X ray findings

Question 1

OA findings

Answer 1

Soft tissue swelling
Joint space narrowing
Subchondral sclerosis
Subchondral cyst formation
Bone attrition (altered contour)
Osteophytes

Question 2

RA findings

Answer 2

Periarticular osteoporosis
marginal erosions
Joint space narrowing
Large subchondral cysts
Ulnar styloid soft tissue swelling 
Deformities: MCP subluxation, ulnar dev digits, swan neck, boutonniere.

Question 3

Haemochromatosis

Answer 3

Hooked osteophytes
Major differential for CPPD
Check ferritin if 2,3 CMC involvement

Question 4

Psoriatic

Answer 4

Erosions and bony proliferations–>fluffy appearance
Asymmetric “ray” distibution
Sausage soft tissue swelling
Pencil/cup
Can get bony ankylosis of joints
Chunky, asymmetrical, non marginal syndesmophytes/comma shaped

Question 5

Gout

Answer 5

Punched out juxta-articular erosions
Soft tissue tophi
Joint space preserved
No osteopaenia

Question 6

Pseudogout

Answer 6

Prominent osteophytes in unusual distribution
Chondrocalcinosis
No errosions, new bone formation
PROMINENT LARGE subchondral cysts

Question 7

DIP spared in…

Answer 7

RA and SLE

Question 8

DIP not spared, think…

Answer 8

gout- tophi + large punched out marginal errosions

psoriatic- ?nail changes, pencil in cup, errosions and new bone formation more than osteophytes

OA- osteophytes, heb and bouchards nodes, juxta aortic sclerosis