Image Based Question – 75074

The given X-ray of Hands is most likely of the patient of

(Also see colour pages)-

A. Osteoarthritis

B. Rheumatoid arthritis

C. Ankylosing spondylitis

D. Hemophilic arthritis

Correct Answer » B Explanation

Answer-B. Rheumatoid arthritis

In the given X-ray

1. There is periarticular osteopenia (see all metacarpo-phalangeal joint have radiolucent area around them)
2. Some of the joint spaces (especially IP joints) are completely obliterated
3. There is no new bone formation or subchondral sclerosis
4. Some of IP joints have erosion of articular margins

• These are typical radiological findings of RA

Following features are seen on X-ray:-

• Reduced joint space
• Erosion of articular margins
• Subchondral cysts
• Juxta-articular rarefaction
• Soft tissue shadow at the level of the joint because of joint effusion or synovial hypertrophy
• Deformities of the hand and fingers
• Periarticular osteopmia (osteoporosis) → Earliest finding