Radiography

Question 1

Is radiographic evidence needed to diagnose OA in people older than 40?

Answer 1

Nah

Question 2

Benefits of x-rays

Answer 2

1. Cost effective
2. Quickly obtained
3. Augment understanding of OA

Question 3

Positioning for pt during x ray, number of views needed

Answer 3

Needs to be load bearing, at least two views

Question 4

Differential diagnosis with x ray

Answer 4

Used to rule out red flag causes, such as sepsis, tumour, #, inflammatory conditions

Question 5

Average exposure compared to when we get x rays

Answer 5

1-3mSV/year. X ray is equal to 3 hours - 10 days of exposure.

Question 6

MRIs good for OA

Answer 6

Nah, all soft tissue, NWB

Question 7

Bone scan helpful for detection of OA?

Answer 7

Yep, also Dx osteomyelitis, bone metastases, metabolic bone disease, implant failure

Question 8

Symmetrical joint space loss indicative of OA?

Answer 8

Nope, probably something inflammatory/systemic

Question 9

ABCDS

Answer 9

Alignment
Bone integrity and mineralization
Cartilage space
Distribution
Soft tissue changes

Question 10

Alignment changes characteristic with RA?

Answer 10

Yeeeee

Question 11

Ulnar or radial deviation in RA/SLE diseases?

Answer 11

Ulnar

Question 12

Bone integrity descriptors

Answer 12

• normal
• osteopenia
• erosional; marginal aggressive, central aggressive, non aggressive
• whiskering, excrescence, periosteal reaction, osseous ankylosis overhanging edge
• osteophytes, subchondral sclerosis

Question 13

OA can lead to ____ on radiograph

Answer 13

Joint space narrowing
sclerosis
osteophytes
subchondral cysts

Question 14

Kellgren Lawrence OA Classification system

Answer 14

0: no evidence of OA
1: doubtful JSN, possible osteophytic lipping
2: definite osteophytes, possible JSN
3: multiple osteophytes, definite JSN, possible bony deformity
4: large osteophytes, marked JSN, severe sclerosis, definite bony deformity

Question 15

Outerbridge Arthroscopy

Answer 15

0: normal
1: cartilage softening swelling
2: partial thickness defect with fissures, less than 1.5cm in diameter
3: fissuring to level of subchondral bone, diameter greater than 1.5 cm
4: exposed subchondral bone

Question 16

Eaton-Littler Classification for thumb OA

Answer 16

1: Subtle CMCJ space widening
2: Slight CMCJ narrowing, sclerosis, cystic changes <2mm
3: advanced CMCJ narrowing, sclerosis, cystic changes > 2mm
4: arthritic changes in the CMC as for stage 3 with scaphotrapezial arthritis