30. Bone Radiology Flashcards Preview

M2 Musculoskeletal > 30. Bone Radiology > Flashcards

Flashcards in 30. Bone Radiology Deck (33):
1

Swelling centered at the joint indicates what kind of arthritis?

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reflects synovial inflammation or injury (ex, RA)

2

what type of arthritis?

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RA

soft tissue swelling, centered at joints

3

what condition?

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gout

soft tissue is lumpy-bumpy

focal collections of urate crystals by joints

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4

what condition?

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psoriatic arthritis

joints thickened in a uniform way (sausage digits)

5

what condition? what is notable?

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RA

demineralization/juxta-articular osteoporisis

demineralization in and around joints

(of limited usefulness diagnostically)

6

condition?

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psoriatic arthritis

increased density (dense-looking phalynges) due to abnormal repair processes.

("Ivory digit")

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7

joint space narrowing indicates what?

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reflects the loss of articular cartilage

 

8

if there is uniform joint space narrowing, what should I be thinking?

uniform reflects diffuse/uniform loss of articular cartilage.

think inflammation: RA, septic arthritis, psoriatic, reactive

9

what cytokines are inside the joint that cause narrowing?

IL6, IL1, metalloproteases

uniform narrowing in inflammatory processes because the same "soup" covers the entire joint

10

condition?

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RA

reflects uniform joint space narrowing.

IMPT SLIDE

11

if I see non-uniform joint space narrowing, what types of conditions should I be thinking about?

degenerative diseases: osteoarthrosis, pseudo-gout (CPPD)

(more focal processes than the inflammatory conditions)

12

condition? notable?

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non-uniform joint space narrowing.

Osteoarthritis

13

what is the most frequently affected part of the knee joint with osteoarthritis?

will the patient be varus or valgus?

most frequently medial compartment narrowing with OA

varus (bow-legged, like there's a horse btwn their legs)

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14

which is RA, which is OA?

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Left: RA (uniform joint narrowing, demineralized bone)

Right: OA (non-uniform joint narrowing)

15

in what arthritic-like conditions is joint space preserved?

how is this possible?

gout, pigmented villonodular synotivis, "early" OA

the joint is preserved because damage is very focal

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16

define Marginal Erosions.

occurs in what conditions?

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destruction of "uncovered" bone by the inflammatory pannus

think RA, psoriatic, reactive

(pic is labeled RA in slides, though it looks a lot like gout to me.....)

- Jen - I looked it up. RA may present very similiarly to Gout but the key difference is that RA has a uniformly narrowed joint space, whereas gout has a preserved joint space (since it does focal damage to the joint). Therefore in this joint, you see that the joint space is narrowed!) Hope this helps..Also you may see a lighter rim bordering the erosion, which is indicative of reactive new bone growing.

17

condition?

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Gout.

note erosions, which are well-defined and may be remote from the joint.

Note also overhanging edge of bone (due to bone having a chance to partially repair)

18

what is sublexation?

what condition will have sublexation with bony erosions?

sublexation without bony erosions?

incomplete or partial dislocation due to laxity or disruption of ligamentous support.

sublex WITH erosions = RA

sublex WITHOUT erosions = SLE

(super high yield)

19

this is sublexation without erosions, therefore the condition is....?

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lupus

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20

this is sublexation with erosions, therefore the condition is....?

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RA

21

what are osteophytes? what condition do they occur in?

endochondral bone formation that extends the articular surface. at point of injury of the articular cartilage

classic for OA

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22

condition? finding?

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osteoarthritis

DIP osteophytes

23

condition? finding?

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swelling around the joint, "fluffy" bone which indicates proliferative bone. 

Psoriatic arthritis. 

Pic: did someone xray a penis? nope. proliferative bone haha. think psoriatic arthritis

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24

what is ankylosis?

in what conditions does it occur?

in what condition do you see ankylosis in carpal and tarsal bones but no where else?

fusion of bone due to joint destruction and inflammation

typical for seronegative spondylitis

in RA, see ankylosis only in carpal and tarsal bones. (HIGH YIELD)

Pic: psoriatic arthritis with ankylosos of IP (big toe)

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25

what's this?

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ankylosing spondylitis.

spine looks like a single line. due to fibrosis, edge of discs have ossified. eventually becomes tubular and remodels over time

26

what is DISH?

how is it different from ankylosing spondylitis?

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DISH = Diffuse Idiopathic Skeletal Hyperostosis. subset of ank spond: the ossification is in the anterior or posterior longitudinal ligament rather than annular ligament (AS). 

DISH has a thick, irregular appearance on imaging

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27

condition? notable?

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overhanging edge of gout.

bone extnding beyone the margin of bone: reactive bone that is adjacent to tophus.

bone trying to grow around the deposit of tophus almost as if it is a foreign body

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28

condition?

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calcification. 

characteristic of scleroderma

29

What is the joint distribution of:

Gout?

OA?

RA?

Gout: 1st MTP

OA: DIP, 1st CMC (base of thumb)

RA: MCP and MTP

HIGH YIELD

30

Practice Q: what is this?

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Rheumatoid Arth

Soft tissue swelling is centered at joint. Uniform loss of joint space/cartilage

Joints affected: MCP, PIP

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31

Practice Q: what is this?

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Psoriatic Arthritis

Preserved bone density

soft tissue swelling (yellow arrow)

Marginal erosions (orange arrows)

periostitis (green arrow)

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32

Practice Q: what is this?

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Gout

lumpy bumpy soft tissue swelling, MTP joint involved

well-defined erosion (orange arrow)

33

Practice Q: what is this?

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Osteoarthritis

Nonuniform narrowing of joint

Subchondral sclerosis

Involvement of hip and knee