Skel Rad Up The A-Hole Flashcards by S S

T or F

A hemi-vertebrae will have an extra rib associated with it

True

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An Omovertebral Bone is typically associated with what condition/deformity?

Sprengle’s Deformity - failure of decent of Scapula

**25% of Sprengle’s occur with Klippel-Feil

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The delayed or non-union of the vertebral bodies forming 2 hemi vertebrae is describing which congenital anomaly?

Butterfly Vertebrae

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What does a Butterfly vertebrae usually cause/lead to?

A congenital scoliosis

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What is a common etiology of Schmorl’s Nodes?

Trauma - from an axial load which are referred to as “Post-Traumatic Schmorl’s Nodes”
Repetitive Axial loading in young spines

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T or F

Cupid’s Bow deformity involves both the superior and inferior endplates

False

Inferior only

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What can Facet Arthrosis lead to?

Central Canal Stenosis by pushing the vbody anterior creating an degenerative anterolisthesis

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When you have an anterolisthesis greater than 60% what are the typical causes for this?

Dysplastic

Ismic *not sure if the spelling is Ischmic??

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When the lower portion of the sternum is depressed inward this anomaly is known as?

Pectus Excavatum

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What syndrome does Pectus Excavatum commonly occur?

Marfan’s

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How does Pectus Excavatum affect the body?

Can push on the heart and displace it. It can mimic heart disease

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T or F

Psoriatic Arthritis is sero+ for Rheumatoid Factor

False

Sero -

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Where does Psoriatic like in the body?

DIP
PIP
MCP
**likes the hands and feet (50%) but likes hands more than feet.

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When Psoriatic affects DIP PIP and MCP what is that termed?

Ray Arthritis

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Name the 5 presentations of Psoriatic Arthritis

DIP & PIP
Rheumatoid Mimic
Arthritis Mutilans
Ray Arthritis
Spine

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T or F

When an individual with Psoriatic arthritis is HLA-B27 negative the likelihood of it going into the spine increases

False

Will decrease when negative

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Primary OA in postmenopausal women is called?

Kelgren’s Disease

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T or F

Psoriatic arthritis will have non-uniform loss of joint space

Fales

This is DJD.

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In the foot where does Psoriatic arthritis like?

Great Toe DIP joint

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What is a good indicator that someone has an arthritic condition of the fingers?

Pitting fingernails

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What percentage of individuals with Psoriasis will have psoriatic arthritis in the spine

50% so of the 10% of the population with psoriatic arthritis 5% will have it in the spine

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What is panus?

Granulation tissue in jo int coming from synovial membrane

- from chronic inflammation

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T or F

Psoriatic arthritis will affect the bone density

False

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T or F

Psoriatic arthritis will not cause erosions

False

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T or F Mouse ears is classic with RA

False Psoriatic

T or F Gull Wings is classic with Psoriatic

False EOA

What is whiskering?

Bone formation at the capsular periosteal jxn which is also known as Mouse Ears

T or F Mouse ears will happen on the PIP

False DIP Gull wing is on the PIP

T or F The periosteal layer is more superficial than the synovial membrane

False They are in the same layer

The mutilating appearance of Psoriatic Arthritis is called?

"Pencil in Cup Deformity" | - the proximal phalange will be the pencil and the distal will form the cup

What are the seronegative arthropathies?

``` Ankylosing Spondylitis Behcet's Syndrome Enteropathic Arthritis Psoriatic Arthritis Reiter's (reactive) ```

What is an enthesopathy?

Erosions at the bone-ligament junctions **prominent fibrous tissue production within the joint cavity may widen the joint and eventually undergo metaplasia to produce bony ankylosis

Lumpy Bumpy disease is a term for what arthritis?

Gout

T or F Psoriatic Arthritis does not go to the SI joints

False

What are the general radiographic findings for Psoriatic Arthritis

- asymmetric - soft tissue swelling - normal bone density - Marginal erosions and tapered bone ends - fluffy juxta-articular periostitis - widened joint

What are two major radiographic findings that help you distinguish Psoriatic from RA?

- normal bone density | - DIP involvement

What is the most painful arthritic disorder?

Gout

T or F A patient with Gout in the spine may have pain and discomfort in spine but will have NO radiographic findings

True Gout DOES NOT have a destructive presence in the spine.

T or F Gout does not touch bone density

True

T or F Gout has a 10:1 male:female predilection

True

Name the 4 stages of Gout

1. Increase Serum Uric Acid 2. Acute Monarticular Arthritis 3. Chronic Polyarticular 4. Chronic Build-up of Mono-urate Crystals

What stage of Gout will be asymptomatic?

The first! | ** will have increased serum levels but no physical symptomology

What is Podagra?

Gout in the 1st MTP Joint

Deposition of Sodium monourate crystals is called?

Tophi

What do some authors consider to be pathoneumonic for Psoriatic Arthritis?

Great Toe DIP joint destruction

Why is Tophi a bad boy?

Cuz he suck ya momma's itty bitty titties ...just playing they are very hard and push on bone and cause remodelling.

What is the classic presentation of Gout

1st MTP

The "Overhanging Margin" is a radiographic sign associated with what arthritis?

Gouty

What is considered to be pathoneumonic for Gout?

Non-Traumatic Olecranon Bursitis | - bilateral

CPPD has 3 distinct radiographic presentations. What are they?

1. Chondrocalcinosis 2. Pseudo-Gout 3. Pyrophosphate Arthropathy - this is DJD in CPDD

T or F CPPD will always present with all 3 radiographic findings: Chondrocalcinos, Pseudo-gout and Pyrophosphate Arthropathy

False The three circles are interconnected but a patient may present with only 1 or all 3 of the presentations. - this can be confusing in your differential dx because it can look like DJD, or can be more inflammatory with the pseudo-gout presentation

What is Main Liner's Disease

When you have a Pseudomonas infection that affects the S joints in the body. Commonly seen with intravenous drug users with osteomyelitis

A neuropathic joint is called?

Charcot's Joint

T or F Charcot's joint is very painful

False Painless!!!!!

What will give you a neuropathic joint?

Tertiary Syphilis Diabetes Syringomyelia

T or F Tertiary Syphilis will typically give you a neuropathic joint in the shoulder and wrist

False Well not totally false but will affect every joint not just the shoulder and wrist. Shoulder and wrist are more commonly affected by Syringomyelia.

Diabetic neuropathic joints will affect what part of the body predominantly?

Ankles and Foot

What are the 6 D's in Charcot's Joints

``` Disorganization Destruction Debris Density Distention Dislocation ```

T or F Charcot's joints are always monarticular

False Can be both!

T or F Arthritis will destroy the joint faster than an infection

False

T or F There is no treatment for a Charcot's Joint

True

T or F Discovertebral DJD in the spine affects the apophyseal joints

False Discovertebral = intervertebral (osteo) chondrosis

T or F Spondylosis Deformans is central nucleus degeneration

False Peripheral annulus Central nucleus degeneration = central nucleus

T or F DISH and OPLL are degenerative arthropathies but NOT an arthritis

True

Neurocentral aka ?

Uncovertebral

What structures are affected/included in Synovial DJD in the spine

Apophyseal joint osteoarthritis | Costovertebral

What are the costovertebral joints?

Rib head & vbody = costovertebral | Rib tubercle & TP = costotransverse

T or F Costrotransverse = T11-T12

False T9-T10

T or F OPLL is more common in the lumbar spine

False Cspine

T or F With IVOC there will be normal or slightly decreased IVD height

False Mod-Sev decrease in disc height Spondylosis = normal or slight decrease

T or F With Apophyseal and CV joints the IVD will be normal

True

T or F DISH is more serious than OPLL

False

T or F The inner annulus = H20 = high single on MRI = dark

False bright signal

What part of the annulus the inner or the outer is up against the bony endplate?

Outer

Why don't we see osteophytes @ the posterior aspect of the v body?

The PLL is very tightly attached to the back of the disc and body.

The water part of the inner annulus is up against what type of cartilage?

Hyaline

T or F IVOC = central nucleus DDD especially cervical and lumbar

True

What is another term used for Dehydration of the disc?

Dessication

T or F Desiccation will change the signal on T2 MRI but will look normal on Xray

True

What happens after the cartilage over the nucleus degenerates? What is it called when it is really bad?

Subchondral Sclerosis of the V body | Bad = Hemispherical Spondylosclerosis

T or F Withe IVOC the symptomology and degeneration have a linear correlation

False

What is the vacuum phenomenon?

When horizontal fissures occur through the disc that can fill with gas. The gas makes it hyper lucent.