RheumaView™ · RV-010 · LM-PER(HW)
Two Reads of One Surveillance Study
The same bilateral hand and wrist radiographs, read two ways — a conventional report beside a RheumaView™ structured radiographic report with selectable output depth.
De-identified case
Male
DOB 1981-xx-xx
baseline 2023 → 2026
Radiograph
Bilateral hands & wrists
Complexity: Longitudinal · two timepoints (2023 → 2026) · Radiograph
Why this is a representative case
A representative longitudinal case: a single imaging modality (radiographs), one region group (bilateral hands and wrists), and a mild, stable structural picture across two timepoints. See how case complexity scales ↓.
structured
per-joint grading
pattern separation
mimic-control
laterality quantified
data-needs
longitudinal baseline
output-depth tiers
Clinical vignette
Male, 40s, with undifferentiated connective tissue disease / mild rheumatoid arthritis, clinically stable and asymptomatic. Surveillance bilateral hand and wrist radiographs were obtained to monitor for structural progression. The same study is read two ways below — a conventional report beside a RheumaView™ structured radiographic report with selectable output depth.
What a typical report says
Radiology report.
Patient — de-identified.
DOB: 1981-xx-xx.
Sex: Male
Study Date(s): 2026-xx-xx; comparison 2023-xx-xx.
Region(s): Bilateral hands and wrists
Patient — de-identified.
DOB: 1981-xx-xx.
Sex: Male
Study Date(s): 2026-xx-xx; comparison 2023-xx-xx.
Region(s): Bilateral hands and wrists
Findings
Right hand. Bones are adequately mineralized. The visualized MCP, PIP and DIP joint spaces are grossly maintained. No definite cortical erosion. Mild degenerative-type change at the thumb base. Soft tissues unremarkable. No fracture.
Right wrist. Carpal alignment preserved. No significant radiocarpal or intercarpal joint space loss. No discrete erosion, fracture or dislocation.
Left hand. Similar appearance. Bones mineralized; MCP, PIP and DIP joint spaces grossly preserved. No definite erosion. Mild degenerative-type change at the thumb base. Soft tissues unremarkable.
Left wrist. Carpal alignment preserved. Joint spaces maintained. No erosion or fracture.
No significant interval change compared with the prior study.
Impression
- No aggressive erosive arthropathy identified.
- Mild degenerative-type changes, bilateral hands (thumb bases).
- No significant interval change compared with 2023.
- No acute fracture or dislocation.
Electronically signed.
RheumaView™ structured report
Patient — de-identified.
DOB: 1981-xx-xx
Sex: Male
Study Date(s): 2026-xx-xx comparison 2023-xx-xx
Region(s): Bilateral hands and wrists
Projection Adequacy Note: Current bilateral multi-projection hand/wrist series is adequate for structural assessment; prior study is adequate for interval comparison but includes fewer projections.
DOB: 1981-xx-xx
Sex: Male
Study Date(s): 2026-xx-xx comparison 2023-xx-xx
Region(s): Bilateral hands and wrists
Projection Adequacy Note: Current bilateral multi-projection hand/wrist series is adequate for structural assessment; prior study is adequate for interval comparison but includes fewer projections.
Region(s) & Projection Count: Bilateral hands/wrists. Current: 10 views total (right PA, oblique, lateral, plus additional focused oblique views ×2; left PA, oblique, lateral, plus additional focused oblique views ×2). Prior: 4 views total (left PA/lateral; right PA/lateral).
Adequacy Statement: Current examination is adequate for bilateral hand/wrist structural assessment. Prior examination is adequate for longitudinal comparison, though prior projection set is less extensive than the current study.
Findings
Right hand / wrist
Projection set reviewed: PA, oblique, lateral, and additional focused oblique views.
Thumb
IP joint: Mild nonuniform joint-space narrowing with tiny marginal osteophytic spurring/remodeling. No marginal erosion. No central erosive collapse.
Count: 1 joint · Distribution: isolated thumb IP · Laterality: right · Morphology: mild nonerosive degenerative change · Size/extent: low-grade marginal spurring · JSN grade: 1 · Symmetry pattern: bilateral counterpart present · Confidence: high
MCP joint: Joint space preserved. No convincing erosive change. Mild tiny marginal spur/contour irregularity only, without destructive feature.
Count: 1 joint · Distribution: thumb MCP · Laterality: right · Morphology: trace degenerative spurring only · Size/extent: minimal · JSN grade: 0 · Symmetry pattern: roughly symmetric · Confidence: moderate-high
CMC1 / triscaphe region: No convincing inflammatory erosion or subluxation. At most trace degenerative contour irregularity/spurring at the radial carpal/thumb-base region, without definite significant narrowing.
Count: 1–2 articulations minimally affected at most · Distribution: thumb-base/radial carpal region · Laterality: right · Morphology: possible trace degenerative change · Size/extent: minimal · JSN grade: 0 to trace 1 · Symmetry pattern: near-symmetric · Confidence: low-moderate for trace change; high for absence of erosive inflammatory abnormality
Index finger
DIP2: Mild nonuniform narrowing with tiny marginal osteophytic lipping. No erosion.
Count: 1 joint · Distribution: DIP · Laterality: right · Morphology: mild nonerosive OA-pattern change · Size/extent: low-grade · JSN grade: 1 · Symmetry pattern: bilateral counterpart present · Confidence: high
PIP2: Trace to mild nonuniform narrowing/remodeling. No erosion.
Count: 1 joint · Distribution: PIP · Laterality: right · Morphology: subtle nonerosive degenerative change · Size/extent: minimal · JSN grade: 0–1 · Symmetry pattern: bilateral counterpart present · Confidence: moderate-high
MCP2: Preserved joint space. No marginal erosion.
JSN grade: 0 · Confidence: high
Middle finger
DIP3: Mild nonuniform narrowing with tiny marginal osteophytic change. No erosion.
Count: 1 joint · Distribution: DIP · Laterality: right · Morphology: mild nonerosive degenerative change · Size/extent: low-grade · JSN grade: 1 · Symmetry pattern: bilateral counterpart present · Confidence: high
PIP3: Trace to mild nonuniform narrowing/remodeling. No erosion.
Count: 1 joint · Distribution: PIP · Laterality: right · Morphology: subtle nonerosive degenerative change · Size/extent: minimal · JSN grade: 0–1 · Symmetry pattern: bilateral counterpart present · Confidence: moderate-high
MCP3: Preserved joint space. No marginal erosion.
JSN grade: 0 · Confidence: high
Ring finger
DIP4: Mild nonuniform narrowing with tiny marginal osteophytic spurring. No erosion.
Count: 1 joint · Distribution: DIP · Laterality: right · Morphology: mild nonerosive degenerative change · Size/extent: low-grade · JSN grade: 1 · Symmetry pattern: bilateral counterpart present · Confidence: high
PIP4: Trace narrowing/remodeling. No erosion.
Count: 1 joint · Distribution: PIP · Laterality: right · Morphology: very mild nonerosive degenerative change · Size/extent: minimal · JSN grade: 0–1 · Symmetry pattern: bilateral counterpart present · Confidence: moderate
MCP4: Preserved joint space. No erosion.
JSN grade: 0 · Confidence: high
Small finger
DIP5: Mild nonuniform narrowing with tiny marginal osteophytic change. No erosion.
Count: 1 joint · Distribution: DIP · Laterality: right · Morphology: mild nonerosive degenerative change · Size/extent: low-grade · JSN grade: 1 · Symmetry pattern: bilateral counterpart present · Confidence: high
PIP5: Trace remodeling/narrowing only. No erosion.
Count: 1 joint · Distribution: PIP · Laterality: right · Morphology: very mild nonerosive degenerative change · Size/extent: minimal · JSN grade: 0–1 · Symmetry pattern: bilateral counterpart present · Confidence: moderate
MCP5: Preserved joint space. No erosion.
JSN grade: 0 · Confidence: high
Carpus / wrist
Radiocarpal, intercarpal, midcarpal, and distal radioulnar joints: Alignment maintained. Joint spaces preserved. No convincing marginal erosions, no carpal collapse, no ankylosis, and no inflammatory-pattern wrist narrowing.
Count: multiple wrist compartments reviewed · Distribution: diffuse carpal/wrist evaluation · Laterality: right · Morphology: no definite inflammatory arthropathy; at most minimal degenerative radial-sided contour change as above · Size/extent: none significant · JSN grade: 0 · Symmetry pattern: symmetric to near-symmetric · Confidence: high
Right hand/wrist osseous background / soft tissues
- Bone mineralization not markedly reduced radiographically.
- No acute fracture, no dislocation, no focal periosteal reaction.
- No soft-tissue calcification or chondrocalcinosis identified.
- No ulnar drift, no MCP subluxation, no boutonniere/swan-neck-type structural deformity.
Left hand / wrist
Projection set reviewed: PA, oblique, lateral, and additional focused oblique views.
Thumb
IP joint: Mild nonuniform joint-space narrowing with tiny marginal osteophytic spurring/remodeling. No erosion. No central erosive collapse.
Count: 1 joint · Distribution: isolated thumb IP · Laterality: left · Morphology: mild nonerosive degenerative change · Size/extent: low-grade marginal spurring · JSN grade: 1 · Symmetry pattern: bilateral counterpart present · Confidence: high
MCP joint: Joint space preserved. No convincing erosive change. Mild tiny marginal spur/contour irregularity only, without destructive feature.
Count: 1 joint · Distribution: thumb MCP · Laterality: left · Morphology: trace degenerative spurring only · Size/extent: minimal · JSN grade: 0 · Symmetry pattern: roughly symmetric · Confidence: moderate-high
CMC1 / triscaphe region: No convincing inflammatory erosion or subluxation. At most trace degenerative contour irregularity/spurring at the thumb-base/radial carpal region, without significant narrowing.
Count: 1–2 articulations minimally affected at most · Distribution: thumb-base/radial carpal region · Laterality: left · Morphology: possible trace degenerative change · Size/extent: minimal · JSN grade: 0 to trace 1 · Symmetry pattern: near-symmetric · Confidence: low-moderate for trace change; high for absence of erosive inflammatory abnormality
Index finger
DIP2: Mild nonuniform narrowing with tiny marginal osteophytic lipping. No erosion.
Count: 1 joint · Distribution: DIP · Laterality: left · Morphology: mild nonerosive OA-pattern change · Size/extent: low-grade · JSN grade: 1 · Symmetry pattern: bilateral counterpart present · Confidence: high
PIP2: Trace to mild nonuniform narrowing/remodeling. No erosion.
Count: 1 joint · Distribution: PIP · Laterality: left · Morphology: subtle nonerosive degenerative change · Size/extent: minimal · JSN grade: 0–1 · Symmetry pattern: bilateral counterpart present · Confidence: moderate-high
MCP2: Preserved joint space. No marginal erosion.
JSN grade: 0 · Confidence: high
Middle finger
DIP3: Mild nonuniform narrowing with tiny marginal osteophytic change. No erosion.
Count: 1 joint · Distribution: DIP · Laterality: left · Morphology: mild nonerosive degenerative change · Size/extent: low-grade · JSN grade: 1 · Symmetry pattern: bilateral counterpart present · Confidence: high
PIP3: Trace to mild nonuniform narrowing/remodeling. No erosion.
Count: 1 joint · Distribution: PIP · Laterality: left · Morphology: subtle nonerosive degenerative change · Size/extent: minimal · JSN grade: 0–1 · Symmetry pattern: bilateral counterpart present · Confidence: moderate-high
MCP3: Preserved joint space. No marginal erosion.
JSN grade: 0 · Confidence: high
Ring finger
DIP4: Mild nonuniform narrowing with tiny marginal osteophytic spurring. No erosion.
Count: 1 joint · Distribution: DIP · Laterality: left · Morphology: mild nonerosive degenerative change · Size/extent: low-grade · JSN grade: 1 · Symmetry pattern: bilateral counterpart present · Confidence: high
PIP4: Trace narrowing/remodeling. No erosion.
Count: 1 joint · Distribution: PIP · Laterality: left · Morphology: very mild nonerosive degenerative change · Size/extent: minimal · JSN grade: 0–1 · Symmetry pattern: bilateral counterpart present · Confidence: moderate
MCP4: Preserved joint space. No erosion.
JSN grade: 0 · Confidence: high
Small finger
DIP5: Mild nonuniform narrowing with tiny marginal osteophytic change. No erosion.
Count: 1 joint · Distribution: DIP · Laterality: left · Morphology: mild nonerosive degenerative change · Size/extent: low-grade · JSN grade: 1 · Symmetry pattern: bilateral counterpart present · Confidence: high
PIP5: Trace remodeling/narrowing only. No erosion.
Count: 1 joint · Distribution: PIP · Laterality: left · Morphology: very mild nonerosive degenerative change · Size/extent: minimal · JSN grade: 0–1 · Symmetry pattern: bilateral counterpart present · Confidence: moderate
MCP5: Preserved joint space. No erosion.
JSN grade: 0 · Confidence: high
Carpus / wrist
Radiocarpal, intercarpal, midcarpal, and distal radioulnar joints: Alignment maintained. Joint spaces preserved. No convincing marginal erosions, no carpal collapse, no ankylosis, and no inflammatory-pattern wrist narrowing.
Count: multiple wrist compartments reviewed · Distribution: diffuse carpal/wrist evaluation · Laterality: left · Morphology: no definite inflammatory arthropathy; at most minimal degenerative radial-sided contour change as above · Size/extent: none significant · JSN grade: 0 · Symmetry pattern: symmetric to near-symmetric · Confidence: high
Left hand/wrist osseous background / soft tissues
- Bone mineralization not markedly reduced radiographically.
- No acute fracture, no dislocation, no focal periosteal reaction.
- No soft-tissue calcification or chondrocalcinosis identified.
- No ulnar drift, no MCP subluxation, no boutonniere/swan-neck-type structural deformity.
Comparison
Prior study date: 2023-xx-xx
Overall interval assessment: No convincing radiographic progression of inflammatory arthropathy. Mild bilateral interphalangeal nonerosive degenerative changes remain overall stable.
Right hand / wrist interval change
- Δerosions: 0 new erosions; 0 enlarging erosions
- ΔJSN: 0 joints with definite grade increase beyond existing mild interphalangeal narrowing
- Δosteophytes: 0 convincing net increase in marginal osteophytic burden
- Δsclerosis: 0 meaningful interval change
- Δalignment: 0
- Δankylosis: 0
- Δradiographic erosive/inflammatory burden: 0
Interval interpretation: stable
Left hand / wrist interval change
- Δerosions: 0 new erosions; 0 enlarging erosions
- ΔJSN: 0 joints with definite grade increase beyond existing mild interphalangeal narrowing
- Δosteophytes: 0 convincing net increase in marginal osteophytic burden
- Δsclerosis: 0 meaningful interval change
- Δalignment: 0
- Δankylosis: 0
- Δradiographic erosive/inflammatory burden: 0
Interval interpretation: stable
Comparison note: Current study includes more projections than the prior exam, increasing present-day sensitivity; despite this, no convincing new erosive or deforming inflammatory abnormality is identified.
Impression
- Mild bilateral, predominantly symmetric, nonerosive degenerative arthropathy involving the interphalangeal joints of both hands, greatest at the thumb IP joints and multiple DIP joints, with additional trace-mild scattered PIP involvement; dominant JSN grade is 1.
- MCP joints, radiocarpal joints, intercarpal joints, and distal radioulnar joints remain preserved, without convincing marginal erosions, inflammatory-pattern narrowing, carpal collapse, ankylosis, or deforming rheumatoid-pattern structural change on the submitted radiographs.
- At most trace radial-sided thumb-base/triscaphe degenerative change bilaterally.
- No convincing interval radiographic progression from 2023-xx-xx to 2026-xx-xx. Numeric longitudinal deltas are 0 for erosions, definite JSN progression, osteophyte burden increase, sclerosis progression, malalignment, and ankylosis.
- No acute osseous abnormality.
EMR Summary
Bilateral hand/wrist radiographs demonstrate a mild stable nonerosive degenerative pattern centered at the interphalangeal joints. Mild joint-space narrowing with tiny marginal osteophytic remodeling involves the thumb IP joints and multiple DIP joints bilaterally, with additional trace-mild scattered PIP involvement. MCP joints and wrist/carpal compartments remain preserved without convincing marginal erosions, carpal collapse, inflammatory wrist narrowing, ulnar drift, or other deforming rheumatoid-pattern radiographic changes. Compared with 2023-xx-xx, no convincing structural progression is identified; numeric interval deltas are 0 for erosions, definite JSN progression, osteophyte burden increase, sclerosis progression, malalignment, and ankylosis. Pattern tags: degenerative. Progression tag: stable. Inflammatory features: none definite radiographically. DISH tag: absent. Fracture tag: absent.
Findings
Mild bilateral nonerosive degenerative change is present at the interphalangeal joints, greatest at the thumb IP joints and multiple DIP joints of both hands, with lesser scattered mild PIP involvement. Findings consist of mild nonuniform joint-space narrowing with tiny marginal osteophytic/remodeling change. No central erosive collapse is seen.
MCP joints are preserved bilaterally without marginal erosions, subluxation, or deforming inflammatory pattern. Radiocarpal, intercarpal, midcarpal, and distal radioulnar joint alignment is maintained, without convincing inflammatory narrowing, carpal collapse, ankylosis, or erosive wrist arthropathy. At most trace minimal radial-sided thumb-base/triscaphe degenerative change is present bilaterally.
No acute fracture or dislocation. No convincing periarticular inflammatory osteopenic pattern, no ulnar drift, and no focal soft-tissue calcification identified.
Comparison
Compared with 2023-xx-xx, the examination is overall stable. Mild bilateral interphalangeal nonerosive degenerative changes persist without convincing interval progression. No new erosive or deforming inflammatory abnormality is identified.
Impression
- Mild bilateral nonerosive degenerative arthropathy of the interphalangeal joints, greatest at the thumb IP and multiple DIP joints, with lesser mild scattered PIP involvement.
- MCP joints and wrist/carpal compartments remain preserved, without convincing radiographic erosive inflammatory arthropathy.
- At most trace minimal bilateral thumb-base/triscaphe degenerative change.
- No convincing interval progression since 2023-xx-xx.
- No acute osseous abnormality.
Findings
Mild bilateral nonerosive degenerative change involves the interphalangeal joints, greatest at the thumb IP joints and multiple DIP joints, with lesser scattered mild PIP involvement. MCP joints remain preserved bilaterally without erosive change. Wrist and carpal compartments are preserved without convincing erosive inflammatory arthropathy, carpal collapse, or malalignment. At most minimal bilateral thumb-base/triscaphe degenerative change. No acute osseous abnormality.
Impression
Mild stable bilateral nonerosive interphalangeal degenerative arthropathy. No convincing radiographic erosive inflammatory hand/wrist arthropathy and no convincing interval progression since 2023-xx-xx. No acute osseous abnormality.
Analytic addendum
Research addendum (PDF)
Research addendum
excerpt · image-derived semiquantitative · not formal central-read scores
Overall research-tier summary: Image-derived analytics support a stable, mild, symmetric, interphalangeal-predominant nonerosive degenerative pattern without radiographic evidence of erosive inflammatory hand/wrist progression over ~27.8 months. No destructive RA-pattern structural burden is demonstrated on the submitted studies.
Joint-class structural burden
| Joint class / region | Right | Left | Bilateral total | Structural pattern |
|---|---|---|---|---|
| Thumb IP joints with definite OA-pattern change | 1 | 1 | 2 | Mild nonerosive degenerative |
| DIP2-5 joints with definite OA-pattern change | 4 | 4 | 8 | Mild nonerosive degenerative |
| PIP2-5 joints with subtle trace-mild change | 4 | 4 | 8 | Subtle nonerosive degenerative |
| Thumb MCP joints with trace spurring only | 1 | 1 | 2 | Minimal/trace degenerative |
| Thumb-base / triscaphe trace-probable change | 1 | 1 | 2 | Minimal/trace degenerative |
| MCP2-5 erosive inflammatory involvement | 0 | 0 | 0 | None detected |
| Wrist/carpal erosive inflammatory involvement | 0 | 0 | 0 | None detected |
| Definite marginal erosions (all visible hand/wrist joints) | 0 | 0 | 0 | None detected |
| Ankylosis | 0 | 0 | 0 | None detected |
| Subluxation / malalignment | 0 | 0 | 0 | None detected |
Research / Analytics Addendum
Scope note: The analytics below are derived from the submitted bilateral hand/wrist radiographs only. No feet films, MRI, CT, DEXA, ultrasound, EMG/NCS, laboratory, or external AI inputs were available in this session. Metrics requiring those inputs are marked not available or not computed.
A. Quantitative Radiologic Measures
1) Joint-class structural burden table
| Joint class / region | Right | Left | Bilateral total | Structural pattern |
|---|---|---|---|---|
| Thumb IP joints with definite OA-pattern change | 1 | 1 | 2 | Mild nonerosive degenerative |
| DIP2-5 joints with definite OA-pattern change | 4 | 4 | 8 | Mild nonerosive degenerative |
| PIP2-5 joints with subtle trace-mild change | 4 | 4 | 8 | Subtle nonerosive degenerative |
| Thumb MCP joints with trace spurring only | 1 | 1 | 2 | Minimal/trace degenerative |
| Thumb-base / triscaphe trace-probable change | 1 | 1 | 2 | Minimal/trace degenerative |
| MCP2-5 erosive inflammatory involvement | 0 | 0 | 0 | None detected |
| Wrist/carpal erosive inflammatory involvement | 0 | 0 | 0 | None detected |
| Definite marginal erosions (all visible hand/wrist joints) | 0 | 0 | 0 | None detected |
| Ankylosis | 0 | 0 | 0 | None detected |
| Subluxation / malalignment | 0 | 0 | 0 | None detected |
2) Burden summary
- Definite nonerosive degenerative joint involvement: 10 joints
- 2 thumb IP joints
- 8 DIP joints
- Additional subtle trace-mild degenerative joint involvement: up to 8 PIP joints
- Ancillary trace degenerative foci: up to 4 sites
- 2 thumb MCP joints
- 2 thumb-base/triscaphe sites
- Definite erosive inflammatory joint count: 0
- Carpal erosive count: 0
- Malalignment / deformity count: 0
- Acute osseous injury count: 0
3) Severity-class summary
- Global structural burden: mild
- Dominant distribution: interphalangeal, DIP-predominant with thumb IP involvement
- Dominant morphology: nonerosive degenerative
- Inflammatory erosive burden: none detected radiographically
- Wrist inflammatory burden: none detected radiographically
4) Formal score applicability
- Full mTSS / Sharp-van der Heijde RA score: not fully computed in this session
- reason: hand/wrist-only dataset, no feet series, and no erosive RA-pattern structural burden identified
- Hand/wrist erosive RA structural score (descriptive): 0 detected erosive burden on submitted films
B. Longitudinal & Temporal Metrics
1) Time interval
- Baseline: 2023-xx-xx
- Follow-up: 2026-xx-xx
- Elapsed interval: 845 days (~27.8 months)
2) Delta matrix
| Category | 2023-xx-xx | 2026-xx-xx | Delta |
|---|---|---|---|
| Definite erosions | 0 | 0 | 0 |
| Joints with definite interval JSN worsening | 0 | 0 | 0 |
| Net osteophyte burden increase | 0 | 0 | 0 |
| Sclerosis progression | 0 | 0 | 0 |
| Malalignment / subluxation progression | 0 | 0 | 0 |
| Ankylosis progression | 0 | 0 | 0 |
| New deforming inflammatory features | 0 | 0 | 0 |
| New wrist/carpal inflammatory abnormalities | 0 | 0 | 0 |
3) Longitudinal interpretation
- Temporal class: stable
- Progression direction: none convincing
- Focal progression: none detected
- Global regression: none detected
- Sensitivity caveat: current study has broader projection coverage than prior study, but no convincing additional inflammatory structural abnormality is unmasked
C. Age-Adjusted Reference Context
- Age at baseline: 42 years
- Age at follow-up: 44 years
- Image-based contextual note: no severe age-incongruent destructive arthropathy is visible in the submitted hand/wrist radiographs
- Formal age-normalization overlay: not computed in this session
- Reason: no external normative engine output was executed within this chat
D. Symmetry & Balance Metrics
1) Bilateral concordance
- Definite joint-pattern concordance (thumb IP + DIP2-5): 10/10 matched bilateral counterpart joints
- Subtle PIP-pattern concordance: 8/8 matched bilateral counterpart joints
- MCP2-5 preservation concordance: preserved bilaterally
- Wrist preservation concordance: preserved bilaterally
2) Symmetry interpretation
- Overall symmetry: high
- Side-dominant excess destructive burden: none
- Side-dominant inflammatory asymmetry: none
- Pattern bias: symmetric low-burden interphalangeal degenerative profile
E. DEXA–Radiograph Correlation Summary
- DEXA data: not available
- DEXA-linked metrics: not computed
- Image-only bone-quality note: no convincing diffuse juxta-articular osteopenic inflammatory pattern is visible on these radiographs
- Cross-modal bone-health correlation: unavailable from current dataset
F. Composite Structural Metrics
| Composite descriptor | Result |
|---|---|
| Structural phenotype | Interphalangeal-predominant nonerosive degenerative profile |
| Burden class | Mild |
| Progression class | Stable |
| Inflammatory erosive class | None detected radiographically |
| Deformity class | None detected |
| Wrist inflammatory class | None detected |
| Mixed-pattern complexity | Low |
| Confidence on absence of erosive RA-pattern change | High |
| Confidence on subtle PIP low-grade degenerative change | Moderate to high |
G. QA / Reliability Indicators
| QA element | Result |
|---|---|
| Current study adequacy | High |
| Prior study adequacy | Moderate-high |
| Laterality certainty | High |
| Current projection completeness | Stronger than prior |
| Longitudinal confidence | Moderate-high |
| Major missingness affecting core interpretation | None in current study |
| Longitudinal limitation | Prior study has fewer projections |
| Internal contradiction detected | None |
Experimental Research Addendum
A. Prototype Composite Metrics
Exploratory descriptive metrics; not clinical scores
| Prototype metric | Value / class |
|---|---|
| Definite IP degenerative burden count | 10 joints |
| Additional subtle IP burden count | up to 8 joints |
| Definite erosive burden count | 0 |
| Bilateral matched-pattern concordance | 1.00 (complete matched counterpart pattern at definite burden level) |
| Net structural change count across primary delta domains | 0 |
| Exploratory stability class | Stable low-burden pattern |
| Exploratory drift class | No measurable drift on submitted radiographs |
B. Extended Bone-Health Models
- Extended densitometric / bone-quality modeling: not computed
- DEXA absent: yes
- Image-only bone-health signal: no diffuse demineralization pattern, no fragility-fracture pattern, no collapse pattern
C. Infection / Oncologic Advanced Operators
- Radiographic infection concern: none detected
- Radiographic oncologic/destructive concern: none detected
- Aggressive lytic or permeative pattern: absent
- Periosteal aggressive reaction: absent
- Therapy-related destructive bone-change signature: not identified on the submitted films
D. Advanced Symmetry Maps
- Hand-to-hand burden mirror: high
- Dominant-side excess structural burden: not demonstrated
- Asymmetric inflammatory drift: not demonstrated
- Asymmetric wrist degeneration: not demonstrated
E. Genetic / Developmental Modulation
- Pediatric/developmental module: not applicable
- Adult dataset: yes
- Congenital/developmental osseous anomaly visible in submitted hands/wrists: none definite
F. External AI Integration Hooks
- Third-party model inputs: none
- Cross-modal fusion: none
- External provenance signals: none available in this session
G. QA & Data Integrity Extensions
| Data-integrity item | Result |
|---|---|
| Current dataset completeness | Adequate |
| Prior dataset completeness | Limited but adequate for comparison |
| Cross-date interpretive consistency | High |
| Missing advanced modality inputs | DEXA/MRI/CT/US/EMG absent |
| Research-only limitation | Full formal multimodal analytics cannot be executed without external inputs |
| Clinical-core integrity | Preserved; no change introduced by research layer |
Overall research-tier summary: Image-derived analytics support a stable, mild, symmetric, interphalangeal-predominant nonerosive degenerative pattern without radiographic evidence of erosive inflammatory hand/wrist progression over ~27.8 months. No destructive RA-pattern structural burden is demonstrated on the submitted studies.
Radiographs — current study (2026-xx-xx)
Radiographs — prior study (2023-xx-xx)
Full-resolution de-identified radiographs available by request.
Downloads
READY+ report (PDF)
READY report (PDF)
READY− report (PDF)
2026 image compilation (PDF)
2023 image compilation (PDF)
How case complexity scales
Foundational
Single-date, one modality — the baseline structural read on a single study.
Longitudinal
This caseMultiple timepoints contribute a baseline and interval comparison. Here: two bilateral hand/wrist studies, ~2 years apart.
Multi-modality
More than one modality compounds the read — e.g. radiograph alongside MRI, ultrasound, or DEXA.