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Diagnostic Imaging COPY 515 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What are the 3 classifications of scoliosis according to age?

A

Infantile (0-3 y.o)
Juvenile (3-10 y.o)
Adolescent (Over 10 y.o)

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2
Q

What is the most common type of scoliosis?

A

Adolescent (usually females over 10 y.o)

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3
Q

T/F: Functional scoliosis can be corrected w/ forward and lateral bending.

A

True

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4
Q

Scoliosis due to muscle spasm or pain is considered functional or structural?

A

Functional

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5
Q

What is a segmental hemivertebra?

A

Partial vertebra that is not attached to another (makes up it’s own segment) as compared to nonsegmental, which is still attached to a separate, complete vertebra

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6
Q

A thoracic curvature in which direction is typically associated with spinal cord abnormalities?

A

Left Thor Curve

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7
Q

Café au lait spots are associated with what condition?

A

Neurofibromatosis

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8
Q

What is the most common tumor that causes painful scoliosis?

A

Osteoid osteoma

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9
Q

If a lateral curve persists upon lateral bending, is the problem structural or non-structural?

A

Structural

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10
Q

Risser’s Sign uses which site of ossification to grade skeletal maturity?

A

Iliac apophyses

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11
Q

Greulich and Pyle use which feature to grade skeletal maturity?

A

(Left Hand); the number of carpals minus one=age…works up to six years old

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12
Q

Bracing is recommended for scoliosis in which 3 instances?

A
  1. Curves progressing to larger than 25 deg
  2. Curves between 30-45 deg
  3. Risser Sign 0, 1, 2 and less than 6 months from the onset of menses in girls
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13
Q

What is the CAT in CATBITES?

A

Congenital
Arthritis
Trauma

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14
Q

What is the BITES in CATBITES?

A 
Blood
Infection
Tumor
Endocrine
Soft Tissue
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15
Q

What is the #1 arthritis in the US?

A

Osteoarthritis

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16
Q

Which arthritis incidence is actually decreasing?

A

Rheumatoid; OA and Gout are increasing in incidence

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17
Q

Which arthritis incidence is actually decreasing?

A

Rheumatoid; OA and Gout are increasing in incidence

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18
Q

Is rheumatoid arthritis degenerative or inflammatory?

A

Inflammatory–>possible ankylosis

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19
Q

If a patient is under the age of 20, what arthritis is most likely to occur?

A

Juvenile rheumatoid arthritis

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20
Q

What is the significance of the ‘bare area’?

A

Area of a joint not covered by cartilage, typically is the location of first signs of erosion

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21
Q

Females are more likely to have DJD in their ___ & ___.

A

Hands and knees

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22
Q

Obese individuals have an increased incidence of DJD in the __ & ___.

A

Knees and Hips

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23
Q

What are osteophytes?

A

Bony outgrowths in the locality of capsular insertion

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24
Q

What are osteophytes?

A

Bony outgrowths in the locality of capsular insertion

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25
Q

What is subchondral sclerosis?

A

Localized thickening of existing trabeculation, usually due to increased mechanical stress

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26
Q

What is another term for subchondral sclerosis?

A

Eburnation

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27
Q

Enlarged soft tissue nodes of the DIP joints in the hand are also called ____’s nodes

A

Heberden’s Nodes -DIP

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28
Q

Enlarged soft tissue nodes of the PIP joints in the hand are also called ___’s nodes.

A

Bouchard’s Nodes -PIP

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29
Q

Which variant of DJD is unusually inflammatory, therefore is often confused with rheumatoid?

A

Erosive Osteoarthritis, MC in middle aged females

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30
Q

‘Gull-Wing’ appearance of the DIP joints is associated with which condition?

A

Erosive osteoarthritis

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31
Q

What would hallux rigidus present with?

A

Pain and stiffness in the area of the 1st metatarsal-phalangeal joint

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32
Q

What would hallux rigidus present with?

A

Pain and stiffness in the area of the 1st metatarsal-phalangeal joint

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33
Q

An enthesopathic change at the inferior aspect of the calcaneus goes by the common name of ___ ___.

A

Heel spur

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34
Q

Does DJD typically attack the glenohumeral joint?

A

Not without prior trauma

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35
Q

Osteophytes from which joint can impinge upon the rotator cuff tendons?

A

Acromioclavicular joint

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36
Q

Superior migration of the humerus due to unopposed deltoid may result from which condition?

A

Rotator cuff arthropathy

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37
Q

Hydroxyapatitie Deposition Disease is most common within which tendon?

A

Supraspinatus tendon

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38
Q

What are the three compartments of the knee joint?

A

Medial tibiofemoral
Lateral tibiofemoral
Retropatellar

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39
Q

Which area of the knee takes the most weight-bearing responsibility?

A

Medial Tibiofemoral

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40
Q

Is ‘bowlegged’ individual considered genu valgus or genu varus?

A

Genu Varus

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41
Q

Where would you find pelligrini-steida calcifications?

A

Medial Tibial Collateral Ligament

42
Q

What is the sesamoid bone found within the lateral head of the gastrocnemius?

A

Fabella

43
Q

What are the two other names for intraarticular fragments?

A

Joint mice, loose bodies

44
Q

What is SOM?

A

Synovial tissue metaplasia produces cartilaginous masses (joint mice) that may ossify; common in the knee

45
Q

What is the slow growing, benign tumor of the synovium often affecting young to middle-aged adults?

A

PVNS (Pigmented Villonodular Synovitis)

46
Q

What is buttressing?

A

Thickening of the cortex associated with DJD of the medial femoral neck

47
Q

Which area of the hip joint takes the most strain from walking?

A

Superior compartment

48
Q

What is malum coxae senilis?

A

Literally means bad old hip; referring to osteoarthritis of the hips

49
Q

What is a geode?

A

Large subchondral cyst

50
Q

What is acetabular protrusion?

A

Severe medial hip migration that can be measured with the Koehler’s Line

51
Q

What are the 2 synonyms for protusio acetabuli?

A

Acetabular Protrusion

Otto’s Pelvis

52
Q

In which individuals may acetabular protrusion be considered a normal variant?

A

Females

53
Q

The type of neuropathic arthropathy that affects weight bearing joints?

A

Hypertrophic

54
Q

Which joints are likely affected by hypertrophic neurotrophic arthropathy complicated by diabetes?

A

Talonavicular

Talometatarsal

55
Q

A ‘licked candy stick’ appearance is associated with what arthropathy?

A

Atrophic neurotrophic arthropathy (also associated with the ‘cutoff’ sign)

56
Q

Where is DDD most common in the cervical spine? And in the lumbar spine?

A

Cervicals= C5 & C6

Lumbars=L4 & L5

57
Q

What is the difference between outer disc degeneration (spondylosis deformans) and inner disc degeneration (intervertebral chondrosis)?

A

Outer-has osteophytes

Inner-has reduced IVD space

58
Q

In what direction do osteophytes form?

A

First horizontally, then vertically; sometimes producing the claw-like osteophytes

59
Q

What are the 4 signs associated with degenerative disc disease?

A

Decr. disc height
Osteophytes
Endplate sclerosis
Vacuum (Knutson’s Phenomenon)

60
Q

What is Knutson’s Phenomenon?

A

Radiolucent (dark) collections of nitrogen gas within annulus; best seen at anterior margin of IVD

61
Q

In the cervical spine, type __ modic changes are more common. Whereas in the lumbar spine, type __ modic changes are more common.

A

C- Type 1 Modic changes (dark T1, bright T2)

L- Type 2 Modic changes (bright T1 and T2)

62
Q

What do each of the type of modic changes represent?

A

Type 1= inflammation–>instability
Type 2= fat–>stability
Type 3= sclerosis

63
Q

What are the associations for posterior subluxation and anterior subluxation, respectively?

A

Posterior sublux= DDD

Anterior sublux= Posterior joint arthrosis

64
Q

What are the 3 F’s of Degenerative Spondylolisthesis?

A

Fourth Lumbar (L4)
Forty & Up (40+ y.o)
Female

65
Q

What areas are prone to degeneration of the zygapophyseal joints?

A

Lower lumbar
Mid cervicals
Upper and middle thoracic spine

66
Q

What is an intercalary ossicle and what is it commonly confused with?

A

Ossification within outer annulus; may look like a fractured osteophyte

67
Q

What is the average age of onset for Scheuermann’s Disease?

A

13-17 y.o

68
Q

What are Schmorl’s Nodes?

A

Radiolucent (dark) IVD displacement into the cancellous bone of the vertebral body; typically non-significant finding in children

69
Q

What is ochronosis?

A

Very dense central calcification of the disc (Nucleus puplosus)

70
Q

What 3 conditions could present with annulus fibrosis calcification of the IVD?

A

Pseudogout
Hemochromatosis
Hypervitaminosis D

71
Q

What is DISH?

A

(Diffuse Idiopathic Skeletal Hyperostosis)

Hypertrophic changes to anterior vertebral body margins, mostly notes along the ALL

72
Q

What are the 2 other names for DISH?

A

Ankylosing Hyperostosis

Forestier’s Disease

73
Q

With what group is DISH most common in?

A

Males over 50; high incidence in diabetics

74
Q

What is enthesopathy?

A

Osseous development at tendon or ligament insertion sites

75
Q

What disease is also known as ‘Japanese Disease’?

A

Ossification of the Posterior Longitudinal Ligament (OPLL)

76
Q

OPLL is also found in what percent of DISH patients?

A

40-50%

77
Q

What symptoms would bring an OPLL patient into your office?

A

Sensory or motor disturbances of the legs
Difficulty walking
Paresthesia or diminished senses over gradually increasing areas

78
Q

What is the majority of mechanical low back pain due to?

A

Lumbar sprain/strain

79
Q

What is the most serious side effect of a disc herniation?

A

Cauda Equina Syndrome

80
Q

What is cauda equine syndrome?

A

Compression of multiple nerve roots; symptoms of altered bowel/bladder fx, impotence, saddle paresthesia

81
Q

What is Lhermitte’s Sign?

A

Flexion of the neck causing electric-like shock that radiates down spine and limbs; RED FLAG of myelopathy

82
Q

Lateral disc herniations of the cervical spine affect which nerve root?

A

The nerve root below; C5 disc herniation affects C6 nerve root

83
Q

In the lumbar spine, what is the difference between a midline disc herniation and a foraminal disc herniation?

A

Midline- affects nerve root BELOW

Foraminal- affects nerve root at SAME level

84
Q

What is the gold standard when trying to image a disc?

A

MRI

85
Q

What is the difference between a disc protrusion and a disc extrusion?

A

Protrusion has a wide base coming off the IVD whereas the extrusion has a narrow base coming off the IVD (think sessile vs. pedunculated bone tumors)

86
Q

What is spinal stenosis?

A

Narrowing of the spinal canal or IVF; may be congenital or acquired

87
Q

What is the measurement for stenosis of the C spine? The L spine?

A

C- less than 12mm

L- less than 15mm

88
Q

What is the correlation between the size, type and location of disc herniations to the outcome/pain/function?

A

Sorry. No correlation!

89
Q

What are the 4 Rheumatoid types (seropositive) of arthritis we discussed?

A

Rheumatoid
SLE
Scleroderma
Jaccouds

90
Q

What are the 4 Rheumatoid variants (seronegative) of arthritis we discussed?

A

Ankylosing Spondylitis
Reiter’s Disease (Reactive Arthritis)
Psoriatic
Enteropathic

91
Q

What is the most common inflammatory arthritis?

A

Rheumatoid; inflammatory, hyperplastic synovitis (pannus)

92
Q

What group is MC affected by rheumatoid arthritis?

A

Young to middle aged females

93
Q

What is the Boutonniere deformity?

A

(Associated with rheumatoid) PIP flexion with DIP extension

94
Q

What is Swan neck deformity?

A

(Ass. with rheumatoid) PIP extension with DIP flexion

95
Q

What are Haygarth’s nodes?

A

(Ass. w/ rheumatoid) soft tissue swelling at the MCP joints

96
Q

Dot-dash appearance, rat bites, and baker’s cysts are all associated with which arthritis?

A

Rheumatoid again

97
Q

What is the Jelling Phenomenon?

A

Stiffness or swelling after inactivity (in the morning usually)

98
Q

What is RF?

A

Rheumatoid Factor; a measurement of the reactive IgM antibodies

99
Q

OA commonly affects the (proximal/distal) joints of the hand whereas Rheumatoid affects the (proximal/distal) joints.

A

OA-Distal (DIP & PIP)

RA- Proximal (PIP & MCP)

100
Q

Where are rat bites usually seen?

A

Bare area of joints (usually superolateral aspect)

Diagnostic Imaging COPY 515 (6 decks)

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