Diagnosis of Seronegative Rheumatoid Arthritis (SNRA) is based on clinical, radiological, and MRI findings with set criteria. High specificity is provided by plain X-rays in the differential diagnosis of rheumatic disorders.

In the study by C Rex et al of pelvis X-rays, they found that ischiopubic ramus enthesopathy was more common than sacroiliitis and they have coined that enthesopathy finding as “hanging drop sign” because of its characteristic appearance.

A total of 152 proven (92 Females, 60 Males) SNRA cases (based on ACR*/EULAR**criteria and ASAS***criteria) were studied for enthesopathy features in their plain X-ray of pelvis. In addition to sacroiliitis, calcification/ ossification of attachment of pelvic muscle and ligaments was documented. Hanging drop enthesopathy was noted i

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