Extra stuff Flashcards

1
Q

Extension of the PIPs and flexion of the DIPs=

A

Swan neck deformity- RA

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2
Q

Flexion of the PIPs and extension of the DIPs=

A

Boutoneirres deformity- RA

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3
Q

Subchondral sclerosis aka

A

Eburnation

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4
Q

What is an increase in mechanical stress that causes thickened existing trabeculation and formation of new ones?

A

Subchondral sclerosis- localized compensatory increase in bone mass

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5
Q

What is the gelling phenomenon?

A

Fluid inside joint becomes thickened like gel, causes stiffness especially in the morn or at rest

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6
Q

Erosive OA is a variant of DJD that appears?

A

Unusually inflammatory- not to be confused with RA

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7
Q

What is the classic radiographic finding with erosive arthritis?

A

Gull wing appearance- DIP

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8
Q

What is the name for degeneration of the 1st MTP of the foot with pain and stiffness?

A

Hallux rigidus

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9
Q

What 2 joint misalignments are common in the feet?

A

Metatarsus varus

Hallux valgus

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10
Q

With rotator cuff arthropathy you have cystic changes and superior migration of the humerus d/t unopposed deltoid and erosion of the acromion. What is the sign used to describe this?

A

Hatchet’s sign

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11
Q

Shoulder impingement syndrome is most often due to?

A

Acromion osteophytes- if acromion points down instead of flat the risk is increased

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12
Q

With HADD, if calcium is within the tendon what happens to ROM?

A

It moves on the 2 should views and there is a significant decrease in ROM

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13
Q

With HADD, if calcium is within the bursa what happens?

A

It is non-moving

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14
Q

What are the 3 knee compartments?

A

Medial tibiofemoral
Lateral tibiofemoral
Retropatellar

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15
Q

What is an asymmetric loss of joint space in the medial compartment of the knee?

A

Genu varus- bow legged

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16
Q

What is calcification of the MCL d/t trauma contacting lateral knee?

A

Pelligrini-steida calcification

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17
Q

Where do you see Pelligrini-steida?

A

Coming off the medial femoral condyle

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18
Q

What is synovial tissue metaplasia that produces cartilaginous tissue with multiple intra-articular loose bodies?

A

SOM- synovial osteochondrometaplasia

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19
Q

SOM tends to lie within the joint ______ rather than the joint ______.

A

Capsule; space

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20
Q

What is a slow growing, benign and locally invasive tumor/ metaplasia of the synovium?

A

Pigmented villanodular synovitis PVNS

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21
Q

Where is PVNS most common?

A

Knee

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22
Q

What should you consider in a young patient with unexplained hip pain?

A

PVNS

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23
Q

What is the radiographic sign seen with pigmented villonodular synovitis?

A

Apple core deformity- concentric erosions of neck and femoral head

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24
Q

How do you differentiate PVNS from RA or OA?

A

Joint space unaffected, cystic changes and usually slighter changes

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25
Q

What is a thickening of cortex at medial aspect of femoral neck in response to increase in stress?

A

Buttressing

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26
Q

What is a “bad old hip”

A

Malum coxae senillis

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27
Q

Where does most degeneration happen at the hip?

A

Superior compartment 80%

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28
Q

What joints are typically affected with hypertrophic and atrophic arthropathies?

A
Hypertrophic= weight bearing joints 
Atrophic= non-weight bearing joints
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29
Q

What is the most common cause of neurotrophic arthropathies?

A

Diabetes

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30
Q

When the knee and lumbar are involved in a neurotrophic arthropathy what is usually the cause?

A

Tabes dorsalis

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31
Q

When the talonavicular or tarsometatarsal are involved in a neurotrophic arthropathy what is usually the cause?

A

Diabetes

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32
Q

What are the 6 D’s seen on films for NA?

A
Distended joints
Density increase
Debris
Dislocation 
Disorganization
Destruction 

Bag of bones

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33
Q

What are the common etiologies for hypertrophic neurotrophic arthritis?

A

Diabetes
Syphilis- Charcot joints
Spinal cord trauma

Usually feet, knees and hips

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34
Q

What causes a tapered bone appearance leading to a sharpened pencil point appearance like a licked candy stick?

A

Atrophic neurotrophic arthritis

35
Q

What is a common example of atrophic neurotrophic arthritis?

A

Bone resorption of proximal humerus 2nd to Syringomyelia

36
Q

What is the name of the radiographic sign associated with atrophic neurotrophic arthritis?

A

Cut off sign

37
Q

Who catergorized disc degeneration based on anatomy of the disc?

A

Resnick and Niwayama

38
Q

What are the 4 seroPOSITIVE inflammatory joint diseases?

A

RA
SLE
Scleroderma/ PSS
Jaccoud’s

39
Q

What are the 4 seroNEGATIVE inflammatory joint diseases?

A
I don't like PEARs 
Psoriatic arthritis
Enteropathic arthritis 
AS
Reactive/ reiters
40
Q

With RA, what is the abnormal layer of fibrovascular formation?

A

Pannus formation

41
Q

What is a “rat bite” seen on films with RA?

A

Marginal erosions-Localized loss of articular cortex at bare area or joint margin; no sclerosis

42
Q

What do you see large pseudocysts on films with RA?

A

D/t synovial fluid and extension of the pannus

43
Q

What is the first radiographic feature seen with RA?

A

Periarticular soft tissue swelling

44
Q

What is a soft tissue swelling adjacent to the MCP?

A

Haygarth node- RA

45
Q

What does SLAC stand for?

A

Scapho-lunate Advanced collapse- RA

46
Q

What is “spotty carpal” sign?

A

Erosions at the radial styloid and carpal bones- RA

47
Q

What is the “zig zag” sign?

A

Loss of carpal joint space, radial rotation with ulnar deviation of the fingers- RA

48
Q

Baker’s cysts are usually seen with what condition?

A

RA

49
Q

Acetabular protrusion is common in?

A

RA

50
Q

RA most commonly does what to the ADI?

A

Increases it

51
Q

What percent of RA patients have C spine involvement?

A

80%

52
Q

What are the juvenile arthritis aka?

A

Still’s disease
Juvenile chronic/idiopathic arthritis

Onset prior to 16

53
Q

Are patients usually seronegative or positive with JRA?

A

Seronegative- unlike adult RA

Seropositive patients have worst prognosis

54
Q

What are some of the common growth deformities seen with JRA?

A

Ballooned epiphysis

Squashed carpi and brachydactyly

55
Q

With what condition would you see increased ADI, hypoplastic C2-C4 bodies, discs with ankylosis apophyseal joints and osteopenia?

A

JRA

56
Q

Where are the typical radiographic findings seen with SLE?

A

Hands; spinal abnormalities uncommon
Transverse ligament laxity may rarely occur and osteoporotic compression fractures may happen secondary to corticosteroid therapy

57
Q

What are the reversible deformities seen with SLE?

A

Ulnar drift
Swan-neck
Boutonnière
Hitchhiker

58
Q

What is a non-erosive, reversible joint deformity with ulnar deviations and flexion of MCPs as well as fibular deviation of MTPs?

A

Jaccoud’s arthropathy

59
Q

What is a generalized inflammatory CT disorder involving skin, lungs, GI, heart, kidneys and MS system?

A

Scleroderma/ progressive systemic sclerosis

No spine involvement

60
Q

Who does scleroderma most commonly affect?

A

Women 30-50

61
Q

How does scleroderma usually present initially?

A

GI symptoms
Raynaud’s
RA- like arthritis

62
Q

What does CREST stand for?

A
Calcinosis 
Raynauds
Esophageal dysmotility 
Sclerodactyly
Telangiectasia
63
Q

What is the resorption of distal bony phalanges?

A

Acro-osteolysis

64
Q

What is a rare autosomal recessive bone dysplasia characterized by osteosclerosis and short stature?

A

Pyknodysostosis

65
Q

What is the MC seronegative spondyloarthropathy and 2 aka?

A

AS
Marie Strumpell
Bechterew disease

66
Q

100% of AS involves?

A

SI joint

67
Q

What are the 3 stages of SI issues with AS?

A

1 pseudowidening
2 erosion and sclerosis MC
3 ankylosis

68
Q

What is the name of the sign for erosions of SI joint?

A

Rosary bead sign

69
Q

What is the star sign?

A

Upper SI ankylosis

70
Q

What is see through ankylosis

A

Ghost joint

71
Q

What percent of AS patients will develop complete ankylosis?

A

50%

40% will get to stage 2 and then resolve

72
Q

the familial form of acro-osteolysis is also known as?

A

Hajdu- Cheney syndrome

73
Q

what is the acronym for scleroderma and diffuse acro-osteolysis?

A

PINCHFO

Pyknodysostosis or Psoriasis 
Injury (frostbite, thermal)
Neuropathy (diabetes) 
Collagen vascular disease (scleroderma, raynauds)
Hyperparathyroidism
Familial (Hajdu-cheney, progeria)
Occupational (polyvinyl exposure)
74
Q

what is an inherited shortening of fingers and toes d/t unusually short bones?

A

brachydactyly

75
Q

what is a thickening and tightening of the skin of the hands and fingers?

A

sclerodactyly

76
Q

what is pannus?

A

hyperplastic synovitis

77
Q

what term describes an intermittent absence of the articular cartilage d/t erosion?

A

dot dash appearance- RA

78
Q

what is felty’s syndrome?

A

leukopenia, splenomegaly and RA

79
Q

what are the 4 stages of RA?

A
  1. synovitis
  2. pannus
  3. fibrous ankylosis
  4. bony ankylosis
80
Q

what percent of patients develop RA in the cervical spine?

A

50% within 10 years of diagnosis

81
Q

what is the MC cause of UC neurologic sx in someone with RA?

A

atlanto-axial impaction

82
Q

what are the common presentations of RA in the cervical spine?

A
apophyseal joint disease 
decreased disc height
subluxation
osteoporosis 
spinous process/odontoid erosion
83
Q

where are the 3 spots your see odontoid erosions from RA?

A

btw dens and arch
btw dens and transverse ligament
tip of dens