Page 16 - Imaging of Osteoarthritis and Rheumatoid Arthritis in Hand Joints

Chapter 1
advanced disease. When imaging early RA, conventional radiographs may also be normal. The first symptom of RA on a radiograph is swelling of the peri- articular tissue, which however is non-specific, and usually also clinically visible. When the inflammative reaction has destroyed enough bone, juxta-articular lucency of the bone can be seen, and erosion of bone close to the attachment of the synovium to the bone becomes visible. The location of these erosions are specific for RA, but they are usually seen on a radiographs after 6-12 months of onset of the disease 10. Ultimately the cartilage also gets destroyed and the whole joint becomes deformed.
Figure 2. Progress of radiographic imaging through time. left: First radiograph ever acquired. Wilhelm Röntgen imaged the hand of his wife Anna Bertha Ludwig (Image duplicated from Wikimedia Commons - public domain). Right: A recently acquired x-ray of the left hand of a healthy person.
CT
The progress in processing power of computers made computed tomography possible since the 70’s. The same x-rays as in conventional radiology are used, but the patient lies on a table while the x-ray tube and the detector rotate around
14