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Ebook Skeletal radiology the bare bones (3rd edition): Part 2

(BQ) Part 2 book "Skeletal radiology the bare bones" presents the following contents: Approach to joint disease, inflammatory arthritis, noninflammatory joint disease, developmental and congenital conditions, metabolic and systemic conditions, infection and marrow disease, postsurgical imaging. | PART III Joint Disease CHAPTER 51 Approach to Joint Disease General Principles Synovial Joints Soft Tissues Cartilage Bone Alignment Intervertebral Disk Joints Entheses Distribution of Disease Laboratory Findings T his chapter describes a pragmatic approach to the radiology of joint disease based on anatomy pathophysiology and radiographic analysis. This approach draws heavily on the work of Forrester Brower and Resnick Table 11.1 . Detailed discussions of specific clinical forms of arthritis are presented in Chapters 12 and 13. GENERAL PRINCIPLES Radiographs mirror the pathologic processes that affect the joints and the functional adaptations that may follow. In general the radiologic diagnosis of arthritis can be highly specific and reliable when classic changes are present in the expected distributions but much less specific in the early stages before the disease process has fully evolved. Regardless of the approach however several frustrations are unavoidable A specific radiologic diagnosis is not always possible many types of joint disease overlap in their radiologic and clinical features two or more diseases may coexist in the same patient and finally clinical disease may precede radiologic abnormalities and vice versa sometimes by years. Diseases that affect joints do so by three broad pathophysiologic mechanisms each with a distinctive radiographic appearance degeneration inflammation and metabolic deposition. For practical purposes one mechanism is usually predominant. Degeneration of a joint refers to mechanical damage and reparative adaptations in essence the joint is worn away. Inflammation TABLE 11.1 Approach to Radiographic Analysis of Arthritic Changes in the Hand A Alignment B Bone mineralization Bone production C Cartilage joint space Calcification D Distribution E Erosions S Soft-tissue swelling Source Data from Brower AC. Arthritis in Black and White. 2nd Ed. Philadelphia PA WB Saunders 1997 and Forrester DM Brown JC. The Radiology of Joint .