XRay Changes in Rheumatic Conditions

Aka: XRay Changes in Rheumatic Conditions

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II. Finding: Decreased bone density

  1. Rheumatoid Arthritis
  2. Late Ankylosing Spondylitis

III. Finding: Bony erosions

  1. Erosive Osteoarthritis in postmenopausal women
  2. Rheumatoid Arthritis
    1. Juxta-articular Osteopenia is an early finding
  3. Psoriatic Arthritis
    1. Erosions begin at joint margins as with Rheumatoid Arthritis
    2. Erosions may progress to involve central joints (pencil-in-cup erosion)
  4. Ankylosing Spondylitis
  5. Tophaceous or Polyarticular gout
    1. Rat-bite erosions with well defined, sclerotic margins

IV. Finding: Cyst Formation

  1. Osteoarthritis (Subchondral cysts)
  2. Rheumatoid Arthritis (Synovial Cysts)
  3. Calcium Pyrophosphate Deposition Disease (CPPD)

V. Finding: Joint space narrowing

  1. Osteoarthritis (non-uniform narrowing)
  2. Rheumatoid Arthritis (uniform)
  3. Calcium Pyrophosphate Deposition Disease (uniform)
  4. Psoriatic Arthritis
  5. Ankylosing Spondylitis

VI. Finding: Bone production

  1. Osteophytes
    1. Osteoarthritis
    2. Calcium Pyrophosphate Deposition Disease (CPPD)
    3. Diffuse Idiopathic Skeletal Hyperostosis (DISH)
  2. Subchondral Sclerosis
    1. Osteoarthritis
    2. Calcium Pyrophosphate Deposition Disease (CPPD)
  3. Tendon and Ligament Ossification
    1. Diffuse Idiopathic Skeletal Hyperostosis (DISH)
  4. Chondrocalcinosis
    1. Calcium Pyrophosphate Deposition Disease (CPPD)

VII. References

  1. Brower (1998) Arthritis Black and White, Saunders
  2. Foster (2023) Am Fam Physician 107(1): 42-51 [PubMed]

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