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8/3/2019 Imaging in logy
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Imaging in rheumatology
Chingching Foocharoen
8/3/2019 Imaging in logy
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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
8/3/2019 Imaging in logy
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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
8/3/2019 Imaging in logy
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8/3/2019 Imaging in logy
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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
8/3/2019 Imaging in logy
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8/3/2019 Imaging in logy
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Psoriatic arthritis Rheumatoid arthritis
8/3/2019 Imaging in logy
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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
8/3/2019 Imaging in logy
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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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8/3/2019 Imaging in logy
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8/3/2019 Imaging in logy
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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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8/3/2019 Imaging in logy
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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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8/3/2019 Imaging in logy
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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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8/3/2019 Imaging in logy
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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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8/3/2019 Imaging in logy
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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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8/3/2019 Imaging in logy
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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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8/3/2019 Imaging in logy
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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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8/3/2019 Imaging in logy
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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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8/3/2019 Imaging in logy
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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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8/3/2019 Imaging in logy
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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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8/3/2019 Imaging in logy
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8/3/2019 Imaging in logy
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Hypertrophic osteoarthropathy
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Charcots joint
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thalassemia
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osteomalaciaPAN