A 60-year-old woman with long-standing seropositive rheumatoid arthritis has bilateral wrist pain and progressive loss of function. Plain radiographs of the wrists are obtained. What is the characteristic early radiological finding in rheumatoid arthritis?

• A Osteophyte formation
• B Pencil-in-cup deformity
• C Chondrocalcinosis
• D Periarticular osteopenia with marginal erosions ✓

Explanation

Periarticular osteopenia and marginal (bare area) erosions at the metacarpal heads and ulnar styloid are the earliest and most characteristic radiographic findings in RA. Osteophytes are seen in osteoarthritis. Chondrocalcinosis is seen in CPPD. Pencil-in-cup deformity is characteristic of psoriatic arthritis.

Reference: Grainger & Allison's Diagnostic Radiology: Musculoskeletal Imaging, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.