ABCDS, CATBITES / VINDICATE

Question 1

What is Radiodense or Radiopaque

Answer 1

Light or white area on the radiograph (due to presence of dense objects in paths of photons - strong absorbers, e.g. metal replacement

Question 2

What is Radiolucent

Answer 2

Dark or black area on the radiograph (due to maximum number of photons passing through the object (e.g. air)

Question 3

What is a contrast

Answer 3

The degree of difference between adjacent densities

Question 4

What is a density

Answer 4

The degree of darkening of an exposed radiograph; density is dependent on amount of radiation received;
white areas = no density;
black areas = maximum density

Question 5

Search pattern: ABCDS

Answer 5

A - Articulation, (alignment);
B - Bone ;
C - Cartilage;
D - Distribution;
S - Soft tissue

Question 6

Example in articulation search pattern

Answer 6

Erosions

Question 7

Example of Bone search pattern

Answer 7

Productive changes - osteophyte formation, spur formation, chondrocalcinosis ect.

Diminished bone density - osteoporosis, osteolysis, cyst formation

Question 8

Example in Cartilage search pattern

Answer 8

Joint space narrowing

Question 9

Example in distribution search pattern

Answer 9

Symmetric vs. Asymmetric;
Proximal vs. peripheral (small or large joints);
monoarticular vs. polyarticular

Question 10

Example in Soft Tissue search pattern

Answer 10

deformity, swelling masses

Question 11

What are types of articular erosions

Answer 11

Marginal erosions;
Subchondral erosions;
Gullwing deformity;
Pencil-in-cup deformity;
Periarticular/juxtaarticular erosions

Question 12

Describe Marginal erosions

Answer 12

In Rheumatoid arthritis (typically seen)
Occur at the bare area of the joint - where the bone is not covered by articular cartilage;
RA - MCP joints (metacarpophalangeal) &
Psoriatic Arthritis of DIP (distal interphalangeal joint)

Question 13

Describe Subchondral erosions

Answer 13

Occur at the subchondral bone plate of the articular surfaces;
Typical feature of erosive osteoarthritis

Question 14

Describe Gullwing deformity

Answer 14

In Erosive Osteoarthritis (OA);
It is the combination of central erosions and osteophytes

Question 15

Describe Pencil-in-cup deformity

Answer 15

In Psoriatic arthritis;
It is the combination of marginal erosions and bone proliferation

Question 16

Describe Periarticular or Juxtaarticular erosions

Answer 16

The location is where the joint capsule attaches to the bone;
most often seen in the fist MTP joint (metatarsophalangeal)

Question 17

Describe Osteophytes in OA

Answer 17

Bony proliferations, that develop at the margins of a synovial joint

Question 18

Describe Osteophytes in a patient with CPPD (Calcium Pyrophosphate Dihydrate Deposition Disease)

Answer 18

Soft tissue calcification next to Osteophytes - commonly affects knees and wrists

Question 19

What are Spondylophytes

Answer 19

Osteophytes in the spine in spondylosis (degenerative disease)

Question 20

What are Syndesmophytes

Answer 20

Bony growths inside spinal ligaments (causing joint (vertebrae) fusion and stiffness

Question 21

What is DISH

Answer 21

Diffuse idiopathic skeletal hyperostosis; It is the ossification in the ALL (anterior longitudinal ligament) of the spine

Question 22

What is an example of non-uniform/ asymmetrical cartilage degenerative disease

Answer 22

OA (Osteoarthritis) - loss on one side more than the other (e.g. - knee - bigger cartilage loss on the medial condyle than on the lateral - due to not evenly distributed mechanical load

Question 23

What is an example of inflammatory uniform joint disease

Answer 23

RA (Rheumatoid arthritis) - same cartilage loss on both sides

Question 24

What is the distribution (location) of OA

Answer 24

CMC1 joint (first carpometacarpal), STT joint (scaphotrapeziotrapezoid), DIP (distal interphalangeal joint)

Question 25

What is the distribution (location) of RA

Answer 25

In the Carpus (carpal bones), MCP joints, PIP joints (proximal interphalangeal)

Question 26

What is the distribution of PA (psoriatic arthritis)

Answer 26

PIP, DIP, STT (scaphotrapeziotrapezoid), Triquetrohamate joints