Radiographic evaluation of arthritis: inflammatory conditions
Jon A. Jacobson, Gandikota Girish, Yebin Jiang, and Donald Resnick
Radiology 2008 248:2, 378-389
 Hypertrophic/proliferative


Degenerative: primary or secondary
Secondary AKA atypical OA



Hemophilia
Gout
trauma
 Erosive

Rheumatoid + variants
 Infectious


TB
Pyogenic/bacterial
 Synovial
proliferation  Pannus
 Inflammatory erosions
 Uniform joint space narrowing
 Soft-tissue swelling
 RA + seronegative variants




Reiters
Ankylosing spondylitis
Enteric arthropathy
Psoriatic arthropathy
 Multiple
joints: systemic
 Periarticular osteopenia
 Juxtaarticular bony erosions (non-cartilage
non-protected bone)
 Subluxation and gross deformity
 Periarticular soft tissue swelling
Younes, Mohamed, et al. "Compared imaging of the
rheumatoid cervical spine: prevalence study and
associated factors." Joint Bone Spine 76.4 (2009):
361-368.
The prevalence of rheumatoid cervical spine
involvement was 47.5% by standard radiography,
28.2% by CT, and 70% by MRI.
 Rheum involvement with high Sharp score and
elevated CRP
 17.5% of those with Cspine abn were w/o sx.
 Overall rheumatoid involvement of the cervical spine
was not significantly associated with any of the
epidemiological, clinical, laboratory, imaging, or
therapeutic factors evaluated in the study.
Criteria:
SI and facet joints
normal
4 contiguous
vertebrae
No disc space
narrowing
 Subchondral
sclerosis, osteophytes
 No
erosions
 Asymmetric joint space
 Nearly all arthritides can lead to DJD
*Weight-bearing radiograph for early detection
Mobius battle
 Microtrauma
– not just body habitus but body
habits AKA repeated use
Monu, Johnny UV, and Thomas L. Pope Jr. "Gout: a clinical
and radiologic review." Radiologic Clinics of North America
42.1 (2004): 169-184.