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Transient erosion of the ulnar styloid process
1Department of Rheumatology, Charing Cross Hospital, London.
British Journal of Rheumatology
|December 1, 1991
Summary
Radiographs initially showed ulnar styloid erosion in a polyarthritis patient, but a third X-ray revealed normal wrists. The erosion was a positional artifact, not a clinical finding, highlighting a potential diagnostic pitfall.
Area of Science:
- Rheumatology
- Radiology
- Medical Imaging
Background:
- Polyarthritis presents a diagnostic challenge, often requiring serial imaging to monitor disease progression or complications.
- Wrist radiographs are crucial for evaluating joint involvement and erosive changes in inflammatory arthropathies.
Observation:
- Initial wrist radiographs of a patient with polyarthritis were normal.
- Follow-up radiographs at 6 months demonstrated complete erosion of both ulnar styloid processes.
- The observed erosions were incongruent with the mild clinical synovitis noted in the patient.
Findings:
- A subsequent radiograph revealed normal ulnar styloid processes.
- The discrepancy was attributed to a positional artifact during the initial X-ray procedure.
- This artifact mimicked significant bone erosion, potentially leading to misdiagnosis.
Implications:
- Clinicians and radiologists must be aware of positional artifacts that can mimic pathological findings on wrist radiographs.
- Careful patient positioning and review of imaging techniques are essential to avoid misinterpretation of bone erosion.
- This 'catch' emphasizes the importance of correlating imaging findings with clinical presentation in diagnosing and managing polyarthritis.