Are joint changes on X-ray a sign of rheumatoid arthritis?

Question

Hello doctor,

I have an upcoming rheumatology appointment and recently had an X-ray. A nurse informed me that it showed signs of arthritis, and my symptoms aligned with rheumatoid arthritis. I have the X-ray with me, but I find it hard to wait patiently until I see the rheumatologist.

From my untrained perspective, I see joint space narrowing in the PIP joints and possibly slight erosion along the sides of those joints. I also suspect there may be osteopenia. Additionally, I have noticed white spots on the knuckles at the MCP joints, but I am unsure what they might indicate or whether they are normal findings.

I have been researching online to better understand these observations, but I know I could be completely wrong. Could you please review the X-ray and let me know your thoughts? Specifically, I would appreciate your feedback on whether my observations are correct.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

It is our sincere pleasure to address your medical concerns.

I am a bit confused, as to why the X-ray shows only two fingers. Was it specifically done that way? Regardless, I appreciate your efforts to interpret the image ahead of your doctor’s appointment.

Let me reassure you that, based on the two fingers and associated bones visible in the image:

The joint spaces appear normal.
There is minimal to no erosion.
The bony opacity is normal, indicating no signs of osteopenia.

These observations, of course, do not discount your pain or other symptoms; they simply indicate that the specific findings you mentioned are not present on the X-ray.

Regarding the white spots you noticed on the knuckles, these are sesamoid bones, which form within certain tendons due to continuous friction. This is a normal anatomical feature.

In summary, the two fingers visible on the X-ray exhibit normal features. Please follow up with your doctor at the scheduled appointment for further evaluation and advice.

Wishing you all the best until then!

I hope that you get your answer.

Please let me know if you want some help.

Thank you.