Friday, September 6, 2013

Rheumatoid arthritis of the shoulder, x-ray appearance

As we've emphasized before (see here), two plain x-rays are necessary and sufficient to make most diagnoses of shoulder arthritis.

Here is an anteroposterior (AP) and an axillary view typical of shoulders with rheumatoid arthritis

The upper view, the AP shows the medial migration of the humeral head so that the lateral tuberosity is medial to the lateral acromion. There is minimal osteophytosis and periarticular osteopenia.

The standardized axillary view reveals much more of the pathology: glenoid is medially eroded and flattened.

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