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Diagnostic imaging > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

How many different arthritic conditions are there and how big of a deal is it anyway?

A

Over 100 arthritic conditions

More than 14 billion

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2
Q

infectious/septic arthritis incidence is most common below what age?

A

30

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3
Q

infectious/septic arthritis most common type

A

monoarticular

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4
Q

how does infectious/septic arthritis develop

A

from blood bourne pathogens and direct implantation

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5
Q

What is the most common organism for infectious/septic arthritis?

A

Staphylococcus aureus

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6
Q

What kind of findings lag behind the other associated with infectious/septic arthritis?

a. radiographic findings
b. clinical findings

A

a

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7
Q

What are the ABCs fo joint disease?

A 
Alignment 
Bone 
Cartilage
Distribution
Soft Tissue
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8
Q

What are the three altered substances that affect the loss of joint space?

A

Fissures, flaking, vascularization

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9
Q

What type of osteoarthritis results in a “gull wing” appearance of DIP joint?

A

Erosive Osteoarthritis

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10
Q

Erosive osteoarthritis is most common in what age population?

A

middle age females

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11
Q

How many compartments make us the knee

A

3

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12
Q

What compartment of the knee is most commonly involved in DJD?

A

medial

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13
Q

thickened cortex at the medial femoral neck as the result of biomechanical changes across the joint.

A

Buttressing

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14
Q

what do subarticular cysts represent?

A

synovial intrusion through cartilage cracks and fissures, large cysts are termed geodes

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15
Q

What are the 6 D’s associated with hypertrophic neurotrophic joints

A 
distended joints
density increase
debris
dislocation
disorganization
destruction
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16
Q

What are the typical radiographic findings associated with DDD?

A 
Decreased disc height
osteophyte formation
endplate sclerosis
vacuum phenomenon
subluxation
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17
Q

What are the categories of disc degeneration as described by Resnick and Niwayama?

A 
Spondylosis deformans (outer disc) (marked by osteophtes)
Intervertebral chondrosis (inner disc) marked by reduced IVD space
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18
Q

What are some findings of intervertebral disc osteochondrosis?

A
  1. primary degeneration of nucleus pulposis
  2. loss of disc height
  3. Knutson’s vacuum phenomenon
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19
Q

A radiolucent collections of nitroen gas within annular fissures is known as what

A

Knutson’s vacuum phenomena

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20
Q

Where is a knutson phenomenon normall seen

A

anterior margin of the IVD on extension films

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21
Q

What does a Knutson’s phenomena normall indicate?

A

DDD

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22
Q

What are findings associated with spondylosis deformans?

A

Degeneration fo the annulus

prominent osteophytosis

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23
Q

Comes from stressed anterior longitudinal ligaments that com from separated intervertebral disc tissue

A

osteophytes

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24
Q

Where do osteophytes develop in the vertebra

A

Where the vertebral body and cartilaginous rim unite

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25
Q

Which direction does osteophytes develop first?

A

extend in the horizaontal direction and then in the vertical direction

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26
Q

What does the presence of intercalary ossicle mean?

A

annulus degeneration

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27
Q

Exaggerated endplate sclerosis associate with DDD is known as?

A

Hemispherical spondylosclerosis

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28
Q

What are the Modic end plate MRI changes associated with on a Modic Type I model?

A

Dark T1 and Bright T2 = inflammation

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29
Q

What are the Modic end plate MRI changes associated with on a Modic Type II model?:

A

Bright T1 and T2 = Fat

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30
Q

What are the Modic end plate MRI changes associated with on a Modic Type III model?

A

Dark T1 and T2 = sclerosis

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31
Q

Schmorl’s nodes, endplate irregularity, and decreased anterior vertebral body height are all part of what diagnosis?

A

scheuermann’s disease aka Juvenile Discogenic disease

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32
Q

What allows a anterior subluxation?

A

posterior joint degeneration

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33
Q

degenerative anterior displaement is also known as?

A

Grade I Degenerative spondyloslisthesis

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34
Q

What is the significance of uncinate hypertrophy?

A

potential IVF encroachment

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35
Q

What is a pathological osseous proliferation at a tendon or ligament insertion?

A

Enthesopathy

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36
Q

An enthesopathy is caused by what?

A

Degenerative chages

Inflammatory changes

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37
Q

The DISH phenomenon occurs at what area of the vertebre?

A

Anterior vertebral body

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38
Q

DISH and what other clincial possibility is associated with it?

A

Diabetes mellitus

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39
Q

Ossification of the PLL is also known as?

A

OPLL

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40
Q

What is the one of the most serious complications of disc herniations?

A

Cauda equina syndrome

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41
Q

What are the symptoms of Cauda equina syndrome?

A

altered bowel and bladder function
impotence
saddle paresthesia
progressive muscle atrophy

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42
Q

midline disc herniaions in the cervical spine create what?

A

myelopathies

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43
Q

lateral disc herniation of the cervical spine do what?

A

compresses the nerve root below

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44
Q

Midline/paracentral disc herniation in the lumbar spine does what?

A

compresses the nerve root below

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45
Q

Foraminal disc herniation in the lumbar spine will involve what?

A

the nerve root at the same level

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46
Q

What is a typical disc herniation?
A. Midline
B. Lateral
C. Foraminal

A

A

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47
Q

Does a typical lumbar disc herniation compromise the exiting nerve root or the traversing nerve root?

A

Traversing nerve root

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48
Q

What are the contents of the spinal canal?

A 
Thecal sac
epidural fat
internal vertebral plexus
ligamentum flavum
posterior longitudinal ligament
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49
Q

What is contained in the thecal sac?

A

cord and cauda equina

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50
Q

When looking at a disc herniation what two things should be considered?

A

is the herniation contained or non contained

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51
Q 
What disc classification is circumferential symmetric extension of the disc  beyond the interspace (around the end plates) 
A. Bulge
B. Protrusion
C. Extrusion
D. Sequstration
A

A

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52
Q 
What disc classification is focal or asymmetric extension of the disc beyond the interspace, with the base against the disc of origin broader than any other dimension of the protrusion
A. Bulge
B. Protrusion
C. Extrusion
D. Sequstration
A

b

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53
Q 
What disc classification is more extreme extension of the disc beyond the interspace, with the base against the disc of origin narrower than the extruded 
portion
A. Bulge
B. Protrusion
C. Extrusion
D. Sequstration
A

C

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54
Q 
What disc classification has no connection between the material and the disc of origin 
A. Bulge
B. Protrusion
C. Extrusion
D. Sequstration
A

D

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55
Q

What do you look for during a myelogram?

A

indention of contrast column

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56
Q

What does the contrast column in a myelogram mean?

A

disc lesion

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57
Q

What are the measurements to consider possible stenosis in the cervical spine?

A

Canal stenosis less than 12 mm

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58
Q

What are the measurements to consider possible stenosis in the lumbar spine?

A

Canal stenosis less than 15mm

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59
Q

What is the preferred method to evaluate potential stenosis?

A

Axial slices of a CT or MRI

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60
Q

What are the two major types of inflammatory joint disease?

A 
Rheumatoid types (seropositive)
Rheumatoid Variants (seronegative)
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61
Q

What are three examples of seropositive inflammatory disease?

A

rheumatoid arthritis
Systemic lupus erythematorsis
scleroderma

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62
Q

What are four examples of Rheumatoid variants?

A

Ankylosing spondylitis
Reiter’s disease
Psoriatic arthritis
Enteropathic arthritis

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63
Q

A generalized connective tissue autoimmune disease involving synovial tissue resulting in polyarticular joint inflammation

A

Rheumatoid Arthritis

64
Q

conditions associated with RA, (five conditions)

A 
Arthritis mutilans
Baker's cyst 
Boutonniere deformity
Felty's syndrome
Haygarth's nodes
65
Q

severe joint deformity/destruction

A

ARthritis mutilans

66
Q

enlargement of the gastrocnemius bursa

A

Baker’s cyst

67
Q

PIP flexion, DIP extension

A

Boutonniere Deformtiy

68
Q

leukopenia, splenomegaly and RA

A

Felty’s syndrome

69
Q

soft tissue swelling at the MCP

A

Haygarth’s nodes

70
Q

stiff joints after inactivity

A

Jelling phenomena

71
Q

accumulation of inflammatory cells, with

necrotic area and fibrosis seen on extensor surfaces

A

Rheumatoid nodule

72
Q

flexion of DIP and extension of the PIP

A

Swan neck deformity

73
Q

intermittent absence of the articular

cortex due to erosion

A

Dot-dash appearance

74
Q

pocket erosions localized loss of
intraarticular cortex adjacent to the capsular insertion due to
pannus erosion at the anatomical bare area

A

Marginal erosion; rat bite

75
Q

loss of joint space in RA is normally
A. symmetrical
B. Asymetrical

A

a

76
Q

What are two findings in RA?

A

Marginal erosion and decreased joint space3

77
Q

ulnar styloid erosion is normally found in what condition?

A

Rheumatoid arthritis

78
Q

Marginal erosion is found in RA due to _______ formation?

A

pannus

79
Q

What is the most likely areas of involvement for RA in the wrist and hand?

A

MCP
PIP
Ulnar aspect of the wrist

80
Q

Someone with Boutonniere Deformity would have PIP __________ and DIP __________

A

flexion; extension

81
Q

Boutonniere deformity is caused by the central slip of the?

A

extensor digitorum communis

82
Q

Swan Neck Deformity is cause by PIP _________ and DIP __________

A

extension; Flexion

83
Q

A synovial cyst that extends into the soft tissues posterior to the knee.

A

Bakers Cyst

84
Q

Flexion and extension studies should be performed to evaluate the atlantodental interval (ADI). This should not exceed _______mm

A

3

85
Q

What should be done if the patient is neurologically compromised?

A

MRI examination

86
Q

Ballooned epiphyses is an indicator of what condition?

A

Juvenile Chronic ARthritis

87
Q

What age is Juvenile RA onset?

A

less than 16

88
Q

Are most cases of Juvenile Rheumatoid seropositive or seronegative?

A

seronegative for Rheumatoid factor

89
Q

systemic Lupus Erythematosus is positive or negative for rheumatoid factor

A

positive

90
Q

Systemic Lupus Erythematosus has what kind of deformity in the hands?

A

Swan-neck deformity

91
Q

Scleroderma is also known as…

A

progressive systemic sclerosis

92
Q

generalized systemic inflammatory connective tissue disorder involving skin, lungs, GI tract, kidneys and musculoskeletal system, causes small vessel disease and fibrosis in multiple organ systems.

A

progressive systemic sclerosis (Scleroderma)
effects females 3:1
30-50 years

93
Q

cyclic vascular changes usually of the hands which is precipitated by the cold or emotional upset

A

Raynaud’s Phenomenon

94
Q

What is CREST Syndrome?

A 
Calcinosis
Raynaud's phenomenon
Esophageal dysmotility
Sclerodactyly
Teangiectasia
95
Q

dilated subdermal blood vessels are known as ?

A

Telangiectasia

96
Q

What are some radiographic findings associated with scleroderma?

A

acral tapering of the soft tissues
osseous resorption (acro-osteolysis) extensive subcutaneous soft tissue calcification
flexion contractures

97
Q

If Rheumatoid Factor is negative what test is positive?

A

HLA B27

98
Q

What four conditions are HLA B27 positive?

A

Ankylosing apondylitis
Psoriatic arthritis
Reiter’s disease
Enteropathic arthritis

99
Q

What are some synonyms for ankylosing spondylitis?

A

Marie Strumpell’s disease

100
Q

50% of AS patients will have peripheral disease especially of the hip and shoulders, what is the condition?

A

Spondylitis Rhizomelique

101
Q

What is the most common seronegative spondyloarthropathy?

A

Ankylosing spondylitis

102
Q

AS is most common in what gender?

A

male 1:10

103
Q

AS is ________% positive HLA-B27

A

90

104
Q

Initial changes in AS consist of synovial proliferation, inflammatory cellular infiltrate producing what?

A

pannus

105
Q

What is the anatomical site of attachment of a ligament or tendon to bone via Sharpey’s fibers

A

Enthesis

106
Q

What occurs to the SI joint in AS

A

lossof subchondral definition ->Erosion and joint spacewidening -> fusion (50% of the time)

107
Q

SI joint ankylosis progresses from what seronegative condition?

A

AS

108
Q

Don’t confuse Osteitis Condensans Ilii with what other condition?

A

AS

109
Q

Osteitis Condensans Ilii is seen in what population?

A

post partum females

110
Q

What condition may also be found in AS in the spine

A

syndesmophytes (bamboo spine)

111
Q

On an x-ray a shiny corner sign is likely what diagnosis?

A

AS

112
Q

Would a HLA B-27 test be helpful is diagnosing AS?

A

Yes

113
Q

vertically oriented spurs that represent the sequalae of inflammatory disease of the spinal ligaments. They are ossification of the outer fibers of the annulus and the inner fibers of the ALL

A

syndesmophytes

114
Q

Vertebral body squaring is an early sign of what condition?

A

Early AS

115
Q

the presence of a Dagger sign would indicate a diagnosis of what?
Woudl a HLA B2-7 exam be benificial?

A

AS

No

116
Q

What ligament is ossified with a dagger sign?

A

calcification of the capsular ligament

117
Q

What causes the trolley tract sign?

A

capsule and inter/supraspinous ossification

118
Q

Sclerosis, irregularity, endplate destruction created by Hypermobility through a fractured previously ankylosed segment

A

Andersson lesion

119
Q

Are there postural changes associate with AS?

A

yes

120
Q

A patient with SI fusion who also has an inflammatory bowel disease such as crohn’s disease you might consider what diagnosis?

A

enteropathic arthritis

121
Q

Can AS involve other sites?

A

Appendicular (hip and shoulder)

Pelvis, calcaneus,bondy proliferation and erosion at the enthesis

122
Q

Enteropathic arthritis is associated with what other disorders?

A

gut

123
Q

Psoriatic arthritis affects ______% of patients with psoriasis

A

5-7

124
Q

Psoriatic arthritis is mediated by what?

A

immune system

125
Q

What are the main targets of Psoriatec arthritis?

A

Hands and to a lesser extend feet

126
Q

The axial skeleton is involved in _______%

A

20-40

127
Q

Psoriatic is an immune reaction similiar to what condition?

A

RA

128
Q

Is Psoriatic arthritis in the hands and feet symmetric or asymmetric small joint involvement?

A

asymmetric

129
Q

What is the main joint involved in psoriatic arthritis?

A

DIP

130
Q

What are some other conditions involved in psoriatic arthritis?

A

peripheral erosions w/ periostitis (“mouse ears”)
central erosions (“pencil-and-cup”)
soft tissue swelling (Sausage digit)
normal mineralization (normal bone density)
bony ankylosis is a common sequela
deformity

131
Q

What are some clinical feature of psoriatic arthritis?

A 
young adults males and females
psoriasis
nail pitting
"sausage" digit fusiform
swelling of entire digit
“cocktail sausage digit”
132
Q

What is unique about psoriatic arthritis?

A

more prominent along one digit instead of joint

133
Q

What may develop from psoriatic arthritis?

A

acroosteolysis

134
Q

is psoriatic arthritis a debilitating form of arthritis?

A

no

135
Q

Psoriatic arthritis mimics what other condition but is less symmetric and thend to have normal bone density?

A

RA

136
Q

Is there bulkier syndesmophytes in AS or psoriatic arthritis

A

psoriatic arthritis nonmarginal syndesmophytes

137
Q

“mouse ears” or periostitis is found in what kind of arthritis

A

psoriatic arthristis

138
Q

is psoriatic arthritis seropositive or negative?

A

negative but HLA B27 positive

139
Q

how do you know that psoriatic arthritis is different from RA?

A

pencil and cup

140
Q

T/F there is nonmarginal syndesmophytes in Psoriatic arthritis

A

True

141
Q

A patient with sausage digits should be diagnosed with what?

A

psoriasis

142
Q

What is the triad of symptoms associated with Reiter’s arthritis?

A

Urethritis
conjunctivitis
arthritis

143
Q

What gender has a high predominance to Reiter’s disease?

A

males

144
Q

Thick nonmarginal syndesmophytes known as “lover’s heels” is present in what condition?

A

Reiter’s arthritis

145
Q

Reiter’s arthritis is similiar to what other condition? What is the main difference?

A

psoriatic arthritis

involves the lower extremities

146
Q

heel spurs and retrocalcaneal bursitis known as “Lover’s heels” is present in what condition?

A

Reiter’s arthritis

147
Q

If the patient is a male and complains of a burning sensation on urination then likely what condition?

A

Reiter’s Arthritis

148
Q

What are the various etiologies of Chondrocalcinosis?

A

Cartilage degeneratoin
Crystal deposition
Cation disease

149
Q

What is an example of Cartilage degeneration of chondrocalcinosis?

A

degenerative joint disease

150
Q

What are some examples of crystal deposition in Chondrocalcinosis?

A

primary CPPD

Gout

151
Q

What are some cation disease in Chondrocalcinosis?

A

hemchromatosis (iron)
hyperparathyroidism (calcium)
Wilsoms disease (copper)

152
Q

What anatomy is calcified in chondrocalcinosis?

A

the meniscus

153
Q

degenerative joint disease at an unusual location should raise suspicion of what entity?

A

A crystal desposition disease such as CPPD

154
Q

Hook osteophyte’s at the 2nd and 3rd metacarpal suggest what diagnosis?

A

hemochromatosis

155
Q

A finding of an olecranon erosion and soft tissue tophi is known as what?

A

Gout

156
Q

a “lumpy bumpy joint disease” is known as what?

A

Gout

157
Q

Gout in the big toe is known as what?

A

podagra

Diagnostic imaging (2 decks)

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