Radiographic projections for the diagnosis of arthritis of the hands and wrists.

One hundred consecutive sets of radiographs with the hands halfway supinated (Nørgaard'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 Nørgaard views.