Bone Imaging Part 2 Flashcards
What part of the joints gets most of the impact during injury
The subchondral surface
A disease that affects a joint and usually the bones on either side of the joints
Arthritis
_________ is almost always accompanied by joint space narrowing
Arthritis
What are the 3 main categories of arthritis
Hypertrophic
Erosive
Infectious
What category of arthritis is characterized by bone formation either by subchondral sclerosis or the production of osteophytes?
Hypertrophic arthritis
What are types of hypertrophic arthritis
Osteoarthritis, erosive arthritis, Charcot arthropathy, calcium pyrophosphate deposition disease
What is the most common form of hypertrophic arthritis
Primary osteoarthritis
Osteoarthritis results from _______ _________ of articular cartilage
Intrinsic degeneration
What causes osteoarthritis and what body parts does this usually involve?
Caused by wear and tear
Involves the hips, knees and hands
Marginal osteophyte formation, subchondral sclerosis, subchondral cysts
Radiologic findings of primary OA
Secondary arthritis occurs because of _________, most commonly __________
Underlying, predisposing condition
Trauma
What separates primary from secondary OA?
Secondary occurs at atypical age, it has an atypical appearance (like unilateral), and it appears in an unusual location
___________ is characterized by more severe inflammation and evidence of _________ changes
Erosive OA
Erosive
Erosive OA occurs most often in what population
Post menopausal females
Erosive OA most often occurs at the _______________, ________________, and ________________
Proximal and distal interphalangeal joints, 1st carpal-metacarpal, and the interphalangeal joint of the thumb
Bony ankylosis may occur with __________ OA
Erosive
Marked inflammation and erosions of the affected joints, centrally located erosions, and gull-wing deformities are findings consistent with _________
Erosive OA
What is ankylosis
Abnormal stiffening and immobility of a joint due to fusion of the bones
___________ develops from a disturbance in sensation that leads to multiple micro fractures
Charcot arthropathy
Autonomic imbalance that leads to hyperemia, bone resorption, and fragmentation of bone. Soft tissue swelling is prominent.
Charcot arthropaty
What is the most common cause of Charcot arthropathy?
Diabetes
most ___________ is found in the lower extremities, especially feet and ankles
charcot arthropathy
What are the causes of Charcot arthropathy in the shoulders, hips, and ankles
shoulder- spinal tumor, syphilis
hips- tertiary syphilis, diabetes
ankles/feet- diabetes, syphilis
Extensive subchondral sclerosis, fragmentation of the bone surrounding the joint, fragments may be resorbed, and no longer visible, eventual destruction of the joint, shares findings with osteomyelitis. Both produce bone destruction and periosteal reaction.
radiographic hallmarks of Charcot arthropathy
how do you differentiate between osteomyelitis and Charcot arthropathy on imaging?
radioactive indium tagged white blood cell bone scan
with what disease is rocker bottom deformity commonly seen
Charcot arthropathy
results from the deposition if calcium phyrophosphate dihydrate crystals in and around joints
calcium phyrophosphate deposition disease
where does CPDD mostly occur?
hyaline cartilage and fibrocartilage; especially in the fibrocartilage of the wrist and menisci
what disease used to be known as pseudogout?
CPDD
how does CPDD differ from primary OA?
occurs in joints not often affected by OA
chondrocalcinosis is present
subchondral cysts are larger and more numerous
hook shaped bony outgrowths along the 2nd and 3rd metacarpal heads
uric acid crystals are characteristic of _______ while calcium pyrophosphate crystals are seen in _______
gout
pseudogout
what are rat bite erosions/ the martel sign
punched out erosions with sclerotic and overhanging margins
All erosive arthitis are associated with some degree of _________ and _____________
inflammation and synovial proliferation
what is pannus formation
abnormal layer of fibrovascular tissue or granulation tissue
what kind of arthritis produces lytic lesions in or near the joint
erosive arthritis
erosive arthritis is found especially where?
small joints of the hands and feet
___________ acts like a mass of growing synovial tissue which leads to marginal erosions
pannus
what are the causes of erosive arthritis
RA, gout, psoriatic arthritis, ankylosing spondylitis, reactive arthritis, sarcoid, hemophilia
is RA more common in males or females?
females
RA frequently involves the ___________ joints of the hands and wrists
proximal
T or F: RA is usually bilateral and symmetrical
true
what is the study of choice for RA
conventional radiographs
what are the early radiographic changes of RA
soft tissue swelling and osteoporosis
what joints in the hand does RA usually effect?
the erosions tend to involve the proximal joints
carpal-metacarpal
metacarpal-phalangeal
proximal interphalangeal joints
what are late findings of RA
ulnar deviation of the fingers at the MCP joints
subluxation of the MCP joints
ligamentous laxity leading to deformities of the fingers
swan neck and boutonniere deformities
how does RA typically affect the wrist?
erosions of the carpals, ulnar styloid and narrowing of the radiocarpal joint
what else can RA cause?
narrowing, sclerosis, and eventual fusion of the facet joints in the cervical spine
with a ____________ deformity, the PIP is flexed and the DIP is extended
boutonniere
with a ___________ deformity, the DIP is flexed and the PIP is extended
swan neck
what is most commonly affected by gout? why?
1st MTP
gravity takes the crystals to the most distal joint
what is rat bite joint associated with?
gout
gout has a __________ development and is usually a _________ diagnosis
chronic
clinical
what disease is diet related in 12% of cases, associated with sugar sweetened beverages, alcohol consumption and high purines?
gout
what health related issues are seen in 75% of cases of gout
abdominal obesity
hypertension
insulin resistance
abnormal lipid levels
sharply marginated, juxtaartixular erosion that tends to have a sclerotic border, joint space narrowing (late), tophi, olecranon butsitis
radiographic findings of gout
