The first question is 'is it a joint disease?'
Hint: both sides of joints are affected usually
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How to differentiate between inflammatory or degenerative joint disease?
Erosion:
Feature of inflammatory joint
Marginal bone erosion: intraarticular bone not covered by cartilage. Seen before subchondral bone plate erosion.
Subchondral bone erosion: subtle discontinuity of subchondral bone plate (e.g. ulnar styloid)
Then extends to trabeculae in medullary spaces.
Joint space narrowing:
Uniform narrowing: inflammatory joints
Non-uniform narrowing: degenerative joints
Soft tissue swelling:
Inflammatory arthropathy
Juxtaarticular osteopenia:
Inflammatory joint
Osteophyte:
Degenerative joint
Bone sclerosis:
Degenerative joint
Subchondral cyst:
Degenerative joint
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