Xray Findings

Osteoarthritis Rheumatoid Arthritis
Psoriatic Arthritis Permeative Lesions
Benign Tumor Malignant Tumor


  • Joint space narrowing, sclerosis, osteophytosis (classic triad)
  • Primary osteoarthritis: familial disease only; affects middle aged women in the DIP, PIP and basilar joints of the thumbs bilaterally

Rheumatoid Arthritis

  • Soft-tissue swelling, osteoporosis, joiont space narrowing, marginal erosions
  • Proximal perdominance
  • Generally bilateral

Psoriatic Arthritis

  • Proliferative erosions, soft-tissue swelling, periostitis
  • Distal predominance

Benign Tumor:
1-No cortical destruction
2-Benign periostitis: thick wavy, uniform or dense = low-grade chronic irritation
3-Narrow zone of transition; can be traced with a pencil

Malignant Tumor:
1-Cortical destruction
2-Aggressive periostitis: lamellated (onion-skinned), amorphous, sunburst
3- Wide zone of transition; imperceptible

Permeative lesions

  • (multiple small holes): not easily categorized as benign vs malignant:
  • multiple myeloma, primary lymphoma of bone, Ewing's sarcoma