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