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Diagnostic Imaging I Exam Two > Rheumatoid Arthritis & Lupus > Flashcards

Rheumatoid Arthritis & Lupus Flashcards

1
Q

What is the most common inflammatory arthritis?

A

RA (1-2% of the population)

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2
Q

Is RA positive or negative for RF?

A

Positive

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3
Q

RA specifically impacts what part of the joint?

A

Synovial tissue

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4
Q

What is the term for the hyperplastic synovitis seen with RA?

A

Pannus

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5
Q

What is the gender bias associated with RA?

A

Females more likely (3:1)

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6
Q

What is the age range for RA?

A

20-60

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7
Q

At what point are men just as likely to develop RA as females?

A

After age 60

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8
Q

Is enthesopathy more frequent with RA or DJD?

A

DJD

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9
Q

What are the lab findings associated with RA?

A

1 RF
2 Elevated ESR
3 +ANA
4 C-RP

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10
Q

What is the characteristic distribution of RA?

A

Bilateral symmetry (and PROGRESSIVE)

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11
Q

What is the mechanism in which RA destroys synovial tissue?

A

Pannus (hardened tissue that grinds away synovial tissue)

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12
Q

What is the term for the enlargement of the gastrocnemius bursa which is commonly seen with RA?

A

Baker’s cyst

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13
Q

What is Boutonniere’s deformity?

A

PIP flexion, DIP extension

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14
Q

What is swan neck deformity?

A

PIP extension, DIP flexion

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15
Q

What is the term for the soft tissue nodes seen at the MCP commonly with RA?

A

Haygarth’s nodes

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16
Q

What is the number one location in the body for RA to target?

A

Hands (second would be wrist)

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17
Q

What is the term for the area between the end of the cartilage and the end of the synovium/joint capsule?

A

Bare area

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18
Q

What is the jelling phenomenon?

A

Stiff joints following inactivity

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19
Q

What is the term for the accumulation of inflammatory cells with necrotic area and fibrosis seen on extensor surfaces with RA?

A

Rheumatoid nodules

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20
Q

What is the intermittent absence of the articular codex due to erosion with RA called?

A

Dot-dash appearance

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21
Q

What is it called when RA gets so bad that it leads to the most severe case of joint deformity and destruction?

A

Arthritis mutilans

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22
Q

What is the condition that includes leukopenia, splenomegaly, and RA?

A

Felty’s syndrome

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23
Q

What is different about the loss of joint space with RA compared to DJD?

A 
RA = UNIFORM 
DJD = NONUNIFORM
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24
Q

RA symptoms are most prevalent during what time of the day due to the jelling phenomenon?

A

Morning (due to inactivity)

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25
Q

What is the most common location in the hand for the effects of RA to take place?

A

MCPs (and PIPs) then proceed proximally

26
Q

What is RF?

A

Rheumatoid factor: measurement of the reactive IgM antibodies seen in the synovial membrane

27
Q

What time table is used to assess the diagnosis of RA?

A

At least 6 week with morning stiffness, pain upon joint motion, swelling of at least 1 joint, and swelling in at least another joint

28
Q

What aspect of the wrist does RA tend to target?

A

Ulnar styloid area

29
Q

What are all the common locations for RA?

A

Hands, wrist, knees, foot, cervical spine

30
Q

What is the term for the marginal erosions seen with RA?

A

Rat bites

31
Q

What is the term for the demineralization of bone near the joint that is commonly seen with RA?

A

Junta-Articular osteoporosis

32
Q

How can RA affect the knees?

A

Symmetric loss of joint space of all compartments (also Baker’s cysts)

33
Q

How can RA affect the hips?

A

Concentric (uniform) loss of joint space and acetabular protrusion

34
Q

How can RA affect the shoulder?

A

Resorption of the clavicle

35
Q

What is the biggest concern when RA reaches the cervical spine?

A

Increased ADI leading to atlantoaxial instability and odontoid erosions

36
Q

What is the most common cause of increased ADI?

A

RA

37
Q

Why is pannus in the odontoid region an issue?

A

Possibly narrowing of the canal and therefore compressive the cord

38
Q

What are the normal ADI levels for children and adults?

A 
Adults = less than 3mm
Children = less than 5mm
39
Q

What procedure should be done in patients with RA to assess for increased ADI?

A

Flexion/extension views

40
Q

Patients with RA that affects the Occ-C1 and C1-C2 facet area with erosions are now at risk for what condition?

A

Basilar invagination

41
Q

What form of Juvenile Chronic Arthritis (JRA) is more common?

A

Seronegative

42
Q

What is another name for JRA?

A

Still’s disease

43
Q

Does JRA more commonly involve one or multiple joints?

A

Multiple

44
Q

How can JRA affect growth?

A

Either stimulate or stunt it

45
Q

How does JRA affect the knee?

A

Ballooning of metaphysis

46
Q

What is the radiographic sign seen due to the periosteal reaction of JRA at the phalanges?

A

“Cloaking layer”

47
Q

Is fusion more common in RA or JRA?

A

JRA

48
Q

Which level of the cervical spine usually appears fused on X-ray due to the angle?

A

C2/C3

49
Q

What visible difference on X-ray will be seen in individuals with “old” JRA on a lateral cervical?

A

Hypodeveloped vertebral bodies

50
Q

What category does lupus fall in?

A

Seropositive rheumatoid type

51
Q

What are the lab findings for lupus?

A

1 elevated ESR
2 +ANA
3 RF positive

52
Q

What dermatological feature is associated with lupus?

A

Butterfly rash

53
Q

What is the normal population associated with lupus?

A

Females aged 20-40

54
Q

How common is an articular complaint with lupus patients?

A

80-90% (but severe radiographic changes are not seen)

55
Q

What is the most frequent and serious feature of SLE?

A

Kidney failure and nephropathy

56
Q

What other organs besides the kidneys can be damaged due to SLE?

A

Heart or lungs (80%) and nervous system (neuropsychiatric)

57
Q

What is unique about the joint involvement with lupus patients?

A

Normal, nonerosive joint spaces and deformities that are easily reversed

58
Q

What external stimulus can irritate symptoms of both RA and lupus?

A

Sun

59
Q

Where is the most common involvement of joint issues with those with lupus?

A

Hands

60
Q

What other osseous issue can arise in lupus patients, especially following corticosteroid treatment?

A

AVN

61
Q

Which joints are usually affected by lupus?

A

MCP and PIP (just like RA)

62
Q

What kinds of deformities and positions are seen with lupus joint involvement?

A

Ulnar deviation, Boutonnière deformity, Swan-neck deformity

Diagnostic Imaging I Exam Two (7 decks)

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