arthridities Flashcards
list 8 general radiological findings in Rheumatoid Arthritis, and when these signs become visible on x-ray
visible within 3-6 months of onset:
- bilateral symmetry
- periarticular soft tissue swelling
- jusxta-articular osteoporosis: inflammatory hyperaemia
- uniform loss of joint space
- marginal erosions (rat bite erosions); loss of cortex at bare area, no sclerotic border
- juxta-articular periostitis
- pseudocysts: 4-6cm; intraosseous pannus and synovial fluid-can stimulate neoplasm or infection
- articular deformity: joint destruction, ligament laxity, altered muscle function, sublux or dislocation; ulna deviation common
list the 8 universal radiological findings of Osteoarthritis
- asymmetric distribution
- non-uniform loss of joint space
- osteophytes (traction and claw); do not confuse with marginal syndesmophytes
- subchondral sclerosis (eburnation) due to trabecular thickening in areas of mechanical stress
- subchondral cysts (geodes) caused by subchondral fluid intruding into subchondral bone; pressure
- intra-articular loose bodies (joint mice)-cartilage fragmentation and subchondral bone flaking or synovial metaplasia with debris
- articular deformity: remodelling articular surfaces-joint subluxation-instability
- vacuum phenomenon-spinal DJD, nitrogen gasin nuclear and annular fissures, radiolucent line
what are 3 major categories of arthridities and give examples of each
- hypertrophic (degenerative) e.g. OA, charcot joints (vascular, neurological deficiency)
- erosive (inflammatory)-PARRS
- infectious e.g. septisemia, septic arthritis
differentiate OA from RA in the hands based on location
OA-more common at DIPS and PIPS
RA-mosre common at MCP and PIPS
where in the body does 80% of RA cases end up affecting?
what are rheumatoid nodules made of?
cervical spine *hence, DO NOT manipulate RA patients
accumulation of inflammatory cells with central focus of necrotic tissue, and outer fibrous layer (necrotic tissue, histocytes, plasma cells, lymphocytes)
what is the most common population to suffer from DISH?
males over 40yo
20-50% have associated Diabetes
affects thoracolumbar first, then cervical and lumbar
*non-inflammatory
what are 4 radiographic diagnostic criteria for DISH?
how can you describe ‘flowing calcification/ossification’?
- flowing calcification/ossification of anterior portions of at least 4 continuous segments
- preservation of IVD height, lack of disc degeneration
- no ankylosing of facets
- no degeneration of SIJs
dripped candle wax, flame shaped osteophytes, flowing hyperostosis, undulating contour ossifications
what are the 6 D’s describing the radiographic findings of degenerative neurotrophic arthropathy?
- Density of subchondral sclerosis
- Destruction of bone
- Debris within joint
- Dislocation due to chronic and severe instability
- Disorganisation of all joint elements
- Distension of joint
what is the most affected population for AS?
what areas are most affected?
what term is used to describe the articular erosions at the SIJ in the early stage?
list up to 8 radiological findings in AS
males aged 15-35
sacroiliac region initially and TL junction
rosary beads (rosary bead destruction)
syndesmopytes, Rommanus lesion, barrel-shaped vertebrae, shiny corner sign, bamboo spine, schmorl’s nodes, ballooning appearance of disc, trolley-track appearance, protrusion acetabuli in hip
fluffy periostitis, ray pattern in hand, mouse ears, pencil in cup deformity, ivory phalanx, and marginal and non-marginal syndesmophytes are all radiological findings of which arthridity?
Psoriatic arthritis
what is the definitive triad of Reactive arthritis?
Reactice arthritis is more common in which gender?
- urethritis
- conjunctivitis
- polyarthritis
M 50: F 1
Systemic Lupus Erythmatosus is more common in which gender?
What classically presents on the skin?
females
classic butterfly rash over face seen in minority of patients
up to 90% have associated arthritis
autoimmune connective disorder
describe gout
uric acid deposition forming crystals, which can occur at any emphyseal site
hyperuricaemia
recurrent episodes
metabolic arthritis
tophus-chalky deposits of urate in joints and periarticular tissues
Male dominance 20:1
overhanging margin sign
CPPD stands for?
list some characteristics/findings
calcium pyrophosphate deposition disease may have gout-like symptoms structural articular changes cartilage loss of fibrillation subchondral trabecular thickening geodes loose bodies osteophytes fragmentation, articular cortical collapse *chondrocalcinosis
what is a schmorl’s node?
what causes the formation of a schmorl’s node?
A schmorl's node is formed by intrusion of the nucleus pulposus into the vertebral body above or below it. A schmorl's node is formed usually by: -repetitive trauma (most common cause) -congenital -weak bone
