MSK imaging: rheumatoid arthritis: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · MSK imaging: rheumatoid arthritis

Sample item

A woman with symmetrical small joint pain has hand radiographs showing periarticular osteopenia, marginal erosions and symmetrical joint space narrowing at the MCP and PIP joints, sparing the DIP joints. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Rheumatoid arthritis

RA shows periarticular osteopenia, uniform loss of joint space and marginal erosions at the bare areas of the joint, mainly in the MCP, PIP and wrists. Osteoarthritis spares the MCP joints and involves the DIP joints with osteophytes. MRI and ultrasound detect early synovitis.

Option by option

  • A. Psoriatic arthritis

    Psoriatic arthritis involves the DIP with a pencil-in-cup deformity and new bone formation.

  • B. Osteoarthritis

    Osteoarthritis shows osteophytes and subchondral sclerosis at the DIP and first carpometacarpal joint.

  • C. Gout

    Gout shows punched-out erosions with overhanging edges.

  • D. Rheumatoid arthritis (correct)

    Correct. Symmetrical marginal erosions with osteopenia at MCPs indicate RA.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Rheumatoid arthritis. RA shows periarticular osteopenia, uniform loss of joint space and marginal erosions at the bare areas of the joint, mainly in the MCP, PIP and wrists.

Why is "Psoriatic arthritis" not the answer?

Psoriatic arthritis involves the DIP with a pencil-in-cup deformity and new bone formation.

Why is "Osteoarthritis" not the answer?

Osteoarthritis shows osteophytes and subchondral sclerosis at the DIP and first carpometacarpal joint.

Why is "Gout" not the answer?

Gout shows punched-out erosions with overhanging edges.

What concept does this question test?

It tests MSK imaging: rheumatoid arthritis in Radiology. Osteoarthritis spares the MCP joints and involves the DIP joints with osteophytes. MRI and ultrasound detect early synovitis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study MSK imaging: rheumatoid arthritis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.