Arthritis

Question 1

Categories of Arthritis

Answer 1

inflammatory 
degenerative
depositional/metabolic 
infectious 
neuropathic

Question 2

Diffuse joint space narrowing
Marginal or central erosions
Absent or minimal subchondral sclerosis
Lack of osteophytes

Answer 2

Inflammatory Arthritis (RA)

Question 3

Juxtaarticular osteoporosis
Periarticular soft tissue swelling
Soft tissue nodules
Articular deformities

Answer 3

Inflammatory Arthritis (RA)

Question 4

Localized joint space narrowing (non-uniform)
Subchondral sclerosis
Osteophyte formation
Cyst or pseudocyst formation
Weight bearing side of the joint usually involved

Answer 4

Degenerative Arthritis (Osteoarthritis)

Question 5

Marginal periarticular erosions
Overhanging edge
Lack of osteoporosis

Answer 5

Metabolic Arthritis (Gout)

Question 6

Lobulated, asymmetric soft tissue mass
Spotty carpals
Relative preservation of articular spacing

Answer 6

Metabolic Arthritis (Gout)

Question 7

Destruction of joint space
Joint effusion
Soft tissue swelling
Osteoporosis

Answer 7

Infectious Arthritis

Question 8

hands:

DIPs and thumb affected

Answer 8

OA

Question 9

hands:

MCPs, PIPs, and thumb affected

Answer 9

RA

Question 10

hands:

proximal thumb and MCPs affected

Answer 10

CPPD

Question 11

knee:

medial joint line and patella

Answer 11

OA

Question 12

knee:

entire joint line and patella

Answer 12

RA

Question 13

knee:

patella

Answer 13

CPPD

Question 14

hip:

superior or inferior joint line

Answer 14

OA

Question 15

hip:

entire joint line (2)

Answer 15

RA and CPPD

Question 16

Asymmetric, non-uniform loss of joint space, osteophytes, subchondral sclerosis, subchondral cysts, loose bodies and subluxation

Answer 16

Degenerative Joint Dz

Question 17

Spondylophytes, loss of disc height, facet hypertrophy, uncinate hypertrophy, IVF encroachment, spondylolisthesis

Answer 17

cervical DJD

Question 18

Spondylophytes

Answer 18

thoracic DJD

Question 19

Spondylophytes, loss of disc height, facet hypertrophy, vacuum sign, spondylolisthesis

Answer 19

lumbar DJD

Question 20

Occurs as a complication of loss of joint space, loss of disc height and remodeling of the facet surfaces to a more sagittal orientation

Answer 20

Degenerative spondylolisthesis

Question 21

m/c at DIPs and PIPs of hands

Sclerosis, osteophytes, periostitis, ankylosis, non-uniform joint space narrowing

Answer 21

Erosive Osteoarthritis

Question 22

Central joint erosions on proximal articular surface and peripheral joint erosions at distal articular surface = “gull wing” sign

Answer 22

Erosive Osteoarthritis

Question 23

Flowing anterior ossification of ALL
Disc height relatively preserved
50% have OPLL
m/c in cervical spine
Stenosis (must order CT)

Answer 23

Diffuse Idiopathic Skeletal Hyperostosis (DISH)

Question 24

Neurotrophic Arthropathy:
Associated with diabetes
Six Ds: joint distention, increased subchondral density, debris, dislocation, disorganization, and bone destruction
Weight-bearing joints

Answer 24

Hypertrophic

Question 25

Neurotrophic Arthropathy: Syringohydromyelia Simulates a sharp amputation of the articular end of the bone: resorption and tapered ends

Answer 25

Atrophic

Question 26

Destruction of the joint with gross disorganization Osseous debris Joint instability, dislocation Joint distention (effusion) Lack of osteoporosis (usually) Can have a “surgical amputation” appearance in the atrophic form (licked candy stick)

Answer 26

Neuropathic Arthropathy

Question 27

charcot's joint is a condition of

Answer 27

Neuropathic Arthropathy

Question 28

Synovial membrane detaches and calcifies/ossifies Multiple round/ovoid, smooth faceted, laminated loose bodies within the joint capsule Associated extrinsic bone erosion or DJD m/c joints: knee, hip, ankle, elbow, wrist

Answer 28

Synoviochondrometaplasia

Question 29

These “bare areas” refer to portions of the bone within the synovial space that are not protected by articular cartilage

Answer 29

Rheumatoid Arthritis (RA)

Question 30

Ulnar deviation of the MCP joints | Swan-neck deformity of the fingers

Answer 30

Rheumatoid Deformities

Question 31

``` Inflammatory Arthritis: ________ arthropathies Ankylosing Spondylitis IBD Arthropathy (Enteropathic) Reiter’s (Reactive) Arthritis Psoriatic Arthritis ```

Answer 31

Seronegative arthropathies

Question 32

``` Absence of osteoporosis Presence of bony proliferation Periostitis Intra-articular bony ankylosis HLA-B27 positive ```

Answer 32

Seronegative arthropathies

Question 33

Fusiform soft tissue swelling (sausage digits) Pencil in cup deformity Fluffy periostitis with erosions at the interphalangeal joints can resemble “mouse ears” Pitting of the nails Bony ankylosis Erosions of the spinous processes in the cervical spine (penciling)

Answer 33

Psoriatic Arthritis

Question 34

Calcaneal enthesopathy Parasyndesmophytes (non-marginal) Unilateral or Bilateral asymmetrical sacroiliitis Lower extremity involvement Fluffy periostitis Ray distribution of involvement (hands/feet)

Answer 34

Reiter's Syndrome (Reactive Arthritis)

Question 35

``` Bony ankylosis of SI joints & facets Marginal bridging syndesmophytes Bilateral SI joint involvement Favors “root joints” Disuse osteoporosis ```

Answer 35

Ankylosing Spondylitis

Question 36

Crystal deposition into the synovial fluid, linings and articular cartilage Soft tissue calcification, chondrocalcinosis Common in knees, wrists, symphysis pubis, elbows and hips DJD

Answer 36

Calcium Pyrophosphate Dihydrate Crystal Deposition Disease

Question 37

``` Calcification within a tendon, bursa or other periarticular soft tissue Self limiting - rotator cuff, bursa - glut max - longus colli ```

Answer 37

Hydroxyapatite Deposition Disease