Arthritides Flashcards
If there are symmetric erosions and soft tissue swelling affecting 1 joint, what arthritis is this?
Infection
If there are proximal,symmetric erosions and soft tissue swelling in more than one joint, with no bony proliferation. What type of arthritis is this?
RA
If there are distal, symmetric erosions and soft tissue swelling, with bony proliferations. What form of arthritis is this most likely?
AS
If the narrowing is asymmetric with osteophytes and sclerosis. What form of arthritis is?
Degenerative (typical OA)
If the narrowing is asymmetric with osteophytes and sclerosis with uneven distribution. What type of arthritis is this?
Atypical OA
What form of arthritis has the generalized age of onset from 0-20?
JRA
What form of arthritis has the generalized age of onset from 20-40?
Seronegatives, seropositive (inflammatory)
What form of arthritis has the generalized age of onset > 40?
Degenerative, DISH, Gout, CPPD
Degenerative arthritis most commonly affects what 3 weight bearing articulations?
Spine, hips, and knees
What are the symptoms of Degenerative arthritis?
Progressive, insidious onset of:
- -aching, swelling, stiffness
- -goes away with activity
What joints are affected with DJD of the hand?
DIPs and PIPs
Where are Heberden’s nodes located?
DIPs
Where are Bouchard’s nodes located?
PIPs
Where is DJD located in the wrist?
1st MCP joint
Where is OA located in the foot?
1st MTP joint
When does OA of the foot become hallux rigidus?
When symptoms present w/ pain and stiffness
What are 2 radiographic indicators of OA of the foot?
Increase in intermetatarsal angle
Enthesopathic changes
DJD of the shoulder is most common in what joint?
AC joint
If there is DJD in the glenohumeral joint, what should you suspect?
Suspicion of significant previous trauma or CPPD
What are 4 RAD indicators of shoulder DJD?
- -Loss of joint space
- -Sclerosis
- -Osteophytes
- -Small cysts
What would be 2 RAD indicators of Rotator Cuff Arthropathy?
- -High riding humerus
- -Decreased joint space in superior aspect of glenohumeral joint
HADD most commonly involves what 2 joints?
Shoulder and hip
HADD most commonly affects what tendon?
Supraspinatus tendon
Which does HADD most commonly affect?
–Tendons or Bursa
Tendons
What compartment is most commonly affect in DJD of the knee?
Medial tibiofemoral
What is the characteristic RAD finding of knee DJD?
Asymmetric loss of joint space
Pelegrini-Steida Calcification often affects what joint?
Medial tibial collateral ligament
What are multiple calcified and/or ossified loose bodies w/ well-defined borders.
SOM
What is a slow growing benign, and locally invasive tumor/metaplasia of the synovium?
PVNS
What deformity is associated w/ PVNS?
“Apple core” deformity at femoral neck
What are the 4 more common locations of PVNS?
Knee, hip, ankle, elbow
If you suspect a patient has OA of hip, what are 5 indicators?
- -Loss of joint space in superior compartment
- -Osteophytes
- -Subchondral cysts
- -Sclerosis
- -Buttressing of medial femoral neck
What is the MC pathology associated w/ neurotrophic arthropathy?
Diabetes
What are 6 visual indicators of neuropathic arthropathy?
- -Distended joints
- -Density increase
- -Debris
- -Dislocation
- -Disorganization
- -Destruction
What arthritic pathology would indicate a complete bone resorption of the ends of affected bone?
Atrophic neurotrophic
What is the radiographic indicator of an atrophic neurotrophic?
Licked candy cane appearance
What are the impacted locations of the following degenerative diseases of the spine?
- -DJD
- -DDD
- -Facet arthrosis
- -Uncinate arthrosis
- -DJD = synovial articulation
- -DDD = IVD
- -Facet arthrosis = facets
- -Uncinate arthrosis = uncinates
What are the 4 radiographic indicators of DDD?
- -Decreased disc height
- -Osteophyte formation
- -Endplate sclerosis
- -Vacuum
What are the 2 categories of DDD?
–Spondylosis Deformans = outer annular fibers
–Intervertebral chondrosis = inner annular fibers
Which category of DDD, produces large osteophytes w/ minimal loss of disc height?
Spondylosis deformans
What DDD category, has a loss of disc height w/ severe endplate sclerosis?
Intervertebral chondrosis
What is the radiolucent collection of nitrogen gas w/in annular fissures?
Knutson’s vacuum phenomenon
An intercalary ossicle is a result of what?
Annulus degeneration
This pathology has at least 3 contiguous vertebra w/ wedging of 5* or more, disc space narrowing, and endplate irregularity.
Scheuermann’s
What are 3 indicators of cervical spine degeneration?
Height loss, osteophytes, sclerosis
What is the most reliable sign of Cervical Spine Degeneration?
DDD, height loss
If you suspect Cervical stenosis, what would the canal measurement be?
< 12 mm
Where is Uncinate arthrosis most commonly found?
Lower segments C5/C6
What does uncinate arthrosis present as on lateral view?
Pseudofracture appearance
How does Thoracic OA most commonly present?
Mostly anterior and right sided osteophytes w/ disc narrowing
How does Lumbar OA generally present?
Non-uniform loss of joint space
What populations are at risk for degenerative Spondyloslisthesis?
- -4th Lumbar
- -over 40
- -female
What condition is characterized by ligamentous ossification/hyperostosis of the ALL?
DISH
What populations are at risk for DISH?
Males over 50
DISH produces what 2 radiographic appearances?
- -Flowing ossification along anterolateral aspect of multiple vertebral bodies
- -Disc height preservation
DISH involves what aspect of the cervicals and lumbars?
- -Lower cervicals
- -Upper lumbars
OPLL is most common in what area of the spine?
Cervical spine
OPLL is most common w/ what population?
Japanese males
What symptoms present w/ OPLL?
Myelopathy
What is the most common complaint of patients w/ disc herniations?
Back pain
What is the most serious complication of IVD herniation?
Claudia equine syndrome
What will be the symptomatology of the following cervical spine herniations?
- -Midline herniation
- -Lateral herniation
Midline = myelopathies
Lateral = nerve root below
What will be the symptomatology of the following Lumbar spine herniations?
- -Midline herniation
- -Foraminal herniation
Midline = nerve root below
Foraminal = nerve root at same level
What are the 4 types of disc herniations?
–Bulge
–Protrusion
–Extrusion
–Sequestration
How would you describe a bulge herniation?
Annular fibers beyond edges of disc space
How would you describe a protrusion herniation?
Incomplete disruption of annulus
How would you describe a extrusion herniation?
Herniations; focal lesion with complete disruption of annulus
How would you describe a sequestration herniation?
Disc tissue that has been displaced from disc space of origin
What are the spinal canal measurements if stenosis is suspected in the cervicals or lumbars?
Cervicals < 12 mm
Lumbars < 15 mm
A High Intensity Zone is an area of high signal intensity on ___-weighted MRI of the disc.
T2-weighted
A High Intensity Zone usually reflects fissures/tears of what structure?
Annulus