I am not a medical professional so I can neither diagnose nor advise an individual on choosing what treatment to take. The imaging alone suggests something is going on.

I will say diagnosis of RA, psoriatic arthritis, etc can be complex and be based as much on what the doctor sees when examining the patient and when looking at all of the test results. These results were the observations of the radiologist which then were interpreted by the rheum in light of the physical exam and laboratory findings.

Getting a second opinion could be worthwhile if what your doctor advises does not satisfy you.

Good luck!