Arthritis
Arthritis is a condition of joint damage.
Introduction
In arthritis, the cushioning surface of the cartilage wears away causing symptoms like stiffness, pain and swelling.
Arthritis can be of several types like degenerative, inflammatory, infectious and so on. The most common type of arthritis is osteoarthritis which is a degenerative arthritis.
Radiographic Evaluation of Arthritis
| Osteoarthritis | Erosive Osteoarthritis | Septic Arthritis | Rheumatoid Arthritis | Axial Spondyloarthritis | Peripheral Spondyloarthritis | Gout | CPPD | |
|---|---|---|---|---|---|---|---|---|
| Distribution | Weight – bearing, repetitive use | Symmetric, distal | Monoarticular | Proximal, symmetric, large and/or small joints | Axial (symmetric SI joints, spine) | Peripheral (asymmetric, sistal, +/- SI joints) | Anywhere! | Symmetric, non-weight bearing |
| Demographics | Older (>55 yrs), male=female | 40-50 yrs, female | Risk factors (DM, surgery/intervention, bacteremia) | 30-50 yrs, female | 20-40 yrs, male (AS) | 20-40 yrs | Rick factors (Renal failure, obesity, medications) | |
| Joint space narrowing | Non-uniform, loose bodies, chronic course | Non-uniform, early aggressive phase | Uniform, rapid | Uniform | Uniform | Uniform, joint space may be preserved even with erosions | Normal, non-uniform | Non-uniform |
| Bone | Subchondral sclerosis, osteophytes | Osteophytes | Bone loss/destruction adjacent to ST abnormality | Osteoarthritis, no body proliferation | Smooth flowing syndesmophytes, ankylosis | Periostitis, ankylosis, bulky syndesmophytes | Subchondral sclerosis, osteophytes | |
| Cysts, Erosions | Subchondral cysts | Central “gull-wing” erosions | Joint-centered erosions | Marginal erosions | Spondylitis, enthesitis | Ill-defined “fluffy” erosions, enthesitis, spondylitis | Well-defined erosions with overhanging edges (“rat-bite”) | Large subchondral cysts, out of proportion to degree of joint narrowing |
| Soft Tissue | +/- Joint effusion | Swelling | Swelling, soft tissue infection (abscess, ulcer, gas) | Swelling/synovitis, bursitis, Rh nodules, tenosynovitis | Dactylitis, nail pitting or onycholysis | Tophus (“lumpy bumpy”; calcified), bursitis | Chondrocalcinosis |