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Diagnostic Imaging - Inflammatory & Non-Inflammatory Arthritic > Radiology of Inflammatory Disorders > Flashcards

Radiology of Inflammatory Disorders Flashcards

1
Q

aka for Osteitis Condensans Ilii

A

Osteitis Triangularis Ilii

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2
Q

AS involves 2 extremities

A
  1. MC = hip
  2. 2nd = GH joint
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3
Q

Which side of the SI joint does AS affect with the majority of changes?

A

Iliac side

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4
Q

RA knee

A
  • frequent involvement
  • bilateral often
  • swelling prominent
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5
Q

RA Target site of Hip - an obvious finding could be

A

Acetabulae protrusio

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6
Q

AS posture changes

A
  1. Lumbar - hypolordosis
  2. Thoracic - hyperkyphosis
  3. Cervical - hypolordosis
  4. Anterior weight bearing

Everything that keeps you bent forward

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7
Q

RA (also Psoriatic) - advanced joint destruction, dislocation, flexion deformity & fibular deviation. This is called ______

A

Lanois deformity

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8
Q

Psoriatic of SI joint is most commonly:

a) bilateral or unilateral?
b) symmetric or asymetric?

A

a) Bilateral
b) Asymetric

Note: According to Medscape, SI involvement may also entail SI widening and sclerosis

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9
Q

AS radiographic “signs”

A
  1. Shiny Corner sign
  2. Ghost joint
  3. Star sign
  4. Bamboo spine
  5. Trolley track sign
  6. Railroad track sign
  7. Dagger sign
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10
Q

AKA for Ankylosing Spondylitis (AS)

A

Marie-Strumpell disease

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11
Q

Triad of Reiters

A
  1. Urethritis
  2. Conjunctivitis
  3. polyarthritis (lower extremity predominance) - plantar fascia or Achilles attachment

“Can’t see, can’t pee, can’t dance with me.”

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12
Q

Labs associated with Reiter’s

A
  • HLA B27 +
  • high ESR
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13
Q

AS initial site of involvement

A

SI joint

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14
Q

Which gender is more affected by AS?

A

Males (10/1)

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15
Q

AS radiographic hallmarks

A
  1. O = Osteopenia
  2. M = Marginal Syndesmophytes
  3. A = Ankylosis
  4. R = Romanus Lesions
  5. S = Shiny Corner Sign
  6. B = Barrel vertebra
  7. A = Anterior Squaring of Vertebra
  8. R = Rosary Bead sign
  9. P = pseudo widening (iliac side of SI)

O MARS BARP (think of Mars Bar - candy bar)

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16
Q

Seronegative Spondyloarthropathies

A
  1. Psoriatic
  2. Enteric
  3. AS
  4. Reiters
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17
Q

Labs of Psoriatic Arthritis

A
  • high ESR
  • HLA B27 (75% + with spine only, 35% with peripheral arthritis)
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18
Q

Psoriatic Arthritis of the Spine - radiographic feature:

A
  1. Asymmetric, non marginal syndesmophytes - Unilateral
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19
Q

Labs - AS

A
  1. high ESR
  2. HLA B27+
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20
Q

Predominant area of infection associated with Psoriatc Arthritis

A
  1. hands and feet @ DIPS = primary
  2. spine and pelvis = secondary
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21
Q

Complications of Enteric Spondyloarthropathy

A
  • Chron’s
  • UC
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22
Q

Psoriatic radiographic features

A
  1. Asymetric
  2. Feet = usually DIPS
  3. Mouse Ears = adj to marginal erosions. Fluffy periosteal new bone formation.
  4. Pencil in Cup = whittling of the articular ends of phalanges at the PIP or DIP articulation that fit together.
  5. Pestle and mortar
  6. Mushroom & stem
  7. balancing Pagoda
  8. Cup & Saucer

5, 6, 7, 8 = same as 4.

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23
Q

RA labs

A
  1. Rheumatoid Factor +
  2. high ESR
  3. high CRP (acute)
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24
Q

Radiologic Hallmarks of RA

A

GettinN RA is a “BUMO”

  • B = bilateral (in extremities)
  • U = uniform joint space narrowing
  • M = marginal erosions due to pannus formations
  • O = osteoporosis
  • N = nodules (pathologic diagnosis)
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25
Q

Radiographic Features of OCI are:

A
  1. Bilateral
  2. Symmetric
  3. Trianglular shaped areas of sclerosis involving the Ilium at SI
  4. Jt spacing & margins = normal

Note: I can remember a lab xray with this feature.

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26
Q

A common skin disorder associated with an erosive arthropathy

A

Psoriasis

Note: According to Medscape, patients rarely have Psoriatic Arthritis (PA) before any skin lesions appear.

27
Q

Name of the healed lesion in AS disc

A

Andersson Lesion

28
Q

RA spine

A
  • C-spine only
  • possible Atlas instability
29
Q

MC causes of Osteitis Pubis

A
  1. Over use in sports
  2. post surgical - prostate, bladder

Bony resorption & spontaneous reossification @ pubic symphasis = OP

Note: Scuderi: OP is very, very rare.

30
Q

Psoriatic (also RA) - fibular deviation with severe joint destruction. This is called _____.

A

Lanois deformity

31
Q

Osteitis Pubis location

A

Pubic Symphasis

32
Q

Target sites of Reiter’s - bones

A

Foot & Ankle

  • MTP joints
  • IP joints
  • +/- Achilles attachment
  • +/- Plantar fascia insertion
  • +/- erosions, osteoporosis, & fluffy periostitis and Achilles or Plantar Fascia insertion.
33
Q

aka for Reither’s Syndrome

A

Reactive Arthritis

34
Q

SI Joint - RA

A
  • not common involvement here
  • Unilateral involvement
35
Q

A spondyloarthropathy that is radiographically indistinguishable from AS due to its inflammatory bowel diseases

A

Enteric Spondyloarthropathy

36
Q

SI joints, pattern - Reiters

A

Unilateral, asymetric

37
Q

7 Main Inflammatory Disorders

A
  1. Psoriatic
  2. Enteric
  3. AS
  4. Reiters
  5. RA
  6. OCI (Osteitis Condensans Ilii)
  7. OP (Osteitis Pubis)
38
Q

RA target sites - MC joints affected in foot

A

MTP joints 4 & 5

IP joint #1

39
Q

Typical patient with OCI is ____

A

Multiparous female

Age 20-40

Chronic LBP

40
Q

Spine involvement - Reiters

A

syndesmophytes:

non-marginal

thick

Asymetric

Unilateral

Or not involved at all.

41
Q

Name the disease

A

Osteitis Condensans Ilii

(aka = Osteitis Triangularis Ilii)

42
Q

Name the disease at red arrows

A

Osteitis Triangularis Ilii

(aka = osteitis condensans Ilii)

43
Q

Name the disease

A

Osteitis Condensans Ilii

44
Q

Name the disease of this child

A

JRA

  • periarticular osteopenia
  • diffuse joint space narrowing
  • epiphyseal deformities and overgrowth
  • osteopenia and fusion of the carpals
45
Q

True or False

JRA is always seronegative

A

False

15% are seropositive = more females

85% are seronegative = both sexes are equal

46
Q

When JRA is systemic it is called _______ disease

A

Still’s disease

47
Q

Name the disease - patient age is over 40 years

A

RA

48
Q

Name the disease. Patient age > 40 years

A

RA

(O=anterior edge of Odontoid

A=posterior margin of anterior arch)

if > 3 mm is unstable

49
Q

Name the disease. Patient age > 40 years. Seropositive

A

RA of foot

50
Q

Name the disease

A

RA

51
Q

Name the disease

A

RA

Bilateral involvement (greater at L than R)

Uniform Narrowing of hip joints

No Spurs (characteristic of RA)

52
Q

Name the disease

A

RA

ulnar styloid erosion

53
Q

Name the disease on R knee

A

RA

uniform joint space loss

erosion of tibial plateau

54
Q

AKA for ankylosing spondylitis

A

Marie Stumpel’s disease

55
Q

Name the Disease

A

AS

56
Q

Name the disease

A

AS

57
Q

Name the disease

A

AS

58
Q

AS - Radiographic features of SI

A

P.E.A.

Pseudowidening

Erosive & sclerotic

Ankylosis (stiffened joint)

59
Q

Name the sign at the arrows & disease associated

A

Shiny Corner Sign - Ankylosing Spondylitis

60
Q

Black arrows are pointing at _____ associated with ___.

A

Syndesmophytes, AS

61
Q

Name the signs in A & B, and disease associated.

A

A) Trolley Track sign

B) saber sheath / dagger sign

disease = AS

62
Q

A ragged vertebral body endplate may indicate _____ mobility of the adjacent body and is termed a _____ lesion in ankylosing spondylitis.

A

Ragged appearance of entire endplate is due to HYPER mobility - a fracture through a previously ankylosed joint.

Termed an ANDERSSON LESION

63
Q

A fracture line through an ankylosed IVD is termed _____ in Ankylosing Spondylitis

A

a Carrot Stick fracture

64
Q
A

Diagnostic Imaging - Inflammatory & Non-Inflammatory Arthritic (2 decks)

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