DI 2 Final - Arthritides Flashcards
Which condition has non-uniform joint space narrowing, osteophytes, subchondral sclerosis, subchondral cysts?
Degenerative Joint Dz
What condition has triangular sclerosis at iliac portion of lower SI joint?
Ostelitis condensans IIii
Is osteitis condensans iIIi more common in males or females?
Women (childbearing)
Is osteitis condensans iIIi unilateral/bilateral?
BL (symmetric sclerosis)
What medical procedure is osteitis pubis associated with?
Surgery near pubic symphysis (lower urinary tract, suprapubic/retropubic prostatectomies)
What is the differnence btwn marginal & non-marginal syndesmophytes?
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)
Which spinal arthritides have marginal vs. non-marginal syndespmophytes?
Marginal: Ankylosing spondylitis
Non-Marginal: psoriatric arthritis, Reiters, DISH, DDD
What systemic condition is commonly found in pts w/diffuse idiopathic skeletal hyperostosis (DISH)?
DM, HLD, Hyperuricemia
What does a cervical spine w/DISH look like?
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
Dysphagia is common in what arthritis condition and why?
DISH
D/t spinal involvement specifically osteophytes anteriorly pushing on esophagus
List the radiographic findings of Neuropathic Arthropathy?
6 Ds
Distended (joint), Density (INC of subchondral bone), Debris, Dislocation, Disorganization (joint), Destruction (articular cortex)
Which conditions may result in neuropathic arthropathy?
DM, Alcoholism, Tabes dorsalis, Paralysis, Syringomyelia
d/t loss of sensation and proprioception
What is synoviochondrometaplasia?
Benign. Metaplasia of hyperplastic synovium to hyaline cartilage (calcifies, ossifies, detaches)
KNEE
Radiodense loose bodies
Joint locking, crepitus, effusion, reduced ROM, DJD
Name common sites of involvement for RA in hands and wrist?
Hand: MCP, PIP, Boutonniere, Swan neck, Ulnar deviation
Wrist: ulnar styloid erosion, radiocarpal jt loss, Triquetrum-Pisiform erosion, Scapholunate dissociation
What is marginal erosion?
Irregular, no sclerotic margin (MC head sides, radial side), bare area, d/t gout, RA, AS
Significant of widening the atlanto-dental interspace?
Directly compress brainstem, neurologic damage d/t excessive kyphosis
- -C1/C2 instability, neuro damage
- -Odontoid/Dens erosions
Which conditions demonstrate laxity of the transverse ligament?
SLE, Downs, RA?, Marfans
Inflammatory
Is SI involvement common in RA?
NO!!!!
Describe radiographic difference btwn RA & Psoriatic Arthritis? (Hand/wrist)
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
What is the gender incidence of vertebral column & pelvis in AS?
Males!! 9:1
Onset 20-60 (40-50)
What’s the first site of involvement of vertebral column/pelvis in AS?
SI JOINT
What’s the 2nd site of involvement of vertebral column/pelvis in SI?
THORACOLUMBAR JXN
Is SI involvement Unilateral/Bilateral in AS?
BL & Symmetrical
Gender incidence of RA?
Female 3:1, until 40 then 1:1
Condition demonstrates squaring of vertebral body?
AS
What’s shiny corner Sx?
INC radiodensity of corners of vertebral body, osteitis
Reactive slcerosis in AS
What’s carrot stick fx?
Fx of ankylosed segment in AS (paralysis) - entire diameter of spine
Which condition demonstrates similar SI jt & vertebral column findings to AS?
Enteropathic arthropathy
UC, Crohns, Whipples, Salmonelle, Shigella, Yersinia
Which 2 seronegative spondyloarthropathies demonstrate non-marginal syndesmophytes & peripheral arthritis?
Psoriatic & Reiters
Reversible deformities in the hand are in what condition?
SLE
What’s acro-osteolysis & what condition?
Resorption of extremities (distal phalanx)
Psoriatic arthritis (PINCH FO)
Scleroderma,DM, Hyperparathyroidism
What’s the overhanging margin sign & which condition is this seen in?
GOUT!!!!
Sclerotic margin outside jt capsule
Structures primarily involved in CPPD (calcium pyrophosphate dehydrate crystal deposition dz)?
Knee, wrist, pubic symphysis (fibrous/hyaline cartilage)
What structures are primarily involved in HADD (hydroxyapatite deposition dz)?
Shoulder, Hip - calcification near tendon insertion
