degenerative part 2 Flashcards
what is pigmented vilonodular synovitis?
slow growing, benign and locally invasive tumor/metaplasia of the synovium
what joint does PVNS most often affect?
knee
also hip, ankle, elbow
who should you consider PVNS for?
younger patients with unexplained hip pain
who are usually affected by PVNS?
young to middle aged adults
what are some radiographic features of PVNS?
intraarticular effusions, lobulated masses
bony erosions more common in “tight joints” such as hip, elbow, wrist
apple core deformity
may appear bubbly
what does a meniscal tear look like on MRI?
light/high signal if damaged
what does an ACL tear look like on an MRI?
loss of fiber continuity
hemorrhage
describe OA of the hip?
loss of joint space osteophyte formation subchondral sclerosis buttressing joint deformity
what compartment of the hip is usually involved in DJD?
superior compartment (80%)
buttressing definition
thickened cortex at the medial femoral neck as a result of biomechanical changes across the joint
cyst formation of the hip joint with OA is due to what?
intra-osseous synovial intrusion with necrosis
what does cyst formation of the hip joint with OA look like on radiograph?
subchondral location and usually with sclerotic borders
what is a subchondral cyst?
subarticular cysts which represent synovial intrusion through cartilage fissues
what are large cysts known as?
geodes
what are the 3 types of holes seen on radiography?
geographic
moth eaten
permative
which hole is the least aggressive?
geographic
describe geographic holes.
usually solitary
indicates slow growing lesions
short zone of tranzition
margin is well defined, can be smooth or lobulated
describe moth eaten holes.
moderate degree of agression
numerous small holes
larger zone of transition
not well defined margins
describe permative holes
most aggressive
numerous small holes (1mm)
poorly marginated
wide zone of transition
describe acetabular protrusion. what are it’s eponym’s? what line evaluates for it?
severe medial hip migration
remodeled acetabulum
also known as otto’s pelvis, protrusio acetabuli
evaulated with Kohler’s line
what arthridities can cause acetabular protrusion?
OA
RA
bone softening disease (paget’s)
what are the max normal measurements for men and women for acetabular protrusion?
men: 3mm
females: 6mm
when is acetabular protrusion a normal variant?
in females
which joint disease has the apple core deformity?
PVNS
what are neurotrophic arthropaties?
joint abnormalities secondary to impaired pain perception or proprioception and lack of nutrition from the CNS
what is the typical distribution of neurotrophic arthropaties?
monoarticular and depends on the underlying abnormality
what are the two types of neuropathic arthropaties based on imaging?
hypertrophic (bone forming)
atrophic (resorptive)
what are some clinical signs and symptoms of neurotrophic arthropathies?
painful, swollen joint, neurological disorder
and radiographic signs of destruction together
decreased pain sensation and proprioception
swollen unstable joint
weightbearing joints can get what kind of neuropathic arthropathy in general?
hypertrophic
non-weightbearing joints can get what kind of neuropathic arthropathy in general?
atrophic
what are common etiologies for neuropathic arthropaties?
congenital indifference to pain alcoholism diabetic syphilis syringomyelia trauma steroids leprosy
what are 6 Ds of radiographic signs of neuropathic arthropathies?
distended joints density increase debris dislocation disorganization destruction
knee and lumbar spine involvement with neuropathic arthropaties are usually due to what?
tabes dorsalis (syphilis infection)
diabetes can cause what joints to be involved in neuropathic arthropathies?
talonavicular and tarsometatarsal
what are etiologies for hypertrophic neurotrophic arthropathies?
disbetes
syphilis (charcot joints)
spinal cord trauma
what joints are typically involved in hypertrophic neurotrophic arthropathies?
feet, knees, spine
atrophic neurotrophic arthropathies present as what?
osteolytic process
surgical amputation appearance
when bone resorption is complete in atriphic neurotrophic arthropathies
licked candy stick appearance
tapered bone appearance leading to a sharp appearance in atrophic neurotrophic arthropthies
cutoff sign
associated with atrophic neurotrophic arthropathies
