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Fundamentals of Imaging > Inflammatory Arthopathies: RA and Juvenile Chronic Arthritis > Flashcards

Inflammatory Arthopathies: RA and Juvenile Chronic Arthritis Flashcards

1
Q

What is known as a chronic relapsing remitting autoimmune inflammatory multi-system disease that primarily affects synovial tissues of the joints, tendons and bursae

A

Rheumatoid arthritis

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2
Q

How does Rheumatoid arthritis come about?

A

CD4 T-cell influx into synovial fluid

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3
Q

What produces gradual destruction of articular cartilage, adjacent bone and peri-articular connective tissues

A

Pannus

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4
Q

How many stages are there with joint involvement of RA?

A

4

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5
Q

What stage has synovial fluid showing high PMN-cell count. Often no radiographic evidence of erosions but soft tissue swelling and osteopaenia may be seen

A

Stage 1 of RA

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6
Q

What stage has synovial pannus beginning to invade joint cavity and destroy articular cartilage and bone. Radiographs may show narrowing of joint space and subtle marginal erosions at the bare area

A

Stage 2 of RA

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7
Q

What stage has synovial pannus leading to larger erosions, further joint space loss and periarticular tissues destruction with laxity, subluxations and dislocations. Tendons rupture may occur.

A

Stage 3 of RA

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8
Q

What stage is the end-stage joint destruction with capsular and periarticular fibrosis, joint ankylosis, fixed deformities and complete loss of function?

A

Stage 4 of RA

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9
Q

What may radiographic imaging show of early RA?

A

marginal erosion at bare area

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10
Q

Where are marginal erosions of the bare area in the hand most common in patients with RA?

A

2nd and 3rd MCP and 3rd PIP

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11
Q

What is inflammation of the tendon sheath where muscle connects to bone?

A

Tenosynovitis

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12
Q

Where are marginal erosions of the bare area in the foot most common in patients with RA?

A

4th and 5th MTP

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13
Q

What is the clinical manifestation of RA?

A

Morning pain and stiffness in the hands and

feet lasting for >45-minutes (jelling phenomenon)

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14
Q

Is RA more prevalent in males or females and by how much?

A

females by 3x

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15
Q

What Blood lab reports are elevated in RA?

A

ESR, CRP, RF, ANA

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16
Q

T/F: Fingers and wrist deformities result from capsular-ligamentous destruction and fibrosis

A

True

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17
Q

What is the more advanced stage of RA called when there is Hyperflexion of the PIP and hyperextension of the DIP?

A

Boutonniere Deformity

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18
Q

What is the more advanced stage of RA called when there is Hyperextension of PIP and hyperflexion of DIP?

A

Swan Neck Deformity

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19
Q

What is the syndrome that involves RA, decreased WBC, and a swollen spleen?

A

Felty Syndrome

20
Q

What is involved with Felty Syndrome?

A 
Splenomegaly
Anemia
Neutropenia
Thrombocytopenia
Arthritis (Rheumatoid)
21
Q

Where are erosions of Shoulder RA presented at?

A

Glenohumeral margins

22
Q

What is another name for popliteal synovial cyst in the knee?

A

Baker’s cyst

23
Q

What is another name for small fibrinoid inclusions?

A

rice bodies

24
Q

What radiographic findings are significant for Knee RA?

A

Large effusions
Baker’s cyst
Valgus Deformity

25
Q

What radiographic finding is significant for Hip RA?

A

Bilateral acetabulum protrusion

26
Q

Where are early erosions present in Spinal RA?

A

C1-C2 w/ atlanto-axial instability

27
Q

T/F: Don’t manipulate cervical spine when diagnosed with RA

A

True

28
Q

What is another term referring to Odontoid erosion in RA spondylitis?

A

Whittling/odontoid impaction

29
Q

Is pannus formation common or uncommon at the level of C1-C2 with RA spondylitis?

A

Common

30
Q

What are the clinical manifestations of RA spondylitis?

A

Neck pain, facial pain, headaches

31
Q

What deformity occurs due to discovertebral instability and facet erosions and overall ligamentous laxity due to RA spondylitis?

A

Step-ladder/stair-step deformity

32
Q

How would you manage RA?

A

Exercise, occupational therapy, and activity modification

33
Q

What is the most common arthritis of childhood and one of the most common chronic diseases in children?

A

Juvenile Idiopathic Arthritis (JIA)

34
Q

Who is at greater risk for JIA?

A

Children exposed to antibiotics at an early age

35
Q

What is the prevalence of JIA?

A

1:500 children (rarely seen before the age of 2)

36
Q

What is the diagnosis of JIA?

A

arthritis > 6weeks in children <16-years of age

37
Q

What are the 3 main subtypes of JIA?

A 
Pauciarticular disease (40%)
Seronegative polyarticular disease (25%)
Systemic JIA (Still's disease) (20%)
38
Q

Which of the 3 subtypes is the most common? and to whom is it most common to?

A

Pauciarticular disease - young girls

39
Q

How many joints does Pauciarticular disease affect?

A

2-3 (<4)

40
Q

What joints are most frequently effected with Pauciarticular disease?

A

Knees, ankles, elbows

41
Q

What is commonly seen in >25% of Pauciarticular disease patients and may lead to blindness

A

Iridocyclitis

42
Q

What kind of blood work would be issued for Iridocyclitis and what are the results?

A

RF - negative

ANA - positive

43
Q

Which of the 3 subtypes has acute systemic manifestations with intermittent spiking fevers, arthralgias and myalgias, distinct salmon-pink evanescent rash on trunk and extremities often linear in appearance?

A

Systemic JIA (Still’s disease)

44
Q

What are the main target radiographic findings for JIA?

A

Mid-carpal joints and esp. peri-capitate region

45
Q

What radiographic finding of the elbow joint is indicative of JIA?

A

effusion and enlargement of the trochlear notch and radial head due to hyperemia and new bone formation

46
Q

What is a common characteristic of large joint effusion of the knee?

A

Flexed knee position

47
Q

What radiographic finding of the knee joint is indicative of JIA?

A

distinct overgrowth and inter-condylar widening of the femoral epiphysis

Fundamentals of Imaging (16 decks)

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