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Skel Rad A > PPT 6 > Flashcards

PPT 6 Flashcards

1
Q

Sutures, tib/fib, radius/ulna are what type of joints?

A

Fibrous Joints

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2
Q

IVD, Symphysis pubis are what type of joints?

A

Cartilage Joints

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3
Q

SI joints, digits and knees are what type of joints?

A

Synovial Joints

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4
Q

The ____ is not visualized radiographically in synovial joints

A

joint capsule

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5
Q

The joint capsule in synovial joints are

A

fibrous

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6
Q

What attaches to the synovial joint capsule and non-articular bone and secretes synovial fluid?

A

Synovial membrane

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7
Q

Synovial membrane is made of what type of tissue?

A

Vascular CT

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8
Q

What provides lubrication and nutrition for the joint?

A

synovial fluid

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9
Q

The articular cartilage is ___ cartilage and ____mm thick

A

hyaline

1-7mm

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10
Q

Active tissue with abundant blood supply and a thin cortex

A

subchondral bone plate

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11
Q

Arthritic disorders can be ____, _____, or ____

A
  1. inflammatory
  2. degenerative
  3. metabolic
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12
Q

Soft tissue swelling, uniform loss of joint space, bone erosions and juxta-articular osteoporosis are radiographic findings of which arthritic disorder?

A

Inflammatory

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13
Q

Examples of inflammatory arthritic disorders:

A
  • RA
  • psoriatic arthritis
  • ankylosing spondylitis
  • reiter’s syndrome (reactive arthirits)
  • primary OA (inflammatory or erosive)
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14
Q

Reiter’s syndrome is ____ arthritis

A

reactive

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15
Q

Non-uniform loss of joint space, osteophytes, subchondral sclerosis, and subchondral cysts are radiographic findings of which type of arthritic disorder?

A

Degenerative/secondary OA

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16
Q

Inflammatory arthritis is _____ while degenerative/secondary OA is _____

A

symmetric

asymmetric

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17
Q

Periarticular soft tissue masses, well marginated bone lesions and preservation of joint space are radiographic findings of which arthritic disorder?

A

Metabolic

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18
Q

T or F: metabolic arthritic disorders may have overlapping degenerative and inflammatory processes

A

True

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19
Q

Gout is an example of which arthritic disorder?

A

Metabolic

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20
Q

What is the MC joint pathology?

A

Degenerative joint disease aka secondary OA

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21
Q

Which disease is progressive, non-inflammatory, affects small joints of hands and larger weight-bearing joints?

A

degenrative joint disease

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22
Q

Primary DJD is ___ and affects _ to _ decade, females with a : ratio

A

idioppathic
5th-6th
10:1

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23
Q

Secondary DJD affects to decade and affects M=F

A

2nd-6th

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24
Q

POOR correlation between radiographic changes and symptoms

A

DJD

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25
Q

DJD has reversible or irreversible changes?

A

irreversible

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26
Q

What is the pathological process of DJD?

A

collagen fibers + proteoglycan (ground substance) = cartilage

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27
Q

What supports collagen fibers and provides cartilage with resilience to mechanical forces?

A

ground substance

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28
Q

Abnormal physical forces on ground substance –> destruction of cartilage = ______ which exposes _____

A

loss of joint space

subchondral bone

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29
Q

Weakness of joint cartilage & cortical microfaractures + synovial fluid enters subarticular (subchondral) bone = ___

A

subchondral cysts

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30
Q

What is the AKA for subchondral cysts?

A

Geodes

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31
Q

Cartilage metaplasia at joint margin + increased capsular insertion stress/ligament traction + ____

A

osteophyte formation

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32
Q

What are the 8 radiographic findings of DJD?

A
  1. asymmetrical distribution
  2. non-uniform joint space loss
  3. osteophytes
  4. subchondral sclerosis
  5. subchondral cysts
  6. intra-articular loose bodies
  7. articular deformity
  8. joint subluxation
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33
Q

An example of asymmetrical distribution for DJD:

A

hip

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34
Q

Non-uniform loss of joint space for DJD is seen at areas of greatest ______ & the joint space is _____ at areas not exposed to as much stress

A

intra-articular stress

preserved

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35
Q

Osteophytes are ____ with ____ changes

A

bony outgrowths/exostoses

hypertrophic

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36
Q

What is the AKA for subchondral sclerosis?

A

eburnation

37
Q

Subchondral sclerosis is seen where _____ cartilage is lost, ____ mechanical stress ____ protection/cushion of cartilage

A

greatest
increased
without

38
Q

In subchondral sclerosis what is REQUIRED to have eburnation?

A

decrease joint space

39
Q

Subchondral cysts are FOCAL areas of ____ within ____ bone

A

osteopenia

subarticular

40
Q

What is the DDX for subchondral cysts in DJD?

A

neoplasm, infection

41
Q

Subchondral cysts have ____ geographic lucency and are _-_mm in diameter

A

ovoid

2-20mm

42
Q

Subchondral cysts have a ____ and ____ margin

A

thin

sclerotic

43
Q

What is next to degenerative joint surface?

A

subchondral cysts

44
Q

If subchondral cysts are large and/or numerous it can lead to

A

fractures and deformities

45
Q

What is the AKA for intra-articular loose bodies?

A

joint mice

46
Q

Intra-articular loose bodies are intra-articular accumulations of ___ with some pieces of ___ bone

A

cartilage

subchondral

47
Q

MC site for intra-articular loose bodies?

A

knees

48
Q

Synoviochondrometaplasia

A

metaplastic synovium that produce cartilaginous and osseous debris

49
Q

Articular deformity can be due to repetitive stress and:

A
  1. trabecular remodeling
  2. fracture
  3. collapse
50
Q

Progressive deformation of articular surfaces can be due to:

A
  1. vascular disturbances
  2. necrosis
  3. collapse
  4. joint degeneration
51
Q

With joint subluxation the degenerative joint can be prone to

A

displacement

52
Q

With joint subluxation weight-bearing or functional stress films can demonstrate

A

instability

53
Q

DJD - HIP AKAs:

A

coxarthrosis, malum coxae senilis

54
Q

DJD-HIP there is an ___ risk of ____

A

increased

osteoporosis

55
Q

In DJD-Hip a non-uniform loss of joint space =

A

migration

56
Q

What are 3 types of migration

A
  1. superior
  2. medial
  3. axial
57
Q

Waldenstrom sign is ___ migration and on CT it is ___ migration

A

superior

anterior

58
Q

Protrusio acetabuli is ___ migration and on CT is is ___ migration

A

medial

posterior

59
Q

Superomedial displacement is ___ migration and seen in __ or ___

A

axial

RA or infection

60
Q

Buttressing characteristics

A
  • thickening
  • MEDIAL side
  • stress-related
  • altered joint mechanics
61
Q

DJD-KNEE what are 3 compartments?

A
  1. medial
  2. lateral
  3. patellofemoral
62
Q

What is the MC compartment of the knee?

A

medial

63
Q

In DJD-KNEE you see ___ of tibial eminence and ___ loose bodies (vs Os fabella)

A

sharpening

calcified

64
Q

Chondromlacia patellae characteristics:

A
  • “cartilage softening”
  • Pain and crepitus
  • From patellofemoral joint
  • Adol/yg adult
65
Q

Chondromlacia patellae could be due to:

A
  • Trauma
  • patellar dislocation
  • misalignment
  • syndrome
  • cartilage vulnerability
  • occupation
66
Q

Chondromlacia patel you can have these signs & symptoms:

A
  • Anteromedial knee pain
  • Crepitus, buckling, locking, stiffness, swelling
  • *movie sign
  • Retropatellar pain with direct compression (knee slightly flexed)
  • Patella alta
67
Q

What is used to detect patellar misalignment?

A

Q angle

68
Q

What is the normal range for Q angle?

A

15-20 degrees

69
Q

What is the Q angle NR for men?

A

14 degrees

70
Q

What is the Q angle NR for women?

A

17 degrees

71
Q

Who usually has a higher Q angle and why?

A

women, because of their naturally wider pelvis

72
Q

If measured laying down the Q angle will be - degrees ___

A

1-3

lower

73
Q

A HIGH Q angle often results in ____ which means it DOES NOT travel over the front of the knee joint as it should

A

malt racking of the patella

74
Q

Overtime, mal tracking of the patella can cause ____ to the cartilage on the ___ of the patella which causes pain often known as

A

microtrauma
rear
anterior knee pain, patellofemoral pain or chondromalacia patella

75
Q

What also places additional strain on the Q angle due to excessive INTERNAL rotation of the tibia?

A

over-pronated feet

76
Q

How do you decrease the Q angle?

A

A thorough biomechanical assessment is required in order to progress with a treatment plan. The first step is to correct any over-pronation at the feet using orthotics.
There is no manipulation or adjustment (such as you might receive at a chiropractor) to reduce Q angle. Correct biomechanics must be achieved through a rehabilitation program which focuses on restoring flexibility to tight muscles (commonly calves, hamstrings and quadriceps. )

77
Q

DJD-ANKLE & TARSAL JTS is in an _____ site and it is the result of ____

A

uncommon site

previous trauma

78
Q

Tamar break, tarsal coalition, calcaneal “spurs” (degenerative) are seen in

A

DJD of the ankle & tarsal its

79
Q

Calcaneal “spurs” (osteophyte) - degenerative are also seen in

A
  • AS
  • Psoriasis
  • Reiter’s
80
Q

DJD of the foot is MC in which joint?

A

1st metatarsophalangeal joint

81
Q

DJD-FOOT characteristics

A
  • *Osteophytes and deformity (hallux valgus)
  • Bony outgrowth – lead to bunion
  • Dorsal and medial surface
  • Simulates Gout!
  • Osteophytes also seen from hallux sesamoids
82
Q

Which DJD stimulates gout?

A

DJD of the foot

83
Q

Pathogenesis of hallux valgus?

A
  • complex deformity with angle between 1st & 2nd MT >9 degrees & valgus angle at MTP joint >20 degrees
  • valgus posture of great toe causing hammer toe like deformity of second toe
  • splaying of forefoot causing bunion
  • incongruence causing OA of 1st MTP
84
Q

Gouty arthritis is characterized by

A

sudden, severe attacks of pain, redness and tenderness in joints, often the joint at the base of the big toe.

85
Q

Who is more likely to get gout?

A

Men

86
Q

Who becomes increasingly susceptible to gout?

A

Women, after menopause

87
Q

Gout occurs when which crystals accumulate in the joint causing pain and inflammation?

A

urate crystals

88
Q

When do urate crystals form?

A

when you have high levels of uric acid in your blood

89
Q

Which tests can be used for gouty arthritis?

A 
joint fluid test
blood test 
xray imaging 
ultrasound 
dual energy CT scan

Skel Rad A (3 decks)

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