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Diagnostic imaging I test 2 > inflammatory joint diseases part 1 > Flashcards

inflammatory joint diseases part 1 Flashcards

1
Q

what are some general assumptions you can make about inflammatory joint diseases?

A

produce pannus
increased ESR
must be Xrayed

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2
Q

what are the seropositive types?

A 
RA
SLE
Sceroderma
Jaccoud's
Sjorgren's
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3
Q

what are the seronegative types?

A

AS
Reactive arthritis
Psoriatic arthritis
Enteropathic arthritis

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4
Q

what is the most common seropositive type?

A

RA

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5
Q

what is the most common seronegative?

A

AS

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6
Q

RA generalizations

A

generalized CT autoimmune disease
IgM-anti-IgG
IgG-anti-IgG
involving synovial tissue resulting in polyarticular joint inflammation

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7
Q

define pannus

A

inflammatory hyperplastic synovitis

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8
Q

which gender is typically associated with RA?

A

female, 20-60

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9
Q

other body systems involved in RA

A 
heart
lungs
small blood vessels
NS
eyes
reticuloendothelial system
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10
Q

clinical features of FA

A 
young to middle aged
females 3:1
elevated ESR
70-80% +Rh
\+ANA
C reactive protein
normocytic normochromic anemia
bilateral symmetry and progressive nature leading to deformity
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11
Q

terms associated with RA

A 
arthritis mutilans
baker's cyst
boutonniere deformity
felty's syndrome
haygarth's nodes
jelling phenomena
rheumatoid nodule
swan neck deformity
dot-dash appearance
marginal erosion
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12
Q

arthritis mutilans

A

severe joint deformity destruction

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13
Q

baker’s cyst

A

englargement of the gastrocneumius bursa

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14
Q

boutonniere deformity

A

PIP flexion

DIP extension

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15
Q

felty’s syndrome

A

leukopenia, splenomegaly, RA

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16
Q

haygarth’s nodes

A

soft tissue swelling at the MCP

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17
Q

jelling phenomena

A

stiff joint after inactivity

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18
Q

rheumatoid nodule

A

accumulation of inflammatory cells with necrotic area and fibrosis seen on extensor surfaces

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19
Q

swan neck deformity

A

flexion of DIP and extension of PIP

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20
Q

marginal erosion

A

rat bite, bocket erosions localized loss of intraarticular cortex adjacent to the casular insertion due to pannus erosion at the anatomical bare area

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21
Q

pathological changes occur where in RA?

A

joints
bursa
tendon sheaths
they are distinct on a radiograph

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22
Q

what are some initial RA abnormalities?

A

acute synovitis with periarticular edema, effusion

juxta-articular hyperemia

23
Q

what does proliferating pannus do in RA?

A

erodes and narrows the cartilage as the pannus releases chondrolytic collagenase enzymes and interferes with nutrition

24
Q

intrusion of pannus into subchondral area produces___

A

cysts

25
Q

when joints are entirely filled with proliferating pannus, what happens?

A

undergoes progressive fibrosis, fibrous ankylosis and possibly bony ankylosis

26
Q

radiographic signs of RA

A 
soft tissue swelling
subcutaneous soft tissue mass
uniform loss of joint space
marginal erosions (bare area)
subchondral cysts
juxtaarticular osteoporosis
ankylosis deformity
27
Q

signs and symptoms of RA usually occur when?

A

insidiously, may be proceeded by emotional or physical stress

28
Q

what are the signs and symptoms of RA?

A 
articular complaints (pain, tenderness, swelling, stiffness especially in morning (jelling phenomenon)), particularly in the PIP and MCP joint
fatigue, muscle weakness, fever
29
Q

what are some other clinical abnormalities that can be found with RA?

A

raynaud’s
osteopenia
cervical spine subluxations/dislocations

30
Q

rheumatoid nodules

A

firm, non-tender nodules found in 20% in patients

31
Q

what are some extra-articular manifestations of RA?

A

lacrimal gland atrophy leading to dry eyes

vasculitis leading to skin ulcerations

32
Q

what are the signs and symptoms that you have to have at least 4 of to have an RA diagnosis

A

morning stiffness for at least 6 weeks
pain on joint motion for at least 6 weeks
swelling of at least one joint for at least 6 weeks
swelling in at lelast one other joint for more than 6 weeks
bilateral symmetrical joint swelling
subcutaneous nodules
radiographic changes
labratory

33
Q

RA principally involves what joints of the hands and wrist?

A

MCP
PIPs
ulnar aspect of the wrist

34
Q

boutonniere deformity

A

flexion of PIP and extension of DIPs

35
Q

swan neck deformity

A

extension of PIPs and flexion of DIPs

36
Q

where do erosions and swelling occur on the ulna in RA?

A

inferior radioulnar compartment
prestyloid recess
extensor carpi ulnaris tendon sheath

37
Q

what happens when the elbows get RA?

A

joint effusion

38
Q

what happens when shoulders get RA?

A

glenohumeral and AC joint get it

resorption of clavicle

39
Q

what happens when hips get RA?

A

axial migration

acetabular protrusion

40
Q

what happens when knees get RA?

A

tricompartmental involvement

baker’s cyst

41
Q

what do you see in a radiograph of someone who has RA of the shoulder?

A

no osteophytes

licked candy stick appearance of the clavicle

42
Q

if there is an enthesopathic change of the calcaneous, how can you tell if it is RA or Reiter’s?

A

RA- there will be a “fluffy” proliferative change

43
Q

50% of RA patients will get RA where within 10 years?

A

cervical spine

44
Q

what happens to the bones if there is RA of the cervical spine?

A

they can have a big ADI
dens erosions
subaxial subluxations
atlanto-axial impaction

45
Q

what are some basic features of RA of the cervical spine?

A 
apophyseal joint disease
decreased disc height
spinous process erosions
subluxation
osteoporosis

could also have: occ-C1 or C1-2 facet erosions, basilar invagination, potential neurological compromise

46
Q

where do the erosions of the dens occur specifically?

A

between dens and anterior arch
between dense and transverse ligament
at the tip of the dens

47
Q

when is the onset of JRA?

A

less than 16 years of age

48
Q

what is the poorest prognosis for JRA?

A

seropositive (10% of patients have this)

49
Q

what is the most common diganosis of JRA?

A

seronegative

50
Q

20% of people with JRA have what other disease?

A

Still’s

51
Q

What are some classic signs and symptoms of JRA?

A

polyarticular involvement (50%)
pauciarticular (30%)
pronounced systemic involvement

52
Q

What are signs and symptoms involved in JRA?

A 
acute intermittent fever
lymphadenopathy
hepatosplenomegaly
carditis
anemia
pale erythematous rash on trunk, face or etremities (fleeting and migratory)
53
Q

what are some radiographic signs of JRA?

A 
soft tissue swelling
osteoporosis
loss of joint space
articular erosions
subluxations
growth disturbances
periostitis
ankylosis
ballooning of the metaphysis
acetabular protursion
cervical erosions and posterior joint ankylosis, vertebral body and disc hypoplasia

Diagnostic imaging I test 2 (8 decks)

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