Title:A Systematic Approach to Diagnosing Arthritis Based on Radiological
Imaging
Volume: 18
Author(s): Kyu-Chong Lee, Kyung-Sik Ahn*, Chang Ho Kang, Suk Joo Hong, Baek Hyun Kim and Euddeum Shim
Affiliation:
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
Keywords:
Infectious arthritis, Pigmented villonodular synovitis, Synovial chondromatosis, Rheumatoid arthritis, Osteoarthritis, Spondylarthritis, Crystal Arthropathies.
Abstract: Radiology plays a key role in the diagnosis of arthritis. We herein suggest an algorithmic
approach to diagnosing arthritis. First, the number of joint involvements is reviewed. Monoarticular
arthritis includes septic arthritis, pigmented villonodular synovitis, and synovial chondromatosis. Second,
polyarticular arthritis can be categorized by its characteristics: erosive, productive, and mixed.
Erosive disease includes rheumatoid arthritis, hemophilia, and amyloidosis, while productive disease
includes osteoarthritis and hemochromatosis. Third, mixed diseases are subcategorized by symmetricity.
Ankylosing spondylitis and inflammatory bowel disease related arthritis affect joints symmetrically,
while psoriatic arthritis, reactive arthritis, and crystalline arthropathy are asymmetric. Adjacent soft
tissue density, periostitis, and bone density are ancillary findings that can be used as additional differential
diagnostic clues. The final step in identifying the type of arthritis is to check whether the location
is a site frequently affected by one particular disease over another. This systematic approach would be
helpful for radiologists in diagnosing arthritis.