MUSCULOSKELETAL IMAGING: Arthritis of the Proximal Joints
Case Author: Kirkland W. Davis, MD, University of Wisconsin School of Medicine and Public Health
History
18-year-old woman with recurrent knee pain.
Imaging Findings
Lateral (A) and anteroposterior (B) radiographs of the right knee show joint space narrowing, large subchondral cysts, osseous deformity with remodeling and ballooning of the epiphyses, and widening of the intercondylar notch. Secondary degenerative changes and a small effusion are evident.
- Hemophilic arthropathy
- Juvenile idiopathic arthritis (JIA)
- Rheumatoid arthritis (RA)
- Septic arthritis
Diagnosis
Hemophilic arthropathy
Teaching Points
The radiographic findings of hemophilic arthropathy resemble those of juvenile idiopathic arthritis (JIA). Secondary degenerative changes may be seen as late manifestations of any inflammatory arthropathy. Radiodense effusion and more squaring of the patella may help to differentiate hemophilic arthropathy of the knee from JIA.
Suggested Readings
Brower AC, Flemming DJ. Arthritis in black and white, 2nd ed. Philadelphia, PA: Saunders, 1997:405–418
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