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18 ORR > Radio 2 > Flashcards

Radio 2 Flashcards

1
Q

most common arthropathy

A

osteoarthritis

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2
Q

essential findings in oa

A

OJ Simpson is OA

  • osteophytes (spurs)
  • sclerosis (increased whiteness or calcification)
  • joint space narrowing (always)
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3
Q

most common weight bearing parts

A
  • medial compartment of knee
  • superolateral aspect of the hip
  • spine (diffuse)

all must be present!

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4
Q

occasional findings in oa

A
  • subchondral cyst/geode
  • marked degenerative joint disease
  • primary osteoarthritis
  • erosions
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5
Q

classic findings in primary osteoarthritis

A
  • dip, pip, base of thumb
  • bilateral
  • symmetric
  • younger patients (female)
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6
Q

differential for oa

A

diffuse idiopathic skeletal hyperostosis

  • osteophytes without sclerosis or joint space narrowing
  • spurs on spine
  • idiopathic
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7
Q

clinical and radiologic hallmarks of rheumatoid arthritis

A

RA! OJ is SOFT, BI, and MARGINALized by the PD

  • soft tissue swelling
  • osteoporosis
  • joint space narrowing
  • marginal erosions
  • proximal distribution
  • bilateral and symmetric
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8
Q

typical presentation of ra

A
  • hand: proximal bilateral symmetrical
  • knee: all compartments
  • hip: axial migration
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9
Q

subgroup of hla b27 spondyloarthropathies

A
  • negative for ra factor
  • involvement of axial skeleton (vertebral bodies)
  • ankylosing spondylitis
  • ibd
  • psoriatic arthritis
  • reactive arthritis (reiter’s)
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10
Q

characteristics of hla b27 spondy

A
  • bony ankylosis
  • proliferative new bone formation
  • predominant axial spinal involvement
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11
Q

what is syndesmophyte

A
  • mostly spine
  • paravertebral ossification
  • as and ibd = syndesmophytes are marginal and symmetric
  • reiter’s and psoriatic arthritis = non-marginal and asymmetric
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12
Q

sacroiliac joint involvement in spondyloarthropathies

A

as and ibd = bilateral and symmetric

pa and rs = bilateral asymmetric or unilateral

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13
Q

bony abnormalities in gout take ___ years to manifest

A

4-6 years

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14
Q

hallmarks of gout

A
  • well defined erosions
  • soft tissue nodules
  • random distribution
  • no osteoporosis
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15
Q

what is podagra

A

specific term for finding in 1st metatarsopahangeal joints

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16
Q

gout vs pseudogout

A

gout: monosodium urate
pseudogout: calcium pyrophosphate dihydrate crystals

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17
Q

classic triad of pseudogout

A
  • pain
  • cartilage calcification (chondrocalcinosis) !!! @ knee, symphysis pubis, triangular fibrocartilage
  • joint destruction
  • severe mimics carcot joint
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18
Q

pseudogout is associated with

A
  • hyperparathyroidism
  • gout
  • hemochromatosis
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19
Q

classic findings in charcot’s joint

A
  • severe joint destruction and fragmentation
  • dislocation
  • heterotopic new bone/osteophyte formation
  • diabetic foot!!
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20
Q

most common etiology of septic arthritis

A

s aureus via hematogenous spread, local direct extension, or trauma

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21
Q

radiologic findings in septic arthritis

A
  • soft tissue swelling and distention of joint capsule with fluid (early)
  • joint space narrowing (late)
  • absence of osteoporosis
  • bone destruction and ankylosis
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22
Q

radiologic findings in tb arthritis

A
  • earliest sign: joint effusion
  • cartilage preservation at sites of weight bearing

phemister triad of classical signs:

  • periarticular osteoporosis
  • gradual joint space narrowing
  • peripheral bone erosion
23
Q

bone infection in adults vs children

A

read

24
Q

how to diagnose acute osteomyelitis

A
  • 10-12 day lag of symptoms and radio findings
  • earliest sign: soft tissue swelling
  • bone scan very sensitive
25
Q

radio sign for bone abscess

A

sharply outlined area of rarefaction or lucency in metaphysis surrounded by irregular dense sclerosis

26
Q

subacute vs chronic osteomyelitis

A

subacute >2 w

chronic >1 mo

27
Q

sequestrum and involcrum in osteomyelitis

A
  • sequestra: necrotic avascular area

- involucrum: shell of bone that cloaks sequestrum

28
Q

what is infectious spondylitis

A
  • osteomyelitis in vertebra
  • hematogenous
  • vertebral body > disc > endplate
29
Q

radiologic findings in infectious spondylitis

A
  • earliest: decreased disc height
  • narrowing of disc space
  • erosion and destruction of vertebral end plates
  • paravertebral soft tissue mass
30
Q

t/f tuberculous spondylitis has a greater tendency to spread in spine compared to infectious spondylitis

A

true

31
Q

most severe form of tuberculous spndylitis

A

bony ankylosis

  • sticking of bones
  • contiguous vertebrae
32
Q

what is a gibbus deformity

A

sharp angulation of the vertical spine

33
Q

most common metabolic bone disease

A

osteoporosis (primary senile osteoporosis most common)

34
Q

how to diagnose osteoporosis

A

sum the cortex of the second metacarpal and sum of the cortex should be more than 1/3 of the entire diaphysis

<1/3 = osteoporosis

35
Q

osteomalacia vs osteoporosis

A

malacia: failure of deposition of calcium salts
porosis: deficiency of organic matrix of bone

both have finding of decreased radiographic density

36
Q

uses of bone dositometry

A
  • diagnose osteoporosis
  • determine susceptibility to fractures
  • monitor treatment
  • postmenopausal with hormones
37
Q

causes of osteomalacia in adults

A
  • renal osteodystrophy !! (chronic renal insufficiency)
  • biliary disease
  • dietary insufficiency
  • vitamin d deficiency
38
Q

radiologic finding for osteomalacia

A
  • less defined cortical outline
  • diffuse osteopenia
  • looser fracture/ looser zone/ pseudofracture
  • bone softening: inward bending of pelvic sidewalls and protrusio acetabuli
39
Q

radio findings in hyperparathyroidism

A
  • subperiosteal resorption
  • earliest: resorption of distal phalanx
  • generalized osteopenia
  • brown tumors
  • chondrocalcinosis
  • osteosclerosis
  • rugger jersey sign (spine)
40
Q

findings in pseudohypoparathyroidism

A

brachydactyly

41
Q

findings in acromegaly

A
  • enlarged joint spaces
  • flaring up of bones
  • enlarged terminal tufts of distal phalanges
  • squared proximal phalanges
  • frontal bossing
42
Q

findings in scurvy

A
  • wimberger’s ring
  • white line of scurvy
  • scurvy zone
  • corner sign
43
Q

vitamin d deficient rickets is common in ___

A

4-18 mos old

44
Q

findings in vit d deficient rickets

A
  • craniotabes (early)
  • most common in knee
  • rachitic rosary sign
  • loss of zone of metaphyseal provisional calcification
  • metaphysis is irregularly coarse, frayed, widened
  • indistinct epiphyseal margins
45
Q

osteosarcoma

A
  • most common malignant primary tumor
  • destructive or lyric changes with sclerosis
  • malignant periosteal reaction
  • soft tissue extension
46
Q

findings in ewing’s sarcoma

A
  • permeative malignancy
  • partially sclerotic appearance
  • onion peel periostitis
47
Q

what is chrondrosarcoma

A
  • from degeneration of osteochondroma/ enchondroma

- lytic destructive lesion with amorphous calcification

48
Q

multiple myeloma

A
  • > 40 yo
  • diffuse with wide margins
  • not hot on bone scan
  • well defined punched out lesions (swiss cheese)
49
Q

what is enchondroma

A
  • !! benign cystic lesion of phalanges

- calcified chondroid matrix except in pahalnges

50
Q

criteria for giant cell tumor

A
  • epiphyseal and abuts articular surface
  • at close epiphyses
  • eccentric
  • well defined border that is not sclerotic
51
Q

soap bubble appearance

A

aneurysmal bone cyst (seen in mri, multiple fluid levels)

52
Q

sites for solitary bone cyst

A

central, metaphyseal

calcaneus, proximal humerus, proximal femur

53
Q

hallmark of avascular necrosis

A
  • icarats
  • increased bone density at an otherwise normal joint
  • early: joint effusion
  • patchy or mottled density
  • subchondral lucency
  • mr most sensitive

18 ORR (21 decks)

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