DI Exam 3 part 1 (RA of the c-spine)

Cspine

Where is the mc place for RA to affect the axial skeleton?

Half (50%)

RA of the c spine with effect about ____ of pateints within 10 years of the diagnosis.

Anterior ADI >3 mm

Post ADI <14 mm

What would indicate a Atlantoaxial subluxations?

Odontoid erosion(s)

What can lead to a whittled dens?

<14mm

Subaxial subluxations has a Canal that is <___mm

Atlanta-axial impaction

What mc cause of upper cervical neurological symptoms in patients with RA?

RA cervical spine

Apophyseal joint disease (not epiphyseal?)

Decreased disc height

Spinous process erosions

Malalignment/subluxation

Osteopenia

All indicate what condition?

1. Between dens and anterior arch (AADI)

2. Between the dens and transverse ligament

3. At the tip of dens

Where can odontoid erosions affected synovial joints?

the anterior atlantodental interval (AADI)

Flexion and extension studies should be performed to evaluate what?

3mm

anterior AADI should not exceed ___mm in the adult

cranial settling

Occ-C1, C1-C2

facet erosions

Basilar

invagination

Potential

neurological

compromise

These all indicate what?

reference tools to evaluate the craniocervical junction (CCJ) on medical imaging (X-ray)

Why did we learn Chamberlain, McGregor, and McRae lines?

Pannus

What may cause a widened anterior ADI due to erosions?

genetic syndromes, congenital bone anomalies, and infections.

What are the other reasons a patient may have a widened anterior ADI?

Outline dens

What should you outline to find the AADI?

Juvenile chronic arthritis

What is a Seronegative condition that has an Onset younger than 16 years of age. This conditions has systemic involvement of organ systems and general body function, equal sex prevalence, and has high, acute intermittent fever, lymphadenopathy, hepatosplenomegaly, carditis, anemia, common to have a pale erythematous rash on trunk, face or extremities, often fleeting and migratory

T (seropositve 10%)

T/f: Seronegative JCA is most common

Seropostive Arthritis

What type of JCA has the poorest prognosis?

Seronegative JCA

Still's disease (classic 20%)

Polyarticular (50%): Next slide

Pauciarticular(30%)* (4 or fewer joints)

Are examples of what type of JCA?

Polarticular

Females

What is the mc Seronegative JCA?

What gender is mc affected?

F

T/f: Polyarticular Form is unilateral and asymmetrical.

Polyarticular form

Systemic signs may be present but mild, fever,

lymphadenopathy, and rash are all symptoms of what?

JCA

Soft tissue swelling

Osteopenia

Loss of joint space

Articular erosions

Malalignments/subluxations

Are all radiographic findings of what?

Malalignments/subluxations

Growth disruptions

Periostitis

Ankylosis

Are all examples of what?

Hands

Knee

Hip

c-spine

Where are the mc locations of JCA?

Hands

What location of JCA is described as a characteristic rheumatoid changes with periostitis and shortening?

"ballooning" of metaphysis

What location of JCA is described as

Hip

What location of JCA is described as acetabular protrusion ?

C-spine

What location of the JCA is described as erosions and posterior joint ankylosis; vertebral body and disc hypoplasia?

Ballooning

______ represents large epiphysis with a constricted

appearance of the metaphysis and diaphysis

Periostits

JCA

What is called when children have loosely attached

periosteum which reacts to the hyperemia by lifting

away from the parent bone?

What condition is is asssocatied with?

JCA

A Young female presented with stiffness and pain in both wrists, limitation of movements of bilateral wrist joints, especially on the right side?

What is the possible diagnosis?

Osteopenia

What is the condition with an enlargement of the distal femoral epiphysis?

Chronic hyperemia

Epiphyseal overgrowth is thought to result from what?

JIA (JCA)

What does this represent if it's a 12 year lad patient with neck pain?

Juvenile chronic arthritis: Still disease, with secondary DJD

What does this image show?

JCA

Hypoplastic bodies and ankylosed facets indicate what condition?