Degenerative & Metabolic Disease Flashcards
Degenerative Joint Disease AKA
OA
Non inflammatory, most commonly involve weight bearing joints
OA
Usually stiffen with rest and improve with activity
OA
Complication of OA includes
Spinal stenosis
IVF encroachment
Most common site in spine affected by OA
C5/6
How OA impacts the spine
IVD narrowing
Osteophytes
Endplate sclerosis
Asymmetrical distribution, non uniform loss of space.
Decreased joint space with sclerosis
OA
Nodes associated with OA
Haberdens (DIP)
How hip is affected with OA
Decreased superolateral joint space with sclerosis
How knee is affected with OA
Decreased medial joint space with lateral space preserved
Diffuse Indiopathic Hyperostosis (DISH) AKA
Forrestier’s disease
Ankylosis Hyperostosis
DISH demographic and symptom
Males >40 YO
with neck stiffness or pain when swallowing
DISH is associated with what condition
Diabetes Melitus
DISH can cause calcification of….
PLL
Radiographic finding associated with DISH
flowing hyperostosis
Candle wax dripping
4 contiguous segments involved
(Anterior bulging)
Is disc space affected with DISH?
No it is preserved
Neurogenic arthropathy AKA
Charcot Joint
Secondary to impaired sensory function in joints. Seen with diabetes, tabes dorsalis, syphilis and syringomyelia
Neurogenic arthropathy
Neurogenic arthropathy: 6D’s most common in weight bearing joings
Distention Density of subchondral sclerosis Debris within joint Dislocation Disorganization Destruction of bone
Synoviochondrometaplasia MC affect…
Knee
Results in multiple loose bodies (popcorn) within the joint that are round or ovoid in shape
synovio-chondro-metaplasia
Metabolic arthritides (4 conditions)
- Gout
- Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD/ Pseudogout)
- Hydroxyappatite Deposition Disease (HADD)
- Septic Arthritis
Due to overproduction of uric acid
Gout
Gout demographic
Male >40
Extremely painful, red, hot swollen joint. TOPHI crystal may be seen.
Usually monoarticular with MC site MTP of big toe (podagra)
Gout
Pharmacology: acute colchicine, chronic allopurinol
gout
Gout Lab and special test
+ESR
Increased uric acid
Special test: Joint aspiration
What AA metabolism is affected with gout
Purine
Overhanging margin
Juxta-articular erosion
Gout
Juxtaarticular = near a joint
Thin linear calcification parallel to the articular cortex within the joint space
CPPD
CPPD when affecting cartilage is called….
Chondrocalcinosis
Chondrocalcinosis is MC affecting
Knee
HADD MC affect which joint
Shoulder
Round or oval calcification near the insertion of bursa or tendon
HADD
Patient presents with fever, chills, possible history of trauma or surgery and warm tender swollen joint
Septic arthrits
Lab for septic arthirtis
WBC count
Management (imaging) for CPPD
MRI to check soft tissue
