A Systematic Approach to Radiographic Evaluation of Arthritis of the Hand and Wrist

More than 92 million adults in the United States have arthritis.1 Initial imaging evaluation of arthritis begins with radiography. Having a systematic approach to the interpretation of the radiographs for arthritis is essential to recognize subtle features and to correctly identify similar appearing diseases. The “ABCs” approach to the radiographic evaluation of arthritis has been a standard for decades. The goal of this article is to review the “ABCs” approach, to discuss how the radiographic features reflect the underlying pathology of common arthropathies, and to provide differential diagnostic considerations for conditions in one of three categories: aggressive erosive, osteoarthritis-like, or mass-like depositional patterns of arthritis.