Arthritis in Black and White

Osteoarthritis

Osteoarthritis is the most common arthropathy. Although many arthropathies lead to secondary osteoarthritic changes, this chapter deals with primary osteoarthritis and osteoarthritis secondary to alteration of normal mechanics across a weight-bearing joint. The radiographic hallmarks of osteoarthritis are as follow:…

Ankylosing Spondylitis

Ankylosing spondylitis is the chronic inflammatory disease that affects primarily the axial skeleton and only secondarily the appendicular skeleton. It is seen predominantly in males between the ages of 15 and 35 years. Of all the inflammatory arthropathies, it is…

Reactive Arthritis

Reactive arthritis (formerly known as Reiter disease) is usually associated with conjunctivitis and urethritis. It is a disease predominantly of males between 15 and 35 years of age and is transmitted through either epidemic dysentery or sexual intercourse. The arthritis…

Psoriatic Arthritis

For years psoriatic arthritis was considered part of the spectrum of rheumatoid arthritis. The classification of psoriatic arthritis as a “rheumatoid variant” persists today. However, the radiographic manifestations, along with clinical and laboratory data, establish psoriatic arthritis as a separate…

Rheumatoid Arthritis

In the practice of rheumatology, rheumatoid arthritis is considered the everyday disease. It is a symmetrical arthritis of the appendicular skeleton, sparing the axial skeleton except for the cervical spine. The common radiographic findings are as follows: 1. Periarticular soft…

The “Phytes” of the Spine

In evaluating the spine, one observes the size, shape, and mineralization of the different vertebral bodies. These parameters become abnormal in various systemic diseases. For example, a large vertebral body is seen in Paget disease, a flattened vertebral body in…

The Sacroiliac Joint

The sacroiliac (SI) joint is perhaps the most difficult joint in the skeleton to image adequately to make an accurate diagnosis of a disorder affecting it. This is partially due to obscuration of the joint by multiple overlying soft tissue…

Approach to the Shoulder

Pain in the shoulder is a common problem affecting all ages of the general population. It is the second most common cause of musculoskeletal pain. Radiographic diagnosis of the disease entity causing nonspecific pain begins with evaluation of how the…

Approach to the Knee

As in the hip, the diagnosis of a disorder of the knee depends foremost on the evaluation of true joint space involvement. This evaluation is made most accurately through an anteroposterior (AP) standing view of the knee and a flexed…

Approach to the Hip

The assessment of hip pain depends on a systematic review of a quality anteroposterior (AP) view of the pelvis. The femurs should be internally rotated approximately 15 degrees, the pelvis should not be oblique, and the sacrococcygeal junction should not…