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Musculoskeletal Radiology > Arthritis > Flashcards

Arthritis Flashcards

1
Q

most common arthritide

A

osteoarthritis of DJD

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2
Q

etiology of DJD

A

caused by trauma– either overt or as an accumulation of microtrauma over years

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3
Q

hereditary form of DJD occurs primarily at what population

A

middle-aged women

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4
Q

hallmarks of DJD

A

joint space narrowing, sclerosis, osteophytosis

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5
Q

the only disorder that will cause osteophytosis without sclerosis or joint space narrowing is

A

diffuse idiopathic skeletal hyperostosis

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6
Q

DJD are common in what body parts

A

hands, knees, hips and spine

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7
Q

primary DJD are commonly seen in what body part

A

hands, DIP, PIP and base of thumb in bilaterally symmetrical fashion

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8
Q

type of osteoarthritis that can be very painful and debilitating is

A

erosive osteoarthritis/Kellgren arthritis

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9
Q

there are few exceptions to the classic triad of findings seen in DJD. Several joints may also exhibit erosions, that can be seen in these body parts

A

TNJ, acromioclavicular joint, SI joints and symphysis pubis

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10
Q

cystic formations that occur around joints in various disorders, including, in addition to DJD, RA, calcium pyrophosphate dihydrate crystal deposition disease and AVN

A

geode

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11
Q

one method of geode formation

A

synovial fluid is forced into the subchondral bone, causing a cystic collection of joint fluid; could also cyst from contused bone

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12
Q

radiographic hallmarks of RA

A

soft tissue swelling, osteoporosis, joint space narrowing, marginal sclerosis

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13
Q

characteristic of erosion in RA

A

marginal; away from weight bearing portion of joint

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14
Q

In the hip, femoral head tends to migrate ____ in RA

A

axially

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15
Q

femoral heads tend to migrate _____ in OA

A

superolaterlally

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16
Q

in RA, humeral head tends to appear

A

high-riding

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17
Q

high-riding humeral head can be seen in

A

RA, torn rotator cuff and CPPD

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18
Q

these disorders are linked to HLA-B27 histocompatibility antigen

A

ankylosing spondylitis, IBD, psoriatic arthritis, reactive arthritis (also called Reiter syndrome)

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19
Q

these group of arthritides are characterized by bony ankylosis, proliferative new bone formation, predominantly axial (spinal) involvement

A

HLA-B27 spondyloarthropathies

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20
Q

syndesmophytes can be seen in

A

HLA-B27 spondyloarthropathies

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21
Q

a paravertebral ossification that resembles an osteophyte, except it runs vertically

A

syndesmophytes

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22
Q

orientation of osteophyte

A

horizontal

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23
Q

bamboo spine is classic finding in

A

ankylosing spondylitis and IBD

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24
Q

characteristic of syndesmophyte in ankylosing spondylitis

A

marginal and symmetrical

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25
Q

characteristic of syndesmophyte in IBD

A

nonmarginal, asymmetrical, large and bulky

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26
Q

characteristic of syndesmophyte in psoriatic arthritis and reactive arthritis

A

unilateral, asymmetrical

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27
Q

ankylosing spondylitis and IBD tyically cause unilateral or bilateral SI joint disease?

A

bilateral

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28
Q

large joint involvement with HLA-B27 spondyloarthropathies is uncommon, but when it occurs, the arthropathy will resemble _____ and what body part is involved 50% of the time

A

RA, hips

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29
Q

cause a distinctive arthropathy that is characterized by its distal predominance, proliferative erosions, soft tissue swelling and periostitis

A

psoriasis

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30
Q

proliferative erosions are different from the clean-cut, sharply marginated erosions, seen in all arthritides in that they have

A

fuzzy margins with wisps of periostitis emanating from them

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31
Q

reactive arthritis occurs almost exclusively in men or women?

A

men

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32
Q

commonly affected body part in reactive arthritis

A

interphalangeal joint of great toe

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33
Q

crystal-induce arthritides includ

A

gout and pseudogout, onchronosis and Wilson disease

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34
Q

metabolic disorder that results in hyperuricemia and leads to monosodium urate crystals being deposited in various sites in the body, especially joints

A

Gout

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35
Q

hallmarks of gout

A

well-defined erosions (sclerotic margins, overhanging edge), soft tissue nodules, random distribution, no osteoporosis

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36
Q

it takes how many years before gout becomes radiographically apparent

A

4 to 6 years

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37
Q

soft tissue nodules in gout calcify if there is accompanying what condition

A

renal failure

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38
Q

gout typically affects what body part

A

metatarsophalangeal joint of great toe

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39
Q

patients with gout often have

A

CPPD

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40
Q

triad of CPPD

A

pain, cartilage calcification and joint destruction

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41
Q

most common location of chondrocalcinosis in CPPD

A

knee, triangular fibrocartilage of wrist, symphysis pubis

42
Q

DJD of CPPD has a proclivity for what body parts

A

shoulder, elbow, radiocarpal joint in the wrist, patellofemoral joint of the knee, metacarpophalangeal joints in the hand

43
Q

three diseases that have a high degree of association with CPPD

A

primary hyperparathyroidism, gout, hemochromatosis

44
Q

drooping osteophytes are often seen in

A

CPPD and hemochromatosis

45
Q

elbow is an unusual place for DJD to occur except in the setting of

A

CPPD or trauma

46
Q

hallmarks of SLE in the hand

A

marked soft tissue wasting as noted by the concavity in the hypothenar eminence, with ulnar deviation of phalanges

47
Q

collagen vascular diseases causing arthritis include

A

scleroderma, SLE, dermatomyositis, mixed connective tissue disease

48
Q

striking abnormality of the hands in collagen vascular diseases

A

osteoporosis and soft tissue wasting

49
Q

erosions are generally not a feature of these disorders

A

collagen vascular diseases

50
Q

soft tissue calcifications are typically present in what collagen vascular disease

A

scleroderma and dermatomyositis

51
Q

calcifications in scleroderma are typically

A

subcutaneous

52
Q

calcifications in dermatomyositis are

A

intramuscular in location

53
Q

mixed connective tissue disease is an overlap of

A

scleroderma, SLE, polymyositis, RA

54
Q

disease that causes if deposition of granulomatous tissue in the body, primarily in the lungs, but also in bones

A

sarcoidosis

55
Q

in skeletal sytem, sarcoidosis has a predilection for the

A

hands, where it causes lytic destructive lesions in the cortex (lace-like appearance)

56
Q

disease of excess iron deposition in tissues throughout the body leading to fibrosis and eventual organ failure

A

hemachromotosis

57
Q

in this condition, classic radiographic changes are essentially DJD, which involves second through the fourth MCP joints

A

hemochromatosis

58
Q

squaring of metacarpal heads are seen in

A

hemochromatosis

59
Q

classic triad of neuropathic or charcot joint

A

joint destruction, dislocation and heterotopic new bone formation

60
Q

progressive joint destruction occurs in a ____ because the joint is rendered unstable by inaccurate muscle action and is unprotected by intact nerve reflexes

A

neuropathic joint

61
Q

has also been termed debris or detritus and consists of soft tissue calcification or clumps of ossification adjacent to the joint

A

heterotopic new bone

62
Q

most commonly seen charcot joint today is

A

foot of a diabetic patient

63
Q

in charcot joint of DM foot, it typically affects the

A

first and second tarsometatarsal joints in a fashion similar to a Lisfranc fracture-dislocation

64
Q

classic findings of JRA and hemophilia are

A

overgrowth of the ends of the bones (epiphyseal enlargement) associated with gracile diaphyses

65
Q

process that can mimic the findings in JRA and hemophilia is a

A

joint that has undergone disuse from paralysis

66
Q

common denominator shared by JRA, hemophilia and paralysis is

A

disuse

67
Q

relatively common disorder caused by a benign neoplasia of the synovium, resulting in deposition of nodules of cartilage in the joint

A

synovial chondromatosis

68
Q

synovial chondromatosis is most commonly seen in the

A

knee, hip and elbow

69
Q

loose bodies are tightly packed in a joint giving the appearance on MRI of a tumor. this has been termed

A

tumefactive synovial chondromatosis

70
Q

true or false: no malignant tumors arise in joints

A

true

71
Q

apple core appearance of bone due to pressure erosion of multiple nonossified chondral bodies. this condition is called

A

nonossified synovial chondromatosis

72
Q

uncommon chronic inflammatory process of the synovium that causes synovial proliferation

A

pigmented villonodular synovitis

73
Q

has been termed giant cell tumor of tendon sheath and tendon sheath xanthoma when it occurs in a tendon sheath

A

pigmented villonodular synovitis

74
Q

pigmented villonodular synovitis are radiographically identical to

A

noncalcified synovial chondromatosis

75
Q

characteristic appearance of pigmented villonodular synovitis in MRI

A

low-signal intensity hemosiderin seen lining the synovium on both T1 and T2

76
Q

also known as shoulder-hand syndrome, reflex sympathetic dystrophy and chronic regional pain syndrome. it is a poorly understood joint affliction that typically occurs after minor trauma to an extremity, resulting in pain, swelling and dysfunction

A

sudeck atrophy

77
Q

radiographically seen in sudeck atrophy

A

severe patchy osteoporosis and soft tissue swelling

78
Q

sudeck atrophy typically affects

A

distal part of an extremity such as a hand or foot

79
Q

most joint effusion are clinically obvious and do not require radiographic validation. _____ is an exception,, if effusion is found in that body part, a fracture is present

A

elbow

80
Q

the only fat pad around the hip that gets displaced with an effusion is the _____

A

obturator internus

81
Q

the radiographic sign for a knee effusion that seems to be the most reliable is the

A

measurement of between the suprapatellar fat pad and anterior femoral fat pad (more than 10 mm is definite evidence of effusion)

82
Q

normal measurement between the suprapatellar fat pad and anterior femoral fat pad

A

less than 5 mm

83
Q

can occur around almost any joint for a host of reasons including steroids, trauma, various underlying disease states and even idiopathic. often seen in renal transplant patients

A

avascular necrosis or osteonecrosis

84
Q

hallmark of AVN

A

increased bone density at an otherwise normal joint

85
Q

earliest sign of VN is

A

joint effusion

86
Q

next sign of AVN after joint effusion

A

patchy or mottled density

87
Q

next sign of AVN after patchy or mottled density

A

subchondral lucency

88
Q

final sign of AVN

A

collapse if articular surface and joint fragmentation; only on one side of the joint

89
Q

focal area of AVN that is most likely due to trauma is called

A

osteochondritis dessicans

90
Q

most sensitive imaging in detecting AVN

A

MRI

91
Q

AVN of lunate is called

A

Kienbock malacia

92
Q

type of ulnar variance that is said to have a high association with Kienbock malacia

A

negative ulnar variance

93
Q

osteochondritis dessicans usually occur in what body part

A

knee at the medial epicondyle, zone of talus

94
Q

osteochondritis dessicans frequently leads to a small fragment of bone becoming a free fragment in the joint called a

A

joint mouse

95
Q

it is the only condition in which a geode can occur in a normal joint

A

AVN

96
Q

AVN of tarsal navicular

A

Kohler disease

97
Q

AVN of metatarsal heads

A

Freiberg infarction

98
Q

AVN of femoral head

A

Legg-Perthes disease

99
Q

AVN of apophyseal ring epiphyses of the spine

A

Scheuermann disease

100
Q

AVN of tibial tubercle

A

Osgood-Schlatter disease also termed surfer knees

Musculoskeletal Radiology (12 decks)

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