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Inflammatory Arthritis
Fathima Fijula P. Manzil, MD; Umesh D. Oza, MD; Brad Perry, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Inflammatory arthritis (IA)
                • Group of chronic diseases characterized by inflammation of joints
                • Commonly autoimmune
                • Affects all ages, often striking in peak working and child-rearing age
                • Includes
                  • Rheumatoid arthritis (RA)
                    • Most common form of IA
                • Psoriatic arthritis
                  • ~ 30% of people with psoriasis develop psoriatic arthritis
                • Ankylosing spondylitis
                  • IA that cause pain and stiffness, mainly in back
                  • Can present as juvenile ankylosing spondylitis, more commonly in boys than girls
                • Juvenile idiopathic arthritis
                  • Most common type of IA in children
                  • Girls > boys
                • Systemic lupus erythematosus
                  • Joints affected along with other organs (kidneys, skin, brain)
                • Gout
                  • Uric acid crystals form in cartilage and are released into joint fluid, producing pain
                • Pseudogout
                  • Calcium pyrophosphate crystals form in synovial fluid in joints
                • Parvovirus arthritis
                  • Contagious, viral arthritis that causes flu-like symptoms along with other IA symptoms
                  • Usually resolves on its own within weeks
                  • 10% of patients may experience ongoing symptoms
                • Lyme disease
                  • Caused by spirochete contracted through bite of infected deer tick
                  • Produce IA symptoms in its later stages

            IMAGING

            • General Features

              • Radiographic Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      • Artifacts and Quality Control

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Almodóvar R et al: Definition of remission and disease activity assessment in psoriatic arthritis: Evidence and expert-based recommendations. Reumatol Clin. ePub, 2019
                                        2. Mosher TJ et al: Osteoarthritis year 2013 in review: imaging. Osteoarthritis Cartilage. Epub ahead of print, 2013
                                        3. van der Laken CJ et al: Nuclear imaging of rheumatic diseases. Best Pract Res Clin Rheumatol. 26(6):787-804, 2012
                                        4. Kubota K et al: FDG PET for rheumatoid arthritis: basic considerations and whole-body PET/CT. Ann N Y Acad Sci. 1228:29-38, 2011
                                        5. Mohan HK et al: SPECT/CT in imaging foot and ankle pathology-the demise of other coregistration techniques. Semin Nucl Med. 40(1):41-51, 2010
                                        6. Costelloe CM et al: Musculoskeletal pitfalls in 18F-FDG PET/CT: pictorial review. AJR Am J Roentgenol. 193(3 Suppl):WS1-WS13, Quiz S26-30, 2009
                                        7. Kubota K et al: Whole-body FDG-PET/CT on rheumatoid arthritis of large joints. Ann Nucl Med. 23(9):783-91, 2009
                                        8. De Leonardis F et al: The role of conventional radiography and scintigraphy in the third millennium. Best Pract Res Clin Rheumatol. 22(6):961-79, 2008
                                        9. Houseni M et al: Facet joint arthropathy demonstrated on FDG-PET. Clin Nucl Med. 31(7):418-9, 2006
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Inflammatory arthritis (IA)
                                                      • Group of chronic diseases characterized by inflammation of joints
                                                      • Commonly autoimmune
                                                      • Affects all ages, often striking in peak working and child-rearing age
                                                      • Includes
                                                        • Rheumatoid arthritis (RA)
                                                          • Most common form of IA
                                                      • Psoriatic arthritis
                                                        • ~ 30% of people with psoriasis develop psoriatic arthritis
                                                      • Ankylosing spondylitis
                                                        • IA that cause pain and stiffness, mainly in back
                                                        • Can present as juvenile ankylosing spondylitis, more commonly in boys than girls
                                                      • Juvenile idiopathic arthritis
                                                        • Most common type of IA in children
                                                        • Girls > boys
                                                      • Systemic lupus erythematosus
                                                        • Joints affected along with other organs (kidneys, skin, brain)
                                                      • Gout
                                                        • Uric acid crystals form in cartilage and are released into joint fluid, producing pain
                                                      • Pseudogout
                                                        • Calcium pyrophosphate crystals form in synovial fluid in joints
                                                      • Parvovirus arthritis
                                                        • Contagious, viral arthritis that causes flu-like symptoms along with other IA symptoms
                                                        • Usually resolves on its own within weeks
                                                        • 10% of patients may experience ongoing symptoms
                                                      • Lyme disease
                                                        • Caused by spirochete contracted through bite of infected deer tick
                                                        • Produce IA symptoms in its later stages

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • MR Findings

                                                        • Nuclear Medicine Findings

                                                          • Imaging Recommendations

                                                            • Artifacts and Quality Control

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Almodóvar R et al: Definition of remission and disease activity assessment in psoriatic arthritis: Evidence and expert-based recommendations. Reumatol Clin. ePub, 2019
                                                                              2. Mosher TJ et al: Osteoarthritis year 2013 in review: imaging. Osteoarthritis Cartilage. Epub ahead of print, 2013
                                                                              3. van der Laken CJ et al: Nuclear imaging of rheumatic diseases. Best Pract Res Clin Rheumatol. 26(6):787-804, 2012
                                                                              4. Kubota K et al: FDG PET for rheumatoid arthritis: basic considerations and whole-body PET/CT. Ann N Y Acad Sci. 1228:29-38, 2011
                                                                              5. Mohan HK et al: SPECT/CT in imaging foot and ankle pathology-the demise of other coregistration techniques. Semin Nucl Med. 40(1):41-51, 2010
                                                                              6. Costelloe CM et al: Musculoskeletal pitfalls in 18F-FDG PET/CT: pictorial review. AJR Am J Roentgenol. 193(3 Suppl):WS1-WS13, Quiz S26-30, 2009
                                                                              7. Kubota K et al: Whole-body FDG-PET/CT on rheumatoid arthritis of large joints. Ann Nucl Med. 23(9):783-91, 2009
                                                                              8. De Leonardis F et al: The role of conventional radiography and scintigraphy in the third millennium. Best Pract Res Clin Rheumatol. 22(6):961-79, 2008
                                                                              9. Houseni M et al: Facet joint arthropathy demonstrated on FDG-PET. Clin Nucl Med. 31(7):418-9, 2006