Extra stuff Flashcards by ashlie harder

Extension of the PIPs and flexion of the DIPs=

Swan neck deformity- RA

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Flexion of the PIPs and extension of the DIPs=

Boutoneirres deformity- RA

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Subchondral sclerosis aka

Eburnation

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What is an increase in mechanical stress that causes thickened existing trabeculation and formation of new ones?

Subchondral sclerosis- localized compensatory increase in bone mass

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What is the gelling phenomenon?

Fluid inside joint becomes thickened like gel, causes stiffness especially in the morn or at rest

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Erosive OA is a variant of DJD that appears?

Unusually inflammatory- not to be confused with RA

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What is the classic radiographic finding with erosive arthritis?

Gull wing appearance- DIP

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What is the name for degeneration of the 1st MTP of the foot with pain and stiffness?

Hallux rigidus

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What 2 joint misalignments are common in the feet?

Metatarsus varus

Hallux valgus

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With rotator cuff arthropathy you have cystic changes and superior migration of the humerus d/t unopposed deltoid and erosion of the acromion. What is the sign used to describe this?

Hatchet’s sign

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Shoulder impingement syndrome is most often due to?

Acromion osteophytes- if acromion points down instead of flat the risk is increased

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With HADD, if calcium is within the tendon what happens to ROM?

It moves on the 2 should views and there is a significant decrease in ROM

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With HADD, if calcium is within the bursa what happens?

It is non-moving

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What are the 3 knee compartments?

Medial tibiofemoral
Lateral tibiofemoral
Retropatellar

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What is an asymmetric loss of joint space in the medial compartment of the knee?

Genu varus- bow legged

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What is calcification of the MCL d/t trauma contacting lateral knee?

Pelligrini-steida calcification

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Where do you see Pelligrini-steida?

Coming off the medial femoral condyle

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What is synovial tissue metaplasia that produces cartilaginous tissue with multiple intra-articular loose bodies?

SOM- synovial osteochondrometaplasia

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SOM tends to lie within the joint ______ rather than the joint ______.

Capsule; space

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What is a slow growing, benign and locally invasive tumor/ metaplasia of the synovium?

Pigmented villanodular synovitis PVNS

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Where is PVNS most common?

Knee

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What should you consider in a young patient with unexplained hip pain?

PVNS

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What is the radiographic sign seen with pigmented villonodular synovitis?

Apple core deformity- concentric erosions of neck and femoral head

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How do you differentiate PVNS from RA or OA?

Joint space unaffected, cystic changes and usually slighter changes

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What is a thickening of cortex at medial aspect of femoral neck in response to increase in stress?

Buttressing

What is a "bad old hip"

Malum coxae senillis

Where does most degeneration happen at the hip?

Superior compartment 80%

What joints are typically affected with hypertrophic and atrophic arthropathies?

``` Hypertrophic= weight bearing joints Atrophic= non-weight bearing joints ```

What is the most common cause of neurotrophic arthropathies?

Diabetes

When the knee and lumbar are involved in a neurotrophic arthropathy what is usually the cause?

Tabes dorsalis

When the talonavicular or tarsometatarsal are involved in a neurotrophic arthropathy what is usually the cause?

Diabetes

What are the 6 D's seen on films for NA?

``` Distended joints Density increase Debris Dislocation Disorganization Destruction ``` Bag of bones

What are the common etiologies for hypertrophic neurotrophic arthritis?

Diabetes Syphilis- Charcot joints Spinal cord trauma Usually feet, knees and hips

What causes a tapered bone appearance leading to a sharpened pencil point appearance like a licked candy stick?

Atrophic neurotrophic arthritis

What is a common example of atrophic neurotrophic arthritis?

Bone resorption of proximal humerus 2nd to Syringomyelia

What is the name of the radiographic sign associated with atrophic neurotrophic arthritis?

Cut off sign

Who catergorized disc degeneration based on anatomy of the disc?

Resnick and Niwayama

What are the 4 seroPOSITIVE inflammatory joint diseases?

RA SLE Scleroderma/ PSS Jaccoud's

What are the 4 seroNEGATIVE inflammatory joint diseases?

``` I don't like PEARs Psoriatic arthritis Enteropathic arthritis AS Reactive/ reiters ```

With RA, what is the abnormal layer of fibrovascular formation?

Pannus formation

What is a "rat bite" seen on films with RA?

Marginal erosions-Localized loss of articular cortex at bare area or joint margin; no sclerosis

What do you see large pseudocysts on films with RA?

D/t synovial fluid and extension of the pannus

What is the first radiographic feature seen with RA?

Periarticular soft tissue swelling

What is a soft tissue swelling adjacent to the MCP?

Haygarth node- RA

What does SLAC stand for?

Scapho-lunate Advanced collapse- RA

What is "spotty carpal" sign?

Erosions at the radial styloid and carpal bones- RA

What is the "zig zag" sign?

Loss of carpal joint space, radial rotation with ulnar deviation of the fingers- RA

Baker's cysts are usually seen with what condition?

Acetabular protrusion is common in?

RA most commonly does what to the ADI?

Increases it

What percent of RA patients have C spine involvement?

80%

What are the juvenile arthritis aka?

Still's disease Juvenile chronic/idiopathic arthritis Onset prior to 16

Are patients usually seronegative or positive with JRA?

Seronegative- unlike adult RA | Seropositive patients have worst prognosis

What are some of the common growth deformities seen with JRA?

Ballooned epiphysis | Squashed carpi and brachydactyly

With what condition would you see increased ADI, hypoplastic C2-C4 bodies, discs with ankylosis apophyseal joints and osteopenia?

JRA

Where are the typical radiographic findings seen with SLE?

Hands; spinal abnormalities uncommon Transverse ligament laxity may rarely occur and osteoporotic compression fractures may happen secondary to corticosteroid therapy

What are the reversible deformities seen with SLE?

Ulnar drift Swan-neck Boutonnière Hitchhiker

What is a non-erosive, reversible joint deformity with ulnar deviations and flexion of MCPs as well as fibular deviation of MTPs?

Jaccoud's arthropathy

What is a generalized inflammatory CT disorder involving skin, lungs, GI, heart, kidneys and MS system?

Scleroderma/ progressive systemic sclerosis No spine involvement

Who does scleroderma most commonly affect?

Women 30-50

How does scleroderma usually present initially?

GI symptoms Raynaud's RA- like arthritis

What does CREST stand for?

``` Calcinosis Raynauds Esophageal dysmotility Sclerodactyly Telangiectasia ```

What is the resorption of distal bony phalanges?

Acro-osteolysis

What is a rare autosomal recessive bone dysplasia characterized by osteosclerosis and short stature?

Pyknodysostosis

What is the MC seronegative spondyloarthropathy and 2 aka?

AS Marie Strumpell Bechterew disease

100% of AS involves?

SI joint

What are the 3 stages of SI issues with AS?

1 pseudowidening 2 erosion and sclerosis MC 3 ankylosis

What is the name of the sign for erosions of SI joint?

Rosary bead sign

What is the star sign?

Upper SI ankylosis

What is see through ankylosis

Ghost joint

What percent of AS patients will develop complete ankylosis?

50% 40% will get to stage 2 and then resolve

the familial form of acro-osteolysis is also known as?

Hajdu- Cheney syndrome

what is the acronym for scleroderma and diffuse acro-osteolysis?

PINCHFO ``` Pyknodysostosis or Psoriasis Injury (frostbite, thermal) Neuropathy (diabetes) Collagen vascular disease (scleroderma, raynauds) Hyperparathyroidism Familial (Hajdu-cheney, progeria) Occupational (polyvinyl exposure) ```

what is an inherited shortening of fingers and toes d/t unusually short bones?

brachydactyly

what is a thickening and tightening of the skin of the hands and fingers?

sclerodactyly

what is pannus?

hyperplastic synovitis

what term describes an intermittent absence of the articular cartilage d/t erosion?

dot dash appearance- RA

what is felty's syndrome?

leukopenia, splenomegaly and RA

what are the 4 stages of RA?

1. synovitis 2. pannus 3. fibrous ankylosis 4. bony ankylosis

what percent of patients develop RA in the cervical spine?

50% within 10 years of diagnosis

what is the MC cause of UC neurologic sx in someone with RA?

atlanto-axial impaction

what are the common presentations of RA in the cervical spine?

``` apophyseal joint disease decreased disc height subluxation osteoporosis spinous process/odontoid erosion ```

where are the 3 spots your see odontoid erosions from RA?

btw dens and arch btw dens and transverse ligament tip of dens

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