Categories of JOINT DISEASE Flashcards
(33 cards)
Categories of Joint Disease–WEEK 2
Classifications of degenerative joint disease X 10
1 – ________ osteoarthritis
• Facet arthrosis, uncinate arthrosis, costotransverse arthrosis, etc.
2 – ________ osteoarthritis
• Secondary to underlying disorder
3 –EROSIVE osteoarthritis
4 – ___________ disease
• Spondylosis deformans
• Intervertebral osteochondrosis
Primary
Secondary
Degenerative spine (disc)
Categories of Joint Disease–WEEK 2
Classifications of degenerative joint disease X 9
5 – Diffuse IDIOPATHIC Skeletal Hyperostosis = (____)
6 – Synoviochondrometaplasia
7 – _________ of the posterior longitudinal ligament (PLL)
8 – Neurotrophic arthropathy
9 – Osteitis condensans iLLii
DISH
Ossification
Categories of Joint Disease–WEEK 2
Classifications of DEGENERATIVE joint disease X 9
1 OF 9 —-PRIMARY OA
• Causes
X 2 = ___________ & _______________
– Idiopathic
– Age
Categories of Joint Disease–WEEK 2
Classifications of DEGENERATIVE joint disease X 9
2 OF 9—-SECONDARY OA
Osteoarthritis \_\_\_\_\_\_\_\_\_\_; – Trauma – Underlying \_\_\_\_\_\_\_\_ process – INCREASED stresses on joints • INCREASED weight • Long term abnormal \_\_\_\_\_\_\_\_\_
following
disease
biomechanics
Categories of Joint Disease–WEEK 2
Classifications of DEGENERATIVE joint disease X 9
3 OF 9—–EROSIVE OA
• Variant of DJD (1961) • EOA a.k.a. INFLAMMATORY OA – Degenerative Joint Disease (DJD) with “\_\_\_ \_\_\_” EROSIONS at PIPs & DIPs – Involvement at the; • Scaphotrapesium joint!!! • Carpal metacarpal joints • 1st MCP joints • NO other joints!!!!!!
**ONLY HANDS AND WRISTS
gull wing
Categories of Joint Disease–WEEK 2
Classifications of DEGENERATIVE joint disease X 9
4 OF 9—DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS —————————(DISH)
- Flowing calcification and ossification of at least— 4—-contiguous VERTEBRA
- Preservation of _____ ______
- Absence of apophyseal ankylosis and SI changes
- ________ if cervical spine is involved
disc height
Dysphagia
Categories of Joint Disease–WEEK 2
Classifications of DEGENERATIVE joint disease X 9
5 OF 9—–SYNOVIOCHONDROMETAPLASIA
- AKA synovial chondromatosis, synovial osteochondromatosis
- Metaplasia and HYPERplasia of the cartilage in a JOINT
- _________ and is nourished by the synovial fluid
- Can calcify or ossify
- _______ _______ in and around the JOINT can then cause damage or dysfunction
Detaches
Loose bodies
Categories of Joint Disease–WEEK 2
Classifications of DEGENERATIVE joint disease X 9
6 OF 9----OSSIFICATION OF THE POSTERIOR LONGITUDINAL LIGAMENT = PLL • Occurs with \_\_\_\_\_ in many cases • Can cause \_\_\_\_\_\_\_\_\_\_ signs • Idiopathic
DISH
neurological
Categories of Joint Disease–WEEK 2
Classifications of DEGENERATIVE joint disease X 9
7 OF 9—-NEUROTROPHIC ARTHROPATHY–6 D’S
• Anything that affects the ______ _______to the components of a joint can cause DAMAGE to THAT joint
EX– Diabetes
EX– Syphilis
EX– Syringomyelia
Hypertrophic Pattern (6 D’s) = 1– \_\_\_\_\_\_\_\_\_\_\_\_\_ 2– Debris 3– \_\_\_\_\_\_\_\_\_\_\_\_\_ 4– Density increased 5– \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 6– Destruction
nervous input
Distention
Dislocation–VERY COMMON
Disorganization
Categories of Joint Disease–WEEK 2
Classifications of DEGENERATIVE joint disease X 9
7 OF 9 CONT…..NEUROTROPHIC ARTHROPATHY
• ATROPHIC pattern
– Can occur following _________ (usually) but other
conditions can cause it as well
– Will demonstrate atrophic bone and joint loss
– _______________ is one type of description
infection
Licked candy stick
Categories of Joint Disease–WEEK 2
Classifications of DEGENERATIVE joint disease X 9
8 OF 9—OSTEITIS CONDENSANS ILII
- Triangular shaped ________ of the iliac side of the SI joint
- More common in WOMEN
- May have a correlation to changes in the pelvis during PREGNANCY
sclerosis
Categories of Joint Disease–WEEK 2
Classifications of DEGENERATIVE joint disease X 9
9 OF 9—Degenerative spine (disc) disease
• Spondylosis deformans
• Intervertebral osteochondrosis
SEE SLIDES 8 AND 9
Categories of Joint Disease–WEEK 2
INFLAMMATORY JOINT DISEASE X 12
1---\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ = • Involves the hands, wrist, foot, knee hip and spine • Periarticular SOFT TISSUE SWELLING • Juxta articular osteoporosis • UNIFORM LOSS of joint space • MARGINAL EROSIONS (rat bite) • LARGE PSEUDOCYSTS • DEFORMITY– SWAN NECK, boutonniere, ULNAR DEVIATION, arthritis mutilans ---ADI INCREASE ---STEELE'S LAW OF THIRDS
• Spinal involvement
– PANNUS formation can affect the transverse ligament
creating instability at the atlantodental region
– Erosions / pannus‐ whittling of the dens and spinous
process
– Anterolisthesis C2‐ C4, STEPLADDER from loss of disc
height, apophyseal joint disease, ligament laxity
– Late stages can get ankylosing
RHEUMATOID ARTHRITIS
Pannus = is an abnormal layer of fibrovascular tissue or granulation tissue. Common sites for pannus formation include over the cornea, over a joint surface (as seen in rheumatoid arthritis), or on a prosthetic heart valve.
Anterolisthesis = is a spine condition in which the upper vertebral body, the drum-shaped area in front of each vertebrae, slips forward onto the vertebra below. The amount of slippage is graded on a scale from 1 to 4.
Ankylosing spondylitis = is a long-term type of arthritis. It affects the bones and joints at the base of the spine where it connects with the pelvis. These joints become swollen and inflamed. Over time, the affected spinal bones join together.
Categories of Joint Disease–WEEK 2
INFLAMMATORY JOINT DISEASE X 12
2–JUVENILE IDIOPATHIC ARTHRITIS
• Onset is less than 16 yrs.
• Used to be called Juvenile rheumatoid arthritis
• Unknown etiology
• Most common type is ______ ______ (subtype of JIA)
Still’s disease
**FUSED CERVICAL
Categories of Joint Disease–WEEK 2
INFLAMMATORY JOINT DISEASE X 12
3—ANKYLOSING SPONDYLITIS
**Ankylosing spondylitis = is a long-term type of arthritis. It affects the bones and joints at the base of the spine where it connects with the pelvis. These joints become swollen and inflamed. Over time, the affected spinal bones join together.
1 • ________– Enthesopathy occurring at discovertebral junction associated with erosion, sclerosis, &
syndesophytosis
2 • _________– Increased radiodensity of the corners of the vertebral body related to osteitis
3 • ______– Straightened or convex anterior margin of the vertebral body related to erosion
4 • __________ _____________= Ossification within the anulus fibrosis leading to thin, vertical radiodense areas
Osteitis
Shiny corner
Squaring
Marginal syndesmophyte
***Syndesmophytes are calcification or heterotopic ossification inside a spinal LIGAMENT or of the annulus fibrosus. Pathologically similar to osteophytes, their apperance on plain film comprises vertical and symmetrical calcification of the lateral margins of the intervertebral disc space.
Categories of Joint Disease–WEEK 2
INFLAMMATORY JOINT DISEASE X 12
3—ANKYLOSING SPONDYLITIS–PART 2 OF 2
5 • _________– Undulating vertebral contour owing to extensive syndesmophytes
6 • _________– Single central radiodense line on frontal radiographs related to ossification of supraspinous & interspinous ligaments
7 • __________– Three vertical radiodense lines on FRONTAL radiographs related to ossification of SUPRAspinous & INTERspinous ligaments & apophyseal joint CAPSULES
Bamboo spine
Dagger sign
Trolley track
Categories of Joint Disease–WEEK 2
INFLAMMATORY JOINT DISEASE X 12
4–REACTIVE ARTHRITIS (REITER’S)
• Complications – \_\_\_\_\_\_\_\_\_ tract obstruction – Iritis – Retrobulbar neuritis – \_\_\_\_\_\_\_\_\_ ulcerations – Aortitis – Etiology • Can be venereal or enteric in origin – most are VENEREAL – Implicated organisms • Mycoplasma? Chlamydia? Viruses? – Progress to osseous ankylosis less frequently than AS
URINARY +CORNEAL
“CAN’T PEE, CANT’ SEE, CAN’T DANCE WITH ME.
**AFFECTS FEET THE MOST
Categories of Joint Disease–WEEK 2
INFLAMMATORY JOINT DISEASE X 12
5–PSORIATIC ARTHRITIS
• Most common location‐ SMALL** JOINTS **OF HANDS
esp. DIPS.
• If DIP, PIP & MCP are all involved in a single digit = _____ ___________ – a reliable diagnostic sign
• 2nd most common – small joints of FEET
• 3rd most common – SI
• 4th most common –spine
• Occasionally – knee, hip or shoulder
• “________ _________”
– FLUFFY periosteal reaction at the margins of
erosion
• Overall shorting = opera glass appearance
• Resorption of TERMINAL TUFT
• “______ ______ ________” telescoping
• Can have psoriatic skin lesions, but NOT always.
RAY pattern
MOUSE EARS
PENCIL IN CUP
*****8”SAUSAGE FINGERS”
Categories of Joint Disease–WEEK 2
INFLAMMATORY JOINT DISEASE X 12
6—ENTEROPATHIC ARTHRITIS
• May be associated with ulcerative colitis, Crohn’s disease, Whipple’s disease, GI _________ or intestinal bypass surgery.
• SI & vertebral changes are indistinguishable from ___
GI INFECTIONS
AS
Categories of Joint Disease–WEEK 2
INFLAMMATORY JOINT DISEASE X 12
7—_________________
• Immunologically induced CONNECTIVE TISSUE DISORDER
• Multi system involvement
• Skin rash is common (BUTTERFLY rash on the face)
• SYMMETRIC, NON EROSIVE arthropathy
• Phalangeal TUFT resorption
• OsteoNECROSIS, usually hip
• TENDON weakening and rupture
• Insufficiency fractures
• Osteomyelitis and septic arthritis from CHRONIC corticosteroid usage
SYSTEMIC LUPUS ERYTHEMATOSUS
**DEFORMITY WITHOUT….EROSIONS!!
Categories of Joint Disease–WEEK 2
INFLAMMATORY JOINT DISEASE X 12
8---\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ • Collagen vascular disease • Two types = 1– LOCALIZED • Usually involves the skin and hands – Tuft resorption
2– PROGRESSIVE
• Progressive systemic sclerosis
– Can affect organ systems AKA = CREST!!!!
– Calcinosis, Raynaud’s, Esophageal dysmotility, Sclerodactyly, Telangiectasia
SCLERODERMA
***Calcinosis = is the formation of calcium deposits in any soft tissue.
***Raynaud’s (ray-NOHZ) disease = causes some areas of your body — such as your fingers and toes — to feel numb and cold in response to cold temperatures
***Esophageal motility refers to contractions occurring in the esophagus, which propel the food bolus forward toward the stomach. When contractions in the esophagus become irregular, unsynchronized or absent, the patient is said to have esophageal dysmotility.
**Sclerodactyly is a localized thickening and tightness of the skin of the fingers or toes. Sclerodactyly often leads to ulceration of the skin of the distal digits and is commonly accompanied by atrophy of the underlying soft tissues.
***Telangiectasia = a condition characterized by dilation of the capillaries, which causes them to appear as small red or purple clusters, often spidery in appearance, on the skin or the surface of an organ.
Categories of Joint Disease–WEEK 2
INFLAMMATORY JOINT DISEASE X 12
9—POLYMYOSITIS / DERMATOMYOSITIS
• Inflammation and degeneration of muscle and skin with associated soft tissue calcification
- PolyMYOsitis – __________ only
- DERMAtoMYOsitis – ______&_________
Muscle
Skin and muscle
**SLIDE 52 IS A GREAT EXAMPLE
Categories of Joint Disease–WEEK 2
INFLAMMATORY JOINT DISEASE X 12
10—___________________
• This is a condition that can demonstrate an
OVERLAP of RA, dermatomyositis, scleroderma
and SLE
MIXED CONNECTIVE TISSUE DISEASE
Categories of Joint Disease–WEEK 2
INFLAMMATORY JOINT DISEASE X 12
11—– Septic arthritis
• Covered later under Infection
12–– Hemophilic arthropathy
• Covered later under Blood/Vascular
BOTH COVERED LATER
