DI 2 Final - Arthritides

Question 1

Which condition has non-uniform joint space narrowing, osteophytes, subchondral sclerosis, subchondral cysts?

Answer 1

Degenerative Joint Dz

Question 2

What condition has triangular sclerosis at iliac portion of lower SI joint?

Answer 2

Ostelitis condensans IIii

Question 3

Is osteitis condensans iIIi more common in males or females?

Answer 3

Women (childbearing)

Question 4

Is osteitis condensans iIIi unilateral/bilateral?

Answer 4

BL (symmetric sclerosis)

Question 5

What medical procedure is osteitis pubis associated with?

Answer 5

Surgery near pubic symphysis (lower urinary tract, suprapubic/retropubic prostatectomies)

Question 6

What is the differnence btwn marginal & non-marginal syndesmophytes?

Answer 6

Syndes: osseous excrescence attached to ligament
Non-marg: not coming from corners (bulky, discontinous)
Marg: ossification of outer annulus fibrosis, thick vertical radiodense areas, adj. vertebrae connected (delicate, symm)

Question 7

Which spinal arthritides have marginal vs. non-marginal syndespmophytes?

Answer 7

Marginal: Ankylosing spondylitis

Non-Marginal: psoriatric arthritis, Reiters, DISH, DDD

Question 8

What systemic condition is commonly found in pts w/diffuse idiopathic skeletal hyperostosis (DISH)?

Answer 8

DM, HLD, Hyperuricemia

Question 9

What does a cervical spine w/DISH look like?

Answer 9

Large anterior bridging osteophytes from C2-T1
Calcification band on post. aspect of verte. bodies
Disc space narrowing, C5-6, C6-7 (C3-4?)
No facet joint fusion/narrowing

Question 10

Dysphagia is common in what arthritis condition and why?

Answer 10

DISH

D/t spinal involvement specifically osteophytes anteriorly pushing on esophagus

Question 11

List the radiographic findings of Neuropathic Arthropathy?

Answer 11

6 Ds
Distended (joint), Density (INC of subchondral bone), Debris, Dislocation, Disorganization (joint), Destruction (articular cortex)

Question 12

Which conditions may result in neuropathic arthropathy?

Answer 12

DM, Alcoholism, Tabes dorsalis, Paralysis, Syringomyelia

d/t loss of sensation and proprioception

Question 13

What is synoviochondrometaplasia?

Answer 13

Benign. Metaplasia of hyperplastic synovium to hyaline cartilage (calcifies, ossifies, detaches)
KNEE
Radiodense loose bodies
Joint locking, crepitus, effusion, reduced ROM, DJD

Question 14

Name common sites of involvement for RA in hands and wrist?

Answer 14

Hand: MCP, PIP, Boutonniere, Swan neck, Ulnar deviation

Wrist: ulnar styloid erosion, radiocarpal jt loss, Triquetrum-Pisiform erosion, Scapholunate dissociation

Question 15

What is marginal erosion?

Answer 15

Irregular, no sclerotic margin (MC head sides, radial side), bare area, d/t gout, RA, AS

Question 16

Significant of widening the atlanto-dental interspace?

Answer 16

Directly compress brainstem, neurologic damage d/t excessive kyphosis

• -C1/C2 instability, neuro damage
• -Odontoid/Dens erosions

Question 17

Which conditions demonstrate laxity of the transverse ligament?

Answer 17

SLE, Downs, RA?, Marfans

Inflammatory

Question 18

Is SI involvement common in RA?

Answer 18

NO!!!!

Question 19

Describe radiographic difference btwn RA & Psoriatic Arthritis? (Hand/wrist)

Answer 19

RA: 
MCPs, PIPs
Lanois, swan neck, boutonniere
Ulnar deviation
BL, Symmetrical

Psoriatic: no hyperemia
DIP, PIP
Ray pattern (all jts of single digit)
ST swelling
Fluffy periositis
Pencil in cup
Asymmetrical

Question 20

What is the gender incidence of vertebral column & pelvis in AS?

Answer 20

Males!! 9:1

Onset 20-60 (40-50)

Question 21

What’s the first site of involvement of vertebral column/pelvis in AS?

Answer 21

SI JOINT

Question 22

What’s the 2nd site of involvement of vertebral column/pelvis in SI?

Answer 22

THORACOLUMBAR JXN

Question 23

Is SI involvement Unilateral/Bilateral in AS?

Answer 23

BL & Symmetrical

Question 24

Gender incidence of RA?

Answer 24

Female 3:1, until 40 then 1:1

Question 25

Condition demonstrates squaring of vertebral body?

Answer 25

AS

Question 26

What’s shiny corner Sx?

Answer 26

INC radiodensity of corners of vertebral body, osteitis

Reactive slcerosis in AS

Question 27

What’s carrot stick fx?

Answer 27

Fx of ankylosed segment in AS (paralysis) - entire diameter of spine

Question 28

Which condition demonstrates similar SI jt & vertebral column findings to AS?

Answer 28

Enteropathic arthropathy

UC, Crohns, Whipples, Salmonelle, Shigella, Yersinia

Question 29

Which 2 seronegative spondyloarthropathies demonstrate non-marginal syndesmophytes & peripheral arthritis?

Answer 29

Psoriatic & Reiters

Question 30

Reversible deformities in the hand are in what condition?

Answer 30

SLE

Question 31

What’s acro-osteolysis & what condition?

Answer 31

Resorption of extremities (distal phalanx)
Psoriatic arthritis (PINCH FO)
Scleroderma,DM, Hyperparathyroidism

Question 32

What’s the overhanging margin sign & which condition is this seen in?

Answer 32

GOUT!!!!

Sclerotic margin outside jt capsule

Question 33

Structures primarily involved in CPPD (calcium pyrophosphate dehydrate crystal deposition dz)?

Answer 33

Knee, wrist, pubic symphysis (fibrous/hyaline cartilage)

Question 34

What structures are primarily involved in HADD (hydroxyapatite deposition dz)?

Answer 34

Shoulder, Hip - calcification near tendon insertion