Arthritis Flashcards
1
Q
most common arthritide
A
osteoarthritis of DJD
2
Q
etiology of DJD
A
caused by trauma– either overt or as an accumulation of microtrauma over years
3
Q
hereditary form of DJD occurs primarily at what population
A
middle-aged women
4
Q
hallmarks of DJD
A
joint space narrowing, sclerosis, osteophytosis
5
Q
the only disorder that will cause osteophytosis without sclerosis or joint space narrowing is
A
diffuse idiopathic skeletal hyperostosis
6
Q
DISH is a common bone-forming disorder that at first glance resembles DJD, except that there is no ____ and no _____
A
no joint space narrowing and there is no sclerosis
7
Q
DJD are common in what 4 body parts
A
hands, knees, hips and spine
8
Q
primary DJD are commonly seen in what 4 body part
A
hands, DIP, PIP and base of thumb in bilaterally symmetrical fashion
9
Q
type of osteoarthritis that can be very painful and debilitating is
A
erosive osteoarthritis/Kellgren arthritis
10
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 4 body parts
A
TNJ, acromioclavicular joint, SI joints and symphysis pubis
11
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
12
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
13
Q
4 radiographic hallmarks of RA
A
soft tissue swelling, osteoporosis, joint space narrowing, marginal erosion
14
Q
characteristic of erosion in RA
A
marginal; away from weight bearing portion of joint
15
Q
In the hip, femoral head tends to migrate ____ in RA
A
axially
16
Q
femoral heads tend to migrate _____ in OA
A
superolaterlally
17
Q
in RA, humeral head tends to appear
A
high-riding
18
Q
high-riding humeral head can be seen in (3)
A
RA, torn rotator cuff and CPPD
19
Q
these disorders are linked to HLA-B27 histocompatibility antigen (4)
A
- ankylosing spondylitis,
- IBD,
- psoriatic arthritis,
- reactive arthritis (also called Reiter syndrome)
20
Q
these group of arthritides are characterized by bony ankylosis, proliferative new bone formation, predominantly axial (spinal) involvement
A
HLA-B27 spondyloarthropathies
21
Q
syndesmophytes can be seen in
A
HLA-B27 spondyloarthropathies
22
Q
a paravertebral ossification that resembles an osteophyte, except it runs vertically
A
syndesmophytes
23
Q
orientation of osteophyte
A
horizontal
24
Q
bamboo spine is classic finding in (2)
A
ankylosing spondylitis and IBD
25
characteristic of syndesmophyte in ankylosing spondylitis
marginal and symmetrical
26
characteristic of syndesmophyte in IBD
nonmarginal, asymmetrical, large and bulky
27
characteristic of syndesmophyte in psoriatic arthritis and reactive arthritis
unilateral, asymmetrical
28
ankylosing spondylitis and IBD tyically cause unilateral or bilateral SI joint disease?
bilateral
29
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
RA, hips
30
cause a distinctive arthropathy that is characterized by its distal predominance, proliferative erosions, soft tissue swelling and periostitis
psoriasis
31
1. proliferative erosions are different from the clean-cut, sharply marginated erosions, seen in all arthritides in that they have
1. fuzzy margins with wisps of periostitis emanating from them
32
1. reactive arthritis occurs almost exclusively in men or women?
1. men
33
commonly affected body part in reactive arthritis
interphalangeal joint of great toe
34
A. crystal-induce arthritides include (4)
B. The abnormal pigmentation, brown-black in color, may be observed in various connective
tissues in patients with alkaptonuria. It describes the bluish-black pigmentation of connective tissue that may be apparent at such sites as the skin, sclera, and ear in patients with alkaptonuria
C. associated with distinctive skeletal abnormalities, including osteopenia, bone fragmentation
and cyst formation, ossicles, poorly defined subchondral bone, and osteochondritis dissecans. These findings superficially resemble the changes in hemochromatosis and idiopathic CPPD crystal deposition disease.
A.
- gout and
- pseudogout,
- onchronosis and
- Wilson disease
B. Ochronosis
C. Wilson's disease
Wilson’s disease (hepatolenticular degeneration) is a rare autosomal recessive disorder characterized by degenerative changes in the brain, particularly the basal ganglia; cirrhosis of the liver; and diagnostic Kayser-Fleischer rings of greenish brown pigment at the limbus of the cornea. The primary abnormality in Wilson’s disease is not known. It is certain, however, that the clinical symptoms and signs of Wilson’s disease result from the relentless accumulation of copper in the body. The copper concentration is increased in the liver, brain, and other tissues; levels of serum copper and copper-binding protein
(ceruloplasmin) are generally decreased.
35
metabolic disorder that results in hyperuricemia and leads to monosodium urate crystals being deposited in various sites in the body, especially joints
Gout
36
4 hallmarks of gout
well-defined erosions (sclerotic margins, overhanging edge),
soft tissue nodules,
random distribution,
no osteoporosis
37
it takes how many years before gout becomes radiographically apparent
4 to 6 years
38
soft tissue nodules in gout calcify if there is accompanying what condition
renal failure
39
gout typically affects what body part
metatarsophalangeal joint of great toe
40
patients with gout often have
CPPD
41
triad of CPPD
- pain,
- cartilage calcification and
- joint destruction
CPPD = CPD
42
most common location of chondrocalcinosis in CPPD (3)
KTS
- knee,
- triangular fibrocartilage of wrist,
- symphysis pubis
43
DJD of CPPD has a proclivity for what body parts (5)
SPERM
- shoulder,
- elbow,
- radiocarpal joint in the wrist,
- patellofemoral joint of the knee,
- metacarpophalangeal joints in the hand
44
three diseases that have a high degree of association with CPPD
PGH
- primary hyperparathyroidism,
- gout,
- hemochromatosis
45
drooping osteophytes are often seen in (2)
CPPD and hemochromatosis
46
elbow is an unusual place for DJD to occur except in the setting of (2)
CPPD or trauma
47
hallmarks of SLE in the hand
marked soft tissue wasting as noted by the concavity in the hypothenar eminence, with ulnar deviation of phalanges
48
collagen vascular diseases causing arthritis include (4)
SS-DM
- scleroderma,
- SLE,
- dermatomyositis,
- mixed connective tissue disease
49
striking abnormality of the hands in collagen vascular diseases
osteoporosis and soft tissue wasting
50
erosions are generally not a feature of these disorders
collagen vascular diseases
51
soft tissue calcifications are typically present in what collagen vascular disease (2)
scleroderma and dermatomyositis
52
calcifications in scleroderma are typically
subcutaneous
53
calcifications in dermatomyositis are
intramuscular in location
54
mixed connective tissue disease is an overlap of (4)
- scleroderma,
- SLE,
- polymyositis,
- RA
55
disease that causes if deposition of granulomatous tissue in the body, primarily in the lungs, but also in bones
sarcoidosis
56
in skeletal sytem, sarcoidosis has a predilection for the
hands, where it causes lytic destructive lesions in the cortex (lace-like appearance)
57
disease of excess iron deposition in tissues throughout the body leading to fibrosis and eventual organ failure
hemachromotosis
58
in this condition, classic radiographic changes are essentially DJD, which involves second through the fourth MCP joints
hemochromatosis
59
squaring of metacarpal heads are seen in
hemochromatosis
60
classic triad of neuropathic or charcot joint
- joint destruction,
- dislocation and
- heterotopic new bone formation
61
progressive joint destruction occurs in a ____ because the joint is rendered unstable by inaccurate muscle action and is unprotected by intact nerve reflexes
neuropathic joint
62
has also been termed debris or detritus and consists of soft tissue calcification or clumps of ossification adjacent to the joint
heterotopic new bone
63
most commonly seen charcot joint today is
foot of a diabetic patient
64
in charcot joint of DM foot, it typically affects the
first and second tarsometatarsal joints in a fashion similar to a Lisfranc fracture-dislocation
65
classic findings of JRA and hemophilia are
overgrowth of the ends of the bones (epiphyseal enlargement) associated with gracile diaphyses
66
process that can mimic the findings in JRA and hemophilia is a
joint that has undergone disuse from paralysis
67
common denominator shared by JRA, hemophilia and paralysis is
disuse
68
relatively common disorder caused by a benign neoplasia of the synovium, resulting in deposition of nodules of cartilage in the joint
synovial chondromatosis
69
synovial chondromatosis is most commonly seen in the (3)
- knee,
- hip and
- elbow
70
loose bodies are tightly packed in a joint giving the appearance on MRI of a tumor. this has been termed
tumefactive synovial chondromatosis
71
true or false: no malignant tumors arise in joints
true
72
apple core appearance of bone due to pressure erosion of multiple nonossified chondral bodies. this condition is called
nonossified synovial chondromatosis
73
uncommon chronic inflammatory process of the synovium that causes synovial proliferation
pigmented villonodular synovitis
74
has been termed giant cell tumor of tendon sheath and tendon sheath xanthoma when it occurs in a tendon sheath
pigmented villonodular synovitis
75
pigmented villonodular synovitis are radiographically identical to
noncalcified synovial chondromatosis
76
characteristic appearance of pigmented villonodular synovitis in MRI
low-signal intensity hemosiderin seen lining the synovium on both T1 and T2
77
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
sudeck atrophy
78
radiographically seen in sudeck atrophy (2)
severe patchy osteoporosis and soft tissue swelling
79
sudeck atrophy typically affects
distal part of an extremity such as a hand or foot
80
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
elbow
81
the only fat pad around the hip that gets displaced with an effusion is the _____
obturator internus
82
the radiographic sign for a knee effusion that seems to be the most reliable is the
measurement of between the suprapatellar fat pad and anterior femoral fat pad (more than 10 mm is definite evidence of effusion)
83
normal measurement between the suprapatellar fat pad and anterior femoral fat pad
less than 5 mm
84
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
avascular necrosis or osteonecrosis
85
hallmark of AVN
increased bone density at an otherwise normal joint
86
earliest sign of VN is
joint effusion
87
next sign of AVN after joint effusion
patchy or mottled density
88
next sign of AVN after patchy or mottled density
subchondral lucency
89
final sign of AVN
collapse if articular surface and joint fragmentation; only on one side of the joint
90
focal area of AVN that is most likely due to trauma is called
osteochondritis dessicans
91
most sensitive imaging in detecting AVN
MRI
92
AVN of lunate is called
Kienbock malacia
93
type of ulnar variance that is said to have a high association with Kienbock malacia
negative ulnar variance
94
osteochondritis dessicans usually occur in what body part (2)
knee at the medial epicondyle,
| zone of talus
95
osteochondritis dessicans frequently leads to a small fragment of bone becoming a free fragment in the joint called a
joint mouse
96
it is the only condition in which a geode can occur in a normal joint
AVN
97
AVN of tarsal navicular
Kohler disease
98
AVN of metatarsal heads
Freiberg infarction
99
AVN of femoral head
Legg-Perthes disease
100
AVN of apophyseal ring epiphyses of the spine
Scheuermann disease
101
AVN of tibial tubercle
Osgood-Schlatter disease also termed surfer knees
