CASE DISCUSSIONDr Rajeev Anand,

MDRD, DNB, MNAMS,FRCRMedical Trust Hospital

RADIOLOGIC INVESTIGATIONS

1. X-RAY - Hands and Pelvis.2. MRI - Pelvis.

3. CT - Spine , Pelvis and Lower limb.

X-RAY HANDS

-B/L.-Poly articular.-Almost symmetrical..-Reduced joint space.-Subarticular erosion.-Dislocations.-Ankylosis and deformity.-Mild soft tissue swelling.-No significant osteopenia

X- RAY PELVIS

-Mild B/L Sacroilitis.-B/L OA Hip

MRI- PELVIS

- Mild B/L Sacroilitis.- Enhancing juxtaaarticular soft tissue.

CT SCAN

B/L Hip OA

CT SCAN

B/L Shoulder OA

CT SCAN

B/L Knee OA

CT SCAN

B/L Facet ArthorpathyB/L Sacroilitis.

CT SCAN

SOFT TISSUE CALCIFICATION

CT SCAN

SOFT TISSUE CALCIFICATION

INFERENCEInvolves joints.Axial skeleton and the Appendicular skeleton.B/L and almost symmetrical.Involvement of small and large joints.Juxta-articular soft tissue swelling .Juxta articular soft tissue mass/ Calcification. Joint space reduction, Subchondral erosions,

OA changes, Ankylosis and Dislocations.

DIAGNOSIS Erosive Osteoarthropathy. DD - Rheumatoid / CTD ? No signft Osteopenia. Associate soft tissue - Deposition diseases.

Final conclusion: Deposition diseases.