Radiology Study Guide

Rheumatoid Arthritis

• Soft tissue swelling
• Demineralization
• Erosions
• Narrowing of the joint space
• Subluxation

JRA

• Ankylosis of Cervical apophyseal joints
• Bony proliferation and periostitis
• Joint erosions and space narrowing relatively late fractures
• Joint subluxation

Psoriatic Arthritis

• Subchondral osteoporosis and erosions “pencil-in-cup”
• Bony erosion with adjacent proliferation
• Intra-articular  bony ankylosis
• Destruction of phangeal tufts
• Paravertebral ossification and or assymmetric sacroiliac involvement

Osteoarthritis

• Hypertrophic spurs
• Subchondral sclerosis
• Joint space narrowing
• Cystic changes of the involved joint

Gout

• Punched-out joint erosions
• Eccentric osseous erosions with normal cartilage and minimal sclerosis
• Extensive fragmentation of bone in association with proliferative changes and soft tissue swelling

Pseudo-Gout

• Linear calcification of fibrocartilage
• Synovial and capsular calcification
• Hyaline cartilage calcification
• Subchondral cyst formation
• Severe destructive arthropathy in occasional patients

Sarcoid

• Assymetric swelling of PIP’s and DIP’s
• Punctate lesions in the phalanges
• Thinning of bony cortex

Acromegaly

• Increased width of joint space
• Increased soft tissue density  (width of calcaneal fat pad)
• Hypertrophic spurs
• Tufting distal phalanges

Hemochromatosis

• Osteoporosis
• Articular calcification
• Arthropathy characterized by subchondral cyst formation and uniform loss of articular cartilage

Multiple Myeloma

• Multiple sites of osteolysis
• Well-circumscribed radiolucent lesions without surrounding sclerosis=
• Scalloping of the endosteal bone margin
• Pathologic fractures

Hemoglobinopathies

• Thickened Bony cortex
• Narrowed medullary cavity
• Sclerotic bone

Pigmented Villonodular Synovitis

• Narrowing of the joint space
• Erosions
• Multiloculated cysts

Osteomyelitis

• Periosteal elevation
• Sequestrum

Spontaneous osteonecrosis of the medial femoral condyle

• Condylar flattening
• Radiolucency surrounded by sclerosis