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Diagnostic Imaging (1.3) > Arthritides > Flashcards

Arthritides Flashcards

1
Q

Inflammatory Arthritide: - Symmetrical distribution - Bilateral uniform loss of joint space - Rat Bite erosions - Pannus formation - Localized periarticular osteoporosis - DIP’s spared - Atlanto-axial instability - Haygarth’s Nodes @ MCP (knuckle) - Swan Neck / Boutonniere deformity - Ulnar/Fibular deviation (Lanois) of fingers/toes

A

Rheumatoid Arthritis (RA)

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2
Q

Rheumatoid Arthritis in children

A

Still’s Disease

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3
Q

What Labs to diagnose RA?

A

+ RA Latex + FANA + ESR + CRP Normocytic Normochromic Anemia

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4
Q

RA when presenting with dry eyes and mouth is called…

A

Sjogren’s

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5
Q

Inflammatory Arthritide: - LBP with morning stiffness - Starts in the SI joints - Males 15-35 yo - Associated with iritis - Bilateral SI joint fusion (ghost joints) - Shiny corner sign (early) in spine - B/L marginal syndesmophytes - Squaring of the VB’s - Bamboo Spine - Dagger Sign - Trolley Track sign - Poker spine

A

Ankylosing Spondylitis

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6
Q

Labs to dx Ankylosing Spondylitis (AS)

A

+ HLA B27 + ESR

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7
Q

Identical to AS in the pelvis with GI dysfunction

A

Enteropathic Arthropathy

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8
Q

Inflammatory Arthritide: - Silver Scaly lesions on extensors - Pitted Nails - Cocktail sausage digits - Males 20-50 - Increase in joint space - Mouse ear deformity - Pencil in cup deformity - Ray sign - Atlanto-axial instability - Non-marginal syndesmophytes in spine

A

Psoriatic Arthritis

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9
Q

Labs to dx Psoriatic Arthritis

A

+ HLA B27

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10
Q

Inflammatory Arthritide: - Males 20-30 yo +/- - Urethritis - Conjunctivitis - Arthritis - Caused by Chlamydia - Calcaneal spur - Fluffy periostitis - Non-marginal syndesmophytes in spine

“Can’t see, Can’t pee, Can’t dance with me”

A

Reiter’s aka Reactive Arthritis

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11
Q

Labs to dx Reiter’s

A

+ HLA B27

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12
Q

Inflammatory Arthritide: - Females - Sunlight precipitates a skin rash on face (malar/butterfly rash) - Oral ulcers - Discoid lesions - Alopecia - Raynaud’s phenomenon (white, blue, red fingers) - Can cause Ulnar Deviation of Phalanges with no joint destruction - Positive Rebound effect

A

Systemic Lupus Erythematosus (SLE)

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13
Q

What labs to dx SLE

A

+ LE prep + FANA + RA latex + ESR Leukopenia Thrombocytopenia

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14
Q

How do you manage SLE?

A

Co-manage with Rheumatologist

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15
Q

Inflammatory Arthritide: - Females 30-50 yo - Associated with erosions of the Distal Tufts of Phalanges - Associated with the CREST syndrome

A

Scleroderma

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16
Q

Scleroderma labs to dx

A

+ FANA + RA latex (30%)

17
Q

Inflammatory Arthritide: - Multiparous females 20-40 yo - Bilateral symmetric triangular sclerotic areas on the lower half of the ilium. - Joint space is normal

A

Osteitis Condensans Ilia ana Osteitis Triangularis

18
Q

Labs & Case management for Osteitis Condensans Ilia

A

Labs: None - self resolving Mgmt: Trochanteric belt for stability

19
Q

Degenerative Arthritide: - Non-inflammatory - MC involves weight bearing joints - Usually stiffens with rest and improves with activity - Complications include spinal stenosis and IVF encroachment

A

DJD aka Osteoarthritis

20
Q

MC site of DJD in the spine

A

C5-C6

21
Q

Radiographic signs: - IVD narrowing - Osteophytes - Endplate sclerosis

A

DJD in spine

22
Q

Radiographic signs: - Heberden’s nodes (DIP) - Decreased joint space with sclerosis - Asymmetrical distribution - Non-uniform loss of joint space

A

DJD in Hand

23
Q

Radiographic signs in the hip of decreased superolateral joint space with sclerosis

A

DJD of Hip

24
Q

Radiographic signs in knee of decreased MEDIAL joint space with lateral space preserved

A

DJD of Knee

25
Q

Degenerative Arthritides: - Males > 40 yo with Neck stiffness or Pain on Swallowing - Associated with DM - Can cause ossification of PLL - Flowing hyperostosis - Candle wax drippings - 4 contiguous segments involved - Disc space preserved

A

DISH (Diffuse Idiopathic Hyperostosis) aka Forestier’s Disease

26
Q

Degenerative Arthritides: - Secondary to impaired sensory functions in joints - Seen with diabetes, tabes dorsalis, syphilis & syringomyelia

A

Neurogenic Arthropathy aka Charcot’s Joint

27
Q

What are the 6 D’s most common in weight bearing joints associated with Neurogenic Arthropathy (aka Charcot’s Joints)

A
  1. Distention 2. Density of subchondral sclerosis 3. Debris within the joint 4. Dislocation 5. Disorganization 6. Destruction of Bone
28
Q

Degenerative Arthritides: - MC joint affected is the Knee - Results in multiple loose bodies within the joint that are round or ovoid in shape

A

Synoviochondrometaplasia

29
Q

Metabolic Arthritide: - Males > 40 yo - Due to overproduction of uric acid - Extremely painful, red, hot and swollen joints - Usually mono-articular with the MC site at the MTP of the big toe (Podagra) - Tophi crystals may be seen - Overhanging margin & Juxta-articular erosions

A

Gout

30
Q

Labs & Special Tests for Gout

A

Labs: Increased Uric Acid, + ESR Tests: Joint aspiration

31
Q

Pharmacology for Gout

A

acute - Colchicine chronic - Allopurinol

32
Q

Metabolic Arthritide: - Thin linear calcification parallel to the articular cortex within the joint space - Called chondrocalcinosis when affecting cartilage - MC seen in the knee

A

CPPD or Pseudogout (Calcium Pyrophosphate Dihydrate Crystal Deposition Disease)

33
Q

Metabolic Arthritide: - MC found in the shoulder joint - Round or oval calcifications near the insertion of a bursa or tendon

A

HADD (Hydroxyapatite Deposition Disease)

34
Q

Metabolic Arthritide: - PPW fever, chills, possible history of trauma/surgery and a warm, tender, swollen joint

A

Septic Arthritis

35
Q

Lab to dx Septic Arthritis

A

WBC Count

Diagnostic Imaging (1.3) (14 decks)

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