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

inflammatory joint diseases part 2 Flashcards

1
Q

what is SLE?

A

generalzed connective tissue disorder involving multiple organs

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2
Q

what are positive signs of SLE?

A 
seropositive (Rh+)
female
increased ESR
presence of LE cells
\+ANA
marked subluxation although joint integrity is relatively normal
butterfly rash
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3
Q

what are some symptoms of SLE?

A 
fever
malaise
anorexia
weight loss
polyarthralgia
skin rash with sunlight
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4
Q

What are some secondary signs and symptoms of SLE due to excessive immunoreactivity?

A

damage to joints, skin, kidneys, serosal membranes

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5
Q

who are more likely to get SLE?

A

females age 20-40

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6
Q

are severe radiographic changes seen in people with SLE? where are the complaints seen?

A

no, 90% have an articular complaint, though

most common areas of complaint are: hands, feet, wrists, knees

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7
Q

what is the most frequent and serious feature of SLE?

A

kidney involvement leading to nephropathy and renal failure

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8
Q

what phenomenon is associated with SLE?

A

raynaud

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9
Q

describe joints for SLE.

A

swelling, pain stiffness

easily reversed joint deformities

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10
Q

administration of steroids to SLE patients can lead to what?

A

osteoporosis
ANV
spinal fracture
gastric ulcerations

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11
Q

what lab results do you get for someone who has SLE?

A

normocytic normochromic anemia
elevated ESR
+ANA
+Rh

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12
Q

deposition of immune complexes and fibrinoid material in tissues results in what for SLE patients?

A

vasculitis, synovitis, pleuritis, pericarditis

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13
Q

what are radiographic changes for SLE?

A 
bilateral, symmetric
reversible deformities
osteoporosis
soft tissue atrophy
minimal arthropathy
soft tissue calcification
increased incicence of AVN
MC involvement in the hand
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14
Q

what are the signs of SLE in the hands?

A

MCP and PIP involvement
ligamentous laxity, which results in reversible nonserosive ulnar deviation of the digits
swan neck and boutonniere deformity

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15
Q

ulnar deviation is involved in what disease?

A

SLE, RA, Jaccoud’s

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16
Q

describe jaccoud’s arthropathy?

A

follows rheumatic fever and multiple connective tissue disorders

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17
Q

jaccoud’s arthropathy patients have had many diagnoses of what?

A

streptococcal pharyngitis, rheumatic fever

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18
Q

jaccoud’s arthropathy is marked by what?

A

non-erosive, reversible joint deformity

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19
Q

what is the demographic for scleroderma?

A

females 30-50 years old

20
Q

what is scleroderma?

A

generalized inflammatory connective tissue disorder involving skin, lungs, GI tract, kidneys and musculoskeletal system

21
Q

what does scleroderma cause?

A

small vessel disease and fibrosis in multiple organ systems. Scleroderma is the cutaneous manifestation of the disease

22
Q

what is the most unique feature of scleroderma?

A

skin appearance: edema, induration (hardening), atrophy

23
Q

what usually exacerbates scleroderma?

A

exposure to cold or emotional upset that precipitates Raynaud’s phenomenon

24
Q

what is raynaud’s phenomenon?

A

sympathetic nervous system dysfunction characterized by cyclic vascular canges usually of the hands which is precipitated by the cold or emotional upset
an initial vasoconstriction followed by a vasodilation with severe pain and swelling

25
Q

what are some non joint related symptoms of scleroderma?

A

dysphagia and heartburn from decreased motility and dilation of esophagus
bowel is sluggish, distention and constipation occurs
muscle weakness and atrophy
skin edema being replaced by thickening and becoming “hidebound”

26
Q

what pneumonic is associated with scleroderma?

A

CREST syndrome

27
Q

what does CREST stand for?

A 
calcinosis
raynaud phenomenon
esophageal dysmotility
sclerodactyly
telangectasia
28
Q

what are the clinical features of scleroderma?

A

females, 30-50 years old, raynaud phenomenon, joint pain and stiffness, dysphagia, elevated ESR, +ANA, RF+

29
Q

what radiology can you see with scleroderma?

A

acral tapering of soft tissues
extensive subcutaneous soft tissue calcification
flexion contractures

30
Q

what are the segonegative arthropathies?

A

AS
Psoriatic arthritis
Reiter’s disease
enteropathic arthritis

31
Q

AS

A

chronic inflammatory disorder, predominately affecting young adult males primarily involves axial skeleton

32
Q

what are some characteristics for AS?

A

sequela of articular ankylosis, ligamentous ossification and enthesopathic changes
chronic low back pain in young men
aching, stiffness typically originate in low back ESPECIALLY IN SI JOINTS

33
Q

50% of AS patients will have a peripheral disease where?

A

in hips and shoulders

34
Q

clinical features of AS

A 
MC seronegative spondyloarthropathy
1:1 to 1:10 female to male ratio
male predominance
90% positive for HLA-B27
unknown etiology
pannus
35
Q

skeletal distribution of AS

A

axial, SI and spine
appendicular: proximal large joints of extremities
enthesis
erosions, bondy proliferation, fusion, bilatreal symmetrical

36
Q

clinical features of AS

A 
male
15-35 years
3 months of physcian observed pain and stiffness
limited spinal motion
SACROILIITIS
limited chest expansion
presents as spinal pain and stiffness
iritis, conjunctivitis
\+HLA B27, +ESR, -RA, -ANA
usually no disability, sometimes severe
aortic insufficiency, pulmonary fibrosis
37
Q

what is the management of AS?

A

long-term plan to prevent, decrease or delay joint and postural deformities
NSAIDS to prevent inflammation and pain
suggest rheumatological cosultation with any of the inflammatory joint diseases

38
Q

what are the discovertebral signs of AS?

A

corner erosions (romanus lesion)
reactive sclerosis (shiny corner sign)
loss of anterior concavity (vertebral squaring)
thin syndesmophyytes (bamboo spine)
disc calcification
interspinous ligament ossification (dagger sign)
trolley track sign (z capsular ossification)
whiskering (ischial entheseopathy)
endplate destruction (anderson lesion)
spinal fracture (carrot stick fracture)

39
Q

spondylitis rhizomelique

A

a type of AS that looks like RA, but also has sacroiliitis

40
Q

enteropathic arthritis is radiographically similar to what?

A

AS

41
Q

is enteropathic arthritis HLA B27 positive or negative?

A

positive

42
Q

5-15% of ulcerative and granulomatous colitis patients progress to what?

A

enteropathic arthritis

43
Q

what are some clinical features of enteropathic arthritis?

A 
abdominal complaint with joint pain
HLA B27 +
conservative management for arthropathy
malaise, anorexia, weight loss in younger adults
no gender association
44
Q

what can surgical bowel removal do for enteropathic arthritis?

A

can stop peripheral involvement of enteropathic arthritis, but not axial involvement

45
Q

how is enteropathic arthritis similar to AS?

A

SI joints bilateral, symmetrical, erosions, sclerosis, bony ankylosis
discovertebral erosions, sclerosis, squaring, thin, bilateral, marginal syndesmophytes
peripheral joints tend to be nonspecific swelling and periarticular osteoporosis

46
Q

what is the difference between an anderson lesion and a carrot stick fracture?

A

if the ankylosed spine is fractured only, then it is a carrot stick fracture
it the ankylosed spine is fracture and hypermobile, it is an Andersson lesion

Diagnostic imaging I test 2 (8 decks)

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