Radiological hallmarks Flashcards
(31 cards)
How many radiological hallmarks are present with osteoarthritis?
8
What are the first 4 OA radiological hallmarks?
- Asymmetric distribution (One side of the body)
- Asymmetric loss of joint space (e.g. medial side > lateral)
- Osteophytic growth (From degeneration and formation of new bone)
- Subchondral sclerosis (Trabecular thickening in areas of mechanical stress)
What are the next 4 OA hallmarks?
- Subchondral cysts (Synovial fluid causing radiolucent mass localised to epiphyseal region)
- Intra-articular loose bodies (Cartilage/bone flaking)
- Articular deformity (Due to remodelling of articular surfaces)
- Joint sublaxation - instability
What is final hallmarks specific for OA that can be seen in the spine region?
Vacuum phenomenon - radiolucent mass present in the disc space/area
What is the typical age/demographic you’d expect to see OA findings?
- Adults over 40 - women > men
- Patients who have had past trauma localised to the affected area
How many radiological hallmarks are present in rheumatoid arthritis?
8
What are the first 4 RA radiological hallmarks?
- Bilateral symmetry between limbs
- Periarticular soft tissue swelling - increased in opacity to adjacent tissues
- Juxta-articular osteoporosis
- Uniform loss of joint space (bilateral)
What are the next 4 RA radiological findings?
- Rat bite erosion -(Loss of cortex at the bare area)
- Juxta-articular periostitis
- Pseudocysts (Pannus leaking contents into the subchondral areas)
- Articular deformity (Joint destruction/ligament laxity/altered muscle function leading to dislocation)
How long can it take for RA symptoms to be visible via x-ray?
Early signs may become visible within 3-6 months of symptom onset
What is the typical age/demographic you’d expect to see RA findings?
- Women > M (3:1)
- Peak incidence @40
- Ageing population at risk
What are some common joint deformities seen with RA?
- Buitonnieres deformity:
- Swan neck deformity:
- Z deformity:
- Ulnar deviation:
How many radiological hallmarks are present in psoriatic arthritis (PA)?
9
What are the first 4 radiological hallmarks seen in PA?
- Asymmetric distribution
- Prominent ST swelling
- Normal bone mineralisation
- Early cortical erosions
What are the next 5 radiological hallmarks seen in PA?
- Fluffy/spiculated periostitis
- PIPs and DIPs distribution
- Ray pattern (PIPs, DIPs, MCPs all effected)
- Gull wing (Digit presentation seen in erosive arthritides)
- Initial joint space widening (which progresses to late stage ankyloses)
Which of the above hallmarks is pathognomonic to PA?
Ray pattern
What needs to be present in the patient to be diagnosed with PA?
Psoriasis of the skin
What associations can linked within the history of a patient to PA?
- Stress
- Skin injury
- Infection history
How many general hallmarks are related to AS?
Ten
How many AS specific hallmarks are there?
Five
What are the first five general AS hallmarks?
- Bilateral
- Symmetrical OP
- Bony ankylosis
- Early bilateral SI involvement
- Can be present from anywhere between pubic symphysis - manubrosternal joint
What are the next 5 general AS hallmarks?
- Ascends from TL region
- Early Cx changes of C2-3 & C6-7
- Syndesmophyte formation
- Romanus lesion (Lucent corner erosion of vertebrae)
- Bamboo appearance (Ankylosed spine or bridging of syndesmophytes
What are the 5 specific AS hallmarks?
- Early subtle SIJ widening
- Rosary bead erosion (Tp SIJ joint = jagged appearance of the articular surfaces)
- Reactive sclerosis with subchondral osteoporosis
- Ghost joint (Visualisation of articular cortex through ankylosed joint)
- Star sign (ossification of superior SI ligament = triangular radio-opacity)
What is the typical age/demographic you’d expect to see AS findings?
- Male > female 2:1
- Patients with a 1st degree genetic link
How many general radiological hallmarks are present in gout?
6
