Rheumatoid arthritis

Case contributed by Chitani Mbewe
Diagnosis certain


Long-standing tiredness, malaise, generalized aches and joint stiffness.

Patient Data

Age: 55 years
Gender: Female

Hand Radiographs


Osteopenia involving the hands bilaterally. 

Erosive and ankylotic changes involving the carpal bones bilaterally.

Significant degeneration of the radial and ulnocarpal joints. 

Periarticular osteopenia surrounding the metacarpophalangeal joints with fusiform soft tissue swelling.

Involvement of some proximal interphalangeal joints as well.

Knee Radiographs


Bilateral periarticular osteopenia. Symmetrical joint space loss (cartilage destruction) involving the medial and lateral condylar surfaces. 

Mild secondary degenerative changes in the form of subchondral sclerosis.

Case Discussion

Rheumatoid arthritis is a chronic autoimmune multisystemic inflammatory disease which affects many organs but with predominant musculoskeletal manifestations.
RA in 1% of worldwide population, with a female predilection. [Female > male (3:1)]
Carpus involved in 80% of patients with RA
MCPs involved in 85% of patients with RA
Hand PIP involved in 75% of patients with RA

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