Imaging in Arthritis Flashcards
What is the role of imaging in arthritis?
Detect features of disease in order to make diagnosis and monitor disease activity and response to treatment
What are some joints affected by osteoarthritis?
Always asymmetrical
Weight bearing or active joints = spine, hip, knee, thumb base, DIP
Secondary OA can affect unusual places
What are some causes of secondary OA?
Overuse, previous injury, previous arthritis
What are some imaging features of OA?
Asymmetric joint reduction, sclerosis of subchondral bone, cysts, osteophytes, gross joint deformity
How does rheumatoid arthritis affect joints?
Always symmetrical, only affects synovial joints = MCP, MTP, PIP, wrists, hip, knee, shoulder, atlantoaxial joint
WHat are some features of rheumatoid arthritis?
Soft tissue swelling, osteopenia (periarticular), erosions, deformity, ankylosis
How do erosions occur in rheumatoid arthritis?
Pannus destroys bone initially at joint margin, spreads across joint over time
What is the hallmark imaging feature of rheumatoid arthritis?
Marginal erosions
How do deformities arise in rheumatoid arthritis?
Erosion shortens bone causing lax ligaments and joint capsule, joint subluxation and deformity occur
What are some features of seronegative arthritis?
Sacroiliac joint and spine involvement, ill defined new bone formation, ankylosis of ligaments and cross joints
What are some features of psoriatic arthritis?
Small joints of hands and feet, DIP, IP of great toe
What are some features of ankylosing spondylitis?
Scattered lower limb large joints
What are some features of Reiter’s Syndrome?
Scattered lower limb large joints, lower limb enthesis
What does imaging indicate?
Largely indicate bone and joint damage that has already occurred = patients may have missed chance to have disease prevented or modified
When do you want to diagnose patients?
Before any significant joint damage has occurred
