Inflammatory, Degenerative, and Crystal Arthropathies — WACS Viva & Clinical Scenarios (Musculoskeletal and Trauma Imaging)

Exam-style inflammatory, degenerative, and crystal arthropathies viva scenarios with examiner probes and model answers for Radiology candidates.

Scenarios covered

• SCENARIO 1: Plain Radiograph Interpretation: A 42-year-old female presents with symmetric bilateral hand and wrist pain accompanied by prolonged morning stiffness. Describe the systematic plain radiographic evaluation, characteristic distribution, key pathological signs, and disease progression staging in suspected autoimmune inflammatory arthropathy.
• SCENARIO 2: Cervical Spine and Advanced Imaging: A 56-year-old female with long-standing seropositive rheumatoid arthritis is scheduled for elective knee arthroplasty. Detail the preoperative radiological evaluation of the cervical spine, specifying essential views, measurement parameters for instability, and indications for cross-sectional magnetic resonance imaging.
• SCENARIO 3: Crystal Arthropathy Differential Diagnosis: Contrast the multimodality imaging manifestations of monosodium urate arthropathy (gout) and calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, detailing anatomical predilection, bone mineralisation response, soft tissue changes, and specific ultrasound and computed tomography signs.
• SCENARIO 4: Seronegative Axial Spondyloarthropathies: Outline the radiological hallmarks, sacroiliac joint grading criteria, spinal syndesmophyte patterns, and MRI staging protocols used to evaluate ankylosing spondylitis and psoriatic spondyloarthropathy.
• SCENARIO 5: Neuropathic Arthropathy versus Osteomyelitis: A 60-year-old diabetic male presents with an acute, warm, swollen, and deformed midfoot. Describe the radiographic signs of Charcot neuroarthropathy (hypertrophic versus atrophic) and explain the multimodality MRI criteria used to differentiate uncomplicated neuropathic joint disorganisation from superimposed osteomyelitis.