Midterm QA Flashcards by Adjusting Rocks

What percentage of pts with RA will develop spine involvement?

60-70%

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With sacroiliac degenerative joint disease:

Changes predominate in the lower 2/3

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Of the four bony cervical contour lines, which would be the most reliable for assessing upper cervical RA?

Spinolaminal line

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Several of the following lines can be used in the evaluation of (scfe); Slipped capital femoral epiphysis
however, which is the most accurate?

Klein’s line

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Shenton’s line would not be useful in the evaluation of:

Hip DJD

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Klein’s line is used as a measurement for:

Salter Harris Type I

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Which radiograph finding would be most suggestive of psoriatic arthritis in the DIP and PIP joints:

Joint space narrowing with erosions and mouse ears

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When using Eisenstein’s method for lumbar sagital canal measurement stenosis would be indicated by:

less than 15 mm

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Putti’s triad consists of:

Congenital Hip Dysplasia:

Increased acetabular angle, femoral head hypoplasia and lateral displacement.

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“Steele’s rule of thirds” is helpful in the evaluation of:

Atlantoaxial translational instability

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The pt found to have partial agenesis of the C1 posterior arch should have:

A flexion view

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Verterbrobasilar insufficiency during rotary adjustments of the cervical spine related to compression or restriction of the vertebral artery may be associated with:

Posterior ponticle

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Which arthritic disorder would be expected in a pt younger than 40 years of age?

Reiter’s syndrome

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Rheumatoid arthritis would be least likely in which area?

Lumbar spine

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Which of the following would NOT be a true statement regarding SLE Systemic lupus erythematous)

Almost all pts exhibit the classic “butterfly rash”

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Which of the following would be a true statement regarding SLE (Systemic lupus erythematous)

Involves significant immunological abnormality
Shows a clear predilection for female its
Frequently involves the urinary, cardiopulmonary, nervous and musculoskeletal systems

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A finding of severe lumbar degenerative disc disease would be:

Vacuum phenomenon

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In erosive osteoarthritis the articular lesions result in a peculiar radiographic appearance called:

“Gull wing” sign

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Which one of the following does not belong in the group?

Apophyseal joint erosion and fusion
Spinous process erosion
Cranial settling
ANSWER: Luschka joing arthrosis

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Ankylosing spondylitis and _______ have virtually indentical radiographic findings:

Enteropathic arthritis

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Which of the following is not in the diagnostic criteria for rheumatoid arthritis?

Atlantoaxial subluxation

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Which of the following is diagnostic criteria for rheumatoid arthritis?

Morning joint stiffness
Rheumatoid nodules
Positive rheumatoid factor

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Costotransverse or costovertebral arthrosis may be associated with:

Roberts Syndrome

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An arthritis which clinically has a predilection for pts

Still’s disease

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Deforming nonerosive arthropathy appearing after repeated attacks of arthritis in pts with rheumatic fever:

Jaccoud’s arthritis

A diagnosis of Forestier’s disease requires flowing hyperostosis at the anterior portion of at least:

Four contiguous vertebrae

Hadley’s “S” curve may be used when evaluating:

Both AP and oblique lumbar xrays

Which of the following is NOT a spinal radiographic finding associated with oschronosis arthropathy?

Normal disc spacing

Which of the following ARE spinal radiographic findingS associated with oschronosis arthropathy?

Vacuum phenomenon Flat lordosis Intervetebral disc chondocalcinosis

Spinal osteophytes

Originate at the attachment of the anterior longitudal ligament

Which of the following is NOT considered a cause of secondary spinal degenerative arthritis?

DISH

Which of the following IS considered a cause of secondary spinal degenerative arthritis?

Ochronosis Acromegaly Hemochromatosis

A male patient with a diagnostic triad of cirrhosis, diabetes, and bronze colored skin, with MCP joint osteoarthritis is likely to have a diagnosis of:

Hemochromatosis

Poorly defined bone erosions are not expected in this arthritis:

Degenerative arthritis

Which condition can be associated with degenerative and inflammatory arthritis?

CPPD arthritis

Young adult female would be the typical pt for:

Scleroderma

In addition to osseous and articular abnormalities, scleraderma can have serious impact on all EXCEPT:

The lungs The heart The GI tract ANSWER: The Kidneys

Diabetes mellitus has a recognized correlation with ____ in up to 32% of pts?

DISH

Sjoegren’s syndrome, seen with various connective tissue disorders is associated with:

Generalized drying of mucous membranes

The anatomy of a typical synovial joint includes:

A fibrous capsule, synovium and hyaline cartilage

Spinal involvement in neurotrophic arthropathy is most often associated with:

Syphilis

An important clinical consideration with rheumatoid arthritis is:

Likelihood of atlantoaxial instability

Rheumatoid arthritis may result in:

Bony ankylosis of synovial joints

Diffuse idiopathic skeletal hyperostosis clinically most commonly occurs in:

Males >40 years of age

Para-articular osteopenia can be seen with all of the following arthritis disorders except:

Rheumatoid arthritis ANSWER: Gout Scleroderma SLE Systemic lupus erythematosus

Spondylolisthesis is correctly defined there is:

Anterolisthesis only

The type of sponylolisthesis commonly found at L4 is:

Degenerative

Which of the following is not characteristic of SLE? Systemic lupus erythematosus

The spine is a common area of involvement

George’s line and Ullman’s line are both used in the evaluation of:

Lumbar spine spondlolisthesis

Which of the following is useful in the evaluation of spondylolisthesis?

Ullman’s line

Which of the following lines can be used as indication of facet subluxation?

Hadley’s S line

Shenton’s or Menards line would NOT be helpful in the detection of

Hip Fractures Slipped Capital femoral epiphysis ANSWER: Hip DJD Hip Dislocation

Which measurement in a pediatric patient is positive with Putti’s triad?

Iliofemoral line

Lordic end plate changes associated with the DDD consisting of decreased signal intensity involved T1 and T2 which would correspond with end plate subchondral sclerosis are classified as type

Three

Using Eisenstein’s method, lumbar saggital perio-stenosis would be indicated by

Less than 15mm

In the cervical spine, the most accurate method of determining saggital canal stenosis is the canal-body ratio or Pavlov’s ratio which is positive with the ratio less than

0.82

“Steele’s rule of thirds” is helpful in the evaluation of:

Atlantoaxial translational instability

Peribasilar invagination could have a variety of associated vertebral defects, however which of the following would not be an expected finding

Hemi-vertebrae

Klippel-feil syndrome may be associated with

Sprengle’s deformity

Which arthropathy would be expected in a patient younger than 40 years of age?

Reiters Syndrome

Articular symptomotology is a common presenting complaint in what % of pts with SLE Systemic lupus erythematosus

90%

Which of the following is NOT a true statement regarding SLE? Systemic lupus erythematosus

A. It involves significant neurologic abnormalities B. Clinical increase in female pts ANSWER: C. Almost all pts exhibit the classic butterfly rash D. It typically involves the urinary, cardiopulmonary, musculoskeletal systems

Which of the following would NOT be a plain film identifier of a cause of lumbar spinal stenosis?

ANSWER: A. Ligamentum Flavum Buckeling B. Vertebral Body Osteophytes C. Retrolisthesis D. Facet arthrosis

This inflammatory arthritis can involve DIP, PIP, and 1st MCC articulations in the hand?

Erosive osteoarthritis

Which one of the following is NOT associated with rheumatoid spinal arthritis?

ANSWER: Epiphyseal joint erosion and fusion Spinous process erosion Cranial settling Os odontodium

Ankylosing spondylitis and what have virtually identical radiographic findings?

Enteropathic arthritis

Which of the following is NOT a diagnostic criteria for rheumatoid arthritis?

Morning joint stiffness lasting greater than an hour ANSWER: Atlantoaxial subluxation Rheumatoid nodules Positive rheumatoid factor

Costo-transverse or costoveretbral arthrosis may be associated with what?

Roberts Syndrome

Hemispheric Spondylosclerosis occurs most commonly at what vertebra level and must be differentiated by what?

B. L4-5, blastic mets or infection

The sacroiliac vacuum phenomenon is what?

Has no clinical significance

Of the following, which one would NOT be considered in a differential for DISH?

Ankylosing spondylitis Spondylosis Psoriatic spinal arthritis ANSWER: Rheumatoid arthritis

Hadley’s S Curve may be used when evaluating what?

AP and oblique lumbar xray

In ochronosis arthropathy, the most common skeletal area of involvement is where

Spine

Spinal Osteophytes are

may be 2 types: traction or claw

Which of the following is NOT considered a cause of secondary spinal degenerative arthritis?

Ochronosis Acromegaly Hemochromotosis ANSWER: DISH

A 50 year old male pt with the diagnostic triad of cirrhosis, diabetes, and bronze colored skin is likely to have a diagnosis of WHAT in osteoarthritis at the WHAT joint?

Hemochromotosis, MCP

Clearly defined bone erosions are NOT expected in this arthritis?

Degenerative arthritis ANSWER: Inflammatory arthritis Infectious arthritis Anabolic arthritis

Which condition can be associated with inflammatory and degenerative arthritis?

CPPD arthritis

Young adult female would be the typical pt for:

Scleroderma

OPLL pts frequently complain of this symptomotology?

Difficulty walking or lower extremity weakness

Diabetes Mellitis and dysphagia can be associated with what?

DISH

Sjorgen’s syndrome and Felty’s syndrome are most commonly associated with what?

Rheumatoid Arthritis

C-R-E-S-T is a term used in identifying major associations of what?

Progressive systemic sclerosis

Which of the following is NOT a characteristic of rheumatoid spinal arthritis?

ANSWER: Marginal bone formation Cranial settling Disc space narrowing Apophyseal joint erosion

Spinal involvement in nuerotropic arthropathy could be associated with:

Syphilis and syringomyelia

Which of the following would NOT be expected to cause alantoaxial instability

Ankylosing spondilytis Rhuematoid arthritis Psoriatic arthritis ANSWER: Scleroderma

Rheumatoid arthritis can result in:

Fibrous ankylosis of fibrocartilaginous joints

Forestier’s Disease (>>>) or Senile ankylosing hyperostosis clinically most commonly occurs in who?

Males greater than 50

Periarticular osteopenia can be seen with all of the following arthritic disorders EXCEPT

Rheumatoid arthritis Gout Scleraderma ANSWER: SLE

The best view for demonstrating ideology with isthmic or degenerative sponylolisthesis is

Lateral View

The rare type of spondylolisthesis found at L5 is

Displastic

The most common cause for bilateral acetabulum protrusion

Rheumatoid arthritis

In a pediatric patient Klein’s line should

Intersect the fovea capitis, relating to the superior margin of femoral head

Conservative treatment of the pt with spondylolisthesis has a poor prognosis if

Flexion-Extension on lateral lumbar films indicate instability at the level of the lesion

Concentric erosion of the femoral neck producing an apple cord deformity may be associated with what?

Synoviochondrometaplasia

The bywaters-dixon Non marginal syndesmophytes may be described as what?

a floating syndesmophyte that bridges the disk space but does not unite the vertebral bodies

Carrot stick fractures caused by ankylosing spondylitis may cause serious neurologic complications and most commonly seen at :

C5-C7

Which of the following is NOT a complication of spinal degenerative arthritis?

Degnerative enterolithesis Discogenic retrolithesis Spinal stenosis ANSWER: Sacroiliac joint fusion

In the Witse classification for spondylolisthesis, which occurs in both the cervical and lumbar spine commonly?

Degenerative

Which of the following is NOT a radiographic finding or an association with peripheral annular degenerative disc disease?

Peripheral marginal vacuum Osteocytosis ANSWER: Normal Disc spacing Accompanying joint arthrosis

With rheumatoid involvement at the S-I joints, which one of the following is NOT and expected radiographic finding?

Unilateral involvement Segmental non uniform Superficial erosions ANSWER: Diffuse sacroiliac joint fusion

Periarticular bone density would be expected to be normal with this arthritis

Lupus

An important clinical consideration associated with psoratic arthritis pts is

severe osteopenia High likelihood of developing bilateral acetabulum protrusions Likelihood of cauda equinous syndrome Likelihood of alantoaxial translational instability.

Soft tissue calcification and __________ are classic findings of progressive systemic sclerosis. (1073)

Acroosteolysis

Which of the following is NOT a type of juvenile chronic Still’s disease?(1028)

Classic systemic Monarticular Polyarticular ANSWER: Peripheral articular

Which of the following lines can be used for indication of facet subluxation?

Hadley’s “S” line Ferguson’s Line Ullman’s line Eisenstein’s line

Shenton’s/Menard’s line would NOT be useful in the detection of:

Hip fracture Slipped capital femoral epiphysis ANSWER: Hip DJD Hip dislocation

This line also referred to as the Garland-Thomas line is useful in the detection of spondylolisthesis.(225)

Ullman’s line

Which measurement in the pediatric patient, is positive with Putti’s triad?

Iliofemoral line

Modic provides a classification system for marrow end plate changes related to the degeneration disc. Decreased end plate signal intensity on T1 and increased signal intensity on T2 weighted images are classified as Type ______ end plate changes and are related to fibrous tissue marrow replacement in the vertebral endplate. (536)

Using Eisenstein’s method, lumbar sagittal canal stenosis would be indicated by: (227)

In the cervical spine, the most accurate method for determining sagittal canal stenosis is the canal-body ratio or Pavlov’s ratio which is positive with a ratio of less than: (209)

.82

Bertolotti’s syndrome is associated with all of the following EXCEPT: (313)

Hemivertebra ANSWER: Sciatica Transitional vertebra Scoliosis

Primary basilar invagination may have a variety of associated vertebral defects; however, which one of the following would NOT be an expected finding?

ANSWER: C3 hemivertebra

Klipper-Feil syndrome may be associated with ________ in 20-30% of patients:

Sprengel’s deformity

A short webbed neck (pterygium colli), low hairline and reduced range of cervical motion clinically indicates:

Klippel-Feil syndrome

Approximately 90% of patients with SLE will present with:

Articular symptomatology

Decreased endplate signal intensity on T1 and T2 – weighted images are classified as Modic Type _____ end plate changes and are related to subchondral sclerosis in the vertebral endplate. (536)

III

The ligamentum flava may be associated with which spinal complication?

Spinal stenosis

This inflammatory arthritis can involve DIP, PIP and first MCC articulations in the hand.

Erosive OA

Cranial settling is an important feature of which arthritis involving the spine?

Rheumatoid

Referencing the “general guide to relative frequency of arthritis” from Y&R, which arthritis would be expected to be seen yearly in general practice? (952)

Infectious arthritis

Which of the following is NOT in the diagnostic criteria for rheumatoid arthritis?

Morning joint stiffness lasting more than 1 hour ANSWER: Boutonniere deformity Rheumatoid nodules Positive rheumatoid factor

Robert’s syndrome is associated with:

Lower thoracic costotransverse arthrosis

Hemispheric spondylosclerosis occurs most commonly at the ______ vertebral level and must be differentiated from ________: (976)

L4-5, blastic neoplasm or infection

Which of the following has NOT been associated with posterior ponticle? (269)

Vertebrobasilar insufficiency Barre – Lieou syndrome Chronic upper cervical syndrome ANSWER: Felty’s syndrome

Gold standaed imaging for the various pathological lesions of intervertebral disc disorders is (996)

MRI

Hadley’s “S” curve may be used when evaluating:

Both AP and oblique lumbar x-rays

The most common factor that results in degenerative disc disease is (536)

Acute or chronic repetitive trauma

The vacuum sign of Knuttsen is associated with: (971)

Central nuclear and peripheral annular DDD

The most significant of the spinal ligaments in relation to degenerative joint disease is: (537)

Ligamentum flava

Putti’s triad is a group of radiographic features associated with:

Congenital hip dysplasia

Degenerative arthritis typically does NOT produce:

ANSWER: Bone erosions Subchondral sclerosis Asymmetrical joint space narrowing Geode formation

Which condition can be associated with degenerative and inflammatory arthritis?

CPPD arthritis

Young adult female would be the typical patient for:

Scleroderma

OPLL patients frequently complain of this symptomatology: (998)

Difficulty walking with lower extremity motor weakness

A complication of facet joint degeneration which can NOT be demonstrated on plain film radiography and is best evaluated with MRI: (539)

Foraminal stenosis Degenerative anterolisthesis Apophyseal joint vacuum phenomenon ANSWER: Synovial cyst

Syndromes that may be associated with rheumatoid arthritis include:

Sjogren’s, Felty’s

C.R.E.S.T. is a term identifying the major associated with __________

Progresive systemic sclerosis

Which of the following is NOT a characteristic of rheumatoid spinal arthritis?

ANSWER: Marginal bone formation Cranial settling Disc space narrowing with end plate Apophyseal joint erosion

Lumbar spine involvement in neurotrophic arthropathy should be associated with?

Syphilis, diabetic neuropathy

Which one of following would NOT be expected to cause alantoaxial instability

Ankylosing spondilytis Rheumatoid arthritis Psoriatic arthritis ANSWER: Scleroderma

Rheumatoid arthritis may result in?

Bony ankylosis of synovial joints

On the lateral lumbar x-ray __________ line should lie above the superior most tip of the adjacent superior articular process of the facet joint (221)

Macnab’s

The best view for demonstrating etiology with isthmic or degenerative spondylolisthesis is?

Lateral view

The type of spondylolisthesis commonly found in the cervical spine is:

degenerative

The most common cause for bilateral acetabular protrusion:

Rheumatoid

In a pediatric patient Klein’s line should

Intersect the superior margin of the femoral head

Conservative treatment of the pt with spondylolisthesis has a poor prognosis if

Motion lumbar films indicate instability

An arthropathy associated with joint ______ and eventually producing secondary OA: (1009)

Synovial chondrometaplasia

Seronegative arthritis in children: (1028)

Still’s disease

In rheumatoid patients, the presence of rheumatoid nodules high ____ of rheumatoid factor and extra articular manifestations are usually indicative of: (1012)

Poor prognosis

Which of the following is NOT a complication of spinal degenerative arthritis:

Degenerative anterolisthesis Discogenic retrolisthesis Spinal stenosis ANSWER: Sacroiliac joint fusion

In the Wiltse classification for spondylolisthesis, which type occurs in both the cervical and lumbar spine commonly:

Isthmic

Which of the following is NOT a radiographic finding or association of peripheral annular degenerative disc disease:

Peripheral marginal vacuum Osteophytosis Normal disc spacing ANSWER: Accompanying luschka joint arthrosis

Primary hyperparathyroidism, gout and hemochromatosis have a strong association with CPPD and could produce this common radiographic finding:

Chondrocalcinosis

An early and frequent rheumatoid finding with Glenohumeral joint disease: (1024)

Rotator tendon cuff rupture

Mouse ears and gull wings radiographic findings are seen with: (1054)

Psoriatic and EOA respectively

The letter joints that may have erosive type changes along articular surfaces in association with DJD include all of the following EXCEPT:

Acromioclavicular (AC) Temporomandibular (TMJ) Symphysis pubis (SP) ANSWER: Sternoclavicular (SC)

Normal para-articular bone density is expected with all of the following arthritic disorders EXCEPT:

Gout ANSWER: Rheumatoid types Degenerative joint disease Foot and ankle

Dysphagia is frequently seen in

PSS Progressive Systemic Sclerosis 917

Which of the following are radiographic findings or associations of peripheral annular degeneration disease

Pick all that apply

Seronegative chronic arthritis in children

Still's Disease | 873

The interohalangeal joint of the great toe (1st digit) showing marginal destruction (rat bites), soft tissue swelling and joint destruction, which may be bilateral is characteristic of

RA | 864

Which of the following are the most common causes for neutrophil (charcot's) joints

Diabetes mellitus Syphilis Syringomyelia 843

Tripartite patella musth be differentiated from

fracture

the most common and lease common disc level respectively for vervain IVOC

C5, C2

The earliest pathophysiological findings of IVOC in the cervical spine

Endplate degeneration?

A patient with secondary Sjogren's syndrome may also be suffering with

SLE PSS RA

An increased ADI greater than 3mm particularly in flexion happen sin the _______ of patients. Spinal compression deformities occur secondary to _____

When evaluating the cercial spine for alighnemntn complications secondary to spinal DJD, which contour line is seldom used

Posterior spinous (least reliable ``` most: spinallaminar others retropheryngeal retrotracheal anterior body posterior body (George's Line) ```

Based on the number of joints involved, which arthritis does not fit in this group

infectious arthritis

Referencing the general rule to relative frequency from Y&R, which arthritis would be expected to be seen monthly in a general average practice

This is a basic fundamental rule to remember about the 2 majority types of arthritis: ____ are to OA, what ____ are to inflammatory arthritis (pick 2)

osteophytes | Erosions

Which of the following joints is an example of a secondary osteoarthritis location

elbow

Mikuliez's Angle will determine the presence of

Coxa Valga Normal 125 Valga 150

Degenerative arthritis typically does not produce

Ulnar deviation

"mouse ears" and "gull Wings" are seen with

psoriatic and EOA respectively

Which of the followup is not associated with gout

normal bone density?

common complication when steroid therapy is used for SLE

femoral head AVN

The great toes (not MTP) isa frequent site fro early and advanced

Psoriatic A

Common spinal levels for framing stenosis related to Uncovertebral arthritis

C5-6, C6-7

The role of radiology in the diagnosis of articular disease is undisputed. Arthritis cons the american economy ___ billion and affects on in every __ people

14, 7

Although the "D" word of neupathic are usually apple to the hypertrophic type they also works ro atrophic type. Which of the following is NOT one one ht e6 "D" Words

Answer: Disgusting 1. disorganization 2. debris 3. density 4. dislocation 5. destruction 6. distended (soft tissue)

Midterm QA Flashcards

(184 cards)