Erosive osteoarthritis
Updates to Article Attributes
Erosive osteoarthritis (EOA) is a form of osteoarthritis where, as the name implies, there is an additional erosive/inflammatory component.
Epidemiology
There is marked female predilection (F:M ~ 12~12:1), typically presenting in the postmenopausal patient. Patients are rheumatoid factor negative.
Clinical presentation
Clinically the presentation mimics inflammatory arthropathies such as psoriatic arthritis or rheumatoid arthritis. Patients complain of a relatively acute or subacute onset of morning stiffness in the fingers of both hands.
Systemic symptoms are however absent.
Radiographic features
Plain film
Erosive osteoarthritis has a predilection for the the hands. The dominant features are those of osteoarthritis, particularly in terms of distribution:
- distal interphalangeal (DIP) joints
- proximal interphalangeal (PIP) joints
- firstcarpometacarpal (CPC) joint
Additional characteristic features include:
- diffuse cartilage space loss
- subchondral erosions (at least two central erosions affecting seperate IP joints); typical central location of the erosions produces the classic "gull wing" appearance
- joint ankylosis
-
absence of 2
- marginal erosions
- fusiform soft-tissue swelling
- osteopaenia
Treatment and prognosis
Treatment is conservative, unless joint destruction and/or contractures require surgical arthrodesis, arthroplasty, or tendon repair.
The prognosis is generally good with remission after several years being seen in most patient. The degenerative changes of course remain, and are then merely those of osteoarthritis.
Differential diagnosis
Imaging differential considerations include
- non-erosive osteoarthritis
- rheumatoid arthritis: different joint distribution
- psoriatic arthritis
- for more wider differential refer to: differential diagnosis of erosive arthritis
-<p><strong>Erosive osteoarthritis (EOA)</strong> is a form of <a href="/articles/osteoarthritis">osteoarthritis</a> where as the name implies, there is an additional erosive/inflammatory component.</p><h4>Epidemiology</h4><p>There is marked female predilection (F:M ~ 12:1), typically presenting in the postmenopausal patient. Patients are rheumatoid factor negative.</p><h4>Clinical presentation</h4><p>Clinically the presentation mimics inflammatory arthropathies such as psoriatic arthritis or rheumatoid arthritis. Patients complain of a relatively acute or subacute onset of morning stiffness in the fingers of both hands.</p><p>Systemic symptoms are however absent.</p><h4>Radiographic features</h4><h5>Plain film</h5><p>Erosive osteoarthritis has a predilection for the the hands. The dominant features are those of osteoarthritis, particularly in terms of distribution:</p><ul>- +<p><strong>Erosive osteoarthritis (EOA)</strong> is a form of <a href="/articles/osteoarthritis">osteoarthritis</a> where, as the name implies, there is an additional erosive/inflammatory component.</p><h4>Epidemiology</h4><p>There is marked female predilection (F:M ~12:1), typically presenting in the postmenopausal patient. Patients are rheumatoid factor negative.</p><h4>Clinical presentation</h4><p>Clinically the presentation mimics inflammatory arthropathies such as psoriatic arthritis or rheumatoid arthritis. Patients complain of a relatively acute or subacute onset of morning stiffness in the fingers of both hands.</p><p>Systemic symptoms are however absent.</p><h4>Radiographic features</h4><h5>Plain film</h5><p>Erosive osteoarthritis has a predilection for the the hands. The dominant features are those of osteoarthritis, particularly in terms of distribution:</p><ul>
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