degenerative part 2

Question 1

what is pigmented vilonodular synovitis?

Answer 1

slow growing, benign and locally invasive tumor/metaplasia of the synovium

Question 2

what joint does PVNS most often affect?

Answer 2

knee

also hip, ankle, elbow

Question 3

who should you consider PVNS for?

Answer 3

younger patients with unexplained hip pain

Question 4

who are usually affected by PVNS?

Answer 4

young to middle aged adults

Question 5

what are some radiographic features of PVNS?

Answer 5

intraarticular effusions, lobulated masses
bony erosions more common in “tight joints” such as hip, elbow, wrist
apple core deformity
may appear bubbly

Question 6

what does a meniscal tear look like on MRI?

Answer 6

light/high signal if damaged

Question 7

what does an ACL tear look like on an MRI?

Answer 7

loss of fiber continuity

hemorrhage

Question 8

describe OA of the hip?

Answer 8

loss of joint space
osteophyte formation
subchondral sclerosis
buttressing
joint deformity

Question 9

what compartment of the hip is usually involved in DJD?

Answer 9

superior compartment (80%)

Question 10

buttressing definition

Answer 10

thickened cortex at the medial femoral neck as a result of biomechanical changes across the joint

Question 11

cyst formation of the hip joint with OA is due to what?

Answer 11

intra-osseous synovial intrusion with necrosis

Question 12

what does cyst formation of the hip joint with OA look like on radiograph?

Answer 12

subchondral location and usually with sclerotic borders

Question 13

what is a subchondral cyst?

Answer 13

subarticular cysts which represent synovial intrusion through cartilage fissues

Question 14

what are large cysts known as?

Answer 14

geodes

Question 15

what are the 3 types of holes seen on radiography?

Answer 15

geographic
moth eaten
permative

Question 16

which hole is the least aggressive?

Answer 16

geographic

Question 17

describe geographic holes.

Answer 17

usually solitary
indicates slow growing lesions
short zone of tranzition
margin is well defined, can be smooth or lobulated

Question 18

describe moth eaten holes.

Answer 18

moderate degree of agression
numerous small holes
larger zone of transition
not well defined margins

Question 19

describe permative holes

Answer 19

most aggressive
numerous small holes (1mm)
poorly marginated
wide zone of transition

Question 20

describe acetabular protrusion. what are it’s eponym’s? what line evaluates for it?

Answer 20

severe medial hip migration
remodeled acetabulum
also known as otto’s pelvis, protrusio acetabuli
evaulated with Kohler’s line

Question 21

what arthridities can cause acetabular protrusion?

Answer 21

OA
RA
bone softening disease (paget’s)

Question 22

what are the max normal measurements for men and women for acetabular protrusion?

Answer 22

men: 3mm
females: 6mm

Question 23

when is acetabular protrusion a normal variant?

Answer 23

in females

Question 24

which joint disease has the apple core deformity?

Answer 24

PVNS

Question 25

what are neurotrophic arthropaties?

Answer 25

joint abnormalities secondary to impaired pain perception or proprioception and lack of nutrition from the CNS

Question 26

what is the typical distribution of neurotrophic arthropaties?

Answer 26

monoarticular and depends on the underlying abnormality

Question 27

what are the two types of neuropathic arthropaties based on imaging?

Answer 27

hypertrophic (bone forming) | atrophic (resorptive)

Question 28

what are some clinical signs and symptoms of neurotrophic arthropathies?

Answer 28

painful, swollen joint, neurological disorder and radiographic signs of destruction together decreased pain sensation and proprioception swollen unstable joint

Question 29

weightbearing joints can get what kind of neuropathic arthropathy in general?

Answer 29

hypertrophic

Question 30

non-weightbearing joints can get what kind of neuropathic arthropathy in general?

Answer 30

atrophic

Question 31

what are common etiologies for neuropathic arthropaties?

Answer 31

``` congenital indifference to pain alcoholism diabetic syphilis syringomyelia trauma steroids leprosy ```

Question 32

what are 6 Ds of radiographic signs of neuropathic arthropathies?

Answer 32

``` distended joints density increase debris dislocation disorganization destruction ```

Question 33

knee and lumbar spine involvement with neuropathic arthropaties are usually due to what?

Answer 33

tabes dorsalis (syphilis infection)

Question 34

diabetes can cause what joints to be involved in neuropathic arthropathies?

Answer 34

talonavicular and tarsometatarsal

Question 35

what are etiologies for hypertrophic neurotrophic arthropathies?

Answer 35

disbetes syphilis (charcot joints) spinal cord trauma

Question 36

what joints are typically involved in hypertrophic neurotrophic arthropathies?

Answer 36

feet, knees, spine

Question 37

atrophic neurotrophic arthropathies present as what?

Answer 37

osteolytic process

Question 38

surgical amputation appearance

Answer 38

when bone resorption is complete in atriphic neurotrophic arthropathies

Question 39

licked candy stick appearance

Answer 39

tapered bone appearance leading to a sharp appearance in atrophic neurotrophic arthropthies

Question 40

cutoff sign

Answer 40

associated with atrophic neurotrophic arthropathies