eMedicine Specialties > Radiology > Musculoskeletal

Rheumatoid Arthritis, Hands: Follow-up

Author: Ian Y Y Tsou, MBBS, FRCR, Clinical Lecturer, Faculty of Medicine, National University of Singapore; Consulting Staff, Department of Radiology, Mount Elizabeth Medical Centre
Coauthor(s): Wilfred CG Peh, MD, MBBS, FRCP(Glasg), FRCP(Edin), FRCR, MHSM, Clinical Professor, Faculty of Medicine, National University of Singapore; Senior Consultant Radiologist, Programme Office, Singapore Health Services; Michael A Bruno, MD, Associate Professor, Departments of Radiology and Medicine, Pennsylvania State University College of Medicine; Director, Radiology Quality Management Services, Milton S Hershey Medical Center, Pennsylvania State University College of Medicine
Contributor Information and Disclosures

Updated: May 10, 2007

Intervention

The primary role of imaging in RA of the hands and wrists is to exclude septic arthritis. Percutaneous ultrasonography-guided aspiration may be useful for localizing and obtaining samples of any collection that can be found. Image 17 shows ultrasonography-guided biopsy of the second MCP joint in the right hand.

Medicolegal Pitfalls

  • Of concern is the possibility of misdiagnosing another erosive arthropathy as RA or vice versa (see Differentials). Because the diagnosis of RA is a predominantly clinical one, the primary role of imaging is in follow-up observation.
  • RA may occur as part of a mixed connective tissue disease in which clinical and radiologic appearances are not typical of one particular disease.
 


More on Rheumatoid Arthritis, Hands

Overview: Rheumatoid Arthritis, Hands
Imaging: Rheumatoid Arthritis, Hands
Follow-up: Rheumatoid Arthritis, Hands
Multimedia: Rheumatoid Arthritis, Hands
References
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References

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Further Reading

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Keywords

RA, human leukocyte antigen, DR4, DRB1, joint deformity, joint fusion, metacarpophalangeal joint, MCP joint, proximal interphalangeal joint, PIP joint, thumb interphalangeal joint, IP joint, distal interphalangeal joint, DIP joint, swan-neck deformity, boutonnière deformity, button-hole deformity, inflammatory joint disease, rheumatoid nodules

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Contributor Information and Disclosures

Author

Ian Y Y Tsou, MBBS, FRCR, Clinical Lecturer, Faculty of Medicine, National University of Singapore; Consulting Staff, Department of Radiology, Mount Elizabeth Medical Centre
Ian Y Y Tsou, MBBS, FRCR is a member of the following medical societies: American Roentgen Ray Society and Royal College of Radiologists
Disclosure: Nothing to disclose.

Coauthor(s)

Wilfred CG Peh, MD, MBBS, FRCP(Glasg), FRCP(Edin), FRCR, MHSM, Clinical Professor, Faculty of Medicine, National University of Singapore; Senior Consultant Radiologist, Programme Office, Singapore Health Services
Wilfred CG Peh, MD, MBBS, FRCP(Glasg), FRCP(Edin), FRCR, MHSM is a member of the following medical societies: American Roentgen Ray Society, British Institute of Radiology, International Skeletal Society, Radiological Society of North America, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

Michael A Bruno, MD, Associate Professor, Departments of Radiology and Medicine, Pennsylvania State University College of Medicine; Director, Radiology Quality Management Services, Milton S Hershey Medical Center, Pennsylvania State University College of Medicine
Michael A Bruno, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Association of University Radiologists, Radiological Society of North America, and Society of Skeletal Radiology
Disclosure: Nothing to disclose.

Medical Editor

Amilcare Gentili, MD, Clinical Professor of Radiology, University of California at San Diego; Consulting Staff, Department of Radiology, Thornton Hospital
Amilcare Gentili, MD is a member of the following medical societies: American Roentgen Ray Society, Radiological Society of North America, and Society of Skeletal Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Lynne S Steinbach, MD, Chief of Musculoskeletal Radiology, Professor, Department of Radiology, University of California at San Francisco
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Felix S Chew, MD, MBA, EdM, Professor, Department of Radiology, Vice Chairman for Radiology Informatics, Section Head of Musculoskeletal Radiology, University of Washington
Felix S Chew, MD, MBA, EdM is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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