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Rheumatoid Arthritis Imaging

Rheumatoid arthritis is a connective tissue disorder of unknown etiology that can affect any synovial joint in the body. It is a bilaterally symmetric inflammatory degenerative disease that involves the following joints in order of decreasing frequency: :

  • Small joints of the hands and feet, with the exception of the distal interphalangeal joints
  • Knees
  • Hips
  • Cervical spine
  • Shoulders Elbows

The major radiographic findings include the following: :

  • Symmetric periarticular soft-tissue swelling
  • Juxta-articular osteoporosis proceeding to diffuse osteoporosis
  • Erosions of the intracapsular portions of the articulating bones not covered by cartilage, which can proceed to severe subchondral bone erosion
  • Uniform joint space narrowing
  • Synovial cysts (e.g., Baker’s cysts behind the knee)
  • Subluxations (e.g., boutonniere or swan-neck deformities of the fingers, and palmar and ulnar subluxation of the proximal phalanges on the metacarpal heads) (Fig. 6-40A,B) (54)

Rheumatoid Arthritis Imaging

FIGURE 6-40. Frontal projections of both hands. There is extensive erosive disease within the wrist joints bilaterally, ulnar subluxations to the 2nd, 3rd MCP and to the 4th PIP and radial subluxation to the 5th PIP on the left.


Source: Physical Medicine and Rehabilitation – Principles and Practice

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