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Not all joint pain is arthritis

To the Editor: I was somewhat confused by the Clinical Picture case in the May 2013 issue.1 The caption for Figure 1 stated that the MRI showed erosions and marrow edema, which were “asymmetrical compared with the other wrist, a finding highly suggestive of rheumatoid arthritis.” However, rheumatoid arthritis is generally considered to be symmetrical.2 Was this a typographical error, or did I miss a crucial concept somewhere?

References
  1. Kochhar GS, Rizk M, Patil DT. Not all joint pain is arthritis. Cleve Clin J Med 2013; 80:272273.
  2. Bukhari M, Lunt M, Harrison BJ, Scott DG, Symmons DP, Silman AJ. Erosions in inflammatory polyarthritis are symmetrical regardless of rheumatoid factor status: results from a primary care-based inception cohort of patients. Rheumatology 2002; 41:246252.
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David L. Keller, MD
Providence Medical Group, Torrance, CA

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Providence Medical Group, Torrance, CA

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To the Editor: I was somewhat confused by the Clinical Picture case in the May 2013 issue.1 The caption for Figure 1 stated that the MRI showed erosions and marrow edema, which were “asymmetrical compared with the other wrist, a finding highly suggestive of rheumatoid arthritis.” However, rheumatoid arthritis is generally considered to be symmetrical.2 Was this a typographical error, or did I miss a crucial concept somewhere?

To the Editor: I was somewhat confused by the Clinical Picture case in the May 2013 issue.1 The caption for Figure 1 stated that the MRI showed erosions and marrow edema, which were “asymmetrical compared with the other wrist, a finding highly suggestive of rheumatoid arthritis.” However, rheumatoid arthritis is generally considered to be symmetrical.2 Was this a typographical error, or did I miss a crucial concept somewhere?

References
  1. Kochhar GS, Rizk M, Patil DT. Not all joint pain is arthritis. Cleve Clin J Med 2013; 80:272273.
  2. Bukhari M, Lunt M, Harrison BJ, Scott DG, Symmons DP, Silman AJ. Erosions in inflammatory polyarthritis are symmetrical regardless of rheumatoid factor status: results from a primary care-based inception cohort of patients. Rheumatology 2002; 41:246252.
References
  1. Kochhar GS, Rizk M, Patil DT. Not all joint pain is arthritis. Cleve Clin J Med 2013; 80:272273.
  2. Bukhari M, Lunt M, Harrison BJ, Scott DG, Symmons DP, Silman AJ. Erosions in inflammatory polyarthritis are symmetrical regardless of rheumatoid factor status: results from a primary care-based inception cohort of patients. Rheumatology 2002; 41:246252.
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Cleveland Clinic Journal of Medicine - 80(11)
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Cleveland Clinic Journal of Medicine - 80(11)
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Not all joint pain is arthritis
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Not all joint pain is arthritis
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