A 65-year-old woman with chronic gout presents for follow-up. She has recurrent attacks despite dietary modifications. Plain radiographs of the feet are obtained. What is the characteristic radiological finding of chronic gouty arthritis?
- A Symmetric joint space narrowing with marginal erosions
- B Bamboo spine with syndesmophytes
- C Punched-out erosions with overhlying edges and preserved joint space until late ✓
- D Periarticular osteopenia without erosions
Correct answer: C. Punched-out erosions with overhlying edges and preserved joint space until late
Explanation
Chronic gout produces well-defined punched-out erosions with characteristic overhanging edges (rat-bite erosions), often preserving joint space until late disease. Tophi may show calcification. Symmetric marginal erosions with osteopenia describe RA. Bamboo spine is seen in ankylosing spondylitis. Periarticular osteopenia alone is a nonspecific early RA finding.
Reference: Grainger & Allison's Diagnostic Radiology: Musculoskeletal Imaging, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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