Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea.
Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea.
Curr Med Imaging. 2022;18(11):1160-1179. doi: 10.2174/1573405618666220428100951.
Radiology plays a key role in the diagnosis of arthritis. We herein suggest an algorithmic approach to diagnosing arthritis. First, the number of joint involvements is reviewed. Monoarticular arthritis includes septic arthritis, pigmented villonodular synovitis, and synovial chondromatosis. Second, polyarticular arthritis can be categorized by its characteristics: erosive, productive, and mixed. Erosive disease includes rheumatoid arthritis, hemophilia, and amyloidosis, while productive disease includes osteoarthritis and hemochromatosis. Third, mixed diseases are subcategorized by symmetricity. Ankylosing spondylitis and inflammatory bowel disease related arthritis affect joints symmetrically, while psoriatic arthritis, reactive arthritis, and crystalline arthropathy are asymmetric. Adjacent soft tissue density, periostitis, and bone density are ancillary findings that can be used as additional differential diagnostic clues. The final step in identifying the type of arthritis is to check whether the location is a site frequently affected by one particular disease over another. This systematic approach would be helpful for radiologists in diagnosing arthritis.
放射学在关节炎的诊断中起着关键作用。我们在此提出一种关节炎诊断的算法方法。首先，回顾关节受累的数量。单关节炎包括化脓性关节炎、色素沉着绒毛结节性滑膜炎和滑膜软骨瘤病。其次，多关节炎可根据其特征分为侵蚀性、增生性和混合性。侵蚀性疾病包括类风湿关节炎、血友病和淀粉样变性，而增生性疾病包括骨关节炎和血色病。第三，混合性疾病根据对称性进行分类。强直性脊柱炎和炎症性肠病相关关节炎对称影响关节，而银屑病关节炎、反应性关节炎和晶体性关节炎则不对称。相邻软组织密度、骨膜炎和骨密度是辅助发现，可以作为额外的鉴别诊断线索。确定关节炎类型的最后一步是检查位置是否为一个特定疾病比另一个疾病更常发生的部位。这种系统的方法将有助于放射科医生诊断关节炎。
