Final Flashcards
(163 cards)
1
Q
OPLL association
A
compression myelopathy
2
Q
diabetes mellitus has a recognized association iwth
A
distal lower extremity charcots
lumbar spine charcots
dish
3
Q
which line is useful in the detection of Wiltse degenerative spondylolisthesis
A
ullmann’s line
4
Q
which type of arthritis can be associated with atlantoaxial instability and also the DIP and PIP pattern of arthritis
A
psoriatic arthritis
5
Q
shentons/menards line and _____ will be positive with rheumatoid acetabular protrusion
A
Iliofemoral
6
Q
which measurement will be positive when a patient has coxa vara
A
femoral angle
7
Q
medic provides a MRI classification system for marrow end plate changes related to the degeneration disc IVOC. Decreased endplate signal intensity on T1 and T2 weighted images are classified as Type___ end plate changes and are related to relative absence of marrow in areas of subchondral sclerosis.
A
III
8
Q
using eisenstein’s method, lumbar sagittal canal stenosis would be indicated by:
A
less than 15 mm
9
Q
a canal body ratio of .85 in the cervical spine is indicative of
A
normal canal
10
Q
a 48 y/o female pt presenting in a chiropractic office with low back and leg pain and found have a L/S transitional segment have be predisposed to this radiographic finding
A
degenerative spondylolisthesis
11
Q
primary basilar imagination may have a variety of associated vertebral defects; however, which one of the following would not be an expected finding
A
small sella turcica
12
Q
the most consistent clinical finding of klippel feel syndrome
A
limitation of neck motion
13
Q
reduced range of cervical motion could be seen with which of the following
A
cervical spine fusion c4 to c6
c2, 3, 4 block vertebrae
DISH
14
Q
an important accompanying condition to remember with SLE
A
corticosteroid induced bone disease
15
Q
increased endplate signal intensity on T1 and mildly increased endplate signal on T2 weighted images are classified as modic type _____ end plate changes and are related to fatty marrow replacement in the vertebral endplate
A
II
16
Q
the ligamentous lava with IVOC may be associated with which spinal complication
A
spinal stenosis
17
Q
this inflammatory arthritis can involve DIP, PIP, and first MCC articulations in the hand
A
erosive osteoarthritis
18
Q
rheumatoid nodules and high titer or rheumatoid factor
A
indicate poor prognosis
19
Q
referencing the “general guide to relative frequency of arthritis” from Yan R which arthritis would be expected to be seen yearly in general practice
A
gout
20
Q
corticosteroid osteoarthopathy as a complicating factor associated with inflammatory joint disease encompasses
A
osteopenic fracture, avascular necrosis
21
Q
lumbosacral transitional vertebra with back pain and antalgic scoliosis is referred to as ___ syndrome
A
bertolotti’s
22
Q
hemispheric spondylosclerosis occurs most commonly at the ___ vertebral level and must be differentiated from ____
A
L4-5, infectious spondylodiscitis
23
Q
clinical symptomatology of neck pain, headaches, eye pain, vertigo, as well as visual phonation and swallowing disturbances related to posterior pentacle have been associated with all of the following conditions except
A
Sjogren’s syndrome
24
Q
the best imaging for the earliest detection of vertebral body bone destruction is ____ and ____
A
radionuclide bone scan
MRI
25
historical hadley's S curve was used when evaluating
both AP and oblique lumbar x-rays
26
the most common factor that results in degenerative disc disease
acute or chronic repetitive-trauma
27
the vacuum sign of knottiness is associated with
central nuclear and peripheral annular DDD
28
the most significant of the spinal ligaments in relation to degenerative joint disease is
ligamentum flava
29
"Putti's Triad" is a group of radiographic features associated with
congenital hip dysplasia
30
degenerative arthritis typically does not produce
"Mouse ears" whiskering
31
which condition can produce arthritis mimicking neuropathic joint disease
CPPD arthritis
32
young adult male would be the typical patient for
reactive arthritis syndrome
33
laboratory evaluation in OPLL patients will show
negative lab findings
34
a complication of facet joint degeneration which can not be demonstrated on plain film radiography and is best evaluated with MRI
synovial cyst
35
syndromes that may be associated with rheumatoid type arthritis include
sjogrens
| caplans
36
this finding often occurs prior to the onset of the skin changes in > 90% of scleroderma patients
raynauds
37
the rare genetic metabolic disorder of homogentisic acid oxidase absence, involves the spine in > ___% of cases
95
38
spinal involvement in neuropathic arthropathy could be associated with
diabetic neuropathy
syringomyelia
syhpilis
39
in addition to disc space narrowing and osteophytosis this is a prominent finding of spinal charcot's
subchondral sclerosis
40
rheumatoid arthritis may result in
bony ankylosis of synovial joints
41
which of the following arthritic disorders classically begins monoarticular
gout
42
on a lateral lumbar x-ray, _____ line should lie above the superior most tip of the adjacent superior articular process of the facet joint
macnab
43
the best view (not only view but the best view) for demonstrating spondylolisthesis
oblique view
44
the type of Wiltse spondylolistehsis rarely seen in clinical chiropractic practice
pathological
45
acetabular protrusion can be seen with all of the following except
osteoporosis
46
in a pediatric patient, Klein's line should
intersect the superior margin of the femoral head
47
conservative treatment of the patient with spondylolisthesis has a poor prognosis if
motion or compression/distraction lumbar films indicate instability
48
an arthropathy associated with joint mice and eventually producing secondary OA
synovial chondrometaplasia
49
seronegative arthritis in childhood
still's disease
50
neuropathic joints occurs in up to ____ % of diabetics, ___% of syphilitics, and up to ____% of syringomyelia pt's
35, 20, 25
51
primary hemochromatosis has a strong association with
diabetes mellitus
52
in the wilts classification for spondylolisthesis, which type may result in a >100% anterolisthesis
dysplastic
53
which of the following is NOT a radiographic finding or association of peripheral annular degenerative disc disease
central nuclear vacuum
54
the articular effects in gout
result in late, uniform loss of joint space
55
DISH spinal bone proliferation must be differentiated from all except
IVOC
must be differentiated from-PA, RAS, SD
56
mouse ears and ray arthritis radiographic findings are seen wtih
psoriatic arthritis only
57
the letter joints that may have erosive type changes along articular surfaces in association with DJD include all of the following except
glenohumeral
have erosive changes= acromioclavicular, sacroiliac, symphysis pubis
58
the spinal area most commonly affected by DISH hyperostosis is
lower thoracic spine
59
the combination of rheumatoid arthritis and a pneumoconiosis such as a "black lung disease" is called
caplans syndrome
60
in the lumbar spine, the posterior spinous line is normal and the anterior and posterior body lines break anterior... what has likely happened? There are two choices
elongation of the pars at the level of disruption
part interarticularis defects at the level of disruption
61
MCP joint DJD must have which two in the DD
hemochromatosis
| CPPD
62
vertebrobasilar insufficiency during rotary adjustments of the cervical spine related to compression or restriction of the vertebral artery may be associated with
posterior ponticle
63
failure of fusion of the vertebral body ossification centers results in
butterlfy vertebrae
64
a pt presenting with lower lumbar pain and radiographic examination reveals T11-T12 and T12-L1 facet arthrosis
maigne's syndrome
65
the six Ds of neurotrophic arthropathy are radiologic signs
common in weight bearing joints during the hypertrophic stage
66
nonunion of the atlas anterior arch results in
nothing, this is clinically insignificant
67
retinoids (Vit A Derivatives), which are used for treating dermopathy such as recalcitrant acne, may be an associated cause of
DISH
68
most development or acquired anomalies of C2 involve the dens with the most common anomalies including all of the following except
hyperplasia
includes- ossiculum terminal
os odontoidium
agenesis
69
typical spinal changes associated with acromegaly as a case of secondary degernative joint disease
SD with disc widening and posterior body scalloping
70
foresteir's disease may cause fusion of
upper SI joints
71
which of the following are types of juveniles chronic still's disease
classic systemic
monoarticular
polyarticular
72
in the cervical spine, the prudential space should not exceed____ mm in children, ____ mm in adults and the retro-dental should not be
5
3
16
73
which of the following lines denotes the suinolaminal line on the lateral lumbar view
eisenstein's line
74
which radiographic finding would be most suggestive of inflammatory osteoarthritis in the DIP and PIP joints
erosions with osteophytosis and sea gull sign
75
the most common location for OPLL is the ____ with typical symptoms of ____
cervical spine
| lower extremity weakness
76
HLA-B8 40% positive
DISH
77
may indicate corticosteroid induced AVN
intravertebral body vacuum sign
78
accompanying C5-6 IVOC
uncovertebral arthrosis
79
foraminal, IVF or central canal stenosis
apophyseal/facet arthrosis
80
may be mimicked by CPPD
Charcots
81
para-articular bone density evaluation is an important part of the radiographic examination of many pt with arthritic disease. Which of the following arthritic disorders do not have para-articular osteopenia
PA
| DJD
82
osgood schlatters disease is
avulsion injury of the tibial tuberosity
83
characteristics findings of the "boutonniere deformity" consist of
PIP flexion and DIP extension
84
CREST is associated with
scleroderma
| aka progressive systemic sclerosis calcinosis raynauds syndrome esophagela deformities scleroderma and tenangiestsia
85
nonuniform, asymmetric joint space narrowing, subchondral cystic formation, normal mineralization and possible joint mice are findings associated with which type of arthritis
osteoarthritis
86
uniform joint space narrowing, bilateral symmetrical distribution, soft tissue swelling, marginal erosions and juxtaarticular osteopenia are findings associated with which type of arthritis
inflammatory arthritis
| aka rheumatoid types or rheumatoid varients-AS enteropathic psoriatic or reuters
87
in male patients the primary source of skeletal metastasis is a primary tumor in the
prostate
88
waldenstrom's sign associated with childhood hip epiphyseal ischemic necrosis will show
medial joint space widening
the most common pattern seen is superior migration. loss of cartilage in the superior joint compartment allows the femur to move superiorly and laterally with the medial joint space being comparitively widened-the medial joint space widening is known as waldenstrom sign pg 979
89
which cause of soft tissue calcification is associated with autoimmune connective tissue disease
calcinosis
90
the radiographic appearance of hemangioma in the spine is most typically
a corduroy cloth/striated vertebra
most spinal hemangioma are solitary. the radiographic appearance includes coarse vertical striations in the vertebral body separated by more lucent zones called the corduroy cloth appearance which is best appreciated not eh lateral view pg 1239
91
which primary malignancy would have the lowest tendency for metastatic spread to the skeleton
colon
92
what are the most common bones to be affected by skeletal matastases
spine, ribs, pelvis
93
what is the most common primary tumor to metastasize to the hands
lung
94
a localized small area of subchondral osteonecrosis which may heal spontaneously or it may separate a loose ossicle into the joint describes
osteochondritis dissecans
95
in RA, the "Lanois Deformity" is found at the
foot
similar to ulnar deviations in the hand. deviations are common and include digital fibular deviation at the metatarsal phalangeal joint except the fifth digit and flexion deformities of the toes with subluxation of the joints. a prominent half values is frequent at the metatarsal bones often appear spread an the longitudinal arch flattened pg 1019
96
what is the most common skeletal site for AVN
femoral head
97
MRI is more sensitive for the detection of vascular necrosis than radionuclide bone scanning
true
98
which type of spondylolistehsis is associated with elongation the pars interarticularis
isthmic
type 2 spondylolisthesis always involves a fracture of the pars interarticularis, the most common type. There are three subtypes. lysis of the pars is a chronic stress fracture and the most common isthmic. elongated pars if a fracture that healed after anterior displacement causing an elongated pars. an acute pars fracture is the third subtype and still shows jagged edges at the scotty dog collar
99
which condition can be associated with disc space narrowing
intervertebral osteochondrosis
ivoc started with disc dessication-dehydration of the central nucleus, which eventually leads to the disc to degenerate and lose space after many years. DISH has NO joint space narrowing, osteoporosis has nothing to do with the joint space, just the bone density. spondylosis deforming is osteophytic bone formation, osteophytosis is a separate process that can occur with or without normal joint space
100
which radiographic finding would be most consistent with inflammatory arthritis
uniform symmetrical loss of joint spacing
subchondral sclerosis and joint mice are seen in osteoarthritis aka degernatrive arthritis
101
which its he most common cause for adult AVN of bone
alcoholism
102
which radiographic finding would be most consistent with OA
subchondral sclerosis
103
arthritis affects approximately 1 in every 7 people in the US. Multiple diagnostic imaging modalities have ben utilized but the plain film radiograph remains the most widely utilized imaging. Place the following arthritic disorders in the correct descending order from most common to least common
OA
CPPD
infection
general rule of relative frequency of arthritis diagnosed in practice .
Weekly= DJD, OA
Monthly= Ankylosing spondylitis, CPPD, DISH, Osteitis condensans illi, PA, rheumatoid arthritis, synoviochondrometaplasia
Yearly= gout, infection of lupus SLE retires and scleroderma
104
RA, AS, PA and scleroderma are all
inflammatory arthritides
polyarthritis- inflammatory joint disease-rheumatoid type (RA, SLE (lupus), PSS aka scleroderma) and rheumatoid variant (AS, retirees aka reactive, PA, IBD) pg 956
105
this condition is associated with synovial tissue undergoing metaplastic transformation and promotes early DJD
osteochondromatosis
106
according to y and r, the most vulnerable time for insufficient femoral head vascularity in egg-calve perches disease is
4-7 years
107
a young male patient presents in your office wit insidious onset of LBP and SI pain which is constant and worsening. Physical exam reveals localized tenderness and some decreased ROM. The pt is afebrile. Sed is elevated, WBC count is slightly elevated. Pt reveals a Hx of IV drug abuse. This should make you suspicius for
AS
108
although there are a multitude of causes for AVN, this 1 is considered to be the most common
alcoholism
109
which type of salter harris fx is common and associated with a separate metaphysical fragment called the thurston-holland fragment
type II
most common with an injury thought he displaced growth plate and turns into the metaphysics. it carries a corner of the metaphysics with it called a thruster holland fragment
110
when there is a reduced quantity of bone but that bone is of normal quality, the correct term for the condition is
osteopenia
111
which arthritis may occur secondary to streptococcal pharyngitis
jaccoud's arthopathy
found in a pt with repeated bouts of acute rheumatic fever. resembles RA and SLE but no erosive changes. just joint deformity changes of ulnar and fibular deviations
112
which of the following arthritic disorders does not belong in this differential
pyrophosphate arthropahty
infectious arthritis
NEUROPATHIC ARTHRITIS
post-rheumatic fever arthritis
113
a pt presents with meyerding grade 5 spondylolistehsis. what is the most likely type
pathological
114
inflammatory arthritis has the greatest destructive impact at the
articular "bare area"
115
which layer of the physics has the greatest oxygenation
resting layer
116
an 8 y/o male presents in your office with left hip pain and a limp. the pt has a positive Kleins line, negative kohl's line, and a negative shentons line
posterior hip dislocation
salter harris and AVN of the femoral epiphysis would also have a posterior kohlers line and shentons line
117
the different categories of bone disease can be remembered with this mnemonic
CATBITES
118
HLA B27 is likely to be present with
seronegative arthritis
119
most common site for OA in the foot is
2,3,4th DIP joints
120
DJD arthritis generally spares
MCP and intercarpal joints
121
erosive OA may involve
the same joints as primary hand OA
122
which type of salter harris fx may not show its impact for a year or more
type V
123
which is not a primary joint location for upper extremity OA
elbow joint
124
which of the following is not an autoimmune related arthritis
PA
125
fat pad sign at the elbow is
a reliable indicator of elbow joint OA secondary to previous trauma
126
nodular enlargment at the pIP joints in the hand are
bouchards nodes, indicative of OA
127
of the following autoimmune related disorders, in which condition is the primary inflammatory target the joint
RA
128
in RA the spine is rarely affected early but later the cervical region will become involved in up to ____ % of patients
80
129
which of the following arthritic disorders has a male bias
gout
130
oa at the shoulder complex most often involves the
AC joint
131
in the spine of an elderly pt, the pseudohemangioumatous radiologic appearance is often caused by
hodgkins disease
132
the most serious location for osteoportic fractures interns of comorbidity and even mortality is
hip
133
spondylolisthesis is correctly defined as
listhesis of a vertebral body in any direction
134
the type of spondylolisthesis commonly found at L4
degenerative
135
which of the following is not characteristic of SLE
the spine si a common area of involvement
136
george's line and illumines line are both used in evaluation of
lumbar spine spondylolisthesis
137
para-articular osteopenia can be seen with all of the following arthritic disorders except
gout
138
DISH clinically most commonly occurs in
males > 40 yrs of age
139
RA may result in
bony ankylosis of synovial joints
| hip dislocation
140
kleins line is used as a measurement for
salter harris III
141
which radiographic finding would be most suggestive of inflammatory OA in the DIP and PIP joints
joint space narrowing with osteophytosis
142
encroachment of the odontoid into the foramen magnum is called
basilar impression
143
os odontoideum
risk for cord compression from trivial trauma
144
if you have a pt with trisomy 21 you should be aware of potential for
atlantoaxial instability
145
a congential hemivertebra is caused by
failure of development of the lateral ossification center
146
compression fracture of the calcaneus resulting in a decreased boehler's angle may have accompanying fracture of
the navicular
147
in AS
the outer annular ossifies
148
which finding associated with CPPD crystal deposition disease can be incidental and asymptomatic
pseudogout
| chondrocalcinosis?
149
lower thoracic costovertebral or costotransverse orthosis may result in
roberts syndrome, which simulates GI disease
this is Maigne's SYndrome
150
among the "universal signs that characterized djd are
syndesmophytes and subchondral sclerosis
151
an important clincial consideration with RA pt is
high likelihood of acetabular protrusion
| likelihood of atlanto axial instability
152
which zone of the physics if injured has the worse long term prognosis
columnar
153
on a T2 weighted MRI study
the brightest signal will be emitted by fat
154
an 11 year old male presents in your office with left hip pain and a limp. The radiographic Dx is SCFE. Which salter harris fx is this?
transverse thought he physis
155
which of the following arthritic disorders would be classified as monoarthritis
infectious
156
which % of pts with RA will develop c-spine involvement
60-70%
157
with SI DJD
changes predominate in the lower 2/3
158
of the 4 bony cervical contour lines, which would be most reliable for assessing upper cervical RA
spinolaminal line
159
shentons line wouldn't be valuable in evaluating
hip dislocation
160
which of the following would not be true statement regarding SLE
all pts do NOT exhibit the classic butterfly rash
161
DJD in the axial skeleton can involve which joints?
```
luschka
facet joint
costovertebral joints
disco vertebral joints
si joints
```
162
which case of secondary DJD typically involves the hip joint
AVN
163
which arthritis may be commonly associated with chondrocalcinosis
pyrophosphate arthropathy
