These are images of the right and left hand demonstrating a diffuse interphalangeal joint space narrowing bilaterally with both osteophytes and erosions. A centrally located erosion can be identified involving the left fourth middle phalanx. In addition to the osteophytes and joint space narrowing, there is subchondral sclerosis. The carpal bones and carpometacarpal joints as well as the metacarpophalangeal joint are relatively uninvolved.
Erosive osteoarthritis is a disease entity which is most common in middle-aged females.
The disease is characterized by acute articular attacks resembling rheumatoid arthritis, although other peripheral joints are unaffected and the serologic tests for rheumatoid factor are negative. The onset of the disease may be abrupt as with painful nodules identified along the distal and proximal interphalangeal joints in association with edema and tenderness. The distribution of the disease is symmetric with the interphalangeal articulations most commonly involved. The course of the disease is quite variable. The radiologic findings are characterized by the combination of findings suggestive of osteoarthritis as well as findings suggestive of rheumatoid arthritis.