Radiology, Vol 139, 577-581, Copyright © 1981 by Radiological Society of North America
Radiographic projections for the diagnosis of arthritis of the hands and wrists
AA De Smet, NL Martin, SL Fritz and HB Lindsley
One hundred consecutive sets of radiographs with the hands halfway
supinated (Norgaard's view) were reviewed retrospectively without knowledge
of the clinical diagnosis to determine the value of this view for diagnosis
of rheumatoid arthritis. Indistinct cortex at specific sites, reported to
be a sensitive indicator of rheumatoid arthritis, was seen in 81% of
rheumatoid patients: however, it was not specific for rheumatoid arthritis,
being present in both inflammatory and noninflammatory arthritides. These
changes are apparently due to variations in cortical morphology and are not
true erosions. Definite erosions, which were more specific for inflammatory
arthritis, were seen at the same sites; however, erosions could be
identified on postero-anterior radiographs in 14 of the 16 cases in which
they were seen on the Norgaard views.
