RheumaView™ Structured Radiographic Report
| Patient | xxxxx — African American Female, DOB: xx-xx-xxxx (42 yo) |
| Study Date | xx-xx-xxxx |
| Exam | Cervical spine, thoracic spine, lumbar spine, sacroiliac joints, pelvis, and bilateral hips radiographs |
| Projections | Cervical spine AP, lateral, bilateral oblique, and open-mouth odontoid views; thoracic spine AP and lateral views; lumbar spine AP, lateral, and bilateral oblique views; AP sacroiliac joints with bilateral oblique SI views; AP pelvis with dedicated right and left hip views; lateral sacrum/coccyx view. |
SECTION I — CLINICAL REPORT
Findings
Cervical Spine
Mild straightening of the cervical lordosis. Alignment is otherwise maintained. Mild lower cervical spondylotic change with mild disc space narrowing at C5-C6 and trace/mild narrowing at C6-C7, with small anterior endplate osteophytes and mild uncovertebral hypertrophic change. Mild bilateral lower cervical osseous foraminal narrowing, greatest at approximately C5-C6/C6-C7. Atlantodental alignment is maintained. No erosive change, syndesmophyte formation, or ankylosis identified on the provided cervical radiographs.
Thoracic Spine
Mild levoconvex thoracolumbar curvature. Mild multilevel endplate spurring/spondylotic change, greatest in the mid/lower thoracic spine and thoracolumbar junction, with mild lower thoracic/thoracolumbar disc space narrowing. Thoracic vertebral body heights are preserved. No compression deformity. No flowing syndesmophytes, focal erosive change, or ankylosis identified on the provided thoracic radiographs.
Lumbar Spine
Transitional lumbosacral anatomy with enlarged L5 transverse processes and asymmetric lumbosacral pseudoarticulation, more pronounced on the left. Mild levoconvex thoracolumbar/lumbar curvature. Mild lower lumbar spondylotic change with mild disc space narrowing at L4-L5 and L5-S1 and mild lower lumbar facet arthropathy, greatest at L4-L5 and L5-S1. No spondylolisthesis on neutral lateral view. No convincing pars defect on the provided oblique views. No definite inflammatory-type syndesmophyte formation or ankylosis identified.
Sacroiliac Joints
Mild bilateral iliac-sided subchondral sclerosis, most evident inferiorly and slightly greater on the right. Sacroiliac joint spaces remain preserved. No definite erosions or ankylosis. Overall radiographic appearance favors mild degenerative/condensing iliac-sided change rather than definite radiographic inflammatory sacroiliitis.
Pelvis / Hips
Mild degenerative change of the symphysis pubis. Mild bilateral hip degenerative change with mild superolateral joint space narrowing and mild acetabular rim spurring. Small bilateral superolateral acetabular rim ossific densities, compatible with chronic os acetabuli/labral ossification-type change, left slightly greater than right. Mild bilateral decreased femoral head-neck offset/asphericity, compatible with subtle cam-type morphology. No fracture, femoral head collapse, protrusio, or inflammatory erosive change identified.
Sacrum / Coccyx
Chronic-appearing anterior coccygeal angulation/deformity with distal coccygeal irregularity/fusion pattern, favored developmental or remote post-traumatic/chronic change. No acute abnormality identified on the provided lateral view.
Impression
▸ Mild multilevel degenerative/mechanical change involving the lower cervical spine, lower thoracic/thoracolumbar junction, lower lumbar spine, sacroiliac joints, and both hips.
▸ Mild bilateral iliac-sided sacroiliac subchondral sclerosis without erosions or ankylosis; radiographic pattern favors mild degenerative/condensing iliac-sided change rather than definite radiographic sacroiliitis.
▸ Transitional lumbosacral anatomy with asymmetric L5 lumbosacral pseudoarticulation, greater on the left.
▸ Mild bilateral hip OA/FAI-type morphology with superolateral acetabular rim ossification/os acetabuli-type change and subtle cam morphology.
▸ No definite radiographic evidence of erosive inflammatory spondyloarthropathy or ankylosing change on this study.
EMR Summary
| Axial and pelvic radiographs dated xx-xx-xxxx show predominantly mild chronic degenerative/mechanical findings rather than definite active radiographic inflammatory spondyloarthropathy. There is mild lower cervical, thoracolumbar, and lower lumbar spondylosis; transitional lumbosacral anatomy with left-greater-than-right L5 pseudoarticulation; mild bilateral iliac-sided SI sclerosis without erosions or ankylosis, favoring degenerative/condensing iliac-sided change over definite radiographic sacroiliitis; and mild bilateral hip degenerative/FAI-type morphology with small superolateral acetabular rim ossifications. No definite radiographic erosive SpA/AS change is identified on this X-ray study. |
SECTION II — RESEARCH / ANALYTICS ADDENDUM
★ Not a part of the clinical report
A. Quantitative Radiologic Measures
1) Region-Level Burden Summary
| Region | Dominant Structural Findings | Burden Level | Pattern Class | Confidence |
| Cervical spine | Mild loss of lordosis; mild C5-C6 disc loss; trace/mild C6-C7 disc loss; small anterior osteophytes; mild uncovertebral/foraminal change | Mild | Degenerative/mechanical | High |
| Thoracic spine | Mild multilevel mid/lower thoracic and thoracolumbar endplate spurring with mild lower thoracic/thoracolumbar disc loss | Mild | Degenerative/mechanical | High |
| Lumbar spine | Transitional L5 anatomy; mild L4-L5 and L5-S1 disc loss; mild lower lumbar endplate spurring; mild lower lumbar facet arthropathy | Mild | Mixed developmental + degenerative/mechanical | High |
| Sacroiliac joints | Mild bilateral inferior iliac-sided sclerosis, right slightly greater than left; preserved joint spaces; no ankylosis | Mild | Non-erosive chronic remodeling, degenerative/condensing favored | High |
| Right hip | Mild superolateral narrowing; mild acetabular rim spurring; chronic rim ossific foci; subtle cam-type morphology | Mild | Mechanical/degenerative | High |
| Left hip | Mild superolateral narrowing; mild acetabular rim spurring; chronic rim ossific focus; subtle cam-type morphology | Mild | Mechanical/degenerative | High |
| Pubic symphysis | Mild degenerative irregularity/sclerosis | Mild | Degenerative | High |
| Coccyx | Chronic anterior angulation/deformity with distal irregularity/fusion pattern | Chronic morphology | Developmental or remote post-traumatic/chronic | Moderate-high |
2) Image-Derived Structural Counts / Binary Fields
| Metric | Output |
| Definite SI erosions | 0 |
| Definite SI ankylosis | 0 |
| Definite syndesmophyte bridges | 0 |
| Definite vertebral corner destructive lesions | 0 |
| Definite vertebral compression fractures | 0 |
| Definite spondylolisthesis on provided neutral lumbar lateral | 0 |
| Pars defects convincingly demonstrated | 0 |
| Transitional lumbosacral anatomy | 1 |
| Bilateral hips with acetabular rim ossific/labral-ossification-type change | 2 |
| Bilateral hips with subtle cam-type contour reduction | 2 |
| Definite inflammatory erosive hip arthropathy | 0 |
| Femoral head collapse / AVN-type collapse on radiographs | 0 |
3) Grade-Style Severity Map
| Compartment | Estimated Grade |
| C5-C6 disc space loss | Mild |
| C6-C7 disc space loss | Trace/mild |
| Lower thoracic/thoracolumbar disc loss | Mild |
| L4-L5 disc loss | Mild |
| L5-S1 disc loss | Mild |
| Lower lumbar facet arthropathy | Mild |
| Bilateral SI sclerosis | Mild |
| Bilateral hip superolateral narrowing | Mild |
| Bilateral acetabular rim spurring | Mild |
4) Burden Concentration Hierarchy
1. Lower lumbar transition/mechanical zone
2. Bilateral hip impingement-labral morphology zone
3. Lower cervical degenerative zone
4. SI iliac-sided remodeling zone
5. Thoracolumbar degenerative zone
B. Longitudinal & Temporal Metrics
Dataset temporal class: single-date multiregion axial-pelvic radiographic study
| Temporal Field | Output |
| Prior image-backed comparison used in this render | No |
| Interval deltas | Not emitted in single-date mode |
| Temporal stability score | Not computable |
| Drift vectors | Not computable |
| Trajectory class | Not computable |
| Progression class | Not computable |
| Region-paired delta matrix | Not computable |
Baseline-Only Future Comparison Targets
| Priority Tier | Highest-Yield Future Tracked Targets |
| Tier 1 | Right anterior/inferior SI joint zone; left anterior/inferior SI joint zone; bilateral L5 transverse process pseudoarticulation interfaces; bilateral superolateral hip joint spaces; bilateral acetabular rim ossific foci |
| Tier 2 | L5-S1 disc space; L4-L5 disc space; lower lumbar facets; C5-C6 and C6-C7 disc spaces; lower cervical foraminal compartments |
| Tier 3 | Thoracolumbar junction disc/endplate compartments; pubic symphysis; coccygeal contour if clinically relevant |
Single-date temporal note: This render establishes a baseline structural map only. No honest interval stability/progression claim is emitted.
C. Age-Adjusted Reference Values
Age at study: 42 years
| Metric | Output |
| Predominant age-adjusted phenotype | Mixed mechanical/degenerative with developmental load-sharing abnormality |
| Age-concordant mild axial degeneration | Present |
| Age-discordant advanced destructive inflammatory phenotype | Not demonstrated |
| Age-discordant advanced hip OA phenotype | Not demonstrated |
| Age-contextual relevance of hip morphology | Elevated for symptoms despite mild OA burden |
| Age-contextual relevance of transitional anatomy | Elevated; likely mechanically meaningful |
Age-Adjusted Interpretation
▸ Lower cervical, thoracolumbar, and lower lumbar degenerative changes are mild for age.
▸ Bilateral hip morphology is more clinically relevant than the mild OA burden alone because the combination of cam-type contour change + acetabular rim ossification/labral-type change can generate symptoms disproportionate to plain-film degenerative grade.
▸ Mild bilateral SI iliac-sided sclerosis is not pristine for age, but the preserved joint spaces and absent erosive/ankylosing change lower the probability of advanced radiographic inflammatory SI destruction.
D. Symmetry & Balance Metrics
| Metric | Output |
| SI symmetry class | Near-symmetric low-grade remodeling with slight right predominance |
| Hip symmetry class | Broadly symmetric bilateral mild OA/FAI-type morphology |
| Left:right SI burden ratio | Mild right-weighted |
| Left:right hip burden ratio | Near-balanced, left rim ossification slightly more conspicuous |
| Lumbosacral transition asymmetry | Left greater than right |
| Global balance class | Bilateral mixed mechanical burden with focal asymmetric developmental loading |
Side-Weighted Burden Summary
▸ Most symmetric dominant feature: bilateral mild hip morphology/acetabular rim change
▸ Most asymmetric structural feature: left-greater-than-right lumbosacral pseudoarticulation
▸ Secondary asymmetry: right-greater-than-left SI iliac-sided sclerosis
Spatial Organization
| Parameter | Output |
| Axial load concentration | Lumbosacral junction |
| Pelvic/hip load concentration | Bilateral superolateral hip compartments |
| Side-bias driver | Congenital/developmental asymmetry rather than erosive unilateral inflammatory destruction |
E. DEXA–Radiograph Correlation Summary
| Field | Output |
| DEXA dataset attached | No |
| Density–structure linkage | Not available |
| Bone-age deviation analysis | Not available |
| Densitometric discrepancy classification | Not available |
| Bone-health fusion metrics | Not available |
Bone-Quality Surrogate Layer
| Field | Output |
| Diffuse radiographic osteopenic background | Not convincing |
| Aggressive osteolysis | Not seen |
| Insufficiency-fracture pattern | Not seen |
| Mineralization-driven dominant pattern | Unsupported on provided radiographs |
Image-based inference: Bone-quality abnormality is not the dominant visible structural driver on this study. The dominant burden is mechanical/morphologic with mild superimposed degeneration.
F. Composite Structural Metrics
| Composite Field | Output |
| Primary structural phenotype | Mixed mechanical/degenerative axial-pelvic phenotype with developmental load-sharing abnormality |
| Dominant chronic burden | Lumbosacral transition zone + bilateral hip impingement/labral-ossification morphology |
| Dominant axial degenerative burden | Lower lumbar and lower cervical |
| Dominant SI pattern | Mild bilateral iliac-sided non-erosive sclerosis |
| Dominant hip pattern | Bilateral mild OA/FAI-type morphology |
| Inflammatory-destructive phenotype | Not demonstrated radiographically |
| Composite asymmetry class | Mild mixed asymmetry, developmentally weighted |
| Current burden concentration | Lumbosacral junction and bilateral superolateral hips |
| Composite stability index | Not computable in single-date mode |
| Trajectory class | Not computable in single-date mode |
| Discrepancy class | Not computable in single-date mode |
Pattern Decomposition
Positive Structural Anchors
✓ Mild lower cervical spondylosis
✓ Mild thoracolumbar degenerative spondylosis
✓ Mild lower lumbar degenerative change
✓ Transitional lumbosacral anatomy with asymmetric pseudoarticulation
✓ Mild bilateral SI iliac-sided sclerosis without erosions/ankylosis
✓ Bilateral mild hip OA/FAI-type morphology with acetabular rim ossification
Negative Structural Anchors
✗ No definite radiographic sacroiliac erosions
✗ No sacroiliac ankylosis
✗ No syndesmophyte bridging
✗ No vertebral ankylosis
✗ No erosive hip arthropathy
✗ No destructive/aggressive osseous lesion pattern
Overall composite interpretation: Current radiographs support a mixed non-destructive phenotype in which mechanical/developmental and mild degenerative factors dominate over radiographically visible inflammatory damage.
G. QA / Reliability Indicators
| QA Field | Output |
| Projection adequacy | High overall |
| Cervical lateral confidence | High |
| Cervical AP / uncovertebral confidence | High |
| Cervical oblique foraminal confidence | High |
| Odontoid fine-detail confidence | Moderate |
| Thoracic confidence | High |
| Lumbar confidence | High |
| SI confidence | High |
| Hip confidence | High |
| Coccygeal confidence | Moderate |
| Main technical limitation | None major; coccygeal evaluation inherently limited by single focused lateral anatomy |
| Dataset completeness for submitted regions | High |
Confidence-Weighted Region Reliability
| Region | Reliability |
| Cervical spine | High |
| Thoracic spine | High |
| Lumbar spine | High |
| SI joints | High |
| Pelvis / hips | High |
| Coccyx | Moderate |
Concordance / Coherence Summary
| Field | Output |
| Cross-section internal coherence | High |
| Pattern coherence (findings vs impression) | High |
| Single-date structural concordance index | High |
| Human-override comparator attached | No |
| External AI provenance attached | No |
Missingness / Suppression Map
| Analytic Domain | Status | Reason |
| Longitudinal deltas | Suppressed | No prior comparison used in this render |
| Temporal stability metrics | Suppressed | Single-date study |
| DEXA fusion | Suppressed | No DEXA data |
| MRI/CT fusion | Suppressed in this render | Current request limited to 03/10/2026 radiographs only |
| Electrophysiology concordance | Suppressed | No EMG/NCS dataset |
| Therapy-response modeling | Suppressed | Single-date XR-only render |
| External provenance hooks | Suppressed | None attached |