Previous Imaging Quizzes

On this page, you'll find available quizzes from images published on EULAR's imaging library: https://www.eular.org/eular_imaging_library_portal.cfm

Case 1 - Ref: 157860

Female patient presents with pain and swelling in the right shoulder. Right shoulder anterior-posterior plain radiography is performed, showing a juxta-articular radiodense mass composed of multiple nodule-shaped lesions (arrow and line).

Author: Esperanza Naredo; Department of Rheumatology. Hospital GU Gregorio Marañón, Madrid, Spain

Which of the following is the most likely diagnosis

  1. Synovial osteochromatosis (metaplasia of synnovial connective tissue)

  2. Chondrocalcinosis

  3. Calcific bursitis

  4. Calcinosis universallis

  5. Cystercicosis

Answer here

Case 2  - 208373

Patient presents with lumbar flexion limitation and inflammatory back pain. Lateral plain radiography of the lumbar spine is performed showing multiple continuous hyperdensities along the anterior border of lumbar spine (arrows).

Author: Juan Carlos Nieto-González; Department of Rheumatology. Hospital GU Gregorio Marañón, Madrid, Spain

These aspects are more likely 

  1. Disc calcification

  2. Normal, age related findings 

  3. Paget disease of the spine 

  4. Multiple lumbar syndesmophytes  

  5. Diffuse osteophytes in Ankylosing spondylitis

Answer here

Case 3 – Ref: 157865

Female patient with rheumatoid arthritis who presented with fever and lumbar pain.
T2-weighted (left) and fat-suppressed T-2 weighted (right) sagittal MRI is performed, showing an hyperintense L4-L5 intervertebral disc (arrows) and increased signal intensity within the adjacent vertebral bodies at L4-L5 level.

Author: Esperanza Naredo; Department of Rheumatology. Hospital GU Gregorio Marañón, Madrid, Spain

What is the most likely finding?

  1. Pott disease

  2. Septic discitis 

  3. Osteoblastic metastases

  4. Fatty degeneration of the lumbar spine

  5. Ankylosing spondylitis related spinal inflammation

Answer here

Case 4  - 212395

Clinical presentation: Elderly man with pain in the first _____ joint. No inflammatory disease. 

Pathological findings: _____ (arrow 1a) with active ______ (arrow 1b) with Doppler signal.

Can you fill the blank text based on the radiographic image? 

Author: Hilde Berner Hammer; Department of Rheumatology, Diakonhjemmet hospital

Answer here

Case 5  - 188537

This Fluorescence optical image (FOI) displays active synovitis, tenosynovitis and 'silent' psoriais.

Can you spot the 3 of them based on the 3 different arrow colours?

Author: Yogan Kisten, Erik af Klint, Anna Karlsson, Hamed Rezaei and Ronald van Vollenhoven; Unit for Clinical Therapy Research, Inflammatory Diseases (ClinTRID), Karolinska Institutet, The Rheumatology Clinic of Karolinska University Hospital, Stockholm, Sweden

Answer here

Case 6  - 206971

Can you identify the structure and disease by the clinical case represented in the image? Note that size is in micrometers... it's a micro abnormality!

Author: Vanessa Smith; Department of Internal Medicine, Faculty of Medicine and Health Sciences, University of Ghent; Department of Rheumatology, Ghent University Hospital

Answer here

Case 7  - 228354

Female patient with systemic sclerosis presents with focal subcutaneous induration on anterolateral side of her thigh. The skin overlying this area was covered with small crust. An ultrasound is done showing a hyperechoic plaque in the subcutaneous tissue in longitudinal and transverse plane (empty arrows), with acoustic shadow spreading on the fascia and quadriceps muscle (asterisk).

Author: Jacek Tomasz Flicinski; Department of Rheumatology, Internal Medicine and Geriatrics, Pomeranian Medical University, Szczecin, Poland. Abbreviations. VL- vastus lateralis muscle

Which of the following is the most likely diagnosis?

  1. Cutaneous tuberculosis
  2. Focal calcification of subcutaneous tissue
  3. Eosinophilic fascitis
  4. Calcinosis universallis
  5. Impetigo

 

Answer here

Case 8  -157857

The following radiographies of hands were asked to a female patient as part of her evaluation.

Author: Esperanza Naredo; Department of Rheumatology. Hospital GU Gregorio Marañón, Madrid, Spain

Based on the radiographies (arrows), which of the following findings is less likely related to the diagnosis of this patient?

  1. Current psoriasis or a personal or family history of psoriasis
  2. Dactylitis
  3. Rheumatoid factor positivity
  4. Nail distrophy or nail pitting
  5. Juxta-articular new bone formation on X-ray

 

Answer here

Case 9  - 210476

75-year-old female patient with long-standing rheumatoid arthritis (50 years of disease duration), positive for rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). Postero-anterior plain radiographies and photographs of patient’s hands are shown.

Author: Esperanza Naredo; Department of Rheumatology. Hospital GU Gregorio Marañón, Madrid, Spain

The images and radiographs show severe structural damage in rheumatoid arthritis. Which of the following findings is shown in the images?

1. Yellow arrows in radiography show carpal destruction and ankylosis, particularly in midcarpal and carpometacarpal joints

2. White arrows in radiography shows luxation of the metacarpophalangeal joints

3. Red arrows in radiography show some metacarpophalangeal joints with prosthesis.

4. Yellow arrows in the photograph show severe multiple hand deformities typical for long-standing rheumatoid arthritis

5. All the above are true

Answer here

Case 10  - 218772

69-year-old female. A doppler ultrasound shows the occlusion of the axillary artery (white arrowhead). Note the reperfusion of the distal part of the artery through the developed collateral circulation (white arrow).

Author: Andreas Diamantopoulos, Department of Rheumatology, Hospital of Southern Norway Trust Kristiansand

Based on the findings on the USG and demographic characteristics, which is the most likely diagnosis in this patient?

  1. Takayasu’s arteritis
  2. Giant cell arteritis
  3. Polyarteritis nodosa
  4. Fibromuscular dysplasia

 

Answer here 

Case 11-Ref: 229954

34 years male presented to the Rheumatology clinic with long standing history of bilateral knee pain. An antero-posterior and lateral plain film showed pedunculated (yellow arrows) and sessile (white arrows) bone growth arising from the metaphyseal region of the femur, tibia and fibula.

Author:  Esperanza Naredo and Giuliana La Paglia. Affiliation: Department of Rheumatology Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain

Which of the following is the most likely diagnosis?

  1. Osteoarthritis
  2. Multiple exostoses or osteochondromas
  3. Enthesophytes
  4. Osteosarcoma
  5. None of the above

Answer here