Midterm: Arthritides Flashcards by B Burr

What are the 2 Degenerative Arthritides?

OA
-primary
-secondary
     -post-traumatic
     -neuropathic Arthropathy
DISH

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What are the 3 inflammatory Arthritides?

RA
Seronegative Spondyloarthropathies
Septic Arthritis

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What are the 2 CT arthritides?

Lupus

Progressive Systemic Sclerosis

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What are the 3 Crystal Deposition Arthritides?

HADD
CPPD
Gout

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Early OA is characterized by __ response

healing

thickening of Art. cartiage
increased H2O content
Increase rate proteoglycan synthesis

*as disease progresses, these change.

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OA cartilage changes: Normal articular cartilage is __ an separated from underlying bone by a layer of __ cartilage. __ may migrate into fissures and produce __.

avascular
calcified
Fibrocytes
fibrocartilage

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What is eburnation?

Smooth, polished appearance of exposed subchondral bone after art. cartilage is worn away.

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Intervertebral Osteochondrosis: Target tissue is __. Dessication of nucleus leads to __ phenomenon in IVD space and decreased __ _

nucleus pulposis
vacuum
IVD height

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Spondylosis deformans target tissue is ___. What are key findings?

Annular fibers

-osteophytes on endplates= SPONDYLOPHYTES

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Hemispherical sclerosis: Type __ modic changes- relative __ of vertebral body adjacent to degenerative __ often with a __ __.

3
sclerosis
disc
schmorls node

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Degenerative Spondylolisthesis: __ is intact. Vertebra moves __ secondary to degenerative remodeling of the __ joints

pars
forward
posterior

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Spinal Stenosis: Acquired most often due to ___. ___ may result. __ artery supplies anterior 2/3 of cord.

DJD
myelomalacia
Ant. Spinal Artery

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DJD hip: MC pattern causes narrowing of __ portion of the joint. (unilateral or bilateral). MC joint for large __ __ formation to occur.

superior lateral

Subchondral Cyst

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DJD AC joint: __ formation here can create impingement on available space for __ tendon (impingement syndrome)

osteophyte

supraspinatous

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Secondary DJD wrist: *not common location for DJD. __ injury may predispose. Volar Intercelated Segment instability (VISI)- indicated by volar rotation of __ and abnormal __-__ spacing angle and __-__ angle

ligamentous
lunate
scapho-lunate
capitolunate

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Manifestations of DJD in hands

Heberden’s nodes- DIP

Bouchard’s Nodes- PIP

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DJD of Knee- Narrowing, subchondral cysts and sclerosis on __ side of __ knee. Tibial ___ may redistribute weightbearing for improvement

medial
right
osteotomy

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DISH: typically - decade. __ may result if c-spine involved. Associated with __ 20-50% of the time.

5-6th
Dysphagia
diabetes

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DISH: ~ __ + HLA B-27

1/3

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DISH: ~__% + HLA B-8

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DISH- at least __ continuous levels involved. Thick flowing __ and/or __ calcification of ossification. No __ joint ankylosis. Relative preservation of __ height and no other signs of degenerative disc disease. No SI joint erosion, sclerosis, or ankylosis

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4
anterior
lateral
posterior
IVD

DISH: diffuse, thick calcification of ___. Involvement of T-spine may be thinner and mimic __ __

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ALL

Ankylosis Spondylitis

OPLL: MAy be isolated of associated with __. __ spine MC involved. C-cord compression may result in upper motor __ findings.

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DISH
Cervical
neuron
*+ babinski, hoffman, hand clumsiness, difficulty walking due to leg spasticity

Osteitis Condensans Illi: Usually which gender? May be uni- or bilateral, but usually __. Affects __ 1/2 of Iliac side of SI joint. __ pattern of reactive sclerosis.

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Uni- or multiparrous women
bilateral
lower
Triangular

Seronegative Spondyloarthropathies: Includes which disorders?

Ankylosing Spondylitis Psoriatic Arthropathy Reactive Arthritis Enteropathic Arthropathy

HLA-B27 levels for Ankylosing Spondylitis

90%

HLA-B27 levels for Psoriatic Arthropathy

50%

HLA-B27 levels for Reactive Arthritis

75%

Ankylosing Spondylitis: Early changes

widening of SI joint space, erosions, ad predilection of the lower portion of joint, *more change on iliac side (thinner)

Ankylosing Spondylitis: Later changes

Bony fusion of Si joint | *~50% pts. fuses completely bilaterally

Ankylosing Spondylitis: Early changes in spine often occur at __ __

thoracolumbar junction

Ankylosing Spondylitis: Syndesmophytes- Describe them. Where do they attach? Bridging of the __ space, resulting in ankylosis--> Bamboo Spine

Thin, vertical and bilateral calcific/ossific density Attach tojoint margin= marginal IVD

Ankylosing Spondylitis: Enthesopathy- iinflammation of __ and __ insertions

ligamentous | tendinous

__ __ sign usually precedes syndesmophyte

shiny corner

Ankylosing Spondylitis: Predisposition to __ __ spinal fracture (through disc), or advanced degenerative change in spinal joints with residual mobility- __ lesion

carrot stick | anderson

Psoriasis: Where are lesions common?

Extensor surfaces of arms/ hands/ in eyebrows, gluteal folds | *nail changes in 80%

Psoriasis: HLA B-27 ~__% is Si joints involved, HLA B-27 factor in __% of those with only small joint changes

75 | 30

Psoriasis: Spine- presence of __. May be __ shaped

syndesmophytes | comma

Psoriasis: hands- __ pattern- involvement of all 3 joints is common. __ joint ankylosis is almost pathognomonic. __ __ erosions and __ joints predilicted

ray IP Mouse ear DIP

Psoriasis: __-__ instability may occur

Atlanto-Axial

Reactive Arthritis: __ factor on 80-90%. Uncommon in __ __. Involvement of __, __, and predilection for __ __ involvement.

``` HLA African Americans eyes urinary tract lower extremity ```

Reactive Arthritis: __ __- calcaneal osteophyte of periostitis, subtle periostitis.

Lover's heels

Reactive Arthritis: Inflammatory erosions of small joints of feet may be seen aka __ __

Lanouis Deformity

RA: __ joint disease in both upper and lower extremities. Misalignments of joints (2)

Erosive Swan neck deformity ulnar drift of MCs

RA: Hips: __ joint space loss and erosions. __ __ may occur

uniform | protrusion acetabuli

RA: Spine: MC* __ formation may stenose canal.

pannus

Gout: MC joint

1st MCP joint | -up to 60%

Gout: __ develops in very chronic cases (10-12 years). Defined as uric acid crystal deposition in __ __

tophus | soft tissue

CPPD: AKA __ __. deposition of CPPD in cartilage of joint may result in cartilage __. What are 3 favorite sites?

Pseudo Gout calcification triangular fibrocartilage of wrist Knee (esp. menisci) 1st and 2nd MCP *usually bilateral, not always symmetrical *cloud like Ca++ of synovium may occur as well

CPPD: X ray findings: Priominent __ __ formation common. Degenerative changes to non-weight-bearing joint. Isolated ___ joint involvement also suggestive.

Subchondral cyst | patellofemoral

HADD aka __ __: MC in __ tendon. Calcification develops in the relatively __ area of tendon near insertion- same place tears frequently occur

Calcific Tendonitis Supraspinous avascular

HADD: __ hand involvement more common.

Dominant

Midterm: Arthritides Flashcards

(52 cards)