MSK Arthritis Flashcards
arthritis –> 5 broad categories?
- degen
- inflamm
- xl deposit
- hematologic
- metab
OA –> key XR findings? (5)
- jt space narrow –> asymm
- subchondral sclerosis
- osteophyte
- subchondral cyst
- no periarticular osteopenia
XR findings of OA –> +extensive subchondral cysts –> ddx? (2)
- OA
- calcium pyrophosphate dihydrate xl deposit dz (CPPD)
what is Heberden node? Bouchard node?
Heberden: OA –> DIP –> lrg osteophyte –> ST swelling
Bouchard: PIP
what is Grashey view?
shoulder –> 40deg obliqued ext rot –> glenohumeral jt in profile
OA –> foot –> 2 common locations?
- 1st MTP
- talonavicular jt
OA –> 1st MTP –> potential complication?
dorsal osteophytes –> stiff big toe (hallux rigidus)
differentiate –> hip –> OA vs inflamm arthritis –> femoral head migration?
- OA: #1 superolat; less common med
- inflamm: axial
RA –> hip –> potential comp?
severe axial migration –> protrusio acetabuli
intervertebral discs –> 3 components?
- nucleus pulposus
- annulus fibrosus
- cartilaginous endplates
uncovertebral jt –> what levels?
C3-C7
what is degen disc dz (DDD)? charact by what findings? (3)
spectrum of intervertebral disc degen:
- disc dessication
- endplate sclerosis
- osteophytosis
vacuum phenomenon –> pathognomic for what condition?
degen disc dz (DDD)
what is Kummel dz?
trauma –> avascular necrosis –> wks-months later –> progressive vertebral body collapse –> gas within vertebral body
diffuse idiopathic skeletal hyperostosis (DISH) –> definition? (3)
- flowing bridging ant osteophytes –> 4 levels
- normal disc space
- normal SI jts
diffuse idiopathic skeletal hyperostosis (DISH) –> assoc condition?
osiffication of post long lig (OPLL) –> spinal stenosis
diffuse idiopathic skeletal hyperostosis (DISH) –> potential comp?
cervical spine –> dysphagia
sacroiliac jt –> superior portion is what type of jt? inf?
- sup –> syndesmotic
- inf –> synovial
OA –> SI jt –> which part is affected?
inf –> synovial jt
erosive OA –> what is similar to OA? RA?
RA –> clinical findings –> ie swelling
OA:
- distribution
- imaging findings
erosive OA –> distribution?
hands only –> DIP, PIP, 1st CMC
erosive OA –> characteristic xray finding?
DIP –> central erosion + marginal osteophyte –> “gull wing” appearance
rheumatoid arthritis –> MOA?
autoimmune disorder –> immune response –> wax & wane –> synovium
RA –> key XR findings? (5)
- symm jt space narrow
- marginal erosion
- periarticular osteopenia
- jt subluxation
- ST swelling
RA –> earliest XR findings? (2)
synovitis & hyperemia:
- ST swell
- periarticular osteopenia
RA –> hand –> early erosions –> typical locations (3)
- 2nd & 3rd metacarpal –> head –> radial aspect
- prox phalanx –> base –> radial & ulnar aspect
- ulnar styloid
RA –> hand –> jt sublux –> 3 common deformities?
- Boutonniere: PIP flex, DIP hyperext
- Swan neck: PIP hyperext, DIP flex
- MCP –> digits –> ulnar sublux
RA –> wrist –> late-stage dz –> potential comp?
complete cartilage loss –> fibro-osseous jt fusion –> carpal ankylosis
RA –> foot –> which jts? (2)
- MTP
- talocalcaneonavicular
protrusio acetabuli –> measuremts?
femoral head –> medial deviation –> past ilioischial line:
- M: >3mm
- F: >6mm
knee –> all 3 compartmts –> symm jt space narrow –> osteophytes –> ddx? (1)
2ary OA
knee –> what XR finding indicates presence of OA? what XR finding indicates severity of OA?
- osteophyte –> presence of OA
- jt space narrow –> severity of OA
RA –> knee –> which compartmt MC involve?
all 3
RA –> knee –> erosions NOT prominent manifestation –> T/F?
T
RA –> cervical spine –> atlantoaxial sublux –> 5 types?
- ant
- post
- vertical (AA impaction)
- rotatory
- lat
RA –> cervical spine –> atlantoaxial sublux –> ant type –> MOA?
adj bursa –> inflamm –> transverse lig –> lax
RA –> cervical spine –> atlantoaxial sublux –> ant type –> measuremts?
atlanto-dental interval:
- adult: >2.5mm
- child: >5mm
RA –> cervical spine –> atlantoaxial sublux –> ant type –> what kind of image view?
flexion
RA –> cervical spine –> atlantoaxial sublux –> vertical (AA impaction) type –> MOA?
C1-C2 facet –> erosion –> collapse –> odontoid –> protrude into foramen magnum
RA –> cervical spine –> atlantoaxial sublux –> vertical (AA impaction) type –> potential comp?
compress midbrain
RA –> shoulder –> potential comp?
chronic rotator cuff tears –> high riding humerus
high riding humerus –> ddx? (3)
- rotator cuff tear
- RA
- CPPD
RA –> shoulder –> erosions –> MC locations? (2)
- humerus –> lat aspect
- AC jt –> distal clavicle “penciling”
seroneg spondyloarthropathy –> assoc w what lab finding?
+HLA-B27
what are the 4 seroneg spondyloarthropathies?
- ank spondylitis
- psoriatic arthritis
- reactive arthritis (Reiters)
- IBD-assoc arthropathy
seroneg spondyloarthropathies –> hallmark finding?
sacroiliitis
seroneg spondyloarthropathies –> sacroiliitis –> involves which portion of SI jt?
inf portion –> synovial jt
sacroiliitis –> bilat –> symm –> ddx? (2)
- IBD
- ank spond
sacroiliitis –> bilat –> asymm –> ddx? (2)
- psoriatic arthritis
- reactive arthritis
sacroiliitis –> unilat –> ddx? (1)
septic arthritis
what conditions assoc w IBD-sacroiliitis? (4)
- ulc colitis
- Crohns
- Whipple dz
- s/p gastric bypass
ank spond –> assoc lung/heart conditions? (3)
- pulm fibrosis
- aortitis
- cardiac conduction defect
ank spond –> earliest XR findings?
symm sacroiliitis:
- erosions
- widening
- sclerosis
ank spond –> what is Romanus lesion?
vertebral body –> endplate –> anterior –> sup or inf –> enthesitis –> erosion
ank spond –> what is shiny corner?
Romanus lesion –> sclerosis
ank spond –> what is “squaring”?
vertebral body –> loss of normal concavity of the anterior border –> “squaring”
ank spond –> what is Andersson lesion?
spine –> completely ankylosed –> pseudoarthrosis
psoriatic arthritis –> MC location? 2nd MC?
#1 hands #2 feet
ivory phalanx –> dx?
specific sign for psoriatic arthritis
differentiate: psoriatic arthritis vs degenerative –> plantar calcaneal spur?
PsA spur –> periosteal rxn
degen spur: no periosteal rxn