Discussion of Erosive osteoarthritis
- Erosive osteoarthritis is a severe and debilitating form of osteoarthrosis occurring primarily in postmenopausal women.
- It is seen most commonly in the hands, with a predilection for the DIP and PIP joints.
- Because it can present as an acute to subacute onset symmetric inflammatory arthritis with morning stiffness, it is often initially mistaken for rheumatoid arthritis or psoriatic arthritis. However, the absence of systemic symptoms, skin rash, or seropositivity coupled with the marked degenerative changes seen clinically and radiographically help confirm the diagnosis.
- Treatment is conservative, unless joint destruction and/or contractures require surgical arthrodesis, arthroplasty, or tendon repair.
- The prognosis is good; in most patients the inflammatory arthritis remits after several years, leaving more classic residual osteoarthritic deformities.
 Imaging Findings for Erosive osteoarthritis
- X-rays of the hands usually reveal severe degenerative changes with osteophytes and subchondral sclerosis at the DIP and PIP joints of the fingers, and the CMC and IP joints of the thumb.
- Central erosions due to destruction of articular cartilage are seen with relative sparing of the joint margins (Seagull sign).
- Deformity at the distal joints with sparing of the MCPs can lead to mediolateral subluxation and contractures.
 See Also
 External Links
 References for Erosive osteoarthritis
- The Johns Hopkins Arthritis Center: hopkins-arthritis.org