Which imaging modality is best for differentiating erosive from non-erosive IMPA?

Which imaging modality is best for differentiating erosive from non-erosive IMPA?

• A. Carpal radiographs
• B. MRI
• C. Ultrasound
• D. CT

Answer: (A)

Erosive inflammatory polyarthritis shows focal bone loss at the joint margins, and the carpal region is a common site where these erosions become evident. Carpal radiographs are the best choice because they directly and quickly reveal marginal bone erosions, which distinguish erosive disease from non-erosive forms. While MRI and ultrasound excel at detecting soft-tissue changes and early or subtle erosions, and CT can show bone detail with high sensitivity, plain radiographs of the carpus are the most practical, accessible, and reliable way to confirm the presence of bone erosions and differentiate the two patterns.

Erosive inflammatory polyarthritis shows focal bone loss at the joint margins, and the carpal region is a common site where these erosions become evident. Carpal radiographs are the best choice because they directly and quickly reveal marginal bone erosions, which distinguish erosive disease from non-erosive forms. While MRI and ultrasound excel at detecting soft-tissue changes and early or subtle erosions, and CT can show bone detail with high sensitivity, plain radiographs of the carpus are the most practical, accessible, and reliable way to confirm the presence of bone erosions and differentiate the two patterns.