Christman chapter 19 Flashcards Preview

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Flashcards in Christman chapter 19 Deck (116)
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1

Causes of Monoarticular joint disease (7)

OCTOPIS

-Osteonecrosis
-Crystal induced
-Trauma
-Osteochondroma
-Pigmented villonodular synovitis
-Infectious disease (septic arthritis)
-Systematic disease (RA, psoriatic arthritis, reactive arthritis)

2

Causes of polyarticular joint disease (2 categories)

Inflammatory causes:
-Chronic tophaceous gout
-Rheumatoid arthritis
-Seronegative spondyloarthritis
-----psoriatic arthritis
-----ankylosing spondylitis
-----Reactive arthritis

Noninflammatory:
-primary OA
-Charcot arthropathy
-Pigmented villonodular synovitis

3

Categories of joint disease:underlying pathology (2)

Degenerative and inflammatory

4

Degenerative joint disease: another word for it

osteoarthritis

5

Inflammatory: 4 types

-Rheumatoid arthritis
-Seronegative:
---Psoriatic arthritis
---reactive arthritis
---ankylosing spondylitis
-Septic arthritis
-Metabolic
---gouty arthritis
---pyrophosphate arthropathy

6

Categories of joint disease : based on radiographic features (2)

-hypertrophic joint disease: subchondral sclerosis and osteophyte formation at the joint margin

-Atrophic joint disease: loss of bone substance through erosion and joint space narrowing

7

Hypertrophic joint disease (2)

-osteoarthritis
-
Detritus arthritis
---tarsus and midfoot charcot arthropathy
---posttraumatic arthritis

8

Atrophic joint disease (5)

-Rheumatoid arthritis

-Seronegative spondyloarthritis
---psoriatic arthritis
---ankylosing spondylitis
---reactive arthritis

-Septic arthritis

-Forefoot charcot osteoarthropathy

-Lumpy-bumpy
---gouty arthritis
---multiple reticulohistiocytosis
---pigmented villonodular synovitis

9

Primary radiographic changes (4)

-Osteophyte
-Erosion
-Subchondral resorption
-Arthritis mutilans

10

Osteophyte: definition and examples

Definition:
-a spur at the margin of a joint
-also known as dorsal flag, lipping and beaking

Pathognomonic of OA

11

Erosion: definition and examples

Definition:
-a localized wearing away of bone that begins along its outer surfaace
-Primary feature of all joint disorders affecting the foot except for OA

Examples:
-Rheumatoid arthritis

-Seronegative spondyloarthritis
---psoriatic arthritis
---ankylosing spondylitis
---reactive arthritis

-gouty arthritis

12

Subchondral resorption: definition and examples

Examples:
-Charcot arthropathy
-Septic arthritic

13

Arthritis Mutilans: definition and examples

Definition:
-erosions that involve both margins

-Most commonly called the "pencil-in-cup"

Examples:
-Psoriatic arthritis
-Charcot neuropathic osteo
-Rheumatoid arthritis (5th MPJ)

14

Bone producing secondary radiographic findings (5)

-Diffuse sclerosis

-periostitis

-Whiskering

-Ivory Phalanx

-Overhanging margin of bone

15

Diffuse sclerosis: association?

association with the repair and remodeling phase of Carcot arthropathy

16

Periostitis:association?

associated with seronegative arthritis, septic arthritis, and forefoot Charcot arthropathy

17

Whiskering: association?

Seen with psoriatic arthritis

18

Ivory phalanx: association?

associated with psoriatic arthritis

19

Overhanging margin of bone: association

associated with gouty arthritis

20

Secondary radiographic findings that result in joint space alteration (2 categories)

Even joint space narrowing:
---inflammatory arthritis

Uneven joint space narrowing:
---OA/trauma

21

Osteoarthritis:
-Joints to be worried about (5)

-Hallux interphalangeal

-First MPJ

-Second met cuneiform

-Intermediate naviculocuneiform

-Talonavicular

22

OA Radiographic features: 6

-Primary finding is osteophyte

-uneven joint space narrowing

-subchondral sclerosis (eburnation)

-geode with sclerotic margins (subchondral cyst)

-Detritus

23

OA: targets what column

Targets the medial column especially the first MPJ

24

Rheumatoid arthritis classification criteria

-Joint involvement
-Serology
-Acute phase reactants
-Duration of symptoms

25

RA: first joint to be affected

5th MPJ is the first

26

Classic presentation of Rheumatoid Arthritis (5)

-Bilateral and symmetric

-Medial erosions at the 1st through 4th ray

-Lateral erosion of the 5th

-Uniform joint space narrowing at affected joints

-Fibular deviation

27

More specific presentations for RA

-increased soft tissue density and volume

-joint space widening (initially)

-Para-articular osteopenia

-Geode

-Erosion (medial sides except for lateral at the 5th)

-Joint space narrowing (to end with)

-Digital misalignment

-Ankylosis

28

Psoriatic arthritis:clinical presentations (5)

-predominant distal interphalangeal joint involvement

-Assymetric MPJ involvement with associated swelling (sausage toe)

-Spondylitis

-Arthritis mutilans

-Psoriatic onychopachydermoperiostitis

29

Psoriatic arthritis: radiographic changes(7)

-Primary: erosion/arthritis mutilans

-Periostitis (adjacent to affected joint line)

-Whiskering/ Ivory phalanx

-Sausage toe

-Acro-osteolysis

-Lack of juxta-articular osteopenia

-Enthesitis

30

Reactive arthritis: what causes it (2)

Shigella/ Chlamydia