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Imaging in rheumatology

Chingching Foocharoen

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x ray

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Soft tissue

Swelling

Calcification

DensityMass

Bony alignment

Deformity

Subluxationdislocation

JointJoint spaceJoint surface

Subchondral bone

Nearby bone

Narrowing: uniform?

WideningIrregularSclerotic border

Erosion

osteophyte

Sclerosis

Osteopenia

CystPeri A osteopenia

Diffuse osteopenia

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Common disease in

rheumatology

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Rheumatoid arthritis

Soft tissue

Bony alignment

Joint

-joint space

-joint surface

-subchondral bone

-periarticular bone

Fusiform swelling

Deformity, subluxation

Joint

-uniform narrowing

-ill-defined marginal

erosion-osteopenia

-diffuse osteopenia

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Spondyloarthropathy

Soft tissue

Bony alignment

Joint

-joint space

-joint surface

-subchondral bone

-periarticular bone

Fusiform swelling

Deformity, subluxation

Joint

-uniform narrowing

-ill-defined erosion

-normal bone density(osteopenia in AS)

-bony formation

-asymmetrical joint

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Psoriatic arthritis Rheumatoid arthritis

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Septic arthritis

Soft tissue

Bony alignment

Joint

-joint space

-joint surface

-subchondral bone

-periarticular bone

Fusiform swelling

Normal

Joint

-widening, uniform

narrowing

-ill-defined

nonmarginal erosion-sclerosis?

-peri A osteopenia,

periosteal reaction

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TB arthritis

Soft tissue

Bony alignment

Joint

-joint space

-joint surface

-subchondral bone

-periarticular bone

Swelling

Normal

Joint

-normal orwidening

-ill-defined marginal

erosion-juxta A osteopenia

-less periosteal Rx

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Osteoarthritis

Soft tissue

Bony alignment

Joint

-joint space

-joint surface

-subchondral bone

-periarticular bone

Nodal

Deformity, subluxtion?

Joint

-nonuniform narrow

-osteophyte, gull wing

erosion-sclerosis, cyst

-normal

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Gout

Soft tissue

Bony alignment

Joint

-joint space

-joint surface

-subchondral bone

-periarticular bone

Lobular mass,

calcification

Normal

Joint

-normal

-well-defined erosion

-sclerosis?

-overhanging edge

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Overhanging edge

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Systemic sclerosisSoft tissue

Bony alignmentJoint

-joint space

-joint surface-subchondral bone

-periarticular bone

Resorption of soft tissueSubcutaneous

calcification

Deformity

Joint

-normal/narrowing

-normal-acro-osteolysis

-osteopenia

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8/3/2019 Imaging in logy

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hyperPTH

Soft tissue

Bony alignment

Joint

-joint space

-joint surface

-subchondral bone-periarticular bone

Subcutaneous calcified

Pathological fracture

Joint

-normal

-normal

-osteopenia-subperiosteal

resorption

-brown tumor

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Avacular necrosis

Soft tissue

Bony alignment

Joint

-joint space

-joint surface

-subchondral bone-periarticular bone

Normal

Deformity?

Joint

-normal

-normal

-osteopenia, crescentsign, collapse head

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Axial joint

Soft tissue

Bony alignment

Bone mineralization Disc space

Facet joint

Pedicle Vertebral body

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Spinal OA (spondylosis)

Soft tissue

Bony alignment

Bone mineralization

Disc space

Facet joint

Pedicle

Vertebral body

Normal

Kyphoscoliosis

Normal

Normal / narrowwith vacuum

phenomenon

Narrowing, erosion

Normal

Horizontal, marginal osteophyte

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TB spondylitis

Soft tissue

Bony alignment

Bone mineralization

Disc space

Facet joint

Pedicle

Vertebral body

Paravertebral soft tissue swelling

with orwithout calcification

Kyphosis (T-spine)

Osteopenia

Early: normal

Normal

Normal

Anteriorwedge shape vertebral

collapse (gibbus deformity)

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Bacterial spondylitis

Soft tissue

Bony alignment

Bone mineralization

Disc space

Facet joint

Pedicle

Vertebral body

Paravertebral soft tissue swelling

Kyphosis

Osteopenia

Narrowing

Erosion

Normal

Vertebral end plate ill-defined

erosion

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Spondyloarthropathy

Soft tissue

Bony alignment

Bone mineralization

Disc space

Facet joint

Pedicle

Vertebral body

Normal, calcified ligament

Kyphosis,loss of lordotic

Osteopenia

Normal

Erosion, fusion

Normal

Squared vertebra

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Osteoporosis

Soft tissue

Bony alignment

Bone mineralization

Disc space

Facet joint

Pedicle

Vertebral body

Normal

Kyphosis

Osteopenia

Normal

Normal

Normal

Wedge shape, fish mouth

vertebra

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Cancer metastasis

Soft tissue

Bony alignment

Bone mineralization

Disc space

Facet joint

Pedicle

Vertebral body

Normal

Kyphosis

Osteopenia, osteosclerosis

Normal

Normal

Loss of pedicle

Punched out osteolytic

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Diffuse idiopathic skeletal

hyperostosis (DISH)

Soft tissue

Bony alignment

Bone mineralization

Disc space

Facet joint

Pedicle

Vertebral body

Calcified ant longitudinal ligament

>4 vertebra

Kyphosis,loss of lordotic

Normal

Normal

Normal

Normal

Normal vertebra, SI joint

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Hypertrophic osteoarthropathy

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Charcots joint

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thalassemia

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osteomalaciaPAN