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Xray diagnosis 1 > Arthrides - Inflammatory > Flashcards

Arthrides - Inflammatory Flashcards

0
Q

What makes RA seropositive or seronegative?

A

Rheumatoid Factor (RF)

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1
Q

MC inflammatory arthritis

A

Rheumatoid Arthritis (RA)

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2
Q

Rheumatoid types are seronegative or seropositive?

A

Seropositive

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3
Q 
Systemic Lupus (SLE) is what type of RA? 
RF positive or negative?
A

Rheumatoid Type

Seropositive

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4
Q

What is the MC form of Juvenile Chronic Arthritis (JCA) and what is the RF?

A

Polyarticular (50%)

Seronegative

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5
Q

What’s another name for the classic form of JCA?

Factor? %?

A

Still’s disease.
Seronegative.
20%

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6
Q

What are the most distinctive features of JCA?

A

Periostitis, and growth abnormalities (ie. bone shortening and ballooned epiphysis).

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7
Q

Inflammatory and hyperemic process loosens the periosteum causing _________ in metacarpals, metatarsals, and proximal phalanges of teenagers.

A

Periostitis

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8
Q

Examples of growth abnormalities caused by JCA

A

“Ballooning” of epiphyseal plates (caused by hyperemia), and bone shortening (caused by premature fusion of growth plates).

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9
Q

Vertebral body and disc hypoplasia (“child’s configuration”) can be caused by _________ in the cervical spine.
What other features?

A

JCA

Erosions and posterior joint ankylosis (facet fusion).

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10
Q

What joints of the hand are MC affected in RA?

A

MCP’s and PIP’s

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11
Q

What sites in the body are MC affected in RA?

A

Synovial tissues of the hands, feet, wrists, hips, knees, elbows and shoulders, and the atlantoaxial subluxation of the cervical spine.

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12
Q

This arthride is marked by bilateral symmetric distribution, and uniform loss of joint space; What other features are found?

A

RA

  • periarticular soft tissue inflammation (pannus)
  • juxta-articular osteoporosis
  • marginal erosions (bare area) - “rat bites”
  • subchondral erosions, cysts (or geodes) and deformities.
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13
Q

In ______ the SI articulations are rarely affected.

A

RA

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14
Q

What deformities are characteristic in RA?

A

Swan neck, boutonnière, and hitchhiker’s thumb.

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15
Q

Flexion of the PIP’s and extension of the DIP’s

A

Boutonnière Deformity

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16
Q

Extension of the PIP’s and flexion of the DIP’s

A

Swan Neck Deformity

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17
Q

Elevated ESR (erythrocyte sedimentation rate) and +RA factor are two clinical features of these arthrides in young middle aged women.

A

RA and Lupus (SLE)

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18
Q

Severe joint deformity / destruction

A

Arthritis mutilans

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19
Q

Enlargement of the gastrocnemius bursa

A

Baker’s cyst

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20
Q

Leukopenia, splenomegaly and RA

A

Felty’s syndrome

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21
Q

Soft tissue swelling at the MCP joints

A

Haygarth’s nodes

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22
Q

Soft tissue swelling at the PIP’s

A

Bouchard nodes

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23
Q

Soft tissue swelling at the DIP’s

A

Heberden’s nodes

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24
Q

Haygarths nodes are first in this type of arthride

A

RA

25
Q

Heberdens nodes are first affected in this type of arthride

A

DJD

26
Q

1 reason for an increased ADI

A

RA in cervical spine

27
Q

An atlanto-axial subluxation is considered when the ADI is more than _____ and the PADI less than ____.

A

ADI >3 mm, PADI <14

28
Q

Reumatoid Types

  • what’s the RF?
  • examples
A
  • Seropositive

- Reumatoid Arthritis, Sistemic Lupus Erythematosis (SLE), Scleroderma, Jaccoud’s.

29
Q

Butterfly rash

A

SLE

30
Q

SLE is MC in what sex and what ages?

A

Females (9:1), ages 20-40 yrs

31
Q

In SLE, what percentage have articular complains?

A

90%

32
Q

Most frequent and serious features of SLE

A

Kidney conditions that may lead to nephropathy and renal failure

33
Q

SLE may be accompanied by this condition where the fingers, toes or other areas get discolored in response to excessive reduced blood flow.

A

Reynaud’s phenomenon

34
Q

This non-erosive arthritis involves multiple organs, is seropositive, has an elevated ESR (erythrocyte sedimentation rate) and a positive ANA (antinuclear antibodies).

A

Systemic Lupus Erythematosis

35
Q

SLE is commonly treated with ________ witch can lead to:

A

Osteoporosis, avascular necrosis (AVN), water retention, spinal fractures and gastric ulcerations

36
Q

In SLE, articular changes are most commonly seen in _______ and these deformities are reversible.
- what joints are usually affected?

A

Hands

- MCP and PIP

37
Q

What is a classic deformity in the hands of patients with SLE?
- what other deformities are possible?

A 
Ulnar deviation (>50% of patients) 
- swan neck and boutonnière
38
Q

SLE deformities are reversible and non-erosive? What does that mean?

A

Yes; it means that the deformities are not rigid, and there is no bone destruction like in RA.

39
Q

What other effect can SLE can have in the spine, specifically upper cervical?

A

It can induce laxity of the transverse ligament increasing the ADI (by 8.5%)

40
Q

Ulnar deviation can be seen in SLE and what two other seropositive reumatoid types?

A

RA and Jaccoud’s

41
Q

This seropositve reumatoid type follows rheumatic fever, multiple connective tissue disorders and has an antecedent of streptococcal pharyngitis

A

Jaccoud’s arthropathy

42
Q

Jaccoud’s arthropathy has no evidence of _________, only capsular fibrosis and DJD.

A

Synovial pathology

43
Q

Jaccoud’s arthropathy causes non-erosive, reversible joint deformity, just like this other reumatoid type.

A

SLE

44
Q

Most important factor to distinguish Jaccoud’s and SLE, besides the butterfly rash, is

A

History and clinical presentation

45
Q

Rehumatoid Type that causes small vessel disease and fibrosis in multiple organ systems.

A

progressive systemic sclerosis / scleroderma

46
Q

Scleroderma is MC in what gender, age population?

A

Females (3:1), ages 30-50

47
Q

In scleroderma, the skin appearance is the most unique feature with progression of 3 stages:

A

Edema, induration (hardening) and atrophy.

48
Q

If a patient with scleroderma is exposed to cold or emotional upset conditions it precipitates ___________ changes of pallor and painful ___________ producing pain and swelling.
What is this condition called?

A

vasoconstrictive ; vasodilation

Reydaud’s phenomenon

49
Q

Reynaud’s phenomenon is a _________ nervous system dysfunction characterized by cyclic vascular changes usually in hands.

A

Sympathetic

50
Q

Vascular pathological changes consisting of a low grade inflammatory reaction in the perivascular tissue with atrophy and fibrosis is characteristic of

A

Scleroderma

51
Q

Patients with this condition can have trouble swallowing and constipation due to decreased motility and dilatation/constriction of the GI tract.

A

Scleroderma

52
Q

Scleroderma affects the lungs in all cases, however only ___% of cases are symptomatic.

A

25%

53
Q

What is the CREST syndrome?

-Where can you find this?

A 
Calcinosis
Raynaud's phenomenon 
Esophageal dysmotility 
Sclerodactyly
Telangiectasia (dilated sub-dermal blood vessels) 
- in patients with Scleroderma
54
Q

Define:
Acro-
Miso-
Rhico-

A 
Acro= distal extremities
Miso= forearms and lower legs 
Rhico= humerus and femur
55
Q

What is acro-osteolysis? Where can this be found?

A

Osseous resorption in terminal phalangeal tufts; this happens in patients with scleroderma.

56
Q

What is the main distribution of Progressive Systemic Sclerosis?

A

Hands, chest and GI

57
Q

How does scleroderma affects the hands?

A

Acro-osteolysis in finger tips, and subdermal calcification.

58
Q

How does scleroderma affects the chest?

A

Interstitial fibrosis

59
Q

How does scleroderma affects the GI tract?

A

Smooth muscle disfunction causing esophageal aperistalsis and reduced lower sphincter pressure.

60
Q 
What reumatoid type has these clinical features: 
Females 3:1
30-50 yrs old 
Raynaud's phenomenon
Joint pain and stiffness 
Dysphagia
Elevated ESR
ANA increased 
RF positive
A

Scleroderma / Progressive Systemic Sclerosis

Xray diagnosis 1 (1 decks)

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