DJD Flashcards
arthritis with greater predisposition for fusion
degenerative
arthritis usually in weight bearing joints
degenerative
non-inflammatory deterioration of articular surface and marginal bone formation
osteoarthritis
uniform loss of joint space
inflammatory
nonuniform loss of joint space
degenerative
well marginated bone lesions are indicative of which arthritis
metabolic
lumpy bumpy arthritis
metabolic
ABCD’S of joint disease
- alignment
- bone
- cartilage
- distribution
- soft tissue
common risk factors for DJD
- age
- females
- obesity
- trauma
- high impact activity
- inactivity or excessive activity
caused by abnormal articular forces upon a joint
loss of chondroitin sulfate
what does the loss of chondroitin sulfate affect
interferes with chondrocyte function
general radiological features of DJD
- asymmetric loss of joint space
- osteophytes
- subchondral sclerosis
- subchondral cysts
- subluxation
- intra-articular loose bodies
- enthesopathy
- ankylosis
what is the significance of degeneration in joint misalignment
- degeneration leads to joint laxity
- muscle tension and gravity may cause misalignment
- redistribution of forces lead to bone deformity
classic radiographical finding is a gullwing appearance in the DIP joints of the hand
erosive osteoarthritis
enlarged soft tissue nodes of DIPs
heberden’s nodes
enlarged soft tissue nodes of PIPs
bouchard’s nodes
enlarged soft tissue nodes of MCPs
haygarth’s nodes
target locations for DJD
- DIPs
- PIPs
- 1st metacarpal-carpal
if DJD is additive, then RA is
erosive
target locations for RA
MCP
appears unusually inflammatory, not to be confused with RA. middle aged females. affects DIPs and PIPs
erosive osteoarthritis
location of DJD in feet
MTP
known as hallux ridigus when present with symptoms of pain and stiffness
DJD in feet
metatarsal varus, hallux valgus joint misalignment is common
DJD in feet
joint of shoulder complex often involved in DJD
acromioclavicular joint
what further complications could AC joint osteophytes cause
they extend inferiorly and may impinge on rotator cuff tendons leading to tendon calcification and superior margination of humerus
what could osteophytes and misalignment in the glenohumeral joint indicate
- signigicant previous trauma
- CPPD (calcium pyrophosphate dihydrate disease)
CPPD
calcium pyrophosphate dihydrate disease (pseudogout)
causes of shoulder impingement syndrome
- elevation of humeral head
- degenerative enthesopathic changes of the humeral head
- AC osteophytes
- supraspinatus degeneration
what color is the cortex on an MRI
black
what color is the cortex on a CT
white
HADD
hydroxyapatite deposition disease
most common location for HADD
tendon of supraspinatus
deposition of calcium within tendons and bursa
HADD
other names for HADD
- calcifying tendinitis and bursitis
- peritendinitis calcarea
three compartments of knee that allow for accurate description of the radiograph
- medial tibiofemoral
- lateral tibiofemoral
- retropatellar
genu varus
loss of joint space in the medial compartment of the knee (DJD)
findings of DJD in knee
- asymmetrical loss of joint space (ex. genu varus)
- subchondral sclerosis
- subchondral cysts
- articular deformity and irregularity
- hypertrophic changes of the intercondylar spines
- enthesopathy of the anterior surface of the patella
calcification of the medial tibial collateral ligament (MCL)
pelligrini-steida calcification
HADD of MCL
pelligrini-steida calcification
what causes pelligrini-steida calcification
post-traumatic dystrophic changes
multiple intra-articular loos bodies (joint mice) from synovial tissue metaplasia that may ultimately ossify to become bisible radiographically
synovial osteochondrometaplasia
refers to fragments of cartilage, meniscus, or synovium within the joint
intra-articular fragments (joint mice)
joint mice can sometimes be confuse with what other disorder
HADD. but HADD is a uniform, homogenously dense finding
where is the groove for the popliteal tendon
lateral epicondyle of femur
PVNS
pigmented villonodular synovitis
slow growing, benign, and locally invasive tumor of the synovium most commonly found in the knee
PVNS
what pathology should be considered in younger patients with unexplained hip pain
PVNS
apple core deformity is a sign of
PVNS
radiographic findings of OA in the hip
- loss of joint space (MC in the superior compartment)
- osteophyte formation
- subchondral cysts (eggar’s cysts)
- sclerosis
- buttressing
- joint deformity
thickened cortex at the medial femoral neck as the result of biomechanical changes across the joint
buttressing
large cysts
geodes
list these three cysts from most benign to most malignant:
- moth eaten
- geographic
- permeative
- geographic (most benign)
- moth eaten
- permeative (most malignant)
if a cyst has a long transition zone it is most likely
malignant
if a cyst has a short transition zone it is most likely
benign
severe medial hip migration with remodeled acetabulum is known as
acetabular protrusion
acetabular protrusion is evaluated by who’s line
kohler’s line
eponym for acetabular protrusion
eponym is otto’s pelvis
joint abnormalities secondary to impaired pain perception or proprioception
neuropathic arthropathy (charcot’s joint)
neurotrophic changes to nonweightbearing joints
hypertrophy
neurotrophic changes to weightbearing joints
atrophy
most common etiology for neurotrophic arthropathy
diabetes (also syphilis and spinal cord trauma)
the six D’s associated with hypertrophic neurotrophic joints
- distended joints
- density increases
- debris
- dislocation
- disorganization
- destruction
knee and lumbar spine involvement of neurotrophic arthropathy is usually due to
tabes dorsalis
a complication of untreated syphilis that involves muscle weakness and abnormal sensations due to demyelingation of sensory nerves
tabes dorsalis
lisfranc joint
tarsometatarsal articulation
cutoff sign
atrophic neurotrophic arthritis leads to this degeneration of the humeral head
if someone has DISH what should they be screened for
diabetes and OPLL
OPLL
ossification of posterior longitudinal ligament
may want to refer back to the diagram written on page 132
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