X-ray of hands in a 55-year-old with symmetric polyarthritis shows loss of joint space, periarticular osteopaenia, marginal erosions, and 'boutonniere deformity'. MRI shows pannus formation in the wrist. These imaging findings are MOST characteristic of:
- A Psoriatic arthritis
- B Rheumatoid arthritis ✓
- C Gout
- D Osteoarthritis
Explanation
Rheumatoid arthritis is characterised radiologically by symmetrical involvement of small joints, periarticular osteopaenia (early), marginal erosions at 'bare areas' (cartilage-free zones), uniform joint space loss, and absence of new bone formation/osteophytes. Pannus (synovial hypertrophy with enhancement on contrast MRI) is the hallmark of active RA. Boutonniere and swan-neck deformities are characteristic late features. Psoriatic arthritis shows 'pencil-in-cup' erosions, DIP involvement, and periostitis. Gout shows eccentric erosions with overhanging edges. OA shows osteophytes and subchondral sclerosis.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.