Rheumatoid arthritis

Case contributed by Dr Matt Skalski

Presentation

Chronic joint pain and limited range of motion.

Patient Data

Age: Middle aged
Gender: Male
Modality: X-ray

There is moderate to severe tricompartmental uniform loss of joint space bilaterally. 

There are marginal erosions of the 3rd-5th metacarpal heads on the left, and 4th and 5th metacarpal heads on the right. There is also a uniform loss of joint space at these locations, as well as at the 2nd metacarpophalangeal joint on the right, and metacarposesamoid articulations bilaterally. 

Modality: X-ray

There is severe uniform lost of joint space at the radiocarpal, ulnocarpal and most of the carpometacarpal articulations, with ankylosis of all of the intercarpal joints and 2nd and 3rd carpomatacarpal joints bilaterally. Interestingly, with this severe pattern of wrist involevment, the metacarpophalangeal joints are spared. 

Modality: X-ray

There is minimal uniform lost of joint space on the right with a mild anterior sail sign and minimal elevation of the posterior fat pad, indicating effusion. 

Case Discussion

These findings are characteristic of advanced skeletal involvement in rheumatoid arthritis. 

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Case Information

rID: 24953
Case created: 24th Sep 2013
Last edited: 28th May 2016
Inclusion in quiz mode: Included

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