Rad L2: Degenerative Disease of the Extremities Flashcards Preview

CHI303:clinical Science And Diagnosis > Rad L2: Degenerative Disease of the Extremities > Flashcards

Flashcards in Rad L2: Degenerative Disease of the Extremities Deck (12):
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What is some general information about degenerative joint disease?

  • Progressive, non-inflammatory
  • changes in cartilage and joints components
  • small joints of hand, larger weight-bearing joints
  • spine, hips, knees, AC, 1st CMC/MTP, D I P's

1

What are the clinical features of degenerative joint disease?

– M >F up to 45 years then reverse – most common type of joint disease – clinical findings disproportionate to observed x-ray findings – any joint can develop DJD – insidious onset of symptoms – aching, swelling, stiffness, goes away with activity – Environment: temp, humidity may aggravate – primary (idiopathic-no factor to set it off) – secondary (known factor or event)

2

What is the pathophysiology of degenerative joint disease?

  • Forces cause loss of ground substance
  • cartilage degrades (loss joint space)
  • synovium thickens
  • osteophyte formation
  • subchondral thickening (sclerosis)
  • synovial fluid enters subchondral bone (cysts)

3

What are the Radiographic signs in the extremities of the DJD?

  • Not all roentgen signs in every case
  • unilateral or asymmetric distribution

4

What are the radiographic signs of the DJD in the hip?

  • Non-uniform loss of joint space
  • osteophytes
  • Subchondral cysts
  • subchondral sclerosis
  • buttressing
  • joint deformity

5

What are the radiographic signs of the DJD in the Knee?

  • Spiking of tibial eminences
  • loose bodies
  • chondrochalsinosis in menisci
  • Medial tibiofemoral Joint
  • Lateral Tibiofemoral Joint
  • Patellofemoral Joint

6

Chondromalacia Patellae

definition

clinical features

criteria for diagnosis 

radiographic features

  • definition: A syndrome of pain and crepitus from the patellofemoral joint. 
  • clinical features: Adolescence, young adults, Obese females, large Q angle (>20°), Trauma, dislocation, malalignment syndromes, occupational
  • criteria for diagnosis: Anteriomedial pain with crepitus, buckling, locking, stiffness, swelling, Aggravated by walking up stairs, Patellar compression painful
  • radiographic features:Plain films are normal, CT air arthrography can detect loss of cartilage, MRI most sensitive to focal loss of cartilage

7

What are the radiographic signs of the DJD in the Ankle/Tarsals?

  • uncommon site unless post-trauma
  • First tarsometatarsal joint may show signs in mid/hind foot - rule out coalition of tarsals

8

What are the radiographic signs of the DJD in the Foot?

  • First MTP most common site
  • Osteophytes seen on dorsal, medial and lateral surfaces of joint
  • Bunion deformity seen as valgus lateral displacement of phalanx

9

What are the radiographic signs of the DJD in the shoulder (AC and GH)?

Acromioclavicular Joint: 

  • DJD more common in A-C than G-H 
  • Loss joint space, sclerosis, osteophytes, small cysts
  • Complication: impingement syndrome, rotator cuff tear

Glenohumeral Joint


  • DJD signs can = previous/occupational trauma



  • Osteophytes inferior humeral head

     





  • Cysts at rotator insertion



     







  • Rotator disruption seen as sup. migration of humeral head











     

10

What are the radiographic signs of the DJD in the elbow?

  • Very rare and secondary to trauma, occupation
  • Loose bodies and osteophytes, olecranon spur at triceps insertion

11

What clinical features present with Erosive osteoarthritis?

  • may suggest Inflammatory process with acute morning pain and stiffness
  • swelling
  • deformity of involved joints