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Radiographic Report — Bilateral Hands and Wrists
Structured radiographic report · single-timepoint study
Header
| Patient | Caucasian female |
| DOB | xxxx-xx-xx |
| Age at study | 57 years |
| Study date | xxxx-xx-xx |
| Region(s) | Bilateral hands and wrists |
| Modality | XR |
| Projection count | 10 views total |
Projections provided
Right hand/wrist: frontal/PA, oblique, lateral, additional coned frontal, additional coned oblique
Left hand/wrist: frontal/PA, oblique, lateral, additional coned frontal, additional coned oblique
| Adequacy statement |
| Bilateral multiview hand/wrist radiographs are adequate for assessment of inflammatory change, remodeling, degenerative change, alignment, and compartment-level joint-space loss. |
Findings
Right hand and wrist
Right radiocarpal joint
Marked chronic joint-space narrowing involving the radiocarpal compartment, greatest at the radioscaphoid/radiolunate region.
| Count / distribution | single major wrist compartment, radial-predominant |
| Laterality | right |
| Morphology | chronic inflammatory/remodeling arthropathy with superimposed secondary degenerative remodeling |
| Extent | advanced |
| JSN grade | 3 |
| Symmetry | bilateral, near-symmetric |
| Confidence | high |
Right intercarpal / midcarpal compartments
Multifocal intercarpal and midcarpal narrowing with carpal crowding/collapse-remodeling appearance. Involvement extends across the scaphoid, lunate, triquetrum, capitate, hamate, trapezium, and trapezoid articulations where visible, greatest in the scaphoid-lunate-capitate/radial carpal column region.
| Count / distribution | multifocal diffuse carpal involvement |
| Laterality | right |
| Morphology | chronic erosive-remodeling inflammatory arthropathy with secondary degenerative change |
| Extent | moderate to advanced |
| JSN grade | 2–3 |
| Symmetry | bilateral |
| Confidence | moderate-high |
Right distal radioulnar joint / ulnar styloid region
Distal radioulnar joint narrowing with chronic hypertrophic remodeling of the distal ulna and chronic erosive-remodeling irregularity at the ulnar styloid region.
| Count / distribution | single compartment plus adjacent styloid abnormality |
| Laterality | right |
| Morphology | inflammatory/remodeling change with secondary degenerative hypertrophy |
| Extent | moderate to advanced |
| DRUJ JSN grade | 2–3 |
| Symmetry | bilateral |
| Confidence | high |
Right thumb CMC1 / STT region
Mild degenerative narrowing/remodeling at CMC1 and adjacent STT/radial-column articulation.
| Count / distribution | 2 adjacent basal thumb/radial-column compartments |
| Laterality | right |
| Morphology | degenerative |
| Extent | mild |
| JSN grade | 1 |
| Symmetry | bilateral similar |
| Confidence | moderate-high |
Right thumb MCP
Severe chronic destructive/remodeling arthropathy with marked joint-space loss, articular contour irregularity, bulky marginal remodeling/osteophyte formation, and chronic malalignment/subluxation.
| Count / distribution | single joint |
| Laterality | right |
| Morphology | severe chronic inflammatory destruction with secondary degenerative remodeling |
| Extent | advanced |
| JSN grade | 3 |
| Symmetry | bilateral high symmetry |
| Confidence | high |
Right thumb IP
Mild narrowing and marginal spurring.
| Count / distribution | single joint |
| Laterality | right |
| Morphology | degenerative |
| Extent | mild |
| JSN grade | 1 |
| Symmetry | bilateral similar |
| Confidence | high |
Right MCP2
Severe chronic arthropathy with marked joint-space loss, metacarpal head flattening/remodeling, marginal erosive irregularity, and subchondral remodeling change.
| Count / distribution | 1 of 4 finger MCP joints severely involved |
| Laterality | right |
| Morphology | rheumatoid-pattern erosive/remodeling arthropathy |
| Extent | advanced |
| JSN grade | 3 |
| Symmetry | bilateral, near-symmetric |
| Confidence | high |
Right MCP3-5
No high-grade destructive erosive change. Mild if any narrowing only.
| Count / distribution | remaining 3 finger MCP joints relatively preserved |
| Laterality | right |
| Morphology | no definite dominant inflammatory destruction |
| Extent | none to minimal |
| JSN grade | 0–1 |
| Symmetry | bilateral similar |
| Confidence | moderate-high |
Right PIP2-5
Multifocal interphalangeal arthropathy. PIP3: severe narrowing with central erosive-remodeling change and irregular marginal osteophytosis/remodeling. JSN grade 3. PIP4: moderate chronic narrowing/remodeling. JSN grade 2. PIP2 and PIP5: mild degenerative narrowing/remodeling. JSN grade 1.
| Count / distribution | all 4 finger PIP joints involved to varying degree, dominant at PIP3 |
| Laterality | right |
| Morphology | superimposed erosive-remodeling OA-pattern change, not dominant global study pattern |
| Extent | mild to severe |
| Symmetry | asymmetric, right greater than left |
| Confidence | high for PIP3, moderate-high otherwise |
Right DIP2-5
Mild scattered DIP degenerative/erosive-remodeling change, greatest at the small finger and additional mild involvement of other visible DIP joints.
| Count / distribution | multifocal, low-grade |
| Laterality | right |
| Morphology | degenerative / erosive-remodeling OA pattern |
| Extent | mild |
| JSN grade | 1–2 in involved joints |
| Symmetry | bilateral, right slightly greater |
| Confidence | moderate |
Right distal radius / distal ulna / mineralization / soft tissues
No acute fracture. Mild diffuse periarticular demineralization/juxta-articular osteopenic change. No definite soft-tissue calcific arthropathy identified on the submitted views.
| Count / distribution | diffuse background bone quality change |
| Laterality | right |
| Morphology | periarticular osteopenic change |
| Extent | mild |
| Symmetry | bilateral |
| Confidence | moderate |