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MOD 2 Quiz 1 > Arthritis imaging > Flashcards

Arthritis imaging Flashcards

1
Q

Which study should you order first?

A

an xray/ plain radiograph ordered first

gives overview and xray corrlated to other non xray studies

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2
Q

Why order a CT scan?

A

if cortical bone is to be evaluated, for early or subtle change
good anatomy detail

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3
Q

Why order an MRI?

A

if soft tissue and marrow edema inducing pathology to be studied
highly sensitive

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4
Q

How do you choose MRI or CT?

A

second study based on pathology

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5
Q

Bone scan?

A

more multiple sites/screens

metastasis

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6
Q

Arthritis?

A

disease affecting joint space, bones and soft tissues on both sides of articulation

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7
Q

Classify, 4 types of arthritis?

A

Degenerative
Inflammatory
Septic/infection/osteomyelitis
Metabolic

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8
Q

Degenerative?

A

osteophytes, subchondral sclerosis, loss of joint space-usually uneven, cysts (geodes)

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9
Q

Inflammatory?

A

eroisions, juta-articualr osteoporosis, uniform loss of joint space, usually soft tissue swelling

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10
Q

Septic/infection/osteomyelitis?

A

rapid onset, usually monarticular, effusion, bone destruction/demineralization

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11
Q

Metabolic?

A

lumpy/bumpy soft tissue swelling, characteristic marginated bony erosion with overhanging edges

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12
Q

Osteoarthritis?

A

Disruption/ injury/ degeration of articular cartilage eventually exposing subchondral bone

diarthrodial weight bearing joints, 1 cmc and mtp joints and dip joints of hands, increased incidence with age

any arthritis can develop into this

aggregated by use, relieved by rest, morning stiffness

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13
Q

Osteoarthritis-DJD?

A

cyst formation, long standing

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14
Q

eburnation?

A

occurs at areas of cartilage loss

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15
Q

DJD of hand?

A

CMC joint

nodes

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16
Q

Rheumatoid Arthritis?

A

Autoimmune/ connective tissue disorder
bilaterally symmetric, soft tissue swelling
2nd and 3rd MCP, 4th and 5th MTP of feet

late- eroisions, marked joints, space narrowing, joint destruction, subchondral cyst, subluxation, fusion, acetabuli protusio (acetabulum into hip)

17
Q

Eburnation with RA?

A

no

18
Q

Other signs of RA?

A

atlantoaxial subluxation
eroision
osteopenia, joint space narrowing

19
Q

Septic arthritis?

A

infection most commonly spread hematogenously from synovium to joint

rapid course, early cortical destruction, pain/swelling, signs of infection (WBS) and monoarticular
high index of suspicion and joint aspiration

20
Q

Septic arthritis Xray findings?

A

joint effusion, periarticular osteoporosis, destruction of articular cartilage and cortex on both side of jt rapid onset

21
Q

Sign of septic arthritis?

A

severly irregular cortex- white line destruction

22
Q

Tuberculous arthritis?

A

insidious course, may take months to have same appearance as pyogenic takes days/weeks

synovitis with pannus leads to chrondronecrosis
phemister triad-gradual, slow joint space narrowing, marginal eroisions, juxtaartricular osteoporosis
condused with atypical monoarticular RA

23
Q

Sequestration?

A

space with bone in it

24
Q

Acute osteomyelitis?

A

new born formation, abscess, effusion, soft tissue swell, rule out tumor

25
Q

Diabetic osteomyelitis?

A

less bony density, osteopenia, irregular

vascular calcification–diabetes
significant soft tissue swell

26
Q

Three phase bone scan?

A

hot- tumors, infections, cellulitis with bone

cellulitis- wont see increased activity

27
Q

Crystal induced arthropathy?

A

CPPD and Gout
crystal deposition in cartilage and soft tissues, inflammation
CPPF: Chondrocalcinosis with arthritis resembling OA, subchondral cysts

28
Q

Joints involved Crystal induced arthropathy?

A

knee, wrist, and hip involvement common

more common in males

29
Q

Chondrocalcinosis?

A

seen with gout and crystal deposit
well outlined disc
calcification in joint

30
Q

Classic gout?

A

1st MTP classic, erosion with overhanging edge, joint space maintained

31
Q

Advantages of plain xray?

A

quick, not expensive, relatively low radiation

32
Q

Disadvantage of plain xrays?

A

not 3D, can miss pathology, may still require other imaging studies

33
Q

CT scanning?

A

excellant anatomic detail
will detect almost all pathology related to cortical bone injury
great for showing displacement or joint involvement

34
Q

Advantages of MRI?

A

no radiation
we can slice through the body using any imaging plane
MRI is very good for looking at the soft tissues
MRI is very sensitive in detecting water

35
Q

Bone scan?

A

Tc99m labeled MDP
injected into a vein
tracer accumulates in osteblasts
increased osteoblasts in fracture, tumor and infection

MOD 2 Quiz 1 (9 decks)

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