Rhumatoid arthritis Autoimmune inflamatory disease Occre in adults Multisystemic disorder فوضى متعددة شاملة Seropositive arthritis Mainly affect the small joints of the hands and feets Cervical spine and rarly large joints are also affected,specially atlantoaxial and shoulder joint

Radiological appearances Soft tissue swelling.periostitis spindle shape appearances of digits Osteoporosis.periarticular Bone erosion Alignment deformity,eg.ulnar deviation,swan neck and botounare. Periosteal reaction رد فعل سمحاقي Secondry osteoarthritis

Clinical and x-ray manisfestations Seropositive rh factor is present in blood Goint pain,fever,weight loss etc Soft tissue swellings spindle shape of interphalengeal joints Osteoporosis Joint space changes and alignment deformities Periostitis التهاب السمحاق Erosions Secondry osteoarthritis

Invistigations X-ray Ultrasound CT Radionuclide studies MRI

Psoriasiatic arthritis Seronegative arthritis Affect the small jpints of hands and feet Nail changes and skin changes Affect distal and proximal interphalangeal goints Affect the spine with syndesmophyte formation Sacroillitis

Reiters disease Syndrome of arthritis,urethritis and conjunctivitis Affect the feet more than the hands Painfull erosion of calcaneus with spur formation Sacroillitis Young adults

Ankylosing spondylitis Seronegative arthritis HLA –B27 is positive Affect young adults Mainly affect the spine with chacteristic changes Squaring of vertebral bodies and bamboo spine Sacroillitis is bilateral and symetrical.sacroillic joints are assesed with prone view of sacroilliac joints

Gout A metabolic disease with abnormality of uric acid Affect the great toe of feet Bone erosions Osteoporosis تحلل العضام Tophi formation

Osteoarthritis Degenerative disease Affect mainly the weight bearing joints يوثر على المفاصل بسبب الوزن Primary when no cause is known Secondry when the goint is abnormal Mainly affect old people Main complain of patient is pain and stiffness تصلب More common in over wight people

X-ray appearences Joint space narrowing Increase bone density Osteophyte formation Loose body Cyst formation Vacuum phenomenon in the intervertebral spaces

Invistigations X-ray CT scan

Spondylolisthesis When there is slip of one vertebra over another Usually occure due to stress fracture in the parse Four grades 25% 50% 75% AND TOTAL

OSTEOPOROSIS Due to decrease bone mass Decrease bone mass result in increase incidence of fracture Senile osteoporosis occue in old people.there is loss of cortical and trabecular bone.Fracture occure more commonly in femoral neck and humerous Postmenopausal osteoporosis.occure in womenabove 50 years of age.vertebral fractures are more common

Rickets Vitamin D defficency disease Occure in childern There is lack of mimeralisation of bones Lack of vitamin D Lack of calcium The above defficiency may be either nutritional or disease process

X-ray appearences Loss of normal zone of proviosnal calcification Fraying of growth plate Splaying cupping of metaphysis Osteoporosis Pigeon chest Rickety rosy Bending of bones(bowing of bones)

Osteomalacia Vitamin defficency disease occure in addults More common in females Bone become soft so bowing occure Looser zones bilateral and symetrical Compression of vertebrae Cordfish vertebra