Author: Tim Milligan

Right hand radiograph in a patient with advanced rheumatoid arthritis. There are extensive marginal erosions and ulnar subluxations at the metacarpophalangeal (MCP) joints. Erosions are also present at PIP joints. (Courtesy of Dr. A. Donovan)

Right wrist radiograph in a patient with rheumatoid arthritis. The arrows show erosions at the ulnar styloid and distal radius. Asterisk shows additional erosions at the carpus. (Courtesy of Dr. A. Donovan)

Left hip joint radiograph shows severe superior joint space narrowing, subchondral cysts, subchondral sclerosis and marginal osteophytes. These are radiographic hallmarks of osteoarthritis. (Courtesy of Dr. A. Donovan)

Bilateral hands in a patient with lupus. Note finger flexion and extension deformities in the absence of erosions. (Courtesy of Dr. A. Donovan)

Right wrist radiograph shows chondrocalcinosis involving the triangular fibrocartilage complex (arrow). (Courtesy of Dr. A. Donovan)

Elbow radiograph in a patient with gout. Note large soft tissue abnormality (arrows) superficial to the olecranon. This represents olecranon bursitis. In addition to gout, it can also be seen in patients with rheumatoid arthritis, or be related to trauma or infection. Bilateral olecranon bursitis is characteristic for gout. (Courtesy of Dr. A. Donovan)

Left toe radiograph shows well-marginated erosions with sclerotic margins (arrow) and overhanging edges (arrowheads) at the interphalangeal joint. The findings are consistent with gouty arthritis. Similar changes are seen at the first MTP joint. (Courtesy of Dr. A. Donovan)

Bilateral hand radiographs in a patient with osteoarthritis. There is moderate joint space loss at the first carpometacarpal (CMC) joints bilaterally (arrows) with subchondral sclerosis and cystic changes. The interphalangeal joints show similar changes. These are shown by the arrowhead. (Courtesy of Dr. A. Donovan)