Radiology - Arthridities

klistu's version from 2016-03-27 23:36

Section 1

Question Answer
RA has _____ changes while psoriatic arthritis has ______ and _____ changeserosive, erosive and new bone formation
in contrast, this arthritis has fusiform swelling that is localized to the jointR.A.
Asymetrical involvement of the distal joints of hands and feet, IPJ whiskering, acro-osteolysis, pencil-in-cup, ivory phalanx, sausage digit, periostitisPsoritatic arthritis
Can't see, can't pee, can't climb a tree, cannot make diagnosis without clinical symptomsReactive arthritis
results from an STD transmission, more common in menEndemic reactive arthritis
results after a case of dysentary (salmonella), more common in women and childrenEpidemic reactive arthritis
typical patient has rapid onset of heel pain, bilateral heel spurs that are abnormal for a person so young, maleAcute Reactive arthritis
Inflammation of the Achille's and peri-articular osteopeniaReactive arthritis (acute phase)
Involves small joints, bil, that progresses to ankylosingReactive arthritis (chronic phase)
Has the highest HLA-B27 concentration, shiny corner sign, calcifications of ligaments cause bamboo spine (syndesomphytes),dagger sign,trolley-track sign, postage stamp like erosionsAnyklosing spondylitis
Longitudinal ligament or annulosis fibrosis is calcifiedSharpey's fibers
Has the lowest HLA-B27 concentration can be caused by bacteria, infection, or IBDEnteropathic spondylitis

Section 2

Question Answer
Rat bite sign (c-shape)gouty arthritis
Under excretion or over production of uric acidprimary gout
High uric acid levels induced by medicationssecondary gout
Elevated urate levels in patients with no known history of things that may cause goutasymptomatic hyperuricemia (1st stage of gout)
Red hot swollen joint, quick onset, crushing pain, one joint acute monoarticuar gout (2nd stage of gout)
Recurrent attacks of gout, less severe but prolongedpolyarticular gout (3rd stage of gout)
Tophi are present, joint starts being destroyed, gouty arthritischronic gout (4th stage of gout)
Spike of new bone that grows to try and wall off the tophusMartel's sign
Hallmark of gouty arthritispreservation of the joint space
CPPD crystals that are rhomboid shaped that prefer to deposit in the knee (meniscal - central and articular - adjacent)Chondrocalcinosis
Needle like monosodium urate crystalsgout

Section 3

Question Answer
Increased subchondral sclerosis (represents bone production)eburnation
Osteophyte formation, decreased ROM, and dorsal flag, subchondray cysts, joint mouse formation, no erosions, non-inflammatoryDJD
Cannot diagnose this wtih x-ray, need ROMHallux limitus
Normal NWB ROM, but limited with WBStage 1 DJD
Pain on end ROM, limited NWB ROMStage 2 DJD
Pain with all ROM, crepitus, and subchondral cystsStage 3 DJD
Major osteophyte formation, obliteration of the jointStage 4 DJD
Bouchard's nodesproximal IPJs
Heberden's nodesdistal IPJs
Will only see this in the hand, gull wing sign, saw tooth signErosive osteoarthritis (EOA)
Heberden's and Bouchard's nodulesDJD and EOA

Section 4

Question Answer
produces the least amount of bone (made then resorbed)RA
Inflammation of the synovium that causes symmetrical joint space lossPannus
More likely to form in pts that are seropositive for RA, located on extensor surfaces, develops at pressure pointsRheumatoid nodule
Fusiform swelling, pannus, and increased soft tissue contourStage 1 RA
Increased pannus and marginal erosionsStage 2 RA
Destruction and erosion begins to lead to joint compression and fusionStage 3 RA
Joint is actually replaced by fibrous tissue (ankylosis)Stage 4 RA
Mainly affects the MPJs and PIPJs (proximal joints),peri-articular osteopenia, increased joint space, prominent primary trabeculae are all prominent signs of this arthritis, dot-dash appearance (ill defined boarders), pseudocysts rather than subchondral cystsRA
RA typically spares this jointCalcaneocuboid
Rarely deviated with RA5th digit
Hyperextension at the DIPJ, flexion at the PIPJBoutonniere deformity
Flexion at the DIPJ, hyperextension at the PIPJSwan neck deformity
Swan neck deformity is seen in which diseasesscleroderma and SLE
Main en lorgnette deformityopera glass hand
Opera glass hand is seen in what diseasesRA, PA, and EOA
See a generalized washed out appearance of all the bones in the feetRA
Bony destruction that is attributed to a loss of sensationNeurotraumatic theory of Charcot
Bony destruction that is attributed to a loss of an autonomic vascular reflexNeurovascular theory of Charcot
Presents initially like an infection would present, diabetes is the most common causeCharcot
Affects the smaller non-weight bearing joints (MTPs/FF)Hypotrophic Charcot
Affects the larger weight bearing joints (ankle/RF)Hypertrophic Charcot


Question Answer
Licked candy stick appearance (osteolysis)Hypotrophic Charcot
Destruction/fragmentation phase, involves increased ROM and swellingAcute Charcot
Coalescence, bone fuses together, becomes more bright white, and slight decrease in swellingSubacute Charcot
Remodeling, false joint formation, ankylosing, and minimal swellingChronic Charcot
Eichenholtz classificationHypertrophic Charcot
6 D's of Hypertrophic CharcotDestruction, Debris, Density increase, Dislocation, Disorganization, and Distention

Section 5

Question Answer
Ligamentous/tendinous calcifications, specifically the anterior longitudinal ligament, common symptoms is dysphasia, left side of the spine is usually spared (pulsating aorta), HLA-B8 antigen (note AS has HLA-B27)DISH
Digital clubbing, symmetric arthritis, and linear periostitis, caused by a neoplasm or infection in the thoracic cavity, commonly targets the tibia, radius, ulna, femur, and fibula (long bones of the arms and legs), double stripe sign on a bone scan, linear and laminar periostitis, can be caused from a bronchogenic carcinomaPHO
Invasive nodular mass that arises from the synovial lining, results in decreased ROM, locking, catching, monoarticular, synovial fluid is usually hemorrhagic and dark brown in color, saucerizationpigmented vilonodular synovitis
Reversible deformity, goes away when WB, can have swan neck and boutonniere deformities like RA, pts develop osteonecrosis of weight bearing jointsSLE
CREST, most commonly involves the hands and wrists, arthritis is the initial symptom in 2/3rds of pts, often preceeds skin changes, acro-osteolysis is also present, tight skin usually the reason for contracturesScleroderma
Causes color changes from white->blue->red in digitsRaynaud's phenomenon
Characterized by symmetric joint space narrowinginflammatory arthritis
Characterized by asymmetric joint space narrowingdegenerative arthritis