Bone Imaging Part 2

Question 1

What part of the joints gets most of the impact during injury

Answer 1

The subchondral surface

Question 2

A disease that affects a joint and usually the bones on either side of the joints

Answer 2

Arthritis

Question 3

_________ is almost always accompanied by joint space narrowing

Answer 3

Arthritis

Question 4

What are the 3 main categories of arthritis

Answer 4

Hypertrophic
Erosive
Infectious

Question 5

What category of arthritis is characterized by bone formation either by subchondral sclerosis or the production of osteophytes?

Answer 5

Hypertrophic arthritis

Question 6

What are types of hypertrophic arthritis

Answer 6

Osteoarthritis, erosive arthritis, Charcot arthropathy, calcium pyrophosphate deposition disease

Question 7

What is the most common form of hypertrophic arthritis

Answer 7

Primary osteoarthritis

Question 8

Osteoarthritis results from _______ _________ of articular cartilage

Answer 8

Intrinsic degeneration

Question 9

What causes osteoarthritis and what body parts does this usually involve?

Answer 9

Caused by wear and tear
Involves the hips, knees and hands

Question 10

Marginal osteophyte formation, subchondral sclerosis, subchondral cysts

Answer 10

Radiologic findings of primary OA

Question 11

Secondary arthritis occurs because of _________, most commonly __________

Answer 11

Underlying, predisposing condition
Trauma

Question 12

What separates primary from secondary OA?

Answer 12

Secondary occurs at atypical age, it has an atypical appearance (like unilateral), and it appears in an unusual location

Question 13

___________ is characterized by more severe inflammation and evidence of _________ changes

Answer 13

Erosive OA
Erosive

Question 14

Erosive OA occurs most often in what population

Answer 14

Post menopausal females

Question 15

Erosive OA most often occurs at the _______________, ________________, and ________________

Answer 15

Proximal and distal interphalangeal joints, 1st carpal-metacarpal, and the interphalangeal joint of the thumb

Question 16

Bony ankylosis may occur with __________ OA

Answer 16

Erosive

Question 17

Marked inflammation and erosions of the affected joints, centrally located erosions, and gull-wing deformities are findings consistent with _________

Answer 17

Erosive OA

Question 18

What is ankylosis

Answer 18

Abnormal stiffening and immobility of a joint due to fusion of the bones

Question 19

___________ develops from a disturbance in sensation that leads to multiple micro fractures

Answer 19

Charcot arthropathy

Question 20

Autonomic imbalance that leads to hyperemia, bone resorption, and fragmentation of bone. Soft tissue swelling is prominent.

Answer 20

Charcot arthropaty

Question 21

What is the most common cause of Charcot arthropathy?

Answer 21

Diabetes

Question 22

most ___________ is found in the lower extremities, especially feet and ankles

Answer 22

charcot arthropathy

Question 23

What are the causes of Charcot arthropathy in the shoulders, hips, and ankles

Answer 23

shoulder- spinal tumor, syphilis
hips- tertiary syphilis, diabetes
ankles/feet- diabetes, syphilis

Question 24

Extensive subchondral sclerosis, fragmentation of the bone surrounding the joint, fragments may be resorbed, and no longer visible, eventual destruction of the joint, shares findings with osteomyelitis. Both produce bone destruction and periosteal reaction.

Answer 24

radiographic hallmarks of Charcot arthropathy

Question 25

how do you differentiate between osteomyelitis and Charcot arthropathy on imaging?

Answer 25

radioactive indium tagged white blood cell bone scan

Question 26

with what disease is rocker bottom deformity commonly seen

Answer 26

Charcot arthropathy

Question 27

results from the deposition if calcium phyrophosphate dihydrate crystals in and around joints

Answer 27

calcium phyrophosphate deposition disease

Question 28

where does CPDD mostly occur?

Answer 28

hyaline cartilage and fibrocartilage; especially in the fibrocartilage of the wrist and menisci

Question 29

what disease used to be known as pseudogout?

Answer 29

CPDD

Question 30

how does CPDD differ from primary OA?

Answer 30

occurs in joints not often affected by OA chondrocalcinosis is present subchondral cysts are larger and more numerous hook shaped bony outgrowths along the 2nd and 3rd metacarpal heads

Question 31

uric acid crystals are characteristic of _______ while calcium pyrophosphate crystals are seen in _______

Answer 31

gout pseudogout

Question 32

what are rat bite erosions/ the martel sign

Answer 32

punched out erosions with sclerotic and overhanging margins

Question 33

All erosive arthitis are associated with some degree of _________ and _____________

Answer 33

inflammation and synovial proliferation

Question 34

what is pannus formation

Answer 34

abnormal layer of fibrovascular tissue or granulation tissue

Question 35

what kind of arthritis produces lytic lesions in or near the joint

Answer 35

erosive arthritis

Question 36

erosive arthritis is found especially where?

Answer 36

small joints of the hands and feet

Question 37

___________ acts like a mass of growing synovial tissue which leads to marginal erosions

Answer 37

pannus

Question 38

what are the causes of erosive arthritis

Answer 38

RA, gout, psoriatic arthritis, ankylosing spondylitis, reactive arthritis, sarcoid, hemophilia

Question 39

is RA more common in males or females?

Answer 39

females

Question 40

RA frequently involves the ___________ joints of the hands and wrists

Answer 40

proximal

Question 41

T or F: RA is usually bilateral and symmetrical

Answer 41

true

Question 42

what is the study of choice for RA

Answer 42

conventional radiographs

Question 43

what are the early radiographic changes of RA

Answer 43

soft tissue swelling and osteoporosis

Question 44

what joints in the hand does RA usually effect?

Answer 44

the erosions tend to involve the proximal joints carpal-metacarpal metacarpal-phalangeal proximal interphalangeal joints

Question 45

what are late findings of RA

Answer 45

ulnar deviation of the fingers at the MCP joints subluxation of the MCP joints ligamentous laxity leading to deformities of the fingers swan neck and boutonniere deformities

Question 46

how does RA typically affect the wrist?

Answer 46

erosions of the carpals, ulnar styloid and narrowing of the radiocarpal joint

Question 47

what else can RA cause?

Answer 47

narrowing, sclerosis, and eventual fusion of the facet joints in the cervical spine

Question 48

with a ____________ deformity, the PIP is flexed and the DIP is extended

Answer 48

boutonniere

Question 49

with a ___________ deformity, the DIP is flexed and the PIP is extended

Answer 49

swan neck

Question 50

what is most commonly affected by gout? why?

Answer 50

1st MTP gravity takes the crystals to the most distal joint

Question 51

what is rat bite joint associated with?

Answer 51

gout

Question 52

gout has a __________ development and is usually a _________ diagnosis

Answer 52

chronic clinical

Question 53

what disease is diet related in 12% of cases, associated with sugar sweetened beverages, alcohol consumption and high purines?

Answer 53

gout

Question 54

what health related issues are seen in 75% of cases of gout

Answer 54

abdominal obesity hypertension insulin resistance abnormal lipid levels

Question 55

sharply marginated, juxtaartixular erosion that tends to have a sclerotic border, joint space narrowing (late), tophi, olecranon butsitis

Answer 55

radiographic findings of gout