Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
37 Cards in this Set
- Front
- Back
|
Where do CPPD crystals frequently deposit?
|
Joint cartilage
|
|
|
What is Chodrocalcinosis?
|
-Radiographic evidence of calcified articular cartilage
-NOTE: NOT interchancheable with CPPD |
|
|
Common locations of Chondrocalcinosis
|
-Knees
-Wrists/MCPs -Symphysis pubis |
|
|
What is Pyrophosphate arthropathy?
|
-Intraarticular deposition of crystals within the cartilage leads to joint manifestations similar to osteoarthiritis
|
|
|
What is Pseudogout?
|
-Clinical presentation of CPPD
-Pt. presents with episodic pain similar to gout -10 - 20% |
|
|
Other than Pseudogout, what are the other presentations of CPPD?
|
-Asymptomatic = 10 - 20%
-Pseudo-rheumatic = 2 - 6% -Pseudo-osteoarthritis = 10 - 60% -Pseudo-neuropathy = 0 - 2% -Miscellaneous = 0 - 1% |
|
|
Age and gender common in CPPD?
|
-Middle-aged with peak onset around 60 years
-No sex predilection |
|
|
M/C signs/symptoms of CPPD that mimic degeneration?
|
-Isidious onset-chronic joint pain
-Decreased ROM -Intermittant swelling and crepitus |
|
|
Prominent places for CPPD?
|
-Peripheral joints
-Knees (MC) -Wrist -Hand -Ankles -Hip -Elbows |
|
|
What cases acute synovitis with CPPD?
|
-Injecctions of the crystals
|
|
|
Where are the crystal deposits found in CPPD?
|
-Hyaline cartilage
*Within intermediate layer NOT on the surface -Fibrocartilage *Within intermediate layer NOT on the surface -Capsular ligaments and tendons |
|
|
What are the laboratory findings of CPPD?
|
-No serum biochemical abnormalities
-Joint aspiration is diagnostic |
|
|
Describe Chondrocalcinosis of hyaline cartilage on film
|
-Thin, linear continuous or interrupted separated from but parallels the articular cortex
|
|
|
Describe chondrocalcinosis of fibrocartilage on film
|
-Thick, irregular, may have a shaggy appearance and poorly defined margins
|
|
|
Describe chondrocalcinosis of joint capsules
|
-Tends to appear linear and bridge the joint
|
|
|
Describe chondrocalcinosis of synovium
|
-Poorly defined
|
|
|
MC locations of Chondrocalcinosis
|
-Menisci of the knees
-Triangular fibrocartilage -Lunotriquetral ligament -Symphysis pubis -Labrums |
|
|
Diseases CPPD is associated with
|
-"WHIP A DOG"
-Wilsons disease -Hyperparathyroidism/Hemochromatosis -Idiopathic -Pseudogout - MC -Acromegaly -Diabetes Mellitus -Ochronosis -Gout |
|
|
2 forms of hemochromatosis (excessive cellular uptake of iron)
|
-Primary form
*autosomal recessive *Bronze diabetes -Secondary form *Multiple blood transfusions |
|
|
How is hemochromatosis similar to CPPD radiographically?
|
-Predilection for the 2nd & 3rd MCp
-Beaklike osteophytes at the radial margins -MRI is the best imaging exam demonstrating iron deposits within the liver |
|
|
Signs of CPPD in the knee (MC)
|
-Chondrocalcinosis
-Unusual compartment distribution -Subchondral cysts and sclerosis |
|
|
Signs of CPPD in the wrist
|
-Chondrocalcinosis of the fibrocartilage of the ulnocarpal joint is common
-Arthropathy favots the radiocarpal joint -May lead to a SLAC wrist -"Spotty Carpal" sign *RA *Gout *CPPD *Sudeck's atrophy |
|
|
Where is CPPD in the spine seen?
|
-Mostly in the lumbar spine
|
|
|
Where does CPPD affect the shoulder?
|
-Glenohumeral joint
|
|
|
Where does CPPD affect the hip?
|
-Hyaline cartilage of the femoral head
-Acetabular labrum -May produce a protrusio acetabuli |
|
|
What kind of calcification is seen in the symphysis pubis with CPPD?
|
-Vertical calcification
|
|
|
What is the AKA for Hydroxyapatite Deposition Disease (HADD)?
|
-Calcific tendonitis
|
|
|
Age and gender with HADD?
|
-Age onset is normally 40 - 70 years
-No sex predilection |
|
|
Symptoms of HADD
|
-Characteristically monoarticular
-Frequently asymptomatic -Pain, tenderness, local swelling -May mimic a monoarticular arthritis or setic arthritis |
|
|
What is seen in the films in periarticular locations of a patient with HADD?
|
-Homogenous cloudlike calcification
*Tendons *Legaments *Joint capsules *Bursae |
|
|
MC locations of HADD?
|
-(Descending order)
-Shoulder -Hips -Spine -Fingers -Elbow -Wrist -Knee -Ankle |
|
|
What are the sites of involvement in descending order of HADD in the shoulder (MC)?
|
-Supraspinatus
-Infraspinatus -Teres Minor -Subscapularis -Biceps tendon (both heads) -Subacromial/subdeltoid bursa |
|
|
What view is HADD best seen in supraspinatus?
|
-External rotation
|
|
|
What view is HADD best seen in infraspinatus?
|
-Internal rotation
|
|
|
Where is HADD commonly seen in the hip?
|
-Commonly affects the gluteus maximus near the insertion on the femur
|
|
|
What are the 2 sites of involvement of HADD in the spine?
|
-Longus Coli muscle
*Usually located anterior to C2 and inferior to the anterior tubercle of C1 -Intervertebral Disc *causes for disc calcifications ^degeneration ^congenital block ^idiopathic |
|
|
Where is HADD commonly seen in the knee?
|
-Medial collateral ligament (MCL)
|
