Radiology of Arthritis

Question 1

What is an inflammatory pannus?

What are the arrows pointing at in this x-ray, which are caused by the inflammatory pannus?

What the arrows are pointing at are the hallmark of what condition?

Answer 1

Thickened synovium

Erosions (begin at the joint margins)

Rheumatoid Arthritis

Question 2

What feature of osteoarthritis does this x-ray show?

Answer 2

Loss of joint space

Question 3

This x-ray shows ill-defined periarticular bone formation. What group of conditions does this occur in?

Answer 3

Seronegative inflammatory arthritis

Question 4

As well as joint fusion, what else might happen in a spine affected by ankylosing spondylitis which will be visible on x-ray?

Answer 4

New bone formation

Question 5

Osteoarthritis usually affects:

A) Small joints

B) Large weight bearing joints

Answer 5

B) Large weight bearing joints

Question 6

Seronegative arthritis’ are characterised by what?

Answer 6

Spine and sacroiliac involvement

Question 7

What are the black arrows pointing at in this x-ray?

What condition is this seen in?

Answer 7

Cysts

Osteoarthritis

Question 8

Joint involvement in osteoarthritis is usually:

A) Symmetrical

B) Asymmetrical

Answer 8

B) Asymmetrical

Question 9

Patients with Bamboo spine are prone to what type of fractures?

Answer 9

Highly unstable C-spine fractures

Question 10

What does this x-ray of a spine with ankylosing spondylitis show?

What will this eventually lead to?

Answer 10

The vertebrae are beginning to fuse together

May lead to a Bamboo spine

Question 11

What is hyperaemia?

What does this cause?

Answer 11

Increased blood supply

Bone demineralisation, resulting in periarticular osteoporosis

Question 12

Erosions shorten bone and produce lax ligaments and joint capsules. What does this result in?

Answer 12

Joint subluxations and deformities

Question 13

What are the arrows pointing at in this x-ray?

What condition is this seen in?

Answer 13

(Synovial proliferation and joint effusions showing) soft tissue swelling

Rheumatoid arthritis

Question 14

What is the white arrow pointing at in this x-ray?

What condition are these mainly seen in?

Answer 14

Osteophyte

Osteoarthritis

Question 15

What feature of osteoarthritis does this x-ray show?

Answer 15

Subchondral sclerosis

Question 16

What does an isotope bone scan show?

Answer 16

Increased vascularity around joints which often accompanies synovitis

Question 17

MRI scans can show what clinical sign, which often precedes joint erosions and damage and provides early evidence of inflammatory joint disease?

What do the bright areas on an MRI suggest?

Answer 17

Bone marrow oedema

Fluid within a bone/joint

Question 18

What seronegative inflammatory arthropathy do the following correspond to?

A) Affects the small joints of hands and feet

B) Affects scattered lower limb large joints

C) Affects scattered lower limb large joints and lower limb entheses

Answer 18

A) Psoriatic arthritis

B) Ankylosing spondylitis

C) Reactive arthritis (Reiter’s Syndrome)

Question 19

What imaging test can show thickening of the synovium and increased blood flow?

Answer 19

Ultrasounds