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Flashcards in Nonmechanical pathology Deck (18)
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1

if infection is suspected, what should you look for in radiological images of soft tissue?

soft tissue swelling, ulcers, subcutaneous air, skin thickening, cellulitis abscesses, fluid

2

if bone infection is suspected, what do you look for in images?

periosteal reaction, destruction

3

septic arthritis

infection involving a joint

4

bone infection

osteomyelitis

5

first line test for infection? 2nd line test (more sensitive)?

First line: X-ray (often negative); Second line; MRI or nuclear medicine bone scan

6

when looking for infection on MRI, what should you look for?

abnormal fluid collections and marrow edema

7

imaging signs of OA/DJD/Secondary arthritis

1. loss of articular cartilage
2. joint space narrowing
3. osteophyte formation
4. sclerosis
5. subchondral cysts

8

most common jts for DJD/OA?

WB jts-hips, knees
Hands

9

Jts less frequently affected by DJD?

shoulder

10

RA: about

chronic autoimmune inflammatory disease; immune complex disease; characterized by joint swelling, joint pain and destruction; synovial inflammation

11

How is RA best diagnosed?

Classification criteria for RA; American College of Rheumatology (2010)

12

Categories of classification for RA

Joint involvement (# of jts involved, large vs. small jts); serology; acute phase reactants; duration of sx

13

Radiographic findings-RA

bilateral, proximal process; soft tissue swelling, osteoporosis, joint space narrowing, marginal erosions (away from WB portion of jt)

14

do you need an XR or MRI to diagnose RA?

NO: use classification scale; imaging shows response to tx, severity of jt damage

15

about gout

Gout caused by hyperuricemia resulting in deposition of monosodium urate crystals
Types: primary (inborn error of metabolism); secondary (disorders affecting urate metabolism-alcoholism); acute (mimics septic arthritis-jt swelling and pain); chronic (tophi erode bone)
Common sites: 1st MTP 90%; metatarsal, olecranon bursitis

16

Radiographic features of gout

Tophi: eccentric soft tissue swelling, usually not calcified; erosions with overhanging edges: reactive bone around a tophus, occur far from joint; joint space PRESERVED b/c deposition in articular cartilage is focal; narrowing only occurs late in the process

17

Bisphosphonate-related atypical femoral fx: etiology

bisphosphonate: osteoporosis medication; reduces bone resorption resulting in increased bone mineral density; but also suppresses normal bone turnover resulting from normal activity; atypical fracture risk increased

18

types of atypical fx related to bisphosphonate: radiologic signs

focal lateral cortical thickening: stress or fatigue fx involving cortex of bone
transverse fx
medial femoral spike: sharp medial cortical projection, typically arising from distal femoral segment
lack of comminution