Which feature favors osteoarthritis over rheumatoid arthritis on radiographs?

• A. Symmetric marginal erosions and periarticular osteopenia
• B. Asymmetric osteophytes and subchondral sclerosis
• C. Periarticular osteopenia without erosions
• D. Widespread joint space preservation

Answer: (B)

On radiographs, osteoarthritis tends to produce asymmetric degenerative changes with bone-forming responses at the joint margins and changes in the bone beneath the cartilage. Osteophytes are classic bony outgrowths at the joint edges, and subchondral sclerosis reflects increased bone density from altered loading. When these features appear together and are not symmetrically distributed, they point toward OA rather than an inflammatory process. Rheumatoid arthritis more often shows symmetric involvement with marginal erosions and periarticular osteopenia due to inflammation. Therefore, the description of asymmetric osteophytes and subchondral sclerosis best fits OA. The other patterns align more with RA or non-specific changes.