Arthritis (midterm) Flashcards
1
Q
What is the foremost crippler in the US?
A
arthritis
2
Q
How common is arthritis?
A
1 in 7 people
3
Q
What is the most common arthritis?
A
osteoarthritis (OA/DJD)
4
Q
What is the only arthritis with the onset of 0-20 years old?
A
juvenile RA
5
Q
What does ABCs stand for when evaluating patients for arthritis?
A
A= alignment
B= bone
C= cartilage
s= soft tissue
6
Q
What is the anatomical term for transition zone between bone and ligament/tendon?
A
enthesis
7
Q
Inflammatory cellular infiltrate at the bone/ligament or bone/tendon junction. Seen in inflammatory arthritides, especially AS, as cortical erosion and periosititis
A
enthesopath
8
Q
loss of bone due to pressure atrophy or active breakdown of bone tissue
A
erosion
9
Q
single joint involved
A
monoarticular
10
Q
2-4 joints involved in disease process
A
pauciarticular
11
Q
> 4 joints involved
A
polyarticular
12
Q
comparing 1 side of the body with the other or 1 joint to another
A
symmetrical pattern of joint involvement
13
Q
Entire joint cavity is decreased due to complete loss of cartilage
A
uniform loss of joint space
14
Q
Uniform loss of joint space is a sign of?
A
inflammatory arthritis
15
Q
localized decrease in joint cavity due to isolated loss of cartilage, usually at site of most stress, is a sign of degenerative change
A
non uniform loss of joint space
16
Q
degenerative bony outgrowth continuous with underlying cortex, covered with a cartilaginous cap, occurring at the insertion of the capsular ligament
A
osteophyte
(tries to stabilize weakened area)
17
Q
inflammatory ossification within a spinal ligament
test q
A
syndesmophyte
18
Q
localized periosteal new bone, seen in inflammatory arthritides
A
periostitis
19
Q
What type of arthritis has these characteristics?
-soft tissue swelling
-edema
-uniform loss of joint space
-bone erosion
-juxta-articular osteoporosis
A
inflammatory arthritis
20
Q
What type of arthritis has these characteristics?
-non-uniform loss of joint space
-osteophytes
-subchondral sclerosis
-asymmetrical distribution
-intra-articular loose bodies (cartilage degeneration) and deformity
-subchondral cysts/geode
A
degenerative arthritis
21
Q
What is the other name for subchondral bone cyst found in degenerative arthritis?
A
geode
22
Q
focal regions of loss in bone density within subarticular bone, geographic lucency, stimulates a neoplasm such as a chondroblastoma
A
subchondral cyst
23
Q
gout is what type of arthritis?
A
metabolic
24
Q
What are the other names for degenerative joint disease (DJD)?
A
-osteoarthritis (OA)
-DDD
-discogenic spondylosis
25
Which arthritis has these sites of involvement?
-weight bearing articulation of the hips, spine, and knees
-1st MTP
-1st metacarpal trapezium and DIP
DJD
26
Which arthritis would have these radiographic features?
-asymmetrical distribution
-non-uniform loss of joint space
-osteophytes
-IVF encroachment in cervical spine
-bone spurs
-subchondral sclerosis and cysts/geode
-intra-articular loose bodies (aka joint mice, flaking/fragmentation of bone and cartilage)
-intra-articular deformity
-vacuum sign/Knuttson's sign
-gull sign
DJD
27
Where is DJD the most common spot?
knee
28
What arthritis has a vacuum sign/knuttson's sign?
DJD
29
What arthritis has gull sign?
DJD
30
What is this sign called?
-linear radiolucency in the disc space represents collection of nitrogen gas in nuclear and annular fissures
vacuum sign/ Knuttson's sign
31
What is this sign called?
-biconcave articular contour at distal and proximal interphalangeal joints (DIP and PIP)
gull sign
32
herberden's nodes=
DIP joints
33
bouchard's nodes=
PIP joints
34
haygarth's nodes=
MCP joints
35
define disc desiccation
disc drying up
36
What is this?
herberden's nodes with OA
37
What is this?
test q
bouchard's nodes with OA
38
What are the other names for diffuse idiopathic skeletal hyperostosis (DISH)?
-Forestier's disease
-spondylosis hyperostotica
-spondylitis ossifcans ligamentosa
-senile ankylosing hyperostosis
39
Which arthritis may have calcification of the ALL, dysphagia, and hoarse voice, AND/OR PLL calcification?
DISH
40
Which arthritis is associated with diabetes mellitus?
DISH
41
Which arthritis has a carrot stick fracture appearance?
DISH or AS
42
What is the most common site of involvement for DISH?
C5-C7
43
What arthritis would have these radiographic features?
-flowing ossification of at LEAST 4 contiguous segments
-normal disc height
-hyperostosis, usually anterior
-flame configuration
-PLL calcification
DISH
44
Which arthritis has the flame configuration?
DISH
45
What are the aka's for flame configuration of DISH?
-dripping candle wax
-flame shaped osteophytes
-flowing hyperostosis
-candle flame hyperostosis
46
Which arthritis would have hyperinsulinemia after glucose challenge tests and HLA-B8?
DISH
47
Which arthritis would have these clinical features?
-low grade fever
-fatigue
-weight loss
RA
48
Which arthritis would have ulnar deviation with cortical/marginal/rat bite erosions, boutonniere deformity, and swan neck deformity?
test q
RA
49
What is this deformity called?
-hyperextension of the DIP joint, while the PIP is flexed
test q
boutonniere deformity
50
What is this deformity called?
-hyperextension of the PIP joint, while the DIP joint is flexed
test q
swan neck deformity
51
Where is RA most common?
hands and feet
52
If RA is found in the cervical spine, then what can be seen with ADI and IVD spaces?
ADI spaces are increased, IVD spaces are decreased
53
Bilateral acetabular protusion = ________ until proven otherwise
RA
54
What is the other name for juvenile RA?
Still's disease
"juveniles don't stay still"
55
Which arthritis is this?
-develops before age 16
-lacks RA factor
-HLA-B27 is present especially with spinal involvement
juvenile RA
56
Which arthritis has the posterior motor unit fused from C2->C5?
juvenile RA
(if anterior motor unit is also fused then its congenital block not juvenile RA!)
57
What are the other names for ankylosing spondylitis (AS)?
-Marie Strumpell's disease
-von Bechterew disease
-spondylitis rhizomelie
58
Which arthritis is this?
-bilateral sciatica which progresses to thoracolumbar segments**
-HLA-B27
-marginal syndesmophyte formation on outer annulus fibers*
-shiny corner sign (erosions with surrounding sclerosis)
AS
59
bilateral sciatica= ________ until proven otherwise
AS
60
Which arthritis has shiny corner sign?
AS (usually in thoracolumbar region)
61
When multiple segments have marginal syndesmophyte =
bamboo spine/poker spine
62
Which arthritis has bamboo spine/poker spine?
AS
63
In the lumbar spine, facet fusion is called?
trolley track sign
64
Which arthritis has trolley track sign?
AS
65
Which arthritis has dagger sign?
AS
66
Which arthritis is this?
-usually targets DIP joints
-pencil in cup deformity
-if present at MCP, PIP, AND DIP= ray pattern
-mouse ears sign
-increased ADI space
psoriatic arthritis
67
Which arthritis has pencil in cup deformity?
psoriatic arthritis
68
Which arthritis has ray pattern?
psoriatic arthritis
69
Which arthritis has mouse ears sign?
psoriatic arthritis
70
What is this?
mouse ears sign= psoriatic arthritis
71
What is this?
pencil in cup deformity= psoriatic arthritis
72
What is this?
ray pattern= psoriatic arthritis
73
What is this?
-bilateral symmetrical SI joint disorder
-bilateral, dense, triangular shapes, iliac subchondral sclerosis involving the lower half of the joint margin
osteitis condensans ilii
74
What is this?
-joint surface erosion
-widened joint space
-moth eaten localized osteoporosis
-looks like infection
osteitis pubis
75
What are the 2 stages of osteitis pubis?
erosive and sclerotic stage
76
What is this?
-disorder of purine metabolism
-deposition of sodium monourate crystals in and around joints which cause inflammatory arthritis, mainly in lower extremities
gout
77
Which arthritis has tophi?
gout
78
Which arthritis is this?
-leukocytosis
-hyperuricemia
-marginal and periarticular erosions called overhanging margin sign
gout
79
Which arthritis has overhanging margin sign?
gout
80
podagra=
gout in foot
81
What are the other names for calcium pyrophosphate dihydrate crystal deposition disease (CPPD)?
-pseudogout*
-chondrocalcinosis
-pyrophosphate arthropathy
82
Which disease is characterized by gout like symptoms?
pseudogout/CPPD
83
What is this?
-in joints only, not surrounding tissue
-cartilage calcification (chondrocalcinosis)
-step ladder appearance/ Terry Thomas sign in wrist
pseudogout/CPPD
84
Where is the most common site of involvement for pseudogout/CPPD?
knee
85
What is this sign called?
-scaphoid moves proximally and the lunate moves distally in the wrist
step ladder appearance/Terry Thomas sign
86
What has step ladder appearance/Terry Thomas sign?
pseudogout/CPPD
87
What are the other names for hydroxyapatite deposition disease (HADD)?
-calcifying tendinitis
-peritendinitis calcarea
-periarthritis calcarea
-hydroxyapatite rheumatism
88
What is this?
-calcification within tendons, bursa, and other periarticular soft tissues
-nucleus pulposis and/or annulus fibrosus calcification
calcium deposits
-drooping shoulder sign
HADD
89
What tendon is the most common to calcify in the shoulder for HADD?
supraspinatus tendon
90
What tendon is the most common to calcify in the hip for HADD?
gluteus maximus tendon
91
What has drooping shoulder sign?
HADD
92
What is another name for neurotrophic arthropathy?
charcot joint
93
What is this?
-destructive articular disease which occurs secondary to a loss of impairment in joint proprioception
-involved joint undergoes premature and excessive traumatic degeneration
-leads to severe destruction and instability
-patient cannot feel the deformity occurring
neurotrophic arthropathy/ charcot joint
94
What are the 2 basic types of neurotrophic arthropathy/ charcot joint?
hypertrophic and atrophic
95
What is this?
hypertrophic neurotrophic arthropathy/ charcot joint
96
What is this?
atrophic neurotrophic arthropathy/ charcot joint
97
What is this?
-resorbed articular surface
-tapered "licked candy stick" appearance
-looks like infection
atrophic neurotrophic arthropathy/ charcot joint
98
What may cause acquired neurotrophic arthropathy/ charcot joint?
-alcoholism
-diabetes mellitus
-MS
-leprosy
-neurosyphilis
-syringomyelia
99
What is another name for ochronosis?
alkaptonuria
100
What is this?
-hereditary degenerative arthritis
-affects large joints and the spine
-abnormal tyrosine metabolism
ochronosis/alkaptonuria
101
Which arthritis has these radiographic features?
-premature DDD
-chondrocalcinosis
-ligament calcification
-total disc calcification
-calcification of interspinous ligament
-begins in lumbars and ascends
ochronosis/alkaptonuria
102
What is another name for sarcoidosis?
BOECK's sarcoid
103
What is this?
-formation of noncaseating granulomas
coarsened trabeculae with numerous areas of decreased density, lace like pattern of long bones of hands and feet
sarcoidosis
104
What are the other names for progressive systemic sclerosis (PSS)?
-scleroderma
-crest syndrome
-acrosclerosis
105
What has a high incidence of Raynaud's phenomenon?
progressive systemic sclerosis (PSS)/ scleroderma
106
What is CREST syndrome?
C=calcinosis
R= Raynaud's phenomenon
E= esophageal abnormality
S= sclerodactyly
T= telangectasia
107
What has these radiographic features?
-tapered fingers
-distal tuft resorption with possible cutis
progressive systemic sclerosis (PSS)/ scleroderma
108
What are the other names for synoviochondrometaplasia?
-synovial chondromatosis
-osteochondromatosis
-osteochondral loose bodies
-joint mice
109
What is this?
-benign arthropathy
-synovial tissue undergoes metaplastic transformation (forms cartilage. calcifies. ossifies. loose bodies)
-most common in knee
-each loose body in the joint is round, ovoid, and smooth****
midterm q
synoviochondrometaplasia
