Arthritis

Question 1

4 seronegative spondyloarthropathies

Answer 1

Ankylosing spondylitis
Reactive arthritis
Psoriatic arthritis
Enteropathic arthropathy (2)

Question 2

Besides SI joints and LS jx, where are most common site of involvement in spine in seronegative spondylarthropathies?

Answer 2

TL

Question 3

Enteropathic arthropathy is caused by what 2 chronic GI conditions

Answer 3

Ulcerative colitis

Crohn’s disease

Question 4

No common SI involvement (3)

Answer 4

DISH
DJD
RA

Question 5

Unilateral or bilateral, asymmetrical sacroilitis

Answer 5

Reactive arthritis

Psoriatic arthritis

Question 6

Bilateral and symmetrical sacroilitis

Answer 6

AS

Enteropathic arthropathy

Question 7

Chronic low back pain in 25 year old male; radiographs = BI, symmetrical sacroilitis and margine syndesmophytes from T10-L1

Answer 7

Marginal syndesmophytes = AS

Question 8

Chronic back pain in 60 year old M; radiographs = thick, flowing hyperostosis b/w T7-L1

Answer 8

Hyperostosis = DISH

Question 9

Intermittent episodes of LBP in 30 year old M w/ hx of urethritis; radiographs = BI, asymmetrical sacroilitis

Answer 9

Reactive arthritis

Question 10

Thin, marginal syndesmophytes

Answer 10

AS and enteropathic arthropathies

Question 11

coarse, non-marginal syndesmophytes

Answer 11

Reiters disease (reactive) and psoriatic arthritis

Question 12

Atlanto-axial instability

Answer 12

RA
AS
Psoriatic arthritisi

Question 13

Distal ungual tuft resportion

Answer 13

Scleroderma and psoriatic arthritis

Question 14

Reversible deformities of hands

Answer 14

SLE

Question 15

Multiple osteochondral bodies

Answer 15

Synoviochondrometaplasia

Question 16

Thick, flowing hyperostosis

Answer 16

DISH

Question 17

Sequestrum

Answer 17

Osteomyelitis

Question 18

Phemister’s triad

Answer 18

TB joint infection

Question 19

Chondrocalcinosis

Answer 19

CPPD

Question 20

Overhanging margins

Answer 20

Gout

Question 21

Thin, marignal syndesmophytes

Answer 21

AS

Question 22

Calcific tendonitis

Answer 22

HADD

Question 23

Triad associated with hypertrophic osteoarthropathy

Answer 23

Digital clubbing, symmetric arthritis (effusion, redness, pain, warmth)
Periostitis (BI, symmetric, solid/single layer; metaphysis and diaphysis; tib and fib, radius and ulna, MCP/MTPs, femur/humerus)

Question 24

Triangular sclerosis of iliac WITHOUT erosion

Answer 24

Osteitis condensates ilii

Question 25

Osteitis pubis = difficult to differentiate from what more serious condition

Answer 25

Osteomyelitis

Question 26

Six D's associated with what condition? Name them

Answer 26

Neuropathic arthropathy 1. Distended joint 2. Density increase 3. Debris 4. Dislocation 5. Disorganizatin 6. Destruction

Question 27

DISH - calcifcation of which tissue/structure

Answer 27

ALL primarily, PLL, LF

Question 28

Radiographic criteria of DISH (3)

Answer 28

1. Thick, flowing hyperostosis anterior to spine in 4 consecutive levels 2. Disc space maintained 3. No facet involvement

Question 29

diabetes is associated with what arthritic condition

Answer 29

Diabetes

Question 30

OPLL occurs in 50% of what arthritic condition patients

Answer 30

DISH

Question 31

What is seen with DJD? (5)

Answer 31

``` Erosions Subchondral cysts Intraarticular calcifications Joint mice Osteophytes ```

Question 32

4 pathways infection can spread to bone. Start with MC

Answer 32

Hematogenous Contiguous Direct implantation Postoperative

Question 33

T/f | Osteomyelitis in adults = insidious vs. children

Answer 33

T

Question 34

5 groups at higher risk of developing osteomyelitis

Answer 34

``` immunosuppresed New born Diabetics Alcoholics Drug addicts (IV) ```

Question 35

Latent radiographic period for osteomyelitis of extremities

Answer 35

10 days

Question 36

Latent radiographic period for osteomyelitis of spine

Answer 36

3 weeks

Question 37

Earliest radiographic changes of bone and joint infection seen where

Answer 37

In soft tissues after 3 days

Question 38

Acute osteomyelitis must be differentiated from what serious pathology

Answer 38

Primary malignancy

Question 39

Brodie's abscess presents clinically like what neoplasm

Answer 39

Osteochondroma

Question 40

2 VIP radiographic findings associated with septic arthritis

Answer 40

Joint distention | Motheaten or permeative destruction

Question 41

3 radiographic findings to help differentiate DDD from infectious discitis

Answer 41

1. DDD = diminished disc height at many levels 2. Infectious discitis = ST involvement (DDD doesn't) 3. Infectious discitis affects discs before vertebral body, while DDD affects body first

Question 42

Dish vs AS

Answer 42

Dish associated with calcification, AS = erosive | DISH = thick hyperostosis; AS = thin, egg shell calcification

Question 43

AS vs psoriatic arthritis

Answer 43

AS = thin symmetric calcification; psoriatic = thick and assymmetric

Question 44

Psoriatic arthritis vs RA

Answer 44

``` Psoriatic = skips joints, RA = uniform psoriatic = DIP only; RA = MCP, wrist, PIP ```

Question 45

DJD vs psoriatic in hands

Answer 45

``` DJD = DIP and PIP; psoriatic = DIP Psoriatic = marginal erosions DJD = no erosion ```

Question 46

64 year old M = focal pain around 1st MTP joint. Exam = red, swollen and exquisitely painful to touch. History of recent URTI. DDX (2)

Answer 46

Gout and hypertrophic osteoarthropathy