmid12477226">{{cite journal |vauthors=Devauchelle-Pensec V, Saraux A, Alapetite S, Colin D, Le Goff P |title=Diagnostic value of radiographs of the hands and feet in early rheumatoid arthritis |journal=Joint Bone Spine |volume=69 |issue=5 |pages=434–41 |date=October 2002 |pmid=12477226 |doi= |url=}}</ref> | ||
*Soft tissue swelling: | *Soft tissue swelling: | ||
** | **It is an early finding in the course of [[rheumatoid arthritis]]. | ||
**Soft tissue swelling is [[fusiform]] and periarticular results from of joint effusion, [[edema]], and [[tenosynovitis]]. | **Soft tissue swelling is [[fusiform]] and periarticular results from of joint effusion, [[edema]], and [[tenosynovitis]]. | ||
*[[Joint]] space narrowing can be symmetrical or [[concentric]]. | *[[Joint]] space narrowing: | ||
*Marginal erosions | **It can be symmetrical or [[concentric]]. | ||
'''Hand and wrist | *Marginal erosions: | ||
**These may result from the erosion by [[pannus]] of the [[bone]] also called as “bare areas”. | |||
'''Hand and wrist''' | |||
The common joints involved in a patient with rheumatoid arthritis, include: | |||
*PIP and [[MCP joint|MCP]] joints (especially 2nd and 3rd [[MCP joint|MCP]]) | |||
*[[Ulnar]] [[Styloid process|styloid]] | |||
*Triquetrum | |||
The findings may include:<ref name="pmid1731813">{{cite journal |vauthors=van der Heijde DM, van Leeuwen MA, van Riel PL, Koster AM, van 't Hof MA, van Rijswijk MH, van de Putte LB |title=Biannual radiographic assessments of hands and feet in a three-year prospective followup of patients with early rheumatoid arthritis |journal=Arthritis Rheum. |volume=35 |issue=1 |pages=26–34 |date=January 1992 |pmid=1731813 |doi= |url=}}</ref><ref name="pmid26247204">{{cite journal |vauthors=Koh JH, Jung SM, Lee JJ, Kang KY, Kwok SK, Park SH, Ju JH |title=Radiographic Structural Damage Is Worse in the Dominant than the Non-Dominant Hand in Individuals with Early Rheumatoid Arthritis |journal=PLoS ONE |volume=10 |issue=8 |pages=e0135409 |date=2015 |pmid=26247204 |pmc=4527732 |doi=10.1371/journal.pone.0135409 |url=}}</ref> | |||
*Subchondral [[cysts]] | |||
*[[Ulnar]] deviation of the [[MCP joint|MCP]] joints | |||
*[[Boutonniere deformity|Boutonniere]] and [[Swan neck deformity|swan neck]] deformities | |||
*Hitchhiker’s thumb deformity | |||
*Scapholunate dissociation, ulnar translocation | |||
*[[Ankylosis]] | |||
[[File:Rheumatoid-hands.jpg|200px|thumb|centre|Source: A.Prof Frank Gaillard,<ref="https://radiopaedia.org<ref /><ref="https://radiopaedia.org/cases/7245">rID: 7245<nowiki></ref></nowiki>]] | [[File:Rheumatoid-hands.jpg|200px|thumb|centre|Source: A.Prof Frank Gaillard,<ref="https://radiopaedia.org<ref /><ref="https://radiopaedia.org/cases/7245">rID: 7245<nowiki></ref></nowiki>]] | ||
[[File:Rheumatoid-arthritis.jpg|200px|thumb|centre|Source:Case courtesy of Dr Hani Salam, <ref="https://radiopaedia.org/">Radiopaedia.org<nowiki></ref></nowiki>]] | [[File:Rheumatoid-arthritis.jpg|200px|thumb|centre|Source:Case courtesy of Dr Hani Salam, <ref="https://radiopaedia.org/">Radiopaedia.org<nowiki></ref></nowiki>]] | ||
'''Feet''' | '''Feet''' | ||
Various radiological findings of the feet that may be seen in rheumatoid arthritis include: | |||
*[[Subtalar joint|Subtalar]] joint involvement | |||
*Posterior [[Calcaneus|calcaneal]] tubercle erosion | |||
*Hammer toe deformity | |||
*[[Hallux]] [[valgus]] | |||
'''Shoulder''' | '''Shoulder''' | ||
Various radiological findings of the shoulder joint that may be seen in rheumatoid arthritis include: | |||
*Distal [[clavicle]] erosions | *Distal [[clavicle]] erosions | ||
*Erosions of the superolateral aspect of the head of the [[humerus]] | *Erosions of the superolateral aspect of the head of the [[humerus]] | ||
*High riding [[shoulder]] due to subacromial-subdeltoid bursitis | *High riding [[shoulder]] due to subacromial-subdeltoid bursitis | ||
'''Knee''' | '''Knee''' | ||
Various radiological findings of the knee joint that may be seen in rheumatoid arthritis include:<ref name="pmid2754663">{{cite journal |vauthors=Fuchs HA, Kaye JJ, Callahan LF, Nance EP, Pincus T |title=Evidence of significant radiographic damage in rheumatoid arthritis within the first 2 years of disease |journal=J. Rheumatol. |volume=16 |issue=5 |pages=585–91 |date=May 1989 |pmid=2754663 |doi= |url=}}</ref> | |||
*[[Joint]] effusions | *[[Joint]] effusions | ||
*Loss of joint space | *Loss of joint space | ||
*[[Prepatellar bursitis]] | *[[Prepatellar bursitis]] | ||
'''Hip''' | '''Hip''' | ||
Various radiological findings of the hip joint that may be seen in rheumatoid arthritis include: | |||
*Concentric loss of [[joint]] space | *Concentric loss of [[joint]] space | ||
*Acetabular protrusio | *Acetabular protrusio | ||
''' | '''Spinal cord''' | ||
Various radiological findings of the the spinal cord joint that may be seen in rheumatoid arthritis include: | |||
*[[Atlantoaxial]] subluxation | *[[Atlantoaxial]] subluxation | ||
*Atlantoaxial impaction: cephalad migration of C2 | *Atlantoaxial impaction: cephalad migration of C2 | ||
Revision as of 23:48, 22 April 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]
Overview
The hallmark of rheumatoid arthritis is soft tissue swelling, joint space narrowing, and erosions. Hand and wrist findings on xray include subchondral cysts, ulnar deviation of the MCP joints, boutonniere and swan neck deformities, hitchhiker’s thumb deformity, scapholunate dissociation, ulnar translocation, and ankylosis. Feet findings on xray are subtalar joint involvement, posterior calcaneal tubercle erosion, hammer-toe deformity, and hallux valgus. Findings of shoulder such as distal clavicle erosions, erosions of the superolateral aspect of the head of the humerus, and high riding shoulder due to subacromial-subdeltoid bursitis. Knee findings include joint effusions, loss of joint space, and prepatellar bursitis. Hip findings include concentric loss of joint space and acetabular protrusio. Spine findings are atlantoaxial subluxation, atlantoaxial impaction: cephalad migration of C2, osteoporosis, and osteoporotic fractures, and erosion of spinous processes.
X Ray
The hallmark of rheumatoid arthritis is:[1]
- Soft tissue swelling:
- It is an early finding in the course of rheumatoid arthritis.
- Soft tissue swelling is fusiform and periarticular results from of joint effusion, edema, and tenosynovitis.
- Joint space narrowing:
- It can be symmetrical or concentric.
- Marginal erosions:
Hand and wrist
The common joints involved in a patient with rheumatoid arthritis, include:
The findings may include:[2][3]
- Subchondral cysts
- Ulnar deviation of the MCP joints
- Boutonniere and swan neck deformities
- Hitchhiker’s thumb deformity
- Scapholunate dissociation, ulnar translocation
- Ankylosis
<ref> tag is malformed or has a bad name<ref="https://radiopaedia.org/cases/7245">rID: 7245</ref>
Feet
Various radiological findings of the feet that may be seen in rheumatoid arthritis include:
Shoulder
Various radiological findings of the shoulder joint that may be seen in rheumatoid arthritis include:
- Distal clavicle erosions
- Erosions of the superolateral aspect of the head of the humerus
- High riding shoulder due to subacromial-subdeltoid bursitis
Knee
Various radiological findings of the knee joint that may be seen in rheumatoid arthritis include:[4]
- Joint effusions
- Loss of joint space
- Prepatellar bursitis
Hip
Various radiological findings of the hip joint that may be seen in rheumatoid arthritis include:
- Concentric loss of joint space
- Acetabular protrusio
Spinal cord
Various radiological findings of the the spinal cord joint that may be seen in rheumatoid arthritis include:
- Atlantoaxial subluxation
- Atlantoaxial impaction: cephalad migration of C2
- Osteoporosis and osteoporotic fractures
- Erosion of spinous processes
References
- ↑ Devauchelle-Pensec V, Saraux A, Alapetite S, Colin D, Le Goff P (October 2002). "Diagnostic value of radiographs of the hands and feet in early rheumatoid arthritis". Joint Bone Spine. 69 (5): 434–41. PMID 12477226.
- ↑ van der Heijde DM, van Leeuwen MA, van Riel PL, Koster AM, van 't Hof MA, van Rijswijk MH, van de Putte LB (January 1992). "Biannual radiographic assessments of hands and feet in a three-year prospective followup of patients with early rheumatoid arthritis". Arthritis Rheum. 35 (1): 26–34. PMID 1731813.
- ↑ Koh JH, Jung SM, Lee JJ, Kang KY, Kwok SK, Park SH, Ju JH (2015). "Radiographic Structural Damage Is Worse in the Dominant than the Non-Dominant Hand in Individuals with Early Rheumatoid Arthritis". PLoS ONE. 10 (8): e0135409. doi:10.1371/journal.pone.0135409. PMC 4527732. PMID 26247204.
- ↑ Fuchs HA, Kaye JJ, Callahan LF, Nance EP, Pincus T (May 1989). "Evidence of significant radiographic damage in rheumatoid arthritis within the first 2 years of disease". J. Rheumatol. 16 (5): 585–91. PMID 2754663.