Skel Rad A - Final Exam

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Skel Rad A - Final Exam
2011-11-22 20:10:11
Life University Ray Radiology CodexSearch

Preparation for Life University Skeletal Radiology A - Final Exam
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  1. Barlow's Disease

    a) AKA

    b) Caused by _________
    a) Infantile Scurvy

    b) Hypovitaminosis C
  2. Forms collagen, osteoid, endothelial linings
    Vitamin C
  3. Scurvy:

    a) Most common in what demographic?

    b) Why in that demographic?
    a) In babies 8-14 months

    b) Fed pasteurized or boiled milk preparations
  4. Latent period for Scurvy =
    4 months
  5. Diagnose:

    - Cutaneous petechiae
    - Bleeding gums
    - Melena, hematuria
    - Joint swelling
    - Irritability
    - Pain
    - Frog-leg position
  6. White Line of Frankel:

    a) Describe
    b) Associated with _____________
    a) Dense zone of provisional calcification (WHITE LINE OF FRANKEL) – delayed conversion to bone.

    b) Scurvy
  7. Wimberger’s Sign:

    a) Describe
    b) Associated with ____________
    a) Ring epiphysis

    b) Scurvy
  8. Corner (Angle) Sign:

    Associated with what disease?
  9. Pelkin's Spurs:

    Associated with what disease?
  10. Scorbutic zone (Trummerfeld’s zone):

    Associated with which disease?
  11. Subperiosteal hemorrhage:

    Associated with what disease?
  12. “Scorbutic rosary”

    Associated with what disease?
  13. Growth hormone is produced in the __________
    Anterior pituitary gland
  14. Define: Acral
    Acral: pertaining to or affecting a limb or other extremity.
  15. Activates bone growth
    Growth hormone
  16. Diagnose:

    - Thick skin…heel pad
    - Skull / facial changes
    - Large hands, tufts
    - ADI
  17. What condition is responsible for release of excessive osteoclastic hormone - PTH?
  18. Most common cause of Primary Hypercalcemia?
    Hyperparathyroidism (Parathyroid adenoma)
  19. Most common cause of Secondary Hyperparathyroidism (HPT)
    Complication of renal disease

    (Constant loss of Ca and P….stimulate Parathormone release)
  20. Most common cause of Tertiary Hyperparathyroidism (HPT)
    Dialysis patient
  21. Diagnose:

    - Female, 30-50 years of age (3:1)
    - Weakness, lethargy, polydipsia, polyuria
    - Calculus formation in kidneys
    Hyperparathyroidism (HPT)
  22. What causes the following symptoms:

    - Stimulates osteoclastic resorption
    - Ca and P accumulates in blood
    - Phosphorus - more readily excreted than calcium
    Hyperparathyroidism (HPT)
  23. What will cause hypercalcemia and hypophosphatemia?
    Hyperparathyroidism (HPT)
  24. Subperiosteal bone resorption of the outer cortex at the ligament and tendon insertion points indicates____________
    Hyperparathyroidism (HPT)
  25. Describe: Brown Tumors
    • - Osteoclastic giant cells
    • - Cyst-like destructive bone lesions
  26. Subperiosteal resorption of the radial margins of the middle and proximal phalanges indicates _______________
    Hyperparathyroidism (HPT)
  27. Subperiosteal resorption of second and third digits of the hand indicates ________________
    Hyperparathyroidism (HPT)
  28. Subperiosteal resorption of medial metaphysis of the humerus and tibia indicates _________________
    Hyperparathyroidism (HPT)
  29. Subperiosteal resorption of undersurface of the distal clavicle indicates _______________
    Hyperparathyroidism (HPT)
  30. Subperiosteal resorption of trochanters and tuberosities indicates __________________.
    Hyperparathyroidism (HPT)
  31. Diagnose radiographic findings:

    Outer cortical erosion
    - Irregular, frayed
    - Lace-like appearance of external surface of bone
    Hyperparathyroidism (HPT)
  32. Diagnose radiographic findings:

    Subarticular bone resorption
    - Widened joint space
    - Osteolysis
    - AC joint, symphysis pubis, SI joints
    Hyperparathyroidism (HPT)
  33. Diagnose radiographic findings:

    Salt and pepper skull/pepper-pot skull
    Hyperparathyroidism (HPT)
  34. Diagnose radiographic finding:

    Accentuated trabecular pattern of remaining trabeculae
    Hyperparathyroidism (HPT)
  35. Diagnose radiographic findings:

    - Loss of cortical definition
    - Subligamentous bone resorption
    Hyperparathyroidism (HPT)
  36. Diagnose radiographic finding:

    - Soft tissue calcification
    Hyperparathyroidism (HPT)
  37. Chondrocalcinosis is associated with _____________
    Hyperparathyroidism (HPT)
  38. List 5 common sites for radiographic findings of hyperparathyroidism.
    • 1) Hands
    • 2) Skull
    • 3) Spine – rugger-jersey spine
    • 4) Pelvis
    • 5) Shoulders
  39. Rugger Jersey Spine is associated with ____________
    Hyperparathyroidism (HPT)
  40. Osteolysis is associated with ______________
    Hyperparathyroidism (HPT)
  41. Hypocalcemia is associated with _____________
  42. Hyperphosphatemia is associated with ____________
  43. Diagnose radiographic finding:

    - Calvarial thickening (thick skull)
  44. Diagnose radiographic finding:

    - Hypoplastic dentition (dental abnormalities)
  45. Diagnose radiographic finding:

    - Basal ganglia calcification
  46. Osteoblastic metastatic disease can cause _____________
  47. Paget’s disease can cause _________
  48. Sickle cell anemia can cause _______________
  49. Involves an end-organ resistance to Parathormone action.
    Pseudohypoparathyroidism (PHP)
  50. If parathormone is actually elevated, not lowered/absent, it indicates ____________.
    Pseudohypoparathyroidism (PHP)
  51. Dwarfism, obesity, round face, brachydactyly are all indicators of ___________________.
    Pseudohypoparathyroidism (PHP)
  52. Define: Brachydactyly
    Brachydactyly refers to shortening of the fingers or toes due to underdevelopment of the bones in the hands or feet.
  53. Abnormal teeth, mental retardation, impaired taste and smell are all indicators of _____________
    Pseudohypoparathyroidism (PHP)
  54. Pseudohypoparathyroidism (PHP) is most common in:
  55. Hypocalcemia and hyperphosphetemia are indicative of ________________.
    Pseudohypoparathyroidism (PHP)
  56. A normocalcemic form of pseudoparathyroidism
  57. Pseudopseudohypoparathyroidism is most common in ___________________
    a sibling of Pseudopseudohypoparathyroidism
  58. A positive metacarpal sign indicates _______________.
  59. Describe a positive metacarpal sign.
    Radiographic finding on a standard posteroanterior hand radiograph, regarded as positive if a line drawn tangential to the distal ends of the heads of the fourth and fifth metacarpals extends through the head of the third metacarpal. A positive metacarpal sign reflects shortening of the 4th metacarpal.
  60. The type of joints between the:
    - Cranial sutures
    - Tibia / Fibula
    - Radius / Ulna
    Fibrous Joints
  61. The Pubic Symphysis and Intervertebral Discs are what types of joints?
  62. The SI joints, digits and knees are all examples of what type of joints?
  63. Provides lubrication and nutrition for the joint.
    Synovial fluid
  64. Articular cartilage in joints is a form of ______________ cartilage.
    Hyaline cartilage
  65. Found directly under the cartilage, this area has active tissue with abundant blood supply .
    Subchondral bone plate
  66. Name the 3 classifications for arthitic disorders
    • 1) Inflammatory
    • 2) Degenerative
    • 3) Metabolic
  67. Which is the only type of arthritis to present with Periostitis?
    Inflammatory arthritis
  68. Which is the only type of arthritis to present with Osteophytes?
    Degenerative arthritis
  69. Which is the only type of arthritis to present with poorly defined bone erosions?
    Inflammatory arthritis
  70. Which is the only type of arthritis to present with sharply defined bone erosions?
    Metabolic arthritis
  71. Which is the only type of arthritis to present with decreased bone density?
    Inflammatory arthritis
  72. Which is the only type of arthritis to present with [normal] or increased bone density?
    Degenerative arthritis
  73. Which is the only type of arthritis to present with normal joint alignment?
    Metabolic arthritis
  74. How many joints must be involved in arthritis for it to be considered "polyarticular"?
    5 or more joints = polyarticular
  75. Which is the only type of arthritis to be strictly polyarticular?
    Inflammatory arthritis
  76. Which is the only type of arthritis to be strictly monoarticular?
    Degenerative arthritis is strictly monoarticular
  77. Which is the only type of arthritis that can be either monoarticular or polyarticular?
    Metabolic arthritis
  78. Which is the only type of arthritis to be symmetrical?
    Inflammatory arthritis
  79. Term for the union of the bones of a joint by proliferation of bone cells, resulting in complete immobility.
    Bony ankylosis
  80. Which is the only type of arthritis to cause Juxta-articular osteoporosis?
    Inflammatory arthritis
  81. Rheumatoid arthritis is what type of arthritis?
    Inflammatory arthritis
  82. Psoriasis is what type of arthritis?
    Inflammatory arthritis
  83. Ankylosing spondylitis is what type of arthritis?
    Inflammatory arthritis
  84. Reiter’s syndrome is what type of arthritis?
    Inflammatory arthritis
  85. Subchondral cysts can be found with what type of arthritis?
    Degenerative arthritis
  86. Subchondral cysts AKA _________
  87. Non-uniform loss of joint space is an indication of what type of arthritis?
    Degenerative arthritis
  88. Subchondral sclerosis is an indication of what type of arthritis?
    Degenerative arthritis
  89. Periarticular soft tissue masses is an indication of what type of arthritis?
    Metabolic arthritis
  90. Well-marginated bone lesions is an indication of what type of arthritis?
    Metabolic arthritis
  91. Preservation of joint spaceis an indication of what type of arthritis?
    Metabolic arthritis
  92. Gout is an example of what type of arthritic disorder?
    Metabolic arthritis
  93. Degenerative Joint Disease (DJD) AKA

    * Even though DJD is not an inflammatory condition.
  94. What is the most common joint pathology?
    Degenerative Joint Disease (DJD)
  95. Degenerative Joint Disease (DJD) can typically be found in what anatomic locations?
    • - Small joints of hands
    • - Larger weight-bearing joints
  96. Primary DJD:
    a) Ratio of Women:Men?
    b) Typical age range for women?
    • a) Ratio of 10:1 Women to Men
    • b) Typically occurs in women during 5th-6th decade
  97. Cartilage is composed of what 2 major substances?
    • 1) Collagen fibers
    • 2) Proteoglycan (aka "ground substance")
  98. A degenerative form of arthritis in which cartilage within joints gradually breaks down.
  99. How do geodes form?
    They form when DJD causes cortical microfractures allowing synovial fluid to enter subarticular (subchondral) bone.

    Geodes = subchondral cysts.
  100. Increased capsular insertion stress and ligament traction can cause _____________.
    Osteophyte formation
  101. List the 8 radiographic findings for Degenerative Joint Disease (DJD.
    • 1) Asymmetrical distribution
    • 2) Subchondral schlerosis
    • 3) Articular deformity
    • 4) Non-uniform joint space loss
    • 5) Joint subluxation
    • 6) Subchondral cysts
    • 7) Osteophytes
    • 8) Intra-articular loose bodies
  102. Typically, non-uniform loss of joint space occurs where?
    At areas of greatest intra-articular stress.
  103. Subchondral schlerosis AKA
  104. What physical condition must be present in order for eburnation (subchondral schlerosis) to occur?
    Decrease in joint space.

    (Seen where there is the greatest loss of cartilage)
  105. What can occur where there are focal areas of osteopenia within subarticular bone?
    Geodes (subchondral cysts)
  106. Diagnose:
    - Ovoid geographic lucency
    - 2-20mm in diameter
    - Thin, sclerotic margin
    - Next to degenerative joint surface
    Geode (subchondral cyst)
  107. Intra-articular loose bodies comprised of pieces of subchondral bone. AKA
    Joint mice
  108. Describe Synoviochondrometaplasia, and why it is different from intra-articular loose bodies (joint mice)
    Synoviochondrometaplasia is metaplastic synovium that produces cartilaginous and osseous debris.

    Joint mice are debris produced by DJD.
  109. Most common site for joint mice / intra-articular debris.
  110. Term for a deformity due to repetitive stress and:
    ◦ Trabecular remodeling
    ◦ Fracture
    ◦ Collapse
    Articular deformity
  111. List 4 conditions that can cause progressive deformation of articular surfaces:
    • ◦ Vascular disturbances
    • ◦ Necrosis
    • ◦ Collapse
    • ◦ Joint degeneration
  112. Coxarthrosis and Malum coxae senilis are both AKA's for _____________________.
    Hip DJD
  113. Hip DJD can cause increased risk of _____________
  114. List the 3 types of Hip DJD joint migration.
    • 1) Superior (Waldenstrom sign)
    • 2) Medial (protrusio acetabuli)
    • 3) Axial (superomedial displacement)
  115. Axial migration of the hip from DJD is typically seen in cases of ____________.
    Rheumatoid arthritis or infection
  116. a) Describe Waldenstrom Sign

    b) How does it appear on CT?
    a) Superior displacement of the hip due to DJD.

    b) Superior migration appears as anterior migration on CT
  117. a) Describe protrusio acetabuli

    b) How does it appear on CT?
    a) Medial displacement of the hip due to DJD.

    b) Medial migration appears as posterior migration on CT
  118. Term associated with DJD that presents the following:

    ◦ Thickening on medial side
    ◦ stress-related
    ◦ altered joint mechanics
  119. a) List the 3 compartments of the knee.

    b) Which is the most common site of DJD?
    • 1) Medial
    • 2) Lateral
    • 3) Patellofemoral *Most Common Site*
  120. List two radiographic findings indicative of DJD in the knee.
    • 1) Sharpening of tibial eminences
    • 2) Calcified loose bodies
  121. Describe: Os fabella
    Os fabella is a well-corticated bone density posterior to the lateral condyle of the left femur. It exists in the location of the lateral head of gastrocnemius tendon.

    It is seen in approximately 10% of the population.
  122. Name a radiographic finding indicative of
    advanced patellofemoral degeneration.
    Patellar Tooth Sign
  123. a) Describe the condition and list symptoms associated with Chondromalacia patellae.
    Cartilage softening with pain and crepitus in patellofemoral joint.

    • - Anteromedial knee pain
    • - Retropatellar pain with direct compression (knee slightly flexed)
    • - Crepitus, buckling, locking, stiffness, swelling.
    • - *Movie Sign*
    • - Patella alta

    b) Trauma, patellar dislocation, malalignment syndrome, cartilage vulnerability, occupation.
  124. List 5 causes of Chondromalacia patellae.
    • 1) Trauma
    • 2) Patellar dislocation
    • 3) Malalignment syndrome
    • 4) Cartilage vulnerability
    • 5) Occupation.
  125. "Movie Sign" is associated with __________
    Chondromalacia patellae
  126. a) Describe "Q Angle"

    b) Normal limits =
    Q Angle is used to detect patellar malalignment

    b) Normal angle = 15°-20°
  127. Talar beak, Tarsal coalition, and Calcaneal “spurs” are all associated with ______________
    DJD of the ankle and tarsal joints.
  128. What is the most common site for DJD in the foot?
    1st Metatarsophalangeal joint
  129. Osteophytes and deformity (hallux valgus) are both associated with ___________________
    DJD in the foot.

    *Simulates signs of gout*
  130. If DJD in glenohumeral joint, suspect ____________
    Suspect previous trauma or cartilagenous disease
  131. What is the most common site, specifically, for DJD of the shoulder?
    Inferior aspect of the Acromio-clavicular (AC) joint
  132. Degenerative tendonitis + calcification =
    • HADD
    • Hydroxyapatite Degenerative Disease
  133. a) Most common site for HADD in the shoulder?
    b) Second most common site for HADD in the shoulder?
    a) 1st MC = Supraspinatus tendon at the insertion on greater tubersity.

    b) 2nd MC = subacromial bursa, below acromion and above humeral head.
  134. What is the most common site for DJD of the wrist?
    1st metacarpal-trapezium joint.
  135. List 4 radiographic findings associated with DJD of the wrist.
    • 1) Radial displacement (subluxation) of the first metacarpal base
    • 2) Sclerosis
    • 3) Osteophytes
    • 4) Loose bodies
  136. List 3 predisposing conditions that can cause DJD of the wrist.
    • Predisposing conditions:
    • 1) Radial and scaphoid fractures
    • 2) Ischemic necrosis – scaphoid and lunate
    • 3) CPPD crystal deposition disease
  137. Triangular fibrocartilage calcification in the wrist is indicative of _________________
    DJD of the wrist
  138. Describe Heberden’s nodes
    DJD (clinically enlarged joints) in the DIPs

    Heberden = DIPs
  139. Describe Bourchard’s nodes
    DJD (clinically enlarged joints) in the PIPs

    Bourchard's = PIPs
  140. Term for Calcifying tendinitis and bursitis
    • HADD
    • Hydroxyapatite Deposition Disease
  141. What is the most common age range and gender for HADD?
    Age Range: 40-70 yoa

    Men = Women in occurence
  142. Most common single joint for HADD
  143. Most definitive for of diagnosis for HADD
  144. Term for tendon calcification at insertion site.
    • HADD
    • Hydroxyapatite Deposition Disease
  145. Diagnose:
    - Ovoid calcifications on tendons
    - Sharp margins
    - Does not blend into cortex of adjacent bone
    • HADD
    • Hydroxyapatite Deposition Disease
  146. List 3 common sites for HADD
    (Hydroxyapatite Deposition Disease)
    • 1) Shoulder rotator cuff
    • 2) Hip
    • 3) Upper Cervical spine
  147. Diagnose: Produces gout-like symptoms
    • CPPD
    • Calcium Pyrophosphate Dihydrate
    • crystal deposition disease
  148. a) In what regions does CPPD commonly present?
    b) Typical age Range for occurance?
    a) Peripheral joints (Knees, wrists, hands, ankles, hips, elbows)

    b) MC > 30 yoa
  149. Term for Crystal deposition into cartilage
    • CPPD
    • Calcium Pyrophosphate Dihydrate
    • crystal deposition disease
  150. Diagnose:
    - Hyaline cartilage appears thin, linear, parallel to articular cortex.
    - Chondrocalcinosis

    • (associated with CPPD)
    • - Calcium Pyrophosphate Dihydrate crystal deposition disease
  151. Diagnose:
    Fibrocartilage appears thick, irregular, shaggy, with poorly defined margins.
    • - CPPD
    • - Calcium Pyrophosphate Dihydrate
    • - crystal deposition disease
  152. Term for structural joint changes occurring due to CPPD crystals within a joint.
    Pyrophosphate Arthropathy
  153. Erosive Osteoarthritis AKA
    Inflammatory OA
  154. Diagnose:
    - Episodic and acute inflammation of the DIP and PIP joints
    - Bilateral
    - Symmetric
    Erosive Osteoarthritis (aka Inflammatory OA)
  155. Diagnose:
    - Middle-aged females
    - Pain
    - Edema
    - Redness
    - Nodules,
    - Decreased ROM
    Erosive Osteoarthritis (EO)
  156. *** TRUE or FALSE:

    CPPD can be found in the annulis fibers of vertebral discs.
    *** TRUE
  157. *** Psoriatic Arthritis has (a)____________-located erosions, versus Erosive Osteoarthritis (EOA) which has (b)__________ erosions.
    (a) Psoriatic Arthritis = Peripheral erosions

    (b) EOA = Central erisions (Gull wing Sign)
  158. He-Bu-Ha:

    • He = Heberden's Nodes = DIPs
    • Bu = Buchard's Nodes = PIPs
    • Ha = Hagarth's Nodes = MCPs
  159. *** RA will NOT be found in the _________

    Distal Interphalangeal joints
  160. ** Describe: Terry Thomas Sign
    Separation of scafoid and lunate bones
  161. ** "Spotty Carpal Sign" is associated with ___________.
    Spotty Carpal Sign = Reumatoid Arthritis (RA)

    * also seen in Gout
  162. ** Most common cause of bilateral protrusio acetabuli
    Reumatoid Arthritis (RA)
  163. - Describe: Psoriatic arthritis.

    - What is it commonly associated with?
    Psoriatic arthritis: – Marginal erosions with adjacent periostitis.

    Commonly associated with Eorosive Osteoarthritis
  164. ** Describe Caput Ulna Syndrome
    Separation at the Radiaus / Ulna joint.
  165. Diagnose:
    - Bilateral, symmetrical
    - Peripheral joint involvement
    - Begin at IP and MCP joints
    - Progresses proximally
    - Pain, tenderness, stiffness, swelling
    - “Jelling phenomenon”
    Rheumatoid Arthithritis
  166. Rheumatoid Arthritis is most commonly found in what demographic?
    • Rheumatoid Arthritis:
    • 20-60yoa
    • Female, 3:1 (in 20-40 yoa group)
    • 1:1 (>40 yoa)
  167. "Jelling Phenomenon" is associated with what disease?
    Rheumatoid Arthritis
  168. Diagnose:

    –Soft tissue swelling
    –MCP joints
    Haygarth's Nodes
  169. Diagnose from Lab Values:

    –↑ ESR and ↑ C-reactive protein
    –Presence of rheumatoid factor (not specific for RA)
    Rheumatoid Arthritis
  170. Diagnose:

    Felty's Syndrome presents RA with what additional symptoms?

    • - Leukopenia
    • - Splenomegaly
  171. - Describe: Pannus

    - What is it associated with?
    Synovial proliferation forms pannus.

    Pannus = vascular tissue – spreads over intra-articular surface of bone and cartilage.
  172. Most common (MC) sites for Rheumatoid Arthritis.

    - (List 6)
    • 1. Hand
    • 2. Wrist
    • 3. Foot
    • 4. Knee
    • 5. Hip
    • 6. Cervical Spine
  173. What part of the hand with Rheumatoid Arthritis NOT be found?
    DIP joints.
  174. List two locations in the hand where marginal erosions are caused by rheumatoid arthritis (RA).
    - Radial margins of 2nd and 3rd metacarpal heads

    – Radial margins of the distal and proximal ends of the proximal phalanges
  175. – Boutonniere deformity
    – Swan-neck deformity
    – Digital ulnar deviation
    – Carpal radial deviation

    Are all associated with what disease?
    Rheumatoid Arthritis
  176. Formed by proliferating fibroblasts and inflammatory cells.
  177. Vascular connective (granulation) tissue
  178. Produces more enzymes that destroy nearby cartilage, aggravating the area and attracting more inflammatory cells, thereby perpetuating the process.
  179. Erosion of the ulnar styloid process indicates _________________.
    Rheumatoid Arthritis (RA)
  180. Term for:
    - multiple marginal erosions throughout carpus.
    - (also seen in gout, tuberculous arthritis and Sudeck’s atrophy).
    Rheumatoid Arthritis
  181. Define: Terry Thomas sign
    Separation of the scaphoid and lunate bones of the hand.
  182. Describe: Caput ulnae syndrome
    (location, movement,
    • - Diastasis at the radioulnar joint
    • - Ulna moves dorsally
    • - May have extensor tendon rupture
  183. In 15% of patients, the [limb] is the initial site of involvement.
    The foot
  184. Diagnose these radiographic findings of the foot:
    - soft tissue swelling
    - marginal erosions
    - juxta-articular osteoporosis
    - uniform loss of joint space
    - deformities
    Rheumatoid Arthritis (RA)

    Rheumatoid Arthritis (RA) will cause marginal erosion on the medial surface of all the metatarsal heads.

    RA will cause marginal erosion on the medial surface of the 1st thru 4th metatarsal heads, and the lateral surface of the 5th metatarsal head.
  186. Describe Lanois Deformity
    - Digital fibular deviation* at MTP joints (except 5th digit)

    * Flexion deformities, dislocations of the toes, and advanced joint destruction
  187. Diagnose Hip Pathology:
    - Bilateral and symmetrical
    - Axial migration of femoral head
    - Superior and medial
    - Small femoral heads
    - Decreased joint space
    Rheumatoid Arthritis
  188. Term for Acetabulum displaced medially
    Protrusio acetabuli
  189. What is the most common cause of bilateral protrusio acetabuli?
    Rheumatoid Arthritis (RA)
  190. What pathology causes superior hip migration?
  191. List two pathologies that cause medial hip migration.
    • - DJD
    • - Paget's Disease
  192. List two pathologies that cause axial hip migration.
    • - Rheumatoid Arthritis
    • - Infection
  193. Lytic mets, multiple myeloma, and hyperparathyroidism will all present what radiographic finding on the shoulder?
    - Pencil-like tapering of the distal clavicle
  194. Diagnose:
    - Synovial erosions at humeral head
    - Early inflammatory rupture of the rotator cuff tendons
    - Humeral head elevates
    - Space between clavicle and humeral head is decreased
    Rheumatoid Arthritis
  195. "Fat Pad" Sign indicates:
    Fat Pad Sign indicates Rheumatoid Arthritis (RA) of the elbow in 90% of cases.
  196. - Describe "Supinator Notch" Sign.

    - What does it indicate?
    • "Supinator Notch" Sign:
    • - Early erosion
    • - Proximal elbow, opposing the neck of the adjacent radius.

    Indicates: Rheumatoid Arthritis
  197. Uniform bicompartmental loss of joint space in the knee indicates _______________.
    Rheumatoid Arthritis
  198. Asymptomatic erosions on superior margins of the 3rd, 4th and 5th posterior ribs indicates _____________.
    Patient with long-term (>14 yrs) of Rheumatoid Arthritis
  199. What is the most frequent systemic autoimmune inflammatory disease affecting children?
    JRA - Juvenile Rheumatoid Arthritis
  200. What is "Still’s Disease"?
    Juvenile chronic arthritis.

  201. What are the three types of Seronegative Chronic Arthritis – Still’s Disease?
    • 1) Classic Systemic Disease (20%)
    • 2) Polyarticular Disease (50%)
    • 3) Pauciarticular-Monoarticular disease (30)
  202. Diagnose:

    - Fever
    - Lymphadenopathy
    - Hepatosplenomegaly
    - Anemia
    - Pale, erythematous rash over trunk, face and extremities – migratory
    - Mild radiographic joint changes
    Classic Systemic disease.

    (A form of Seronegative Chronic Arthritis – Still’s Disease)
  203. Diagnose:

    - 2x MC in females
    - Bilateral, symmetrical with pain and swelling at distal extremities and cervical spine
    - Clinical presentation simulates rheumatic fever
    - Chronic – “bird-like” appearance
    - Frail, delicate features of limb and face
    - Small, receded jaw
    Polyarticular disease

    (A form of Seronegative Chronic Arthritis – Still’s Disease)
  204. Diagnose:

    - 3x MC in females
    - Larger joints MC
    - MC monoarticular site –knee
    - In monoarticular type – complicated with iridocyclitis (inflammation of the iris and ciliary body)
    Pauciarticular-Monoarticular disease

    (A form of Seronegative Chronic Arthritis – Still’s Disease)
  205. Diagnose:

    - MC in females
    - 2nd to 4th decades
    - Fever
    - Malaise
    - Anorexia
    - weight loss
    - Polyarthralgia
    - skin rash
    Systemic Lupus Erythemetosis (SLE)

    * Rash affects face, neck, elbow, dorsum of hands. Butterfly Rash in 40% of patients.
  206. Alopecia occurs in 20% of patients with ___________.
    Systemic Lupus Erythemetosis (SLE)
  207. Ulcerations of the oral mucosa occurs in 19% of patients with ___________.
    Systemic Lupus Erythemetosis (SLE)
  208. Pericarditis occurs in 19% of patients with ___________.
    Systemic Lupus Erythemetosis (SLE)
  209. What are the three classic signs of Sjogren's Syndrome?
    • 1) Keratoconjunctivis sicca (dry eyes)
    • 2) Xerostomia (dry mouth)
    • 3) Rheumatoid arthritis

    *only 2 of 3 needed for it to be considered Sjogren's Syndrome.
  210. Parotid gland enlargement in 50% of patients indicates ______________.
    Sjogren's Syndrome