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Diagnostic imaging I test 2 > Intro, degenerative part 1 > Flashcards

Intro, degenerative part 1 Flashcards

1
Q

General description of inflammatory joint disease

A

Soft tissue swelling, edema, uniform loss of joint space, erosions juxta-articular osteoporosis
Monoarticular or para-articular
Systemic pattern
Greater predisposition to ankylosis

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2
Q

General description of degenerative joint disease

A

Nonuniform loss of joint space, osteophytes, subchondral sclerosis, cysts
Asymmetric

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3
Q

Describe T1 MR

A

Short time repitition, short time echo

Black CSF, white bone marrow

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4
Q

Describe T2 MR

A

Long time repitition, long time echo

White CSF, black bone marrow

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5
Q

General description of metabolic joint disease

A

Noteable soft tissue masses within periarticular soft tissues
Well marginated bone lesions
Relative preservation of joint space
Overlapping degenerative and inflammatory changes is common
AKA lumpy bumpy arthritis

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6
Q

General description of infectious/septic joint disease

A

Known cause of grossly destroyed and disintegrated joints
Greatest incidence below 30
Monoarticular moat common
Bloodborne pathogens and direct implantation
Staphylococcus aureus most common organism
Radiographic findings lag behimd clinical

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7
Q

ABCDs pf joint doseases

A 
Alignment
Bone
Cartilage
Distribution
Soft tissue
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8
Q

Generalized age onset of each joint disease

A

0-20 JRA
20-40 seronegative, seropositive
>40 degwnerative, DISH, gout, CPPD

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9
Q

What joints are usually affected in degnerative arthritis?

A

Weight bearing articulations of the spine, hips and knees
1st MTP, 1st MC trapezium
DIP

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10
Q

How do you get degenerative arthritis? What are some symptoms?

A

Insidious onset, intermittent exacerbations, aching pain, stiffness, environmental
Changes such as cold and lowered barometric pressure as it may aggravate symptoms

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11
Q

underlying etiology of primary osteoarthritis

A

no evidence of underlying etiology

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12
Q

underlying etiology of secondary osteoarthritis

A

abnormal forces including obesity, trauma, and joint deformity
pre-existing cartilage pathology such as RA, fractures and meniscal damage
collapse of subchondral bone, such as avascular necrosis and osteoporosis

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13
Q

risk factors of DJD

A 
age (increased DJD with age)
gender (females)
obesity
trauma (most significant local factor)
physical activity (higher impact)
inactivity or excessive activity
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14
Q

clinical features of DJD

A 
poor radiographic-clinical correlation
stiffness, especially with rest
normal blood work
spinal stenosis
vertebrobasilar ischemia
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15
Q

osteophytes have a _____ cortex and internal structure continuous with the parent bone and capped with____.

A

distinct

cartilage

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16
Q

general radiology features of DJD

A 
asymmetric distribution
asymmetric loss of joint space
osteophytes
subchondral sclerosis
subchondral cysts (geodes)
subluxation (midalignments)
intra-articular loose bodies
entheseopathy
ankylosis (rare)
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17
Q

osteophyte definition

A

bony outgrowths in the locality of capsular insertion. bony excrescences with internal trabeculation and cortex, with a cartilage cap pathologically from carilage metaplasia and ligamentous traction and infrequently will create ankylosis

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18
Q

subchondral sclerosis definition

A

increased mechanical stresses cause thickened existing trabeculation and formation of new ones, localized compensatory increase in bone mass

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19
Q

subchondral cysts definition

A

focal regions of bone loss within the subchondral bone. they are ovoid or rounded cysts often with a sclerotic border due to intraosseous synovial fluid intrusion through exposed articular plate

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20
Q

how are intraarticular loose bodies made?

A

from cartilage degradation, flaking, and fragmentation and occasionally include subchondral bone

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21
Q

articular deformity results form what?

A

time and continued repetitive stress deforms secondary to trabecular remodeling, fracture and collapse

22
Q

joint subluxations from (1,2,3,4) render the joint prone to displacement

A
  1. progressive loss of joint space
  2. capsular laxity
  3. ligamentous laxity
    4 joint deformation
23
Q

entheseopathy definition

A

pathological change of an enthesis

24
Q

degeneration of hands is common among what?

A

middle-aged postmenopausal women

25
Q

DIP soft tissue nodes

A

Heberden’s nodes

26
Q

PIP soft tissue nodes

A

Bouchard’s nodes

27
Q

gull wing sign

A

bilateral DJD with central joint erosions

28
Q

target locations on hands for DJD

A

DIP
PIP
1st MCP
osteophytes, sclerosis, cystic changes, loss of joint space, misalignment

29
Q

radiographic changes in DJD

A 
osteophytes
decreased joint space
sclerosis
lateral displacement
cystic changes
30
Q

describe erosive osteoarthritis

A

variant of DJD
appears unusually inflammatory
not to be confused with RA

31
Q

symptoms/signs of erosive osteoarthritis

A

gull wing sign
pain, redness, swelling and decreased motion
middle aged females

32
Q

describe degeneration of feet

A

common in first MTP joint
known as hallux rigidus when present with symptoms of pain and stiffness
metatarsal varus, hallux valgus joint misalignment is common
bunion

33
Q

where are heel spurs specifically?

A

on the inferior part of the calcaneous on the posterior side of it

34
Q

spurs are an _______change

A

enthesopathic

35
Q

which joint of the shoulder is most commonly associated with DJD?

A

AC joint

36
Q

how does DJD affect the AC joint?

A

osteophytes extend inferiorly and may impinge on rotator cuff tendons leading to tendon calcification and superior migration of the humerus

37
Q

how does CPPD affect the glenohumeral joint?

A

osteophytes and joint misalignment and arouse suspicion of significant previous trauma or CPPD

38
Q

what is shoulder impingement syndrome?

A

elevation of the humeral head
degenerative enthesopathic changes of the humeral head
spurring of the AC joint
rotator cuff degeneration

39
Q

where does the supraspinatus tendon ususally insert? where does it break and why?

A

inserts on the greater tuberosity of the humeral head

usually tears about an inch from the tuberosity because that’s where there is less blood flow

40
Q

how does a supraspinatus tnedon tear show up on MR?

A 
increased whiteness
(the tendon is usually black)
41
Q

what is HADD?

A

deposition of calcium within tendons and bursa

42
Q

wherre is HADD commonly seen?

A

shoulder, elbow, rist, hip, knee, ankle, spine

43
Q

where is HADD most common?

A

supraspinatus tendon

44
Q

what age range usually experiences HADD?

A

40-70 years old

45
Q

what are the signs and symptoms of HADD?

A

pain, tenderness, localized swelling, reduced ROM

calcification of soft tissue on radiograph

46
Q

what are the 3 parts of the knee?

A

medial tibiofemoral
lateral tibiofemoral
retropatellar

47
Q

what are radiographic signs of DJD of the knee?

A

asymmetric loss of joint space
subchondral sclerosis
articular deformity and iregularity
hypertrophic changes of the intercondylar spines
enthesopathy of the anterior non-articular surface of the patella

48
Q

what part of the knee most commonly experiences DJD?

A

medial compartment causing genu varus

49
Q

pelligrini-steida calcifications

A

calcification of medial tibial collageral ligament (HADD)

post-traumatic dystrophic changes

50
Q

what do you need to differentiate for pelligrini-steida?

A

fabella

51
Q

what are intraarticular fragments?

A

fragments of cartilage, meniscus or synovium within the joint
heterogeneously dense, popcorn ball looking

52
Q

what is synovial osteochondrometaplasia?

A

laminated, stippled, concentric calcific densities

Diagnostic imaging I test 2 (8 decks)

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