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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 |