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Fundamentals of Imaging > Degenerative Joint Disease of Extra-spinal & Spinal Origin > Flashcards

Degenerative Joint Disease of Extra-spinal & Spinal Origin Flashcards

1
Q

Is it Primary or Secondary DJD when it is age-related, generalized?

A

Primary

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2
Q

Is it Primary or Secondary DJD when it is post-traumatic or a result of other joint afflictions?

A

Secondary

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3
Q

What is the most common articular disorder that involves the entire joint complex?

A

Osteoarthritis

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4
Q

What are the typical joints involved in osteoarthritis?

A 
-Knees
• Hips
• Cervical and Lumbosacral spine
• Distal interphalangeal (DIP)
• 1st CMC joint of the thumb & trapezium-scaphoid-trapezoid complex.
• 1st TMT joint of big toe (hallux)
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5
Q

What is known as abnormal proliferation of marginal bone?

A

Osteophytes

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6
Q

What are the general radiographic features of Osteoarthritis (L.O.S.S.)?

A
  • L-loss of joint space (non-uniform or asymmetric)
  • O-osteophytes
  • S-subchondral sclerosis
  • S-subchondral cysts
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7
Q

What is known as a change in exposed subchondral bone in degenerative joint disease in which it is converted into a dense substance with a smooth surface like ivory?

A

Eburnation

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8
Q

What is the most common site of extra-spinal Osteoarthritis?

A

Knee

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9
Q

What is the most common deformity of the knee?

A

Genu Varum

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10
Q

What are the 3 compartments of the knee?

A

Medial femorotibial compartment
Lateral femorotibial compartment
Patellofemoral compartment

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11
Q

Which of the 3 compartments are most affected of OA?

A

Medial femorotibial compartment

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12
Q

In regards to the femorotibial compartment, what is typically found on the medial aspect of the tibia in patients with OA?

A

subchondral sclerosis

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13
Q

Where are osteophytes found in the femorotibial compartment?

A

femoral and tibial margin

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14
Q

T/F: PF OA is almost always presented with femorotibial OA.

A

True

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15
Q

What is known as broken-off osteophytes?

A

Osteocartilagenous loose bodies

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16
Q

What condition is Osteocartilaginous loose bodies indicative of besides OA?

A

Chondromatosis

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17
Q

What is the clinical manifestation of OA of the hip?

A

Hip pain in the groin with occasional knee referral

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18
Q

What are the 3 main patterns of femoral head migration?

A

Superior
Medial
Axial

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19
Q

What is the most common femoral head migration?

A

Superior

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20
Q

Where are osteophytes typically found on OA of the hip?

A

Superior and lateral acetabular rim

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21
Q

What is a characteristic feature of hip OA and can become large in which is referred to as geoid’s or Eggar’s cyst?

A

Subchondral cysts

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22
Q

What are the 2 types of prosthesis for treatment of OA of the Hip?

A

Cemented

Non-cemented

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23
Q

Which prosthesis may provide faster pain relief but may show a higher rate of failure?

A

Cemented

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24
Q

Which prosthesis may be longer lasting and gained more application with younger patients due to bone ingrowth and longer lasting fixation?

A

Non-cemented (biological)

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25
Q

What is the most common site for Foot OA?

What is the 2nd most common site?

A

Most common: 1st MTP articulation of the big toe

2nd most common: 1st TMT joint

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26
Q

What is the clinical manifestation of Foot OA?

A

Pain on walking and loss of big toe extension (Hallux rigidus)

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27
Q

T/F: Hallux Valgus and bunion formation are often observed with Foot OA

A

True

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28
Q

Is ankle OA common or uncommon?

A

Uncommon

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29
Q

Is ankle OA a primary or secondary condition?

A

Secondary

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30
Q

What is an abnormal connection that develops between two bones in the back of the foot?

A

Tarsal coalition

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31
Q

What is the most common site for Primary Shoulder OA?

A

Acromioclavicular Joint

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32
Q

Is the Glenohumoral Joint a common or uncommon site for Primary Shoulder OA?

A

Uncommon

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33
Q

If there is no trauma, what pathologies should you consider with Shoulder OA?

A

CPPD
acromegaly
ochronosis

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34
Q

What muscle tendon would inferior osteophytes of the Acromioclavicular joint compromise?

A

Supraspinatus tendon

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35
Q

If the Supraspinatus tendon tears, what kind of migration would happen to the humeral head?

A

Superior migration

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36
Q

Is Elbow OA usually a primary or secondary OA?

When secondary, what disease should you consider?

A

Secondary

CPPD

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37
Q

What X-Ray findings would you typically see with elbow OA?

A

L.O.S.S.

osteocartilaginous loose bodies

38
Q

What is a disorder involving the attachment of a tendon or ligament to a bone and involves the olecranon in OA?

A

enthesitis

39
Q

Is Wrist OA usually primary or secondary OA?

A

Secondary

40
Q

Does the radial or ulnar side dominate with wrist OA?

A

Radial side

41
Q

What is the most common site for Wrist OA?

A

Trapezium-1st Metacarpal joint

42
Q

What disease is often found with OA of the Scaphoid-Trapezium-Trapezoid Joint (STT)?

A

CPPD

43
Q

T/F: Radiocarpal or other joints of the wrist are rarely affected w/o past trauma or pathology?

A

True

44
Q

What disease of the lunate may lead to Wrist OA?

A

Keinbock disease

45
Q

What is the clinical manifestation of wrist OA?

A

pain, swelling and sometimes significant loss of thumb function

46
Q

What radiographic view is best for X-ray of Wrist OA?

A

P-A medial oblique

47
Q

What do scaphoid fractures followed by the ischemic bone necrosis (AVN) lead to?

A

Scaphoid non-union advanced collapse wrist (SNAC wrist)

48
Q

Is OA of the hand common or uncommon?

A

Very Common

49
Q

What are the 3 most common sites for Hand OA?

Which site is usually painful?

A

DIP, PIP, 1st CMC

Painful site: 1st CMC

50
Q

What is it called when there is OA of the DIP?

A

Heberden’s nodes

51
Q

What is it called when there is OA of the PIP?

A

Bouchard’s nodes

52
Q

If the MCP joint is affected, what complications should you suspect?

A

CPPD

Hemochromatosis

53
Q

What is a subtype of OA where localized inflammatory erosive changes tend to predominate?

A

erosive OA

54
Q

What joints are typically involved with erosive OA?

A

DIP, PIP, 1st CMC

55
Q

Who is typically affected with erosive OA?

A

Middle-aged female (12:1)

56
Q

In regards to erosive OA, what are the radiographic features of the DIP?

A

central erosions, marginal osteophytes, subchondral sclerosis, gull-wing appearance

57
Q

What is the most significant radiographic feature of DIP erosive OA?

A

Gull-Wing appearance

58
Q

Where on the DIP joint are the central erosions most commonly at?

A

Proximal side of joint

59
Q

Where is Spinal OA most common?

A

Cervical and Lumbosacral regions (most mobile areas)

60
Q

What disease is the onset of Spinal OA?

A

Degenerative Disc Disease (DDD)

61
Q

What is considered TRUE Spinal OA?

A

DJD of facet joints

62
Q

What spinal levels is Von-Lushka joint degeneration typically seen?

A

C3-C7

63
Q

What are the most common areas affected by spondylosis?

A

C5-C7; L4-S1

64
Q

What disease is known as disc degeneration that begins with the loss of proteoglycan composition of the intervertebral disc?

A

DDD

65
Q

What may an anterior herniation cause?

A

Limbus bone formation

66
Q

What does a central herniation cause?

A

Schmorl’s nodes

67
Q

What is an important feature of DDD (collection of gas within the disk space)?

A

Intradiscal Vacuum Phenomenon

68
Q

What is the hallmark for spinal degenerative changes?

A

anterior-lateral spondylophyte

69
Q

What is called when there is bulging of the annulus that creates traction on Sharpey’s fibers?

A

Spondylosis deformans

70
Q

What will facet degeneration result in?

A

degenerative spondylolisthesis

71
Q

Are uncovertebral joints of Von Lushka present at birth or develop later in life?

A

develop later in life

72
Q

T/F: SI arthrosis often co-exists with lumbar DDD/DJD.

A

True

73
Q

What is the disease called when there is degenerative rubbing of spinous processes in the lumbar spine and also known as “Kissing spines?”

A

Baastrup disease

74
Q

What is the disease called when there is abnormal flowing proliferation/ossification of anterior spinal ligaments and occasional peripheral sites? Also known as Forestier Disease

A

DISH (Diffuse Idiopathic Skeletal Hyperostosis)

75
Q

What condition is DISH often associated with?

A

Type 2 DM

76
Q

Are most patients of DISH symptomatic or asymptomatic?

A

asymptomatic

77
Q

What radiographic findings will you see with DISH?

A

ossification of ALL
lateral degeneration of annulus fibrosis
periosteal new bone formation

78
Q

Where is DISH most commonly seen?

A

thoracic (T7-T11) & cervical spine

79
Q

How many spinal segments must be involved in order for it to be diagnosed as DISH?

A

4

80
Q

What are 2 complication of DISH?

A

“Chalk Stick” spinal fracture

Dysphagia

81
Q

T/F: OPLL is less common than DISH but more clinically significant

A

True

82
Q

Where is the most common site for OPLL?

A

C4-C7

83
Q

What is the radiographic feature of OPLL?

A

linear hyperdensity posterior to vertebral bodies

84
Q

What is known as a severe destructive arthropathy that develops in patients with neurological or some systemic conditions that result in the disturbance of the sensory, motor & autonomic components innervating the regions about the bone and joint?

A

Neuropathic osteoarthopathy (NOA)

85
Q

What is another name for Neuropathic osteoarthopathy?

A

Charcot Joint

86
Q

What are the most common diseases of the Charcot Joint?

A

DM (most common)
Tabes Dorsalis
Syringomyelia

87
Q

If a chariot Joint is left untreated, What complication can it lead to?

A

Rocker-Bottom Foot

88
Q

What are the 5 Ds of the Charcot Joint?

A 
Density
Debris
Disorganization
Dislocation
Distention
89
Q

What part of the body is Charcot Joint most commonly seen?

A

Foot and ankle

90
Q

Where on the foot is the most common site that for a Charcot Joint?

A

mid tarsal and TMT joint

91
Q

What condition does the patient typically have when they have a Shoulder Charcot Joint?

A

syringomyelia

Fundamentals of Imaging (16 decks)

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