Final Review 1 Flashcards
(115 cards)
1
Q
OPLL association:
A
Compression myelopathy
2
Q
OPLL association:
A
Compression myelopathy
3
Q
Diabetes Mellitus has a recognized association with:
(pick all that apply):
A
Distal lower extremity Charcot’s
Lumbar spine Charcot’s
DISH
4
Q
Which line is useful in the detection of Wiltse degenerative spondylolisthesis:
A
Ullmann’s line
5
Q
Which type of arthritis can be associated with atlantoaxial instability and also the “DIP & PIP pattern” of arthritis?
A
Psoriatic arthritis
6
Q
Shenton’s/Menard’s line and ____ will be positive with rheumatoid acetabular protrusion.
A
Iliofemoral
7
Q
Which measurement will be positive when a patient has coxa vara?
A
femoral angle
8
Q
Modic provides a MRI classification system for marrow end plate changes related to the degenerating 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
9
Q
Using Eisenstein’s method, lumbar sagittal canal stenosis would be indicated by:
A
10
Q
A canal body ratio of .85 in the cervical spine is indicative of:
A
normal canal
11
Q
A 48 yo. female pt presenting in a chiro office with low back and leg pain and found to have a L/S transitional segment may be predisposed to this radiographic finding:
A
Degenerative spondylolisthesis
12
Q
Primary basilar invagination may have a variety of associated vertebral defects; however, which one of the following would not be an expected finding?
- assimilation of C1 to the occiput
- C1 spina bifida
- Klippel-Feil deformity
- small sella turcica
A
small sella turcica
13
Q
The most consistent clinical finding of Klippel-Feil syndrome:
A
limitation of neck motion
14
Q
Reduced range of cervical motion could be seen with which of the following:
(pick all that apply)
A
- cervical spine fusion C4 to C6
- C2, 3, 4 block vertebra
- DISH
15
Q
An important accompanying condition to remember with SLE:
A
corticosteroid induced bone disease
16
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
17
Q
The Ligamentum flava with IVOC may be associated with which spinal complication?
A
Spinal stenosis
18
Q
This inflammatory arthritis can involve DIP, PIP and first MCC articulations in the hand.
A
Erosive Osteoarthritis
19
Q
Rheumatoid nodules and high titer of rheumatoid factor:
A
indicate poor prognosis
20
Q
Referencing the “general guide to relative frequency of arthritis” from Y&R, which arthritis would be expected to be seen yearly in general practice?
A
Gout
21
Q
Corticosteroid osteoarthropathy as a complicating factor associated with inflammatory joint disease encompasses:
A
osteopenic fracture, avascular necrosis
22
Q
Lumbosacral transitional vertebra with back pain and antalgic scoliosis is referred to as ___ syndrome:
A
Bertolotti’s
23
Q
Hemispheric spondylosclerosis occurs most commonly at the ___ vertebral level and must be differentiated from:
A
L4-5, infectious spondylodiscitis
24
Q
Clinical symptomatology of neck pain, headaches, eye pain, vertigo, as well as visual, phonation and swallowing disturbances related to posterior ponticle have been associated with all of the following conditions except:
- Vertebrobasilar insufficiency
- Barre-Lieou syndrome
- Chronic upper cervical syndrome
- Sjögren’s syndrome
A
Sjögren’s syndrome
25
the best imaging for the earliest detection of vertebral body bone destruction is __ & ___. (2 choices)
- Radionuclide bone scan
- CT myelography
- CT
- MRI
- Radionuclide bone scan
| - MRI
26
Historical Hadley's "S" curve was used when evaluating:
both AP and oblique lumbar x-rays
27
The most common factor that results in degenerative disc disease is:
acute or chronic repetitive- trauma
28
The vacuum sign of Knuttsen is associated with:
central nuclear and peripheral annular DDD
29
The most significant of the spinal ligaments in relation to degenerative joint disease is:
Ligamentum flava
30
"Putti's triad" is a group of radiographic features associated with:
Congenital hip dysplasia
31
Degenerative arthritis typically does not produce:
"mouse ears" whiskering
32
Which condition can produce arthritis mimicking neuropathic joint disease?
CPPD arthritis
33
Young adult male would be the typical patient for:
Reactive arthritis syndrome
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
A complication of facet joint degeneration which can not be demonstrated on plain film radiography and is best evaluated with MRI:
synovial cyst
36
Diabetes Mellitus has a recognized association with:
| (pick all that apply):
Distal lower extremity Charcot's
Lumbar spine Charcot's
DISH
37
Which line is useful in the detection of Wiltse degenerative spondylolisthesis:
Ullmann's line
38
Which type of arthritis can be associated with atlantoaxial instability and also the "DIP & PIP pattern" of arthritis?
Psoriatic arthritis
39
Shenton's/Menard's line and ____ will be positive with rheumatoid acetabular protrusion.
Iliofemoral
40
Which measurement will be positive when a patient has coxa vara?
femoral angle
41
Modic provides a MRI classification system for marrow end plate changes related to the degenerating 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.
III
42
Using Eisenstein's method, lumbar sagittal canal stenosis would be indicated by:
less than 15mm
43
A canal body ratio of .85 in the cervical spine is indicative of:
normal canal
44
A 48 yo. female pt presenting in a chiro office with low back and leg pain and found to have a L/S transitional segment may be predisposed to this radiographic finding:
Degenerative spondylolisthesis
45
Primary basilar invagination may have a variety of associated vertebral defects; however, which one of the following would not be an expected finding?
- assimilation of C1 to the occiput
- C1 spina bifida
- Klippel-Feil deformity
- small sella turcica
small sella turcica
46
The most consistent clinical finding of Klippel-Feil syndrome:
limitation of neck motion
47
Reduced range of cervical motion could be seen with which of the following:
(pick all that apply)
- cervical spine fusion C4 to C6
- C2, 3, 4 block vertebra
- DISH
48
An important accompanying condition to remember with SLE:
corticosteroid induced bone disease
49
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.
II
50
The Ligamentum flava with IVOC may be associated with which spinal complication?
Spinal stenosis
51
This inflammatory arthritis can involve DIP, PIP and first MCC articulations in the hand.
Erosive Osteoarthritis
52
Rheumatoid nodules and high titer of rheumatoid factor:
indicate poor prognosis
53
Referencing the "general guide to relative frequency of arthritis" from Y&R, which arthritis would be expected to be seen yearly in general practice?
Gout
54
Corticosteroid osteoarthropathy as a complicating factor associated with inflammatory joint disease encompasses:
osteopenic fracture, avascular necrosis
55
Lumbosacral transitional vertebra with back pain and antalgic scoliosis is referred to as ___ syndrome:
Bertolotti's
56
Hemispheric spondylosclerosis occurs most commonly at the ___ vertebral level and must be differentiated from:
L4-5, infectious spondylodiscitis
57
Clinical symptomatology of neck pain, headaches, eye pain, vertigo, as well as visual, phonation and swallowing disturbances related to posterior ponticle have been associated with all of the following conditions except:
- Vertebrobasilar insufficiency
- Barre-Lieou syndrome
- Chronic upper cervical syndrome
- Sjögren's syndrome
Sjögren's syndrome
58
the best imaging for the earliest detection of vertebral body bone destruction is __ & ___. (2 choices)
- Radionuclide bone scan
- CT myelography
- CT
- MRI
- Radionuclide bone scan
| - MRI
59
Historical Hadley's "S" curve was used when evaluating:
both AP and oblique lumbar x-rays
60
The most common factor that results in degenerative disc disease is:
acute or chronic repetitive- trauma
61
The vacuum sign of Knuttsen is associated with:
central nuclear and peripheral annular DDD
62
The most significant of the spinal ligaments in relation to degenerative joint disease is:
Ligamentum flava
63
"Putti's triad" is a group of radiographic features associated with:
Congenital hip dysplasia
64
Degenerative arthritis typically does not produce:
"mouse ears" whiskering
65
Which condition can produce arthritis mimicking neuropathic joint disease?
CPPD arthritis
66
Young adult male would be the typical patient for:
Reactive arthritis syndrome
67
Laboratory evaluation in OPLL patients will show:
negative lab findings
68
A complication of facet joint degeneration which can not be demonstrated on plain film radiography and is best evaluated with MRI:
synovial cyst
69
Syndrome's that may be associated with rheumatoid type arthritis include:
Sjögren's, Caplan's
70
This finding often occurs prior to the onset of the skin changes in >90% of scleroderma patients:
Raynaud's
71
The rare genetic metabolic disorder of homogentistic acid oxidase absence, involves the spine in >__% of cases.
95
72
Spinal involvement in neuropathic arthropathy could be associated with:
(pick all that apply)
- diabetic neuropathy
- syringomyelia
- syphilis
73
In addition to disc space narrowing & osteophytosis this is a prominent finding of spinal Charcot's:
subchondral sclerosis
74
Rheumatoid arthritis may result in:
Bony ankylosis of synovial joints
75
Which of the following arthritic disorders classically begins monoarticular?
- scleroderma
- CPPD arthropathy
- Gout
- Rheumatoid
Gout
76
On a lateral lumbar x-ray, ____ line should lie above the superior most tip of the adjacent superior articular process of the facet joint.
Mcnab's
77
The best view (not the only view, but the best view) for demonstrating spondylolisthesis (Wiltse) etiology is:
Oblique view
78
The type of Wiltse spondylolisthesis is rarely seen in clinical chiropractic practice:
pathological
79
Acetabular protrusion can be seen with all of the following except:
- Paget's disease
- Osteomalacia
- Osteoporosis
- Rheumatoid arthritis
osteoporosis
80
In a pediatric patient, Klein's line should:
intersect the superior margin of the femoral head
81
Conservative treatment of the patient with spondylolisthesis has a poor prognosis if:
motion of compression/distraction lumbar films indicate instability
82
An arthropathy associated with joint mice and eventually producing secondary OA:
Synovial chondrometaplasia
83
Seronegative arthritis in childhood:
Still's disease
84
Neuropathic joints occurs in up to __% of diabetics, ~__% of syphilitics, and up to __% of syringomyelia patients.
35, 20, 25
85
Primary hemochromatosis has a strong association with:
Diabetes mellitus
86
In the Wiltse classification for spondylolisthesis, which type may result in a >100% anterolisthesis.
Dysplastic
87
Which of the following is NOT a radiographic finding or association of peripheral annular degenerative disc disease:
- peripheral marginal vacuum
- osteophytosis
- normal disc spacing
- central nuclear vacuum
-central nuclear vacuum
88
The articular effects in gout:
result in late, uniform loss of joint space
89
(DISH) spinal bone proliferation must be differentiated from all except:
- PA
- RAS
- SD
- IVOC
IVOC
90
"Mouse ears" and "ray arthritis" radiographic findings are seen with:
Psoriatic arthritis only
91
The "letter joints" that may have erosive type changes along articular surfaces in association with DJD include all of the following except:
- acromioclavicular (AC)
- glenohumeral (GH)
- sacroiliac (SI)
- symphysis pubis (SP)
GH
92
The spinal are most commonly affected by (DISH) hyperostosis is:
lower thoracic spine
93
The combination of rheumatoid arthritis and a pneumoconiosis such as "black lung disease" is called:
Caplan's syndrome
94
In the lumbar spine, the posterior spinous line is normal and the anterior and posterior body lines break anterior... what has likely happened?
(remember Wiltse- 2 things happened!)
- elongation of the pars at the level of disruption
| - pars interarticularis defects at the level of disruption
95
MCP joint DJD must have which two in the DD?
- Hemochromatosis
| - CPPD
96
Vertebrobasilar insufficiency during rotary adjustments of the cervical spine related to compression or restriction of the vertebral artery may be associated with:
posterior ponticle
97
Failure of fusion of the vertebral body ossification centers results in a ___.
butterfly vertebra
98
A patient presenting with lower lumbar pain and radiographic examination reveals T11-12 and T12-L1 facet arthrosis. This pt. may have:
Maign'e syndrome
99
The "six D's" of neurotrophic arthropathy are radiologic signs:
common in weight bearing joints during the hypertrophic stage
100
Nonunion of the Atlas anterior arch results in:
nothing, this is clinically insignificant
101
Retinoids (Vit. A derivatives), which are used fro treating dermopathy such as recalcitrant acne, may be an associated cause of:
DISH
102
Most developmental or acquired anomalies of C2 involve the dens with the most common anomalies including all of the following except:
- Hyperplasia
- Ossiculum terminale
- Os odontoideum
- Agenesis
-Hyperplasia
103
Typical spinal changes associated with acromegaly as a cause of secondary degenerative joint disease:
SD (spondylosis deformans) with disc widening and posterior body scalloping
104
Forestier's disease may cause fusion of:
Upper SI joints
105
```
Which of the following are types of juvenile chronic Still's disease?
1- Classic systemic
2- Monoarticular
3- Polyarticular
4- Peripheral articular
```
1, 2, 3
106
In the cervical spine, the predental space should not exceed __mm in children, __mm in adults and the retro-dental should not be
5, 3, 16
107
Which of the following lines denotes the spinolaminal line of the lateral lumbar view?
Eisenstein's line
108
Which radiographic finding would be most suggestive of inflammatory osteoarthritis in the DIP and PIP joints:
Erosions with osteophytosis and sea gull sign
109
The most common location for OPLL is the __ with typical symptoms of __.
cervical spine, lower extremity weakness
110
DISH=
HLA-B8 40% positive
111
Intravertebral body vacuum sign=
May indicate corticosteroid induced AVN
112
Uncovertebral arthrosis=
Accompanying C5-6 IVOC
113
Apophyseal/Facet arthrosis=
Foraminal, IVF or central canal stenosis
114
Charcot's=
May be mimicked by CPPD
115
Para-articular bone density evaluation is an important part of the radiographic examination of any patient with arthritic disease. Which of the following arthritic disorders do not have para-articular osteopenia: (pick all that apply)
- PA
- DJD
- SLE
- RA
- PA
| - DJD
