Arthritis

SLE Arthropathy

  • Reversible ulnar deviation

    • Ulnar deviation of fingers with supination but return to normal with pronation basically

  • Does not typically cause advanced erosive changes (minimal ones sure but not bad ones)

Rheumatoid Arthritis

  • Classic findings

    • Ulnar styloid erosion

    • 5th metatarsal head erosion

  • Erosions without osteophytes

  • Basically osteoarthritis without osteophytes

    • Sclerosis

    • Subchondral cysts

    • UNIFORM joint space narrowing

Psoriasis

  • Asymetric sacroilitis

  • Sausage digit

  • Enthesopathy

  • Ivory bone sign

  • Ankylosis in hand

  • Gull wing deformity

  • Pencil in cup deformity

  • Fluffy periosteal bone

  • Lateral bridging osteophytes of spine

  • Bone density is normal

Juvenile Idiopathic Arthritis (Still Disease)

  • Carpal arthrosis

  • Look for concurrent normal MTP joints to differentiate from RA

  • Hypoplastic iliac wings

  • Gracile bones (slender bones)

Sacroilitis

  • Unilateral —> infection

    • IV drug users

    • Pseudomonas

  • Bilateral (P-ai-R)

    • Symmetric

      • Ankylosing pondylitis

      • Inflammatory bowel disease

    • Asymmetric

      • Psoriatic artrhitis

      • Reactive arthritis

References:

Jaccoud Arthropathy

  • Reversible ulnar deviation

  • Basically arthritis after a viral illness

    • "Post rheumatic fever arthritis”

Renal Osteodystrophy

  • Erosion of the underside of the clavicle or ribs

  • Joint space widening

  • Narrowing of femoral neck

  • Massively widened SI joints

  • Rugger jersey spine

  • Look for atrophic kidneys in background

  • Salt & pepper skull

Hemophilia

  • Males

  • Does not typically affect shoulder

Adult onset Still Disease

  • Triad of

    • Fever

    • Arthropathy

    • Salmon colored rash

  • Nonspecific inflammatory disorder

Ochronosis

  • Alkaptonuria

  • Multilevel disc calcification

  • High homogenistic acid?

Chronic Reactive Arthritis

  • Asymmetric sacroilitis

  • Sausage digit

  • Enthesopathy

  • All also seen in psoriatic arthritis

Neuropathic Arthropathy

  • Looks like nonspecific destruction of the bone/joint

  • Should get spine/brain MR if you see this

    • Commonly have syrinx

CPPD

  • Hook osteophytes of metacarpal heads (2nd & 3rd)

    • Also seen in hemochromatosis (all 4 - 4 points on H)

Acro-osteolysis

  • Scleroderma

  • Raynauds

  • Psoriatic arthritis