Auto Bone and Joint MT1

Arthritis almost universal is people > 75 years old

Osteoarthritis

Osteoarthritis age

Men less than 50

Women greater than 50

What type of arthritis involves soft tissue swelling, uniform loss of joint space, bony erosion

Inflammatory

What type of arthritis involves juxta-articular osteopenia (bone mass loss)

Inflammatory

What type of arthritis has non-uniform loss of joint space, osteophytes and subchondral sclerosis (hardening of the bone just below the cartilage surface)

Degenerative

What arthritis is caused by overuse of joints

Degenerative

What arthritis involves ST masses, early preservation of joint space and well-marginated bone lesions

Metabolic

Most common arthritis

Osteoarthritis

Osteoarthritis is MC in which part of the spine

C5/6

What type of osteoarthritis has an unknown cause

Primary

X-ray findings of osteoarthritis

Joint space narrowing

Osteophytes

Subchondral sclerosis

Which pain is distributed along dermatomes

Radiculopathy

Which pain is distributed along embryologic connections

Sclerogenic

What artery supplies the primary growth center/diaphyseal region

Nutrient a.

What artery is subject to pooling/stasis at the growth plate

Metaphyseal a.

What artery is unable to cross cartilage plate prior to skeletal maturity

Epiphyseal a.

What artery is isolated before maturity

Epiphyseal a.

T or F: cartilage contains VAN

False

Chondro means

Cartilage

What collage makes up cartilage

Type 2

What collagen makes up bone

Type 1

What cartilage growth grows from within with new chondrocytes

Interstitial

What cartilage growth increases length

Interstitial

What cartilage growth grows on old chondrocytes

Appositional

What cartilage growth increases width

Appositional

Bone is radio_____

Dense

Air is radio_______

Lucent

Solid periosteal reaction

Single layer attached to cortex

Benign or slow growing lesion/infection

Laminated periosteal reaction

Layers of growth not fully connected to cortex

Can be benign/aggressive

Spiculated periosteal reaction

Spicules of bone radiating away from cortex (hair on end)

Aggressive

Codmans triangle periosteal reaction

Pushes bone up creating a triangle

Aggressive condition like cancer

Endosteal scalloping

Thinning of cortex

The organic matrix is ____% of bone

35

The inorganic matrix is _____% of bone

65

What is the organic matrix made of

Type 1 collagen

What is the inorganic matrix made mostly of

Hydroxyapatite

Cortical bone aka

Compact bone

What is the outer covering of a bone made of

Compact bone

What are the two layers of the periosteum

Outer fibrous later and inner cambium layer

Lamellar and woven bone

Trabecular, cancellous, spongy bone

Where is the primary growth center located

Diaphysis

What is the medullary cavity (yellow bone marrow) made up of

Trabecular, cancellous, spongy bone

Where does Osteoblastic/clastic activity occur

Inner cambium layer of periosteum

Endosteum

What lines the margin of the cortex and all trabeculae

Endosteum

End of the bone that supports articular cartilage

Epiphysis

When the epiphysis matures, what is it made of

Cancellous bone with a thin cortex

Where is the secondary growth center

Epiphysis

Secondary ossification centers occur when

After birth

Physis aka

Epiphyseal/growth plate

What is the Epiphyseal plate made of before maturity

Cartilage

Between physis and shaft

Metaphysis

Shaft of bone

Diaphysis

What part of the bone contains bone marrow

Diaphysis

Most metabolically active part the bone

Metaphysis

Stem cell of bone

Osteoprogenitor cells

Where are osteoprogenitor cells found

Periosteum and endosteum

What cells secrete and synthesize Osteoids

Osteoblasts

Cytoplasm of osteoblasts contains what enzyme

Alkaline phosphotase

What initiates bony mineralization

Osteoblasts

What type of collagen do osteoblasts synthesize

1

What are the mediator of wolffs law

Osteocytes

What are osteocytes

Mature osteoblasts in the lacunae of bone

What cells are responsible for bone resorption

Osteoclasts

Where are osteoclasts found

Howship's lacunae on bone surface

Hyperemia is ______ blood flow

Increased

During Hyperemia osteolytic activity is ________

Increased

What does Hyperemia lead to

Osteoporosis

What does ischemia lead to

Bone sclerosis

Ischemia is _______ blood flow

Reduced

Ischemia leads to ______ Osteoblastic activity

Increased

Ossification occurs during weeks ______ during fetal development

6-8

Types of bone growth

Endochondral and intramembranous

Bones form directly from osteoblasts

Intramembranous ossification

Pre-existing cartilage model calcifies and is replaced by bone

Endochondral ossification

Herberden's nodes occur at

DIP

Bouchards node occurs at

PIP

Common locations of osteoarthritis

Hips and knees

T or F: osteoarthritis is in the hip is more often found in males

True

T or F: osteoarthritis in the knee is more often in the lateral compartment

False (medial)

Normal uncinate processes are typically

Pointed (like Batman's ears)

Osteoarthritis has uncinate processes that appear

Curved (scooby doo ears)

Pseudofracture sign

A lucency is seen on lateral projection due to uncinate degeneration

T or F: you can see disc herniations on X-ray

False

Why are osteophytes more common on the right side of the thoracic spine than the left

Pumping of the thoracic aorta (on the left) prevents growth

The vacuum sign occurs in the

Lumbar spine

Vacuum sign

Air in the disc space

Vacuum sign is seen in which type of arthritis

Degenerative

Enthesophyte

Osseous spur at tendon/muscle attachment to bone

Diffuse idiopathic skeletal hyperostosis (DISH) aka

Forrestier's dx

Ligament calcification and ossification (especially of ALL)

DISH

T or F: DISH is ossification followed by calcification

False (visa versa)

What condition has morning stiffness and musculoskeletal pain in the spine

DISH

DISH affects what ligament

ALL

DISH is MC in

Males >65

Where is DISH MC

Thoracic spine T7-T11 right side

Common location of DISH in cervicals

C4-7

Common locations of DISH in lumbar

L1-3

PLL ossification associated with

DISH

What can DISH affect in regards to the GI system

Swallowing/dysphagia

DISH has an X-ray finding of flowing calcification and ossification at _______ vertebral bodies

4 contiguous