Introduction
This topic covers the radiological picture of inflammatory and degenerative-dystrophic diseases of the joints and spine: arthritis versus osteoarthrosis, rheumatoid arthritis, ankylosing spondylitis, coxarthrosis, gonarthrosis, and degenerative diseases of the spine (osteochondrosis, spondylosis, spondyloarthrosis).
Arthritis versus osteoarthrosis
- Arthritis is an inflammatory joint disease. It starts from the synovial membrane and engages the joint cartilage and the adjacent bone joint edges. The joint space narrows evenly.
- Osteoarthrosis is a non-inflammatory degenerative-dystrophic change of the articular cartilage with proliferative processes in the adjacent bone tissue. The joint space is unevenly narrowed.
X-ray AP view of the hands with periarticular osteoporosis (early sign) at the distal end of the metacarpals.
Rheumatoid arthritis
- A chronic autoimmune inflammatory disease, in women aged 30-50.
- It begins bilaterally and symmetrically in the metacarpophalangeal and proximal interphalangeal joints; as the disease progresses it can affect larger joints.
Radiological features
- Periarticular osteoporosis (early sign).
- Even narrowing of the joint space.
- Erosion of the joint edges.
- Small subchondral cysts at the ends of the small bones.
- Subluxations and ulnar deviation.
- Ankylosis.
X-rays of the hands show subluxation of the metacarpophalangeal joints with ulnar deviation; the bottom picture shows degenerative changes in the radiocarpal articulation.