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April 2003
By Theodore E. Keats, MD
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A 50-year-old woman complains of knee pain of many years'
duration that has worsened recently. What is your interpretation
of this frontal film of her knees?
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ANSWER
The diagnosis is rheumatoid arthritis. Note the uniform loss
of articular cartilage in both medial and lateral compartments,
unlike degenerative arthritis, in which cartilage loss is
uneven. Note also the enlargement of the intercondylar notch,
a reflection of chronic synovial hypertrophy. The sclerotic
lesions in the distal femurs probably represent bone infarcts.
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This series of diagnostic quizzes that
challenge your ability to read a variety of x-ray films is edited
by Dr. Keats, professor of radiology and professor of orthopedics
at the University of Virginia School of Medicine in Charlottesville.
Emerg Med 35(4):63, 2003
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