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Rad 2 lifewest
RAD 2 ARTHRITIES
| Question | Answer |
|---|---|
| licked candy stick appearance | atrophic charcot joint |
| what disease's most common cause is syringomyelia | Atrophic Charcot Joint |
| tumbling block vertebra sign (what disease) | Hypertrophic Charcot Joint |
| the 6 D's (what disease) | Hypertrophic Charcot Joint |
| what disease's most common cause is diabetes, then tabes dorsalis | Hypertrophic Charcot Joint |
| neurotrophic joint (loss of proprioception AND pain sensation) | Charcot Joint |
| most important indicator for Hypertrophic Charcot Joint (one of 6 D's) | debris |
| DISH aka | Forestier’s Disease |
| thick, flowing hyperostosis like dripping candle wax appearance | DISH |
| most commonly occurs at T7-T11 | DISH |
| smaller-absent osteophytes on L side of thoracic spine, due to pulsating aorta | DISH |
| disc spaces relatively preserved (depends on age of onset) | DISH |
| enthesopathy of upper 1/3 of SI joints (ligamentous portion) | DISH |
| ___% of patients with DISH will develop OPLL | 50% |
| OPLL without DISH:almost exclusively in patients of _____ decent | Japanese |
| disc bulges out against ALL (i.e. with aging = ↓ turgor, hypermobility, etc.) and pulls down on periosteum above and below | anterior osteophytes/spurs |
| osteophyte at anterolateral portion of vertebral body endplates | spondylophyte |
| - end plate osteophytes/spondylophytes- subchondral sclerosis | spondylosis |
| - disc narrowing- disc calcification- vacuum phenomenon of Knuttson/Phantom Disc | intervertebral osteochondrosis |
| combination of spondylosis and/or intervertebral osteochondrosi | DDD |
| arthrosis=? | i.e. OA, but at facet/uncovertebral joints only (spine only) |
| disc calcifies and becomes bone (vs. new bone formation at anterior body) | posterior osteocartilagenous ridges - aka posterior spur |
| - hourglass shape of IVF (normally ovoid) - hypertrophy - sclerosis - loss of joint space | uncinate arthrosis |
| - at lateral and posterior facets - osteophytes, sclerosis → “cartilagenous cap” of osteophyte (will fill in with bone eventually) - loss of joint space | facet arthrosis |
| pseudofracture sign associated with | uncinate arthrosis |
| spinal canal < 80% width of vertebral body = stenosis | Torge Ratio |
| build-up of N2 gas due to active degeneration | Vacuume Phenomenon |
| calcification of anterior fibers of annulus fibrosis,“cartilagenous cap” over osteophyte→ will eventually ossify entirely | intercalary bone |
| costovertebral arthrosis | thoracic vertebrae OA |
| triangular-shaped (i.e. claws) at rib/body junction implicated in pain production | costotransverse arthrosis (OA) |
| Robert’s Disease | pain simulates upper GI disease Due to Costotransverse arthrosis (OA)usually invovles lower thoracic spine |
| The four F's (Fat,Forty,L4,Female) | degenerative spondy |
| hemispherical sclerosis | OA (lumbar?) |
| osteophytes either at junction of upper 1/3rd and lower 2/3rd, OR at inferior aspect of SI joint | OA |
| AKA DJD | OA |
| superior migration of femoral head & loss of superior joint space (general joint space narrowing) | HIP JOINT OA |
| Widening of medial joint space @ acetabulum = | Waldenstrom’s sign |
| subchondral cysts of OA - very large cyst = | geode |
| osteophyte formation on the femoral head has ___________ apperance | “mushroom cap” appearance (different than osteophytes on other bones!) |
| extensive/advanced OA of the hip (severe degeneration) | Malum Coxae Senilis/Coxarthrosis |
| ▪ bilateral joint space loss - non-uniform - more prominent on medial side▪ osteophytes - often small and hard to see▪ prominent tibial eminence▪ subchondral sclerosis | OA of the knee |
| Loss of patello-femeral joint space due to OA best seen on what view | sunrise view |
| patellar tooth sign | enthesopathy at site of attachment of quadriceps tendon |
| softening of patellar cartilage | chondromalacia patella |
| movie/isle sign: pain with prolonged flexion, so sit at isle of movie theater/airplanes so can extend leg | Chondromaliacia Patella |
| most common location For OA in the Foot | metatarsophalangeal (MTP) joint |
| most common location for OA in shoulder girdle MAY CAUSE IMPINGMENT SYNDROME | AC joint |
| - rotator cuff tear with retraction causes superior humeral head displacement - results in subchondral sclerosis and osteophytes (acromion) - i.e. “mushroom cap” ▪ more often CPPD, bcse unlikely to normally have osteophyte formation here | OA of the GH joint (glenohumeral) |
| OA of the hand is most commonly located at? | most common location = DIP, then PIP joints - DIP = Heberden’s nodes - PIP = Bouchard’s nodes |
| Most common location of OA in the wrist | 1st carpometacarpal (CMCP) joint |
| gull wing appearance | Erosive OA (due to pannus, erosion) |
| aka synovial chondromatosis, synovial osteochondromatosis | SYNOVIOCHONDROMETAPLASIA |
| Cartilage piece flakes off:develops vascular supply, grows, and ossifies | synoviochondrometaplasia |
| “joint mice” | loose bodies/ossicles of bone(2-5 per joint){synoviochondrometaplasia} |
| 3 sings of RHEUMATOID ARTHRITIS | 1. marginal erosions2. uniform joint space loss3. articular surface erosions |
| (+) RF in serum analysis#RHEUMATOID ARTHRITIS | RHEUMATOID ARTHRITIS |
| 6 months-2 years before x-ray changes seen! | RA |
| Boutonniere deformity | RA deformity of the hand |
| Arthritis Mutilans/Opera Glass appearance | RA deformity of the hand |
| Swan Neck deformity | RA deformity of the hand |
| MCP and/or PIP,pancarpal/universal carpal involvement (radiocarpal, carpals, CMCP joints) | RA of the Hand |
| what deformity in the wrist should you always assume RA until proven otherwise | ulnar styloid erosion |
| what shows synovitis well in an RA hand (modality of choice=) | MRI |
| what view do you use to better visualize 5th metacarpal-base erosion in RA (a common site of early RA erosion) | Noorgart’s/Ballcatcher’s view |
| stair-stepping appearance | RA (cervical spine) |
| __of patients with RA have in spine _-_%in cervical spine | 1/2 ....80-90% |
| ______moves lateral to medial in the foot: where _____ is more random, moves medially to laterally | RA....Gout |
| RA in the upper cervicals leads to atlantoaxial instability due to what two main reasons? | involvement of 1. anterior tubercle to anterior dens 2. transverse ligament to dens |
| most common cause of protrusio acetabuli/Otto’s pelvis | RA |
| uniform joint space loss, erosions, osteoporosis, no osteophytes or sclerosis occurs in what disease of the hip | RA |
| DDx: AS HIP(rosary bead erosion) | RA |
| JRA before age__ | 16 rapid changes, leading to early ankylosis (i.e. by 10-12 years of age!!) |
| JRA m/c in male or female | female |
| Need to do AS SLIDES | ASAP |
| what disease always starts at the bottom 2/3 of the S.I. joints? | AS |
| is AS unilateral or bilateral/symmetrical or Asymmetrical? | Bilateral and Symm... |
| What does Early AS look like in the SI jt's? | Frayed jt margin,w/ sclerosis on liliac side, bilateral and symmetric |
| Erosions="Rosary bead erosions";reactive sclerosis(bilat/symm)? | AS |
| ghost sign & star sign? | Chronic AS (both SI jts fused) |
| healing of erosion causes transient reactive sclerosis=? | "shiny corner sign" AS |
| Focal destruction and erosion of body rim at annulus enthesis=? | "Romanus Lesion" AS |
| Changes of new thicker bone in the corner (AS) | Shiny Corner Sign |
| only Two disorders that Cuase SQUARING of the vertebral body | AS and Paget's dx |
| Bamboo spine / poker spine | AS (KNOWN AS MARGINAL SYNDESMOPHYTE) |
| ossification of the outer annulus fibers in AS is known as? | Bamboo/poker spine |
| OALL difference in DISH and AS =? | DISH=thick / AS=thin |
| TROLLY TRACK sign? | AS |
| Dagger sign? | AS |
| Calcification of inter/supra-spinous ligaments | AS (Dagger sign) |
| Calcificatoin of the apophyseal joints and ligamentum flavum? | AS (trolly track sign) |
| Carrot stick Fx | AS |
| Where is Carrot stick fx most commonly found? | lower cervical & T/L junction |
| epidural hematoma occurs in __% of carrot stick fx | 20% |
| andersson lesion is a complication | Carrot stick fx (AS) |
| 80% of males w/ AS have ______ | prostititis |
| GI dx most commonly associated with? | AS (patients 26x M/L to have GI dx) |
| AS is a SERO (+ or -) arthropathie? | SERONEGATIVE ARTHROPATHIE |
| what are the 4 disorders that are seronegative arthropathies? | AS,Enteropathic Arthropathy, Psoriatic arthritis,Reiter's syndrome |
| Psoriasis invovles nail beds in __% of PA? | 80% |
| DIP then PIP then MCP (effecting all 3)W/ IP of toe common site of involvement? | PA |
| Ray sign | invovlement of all 3 phalangeal articulations of the hand (PA) |
| Mouse Ears (fluffy periosteal new bone formation (periostitis) | PA |
| 3 joints involved (ray sign) & bony ankylosis | PA (excludes OA & RA) |
| spinal changes in PA are identical w/ those seen in _______ | Reiter's Syndrome (non-margnial syndesmophytes) |
| what two disorders include Non-marginal Syndesmophytes? | PA and Rieter's |
| Erosions, Sclerosis, & hazy SI jt margin (bilat..Asymm...but may be unilateral) | PA |
| Lover's Heel | Reiter's syndrome (changes at the achilles insertion |
| AKA...reactive arthritis | Reiter's syndrome |
| triad of Urethritis, Conjuctivitis, & Polyarthritis | Reiter's syndrome |
| Reiter's Syndrome common sites? | foot, ankle, spine |
| AKA...Systemic Progressive Sclerosis | scleroderma |
| Acroosteolysis (tapered conical fingertips | Scleroderma |
| Scleroderma occurs almost exclusivly at? | Hands |
| What is the mechanism of Scleroderma? | Tightening of Skin |
| CREST syndrome | Scleroderma |
| C in CREST | Calciinosis (Scleroderma) |
| R in CREST | raynaud's phenomenon (Vasoconstriction) SCLERODERMA |
| decrease blood circulation to ends of fingers ("feel cold") | Raynaud's of Scleroderma |
| E in CREST | Esophageal Motility Disorder SCLERODERMA |
| S in CREST | SCLERODERMA |
| T in CREST | Telangiectasia (scleroderma) |
| Bilateral Sclerosis on iliac side w/ no joint invovement | Osteitis Condensans Ilii (OCI) |
| Sclerosis and erosions at the pubic symphysis | Osteitis (Condensans)Pubis |
| overhanging margin sign | Gout |
| Crystal Depositions arounds Jts (clusters=TOPHI) | Gout |
| Lumpy,Bumpy (varitey of Jts involved~random) | Chronic Gout |
| Relative preservation of Jt space & periarticular erosions w/ soft tissue swelling | Gout |
| AKA Psuedogout | CPPD (Calcium Pyro-Phosphate Deposition Disease |
| CPPD/Psudogout has what Hallmark potential sites of Ca++ | hyaline cartilage &fibrocartilage of knee |
| 3 most common locations of CPPD/Psudogout | knee,wrist,pubic symhysis |
| AKA... Calcific Tendinits | HADD (Hydroxy Appetitie Deposition Disease |
| Calcification w/in tendon, bursa or other periarticular soft tissue | HADD hydroxy appetite deposition disease |
| common Location for HADD | SITS muscle of shoulder and shoulder bursae |
Created by:
JRW
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