Degenerative & Metabolic Disease

Question 1

Degenerative Joint Disease AKA

Answer 1

OA

Question 2

Non inflammatory, most commonly involve weight bearing joints

Answer 2

OA

Question 3

Usually stiffen with rest and improve with activity

Answer 3

OA

Question 4

Complication of OA includes

Answer 4

Spinal stenosis

IVF encroachment

Question 5

Most common site in spine affected by OA

Answer 5

C5/6

Question 6

How OA impacts the spine

Answer 6

IVD narrowing
Osteophytes
Endplate sclerosis

Question 7

Asymmetrical distribution, non uniform loss of space.

Decreased joint space with sclerosis

Answer 7

OA

Question 8

Nodes associated with OA

Answer 8

Haberdens (DIP)

Question 9

How hip is affected with OA

Answer 9

Decreased superolateral joint space with sclerosis

Question 10

How knee is affected with OA

Answer 10

Decreased medial joint space with lateral space preserved

Question 11

Diffuse Indiopathic Hyperostosis (DISH) AKA

Answer 11

Forrestier’s disease

Ankylosis Hyperostosis

Question 12

DISH demographic and symptom

Answer 12

Males >40 YO

with neck stiffness or pain when swallowing

Question 13

DISH is associated with what condition

Answer 13

Diabetes Melitus

Question 14

DISH can cause calcification of….

Answer 14

PLL

Question 15

Radiographic finding associated with DISH

Answer 15

flowing hyperostosis
Candle wax dripping
4 contiguous segments involved
(Anterior bulging)

Question 16

Is disc space affected with DISH?

Answer 16

No it is preserved

Question 17

Neurogenic arthropathy AKA

Answer 17

Charcot Joint

Question 18

Secondary to impaired sensory function in joints. Seen with diabetes, tabes dorsalis, syphilis and syringomyelia

Answer 18

Neurogenic arthropathy

Question 19

Neurogenic arthropathy: 6D’s most common in weight bearing joings

Answer 19

Distention
Density of subchondral sclerosis
Debris within joint
Dislocation
Disorganization
Destruction of bone

Question 20

Synoviochondrometaplasia MC affect…

Answer 20

Knee

Question 21

Results in multiple loose bodies (popcorn) within the joint that are round or ovoid in shape

Answer 21

synovio-chondro-metaplasia

Question 22

Metabolic arthritides (4 conditions)

Answer 22

1. Gout
2. Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD/ Pseudogout)
3. Hydroxyappatite Deposition Disease (HADD)
4. Septic Arthritis

Question 23

Due to overproduction of uric acid

Answer 23

Gout

Question 24

Gout demographic

Answer 24

Male >40

Question 25

Extremely painful, red, hot swollen joint. TOPHI crystal may be seen.
Usually monoarticular with MC site MTP of big toe (podagra)

Answer 25

Gout

Question 26

Pharmacology: acute colchicine, chronic allopurinol

Answer 26

gout

Question 27

Gout Lab and special test

Answer 27

+ESR
Increased uric acid

Special test: Joint aspiration

Question 28

What AA metabolism is affected with gout

Answer 28

Purine

Question 29

Overhanging margin

Juxta-articular erosion

Answer 29

Gout

Juxtaarticular = near a joint

Question 30

Thin linear calcification parallel to the articular cortex within the joint space

Answer 30

CPPD

Question 31

CPPD when affecting cartilage is called….

Answer 31

Chondrocalcinosis

Question 32

Chondrocalcinosis is MC affecting

Answer 32

Knee

Question 33

HADD MC affect which joint

Answer 33

Shoulder

Question 34

Round or oval calcification near the insertion of bursa or tendon

Answer 34

HADD

Question 35

Patient presents with fever, chills, possible history of trauma or surgery and warm tender swollen joint

Answer 35

Septic arthrits

Question 36

Lab for septic arthirtis

Answer 36

WBC count

Question 37

Management (imaging) for CPPD

Answer 37

MRI to check soft tissue