Dx Imaging

  1. osteochondroma
    • MC BBT of the appendicular skeleton
    • either pedunculated or sessile
    • hereditary multiple exostosis (HME) are multiple osteochondromas
    • 20% undergo malignancy
  2. Unicameral Bone Cyst aka Simple Bone Cyst
    • benign
    • diaphyseal/metaphyseal location
    • centrally located
    • less than 20 yo
    • fluid filled
    • associated with fallen fragment sign
  3. Aneurysmal Bone Cyst
    • diaphyseal/ metaphaseal location, eccentrically loacted
    • less than 20 yo
  4. Giant Cell Tumor
    • epiphyseal/metaphyseal location
    • 20-40 yo
    • 20% of time quasi malignant
    • assocated with soap bubble lesion
    • benign
  5. Chondroblastoma
    • epiphyseal/metaphyseal location
    • less than 20 yo
  6. osteoid osteoma
    • night pain relieved by aspirin
    • radiolucent central nidus with severe reactive sclerosis and bone expasion
    • benign
  7. Brodie's Abscess
    night pain relieved by aspirin appears like an osteoid osteoma
  8. Enchondroma
    • MC BBT of hand
    • stippled appearance
    • multiple enchondromas is ollier's disease
    • ollier's - 10-50% rate of malignant degeneration
    • Soft tissue calcification is known as maffucci's syndrome
  9. Hemangioma
    • MC BBT of spine
    • vertical striations
    • corduroy cloth appearance
  10. Enostoma
    • bone island
    • round or oblong radiopaque lesion
  11. Osteopoikilosis
    multiple bone island
  12. Osteoblastoma
    MC BBT to affect the neural arch
  13. Osteoma
    • MC BBT affects the skull
    • found in frontal sinus most commonly and best seen on the calwell projection
  14. Fibrous Dysplasia
    • monostotic form associated with rind sign
    • polystotic form
    • physiologic resorption of normal bone replaced by fibrous tissue
    • causes deformity
    • saber shin tibia and sheppards crook
    • ground glass appearance
    • cafe au lait spots
    • coast of maine appearance
  15. Neurofibromatosis
    • familial history
    • pt may present with scoliosis
    • cervical kyphosis
    • vertebral body scalloping with IVF enlargement
    • cafe au lait spots with Coast of California appearance
  16. Multiple Myeloma aka Plasma Cell Sarcoma
    • >50 yo cachexia, weightloss, anemia, MC primary malignancy of bone, malignant proliferation of plasma cells infiltrating bone marrow
    • multiple dark densities that are similar in size (punched out lesions) can cause pathological collapse
    • rain drop skull
    • labs: M spike on the immunoelectrophoresis 2. reversal of the albumin globulin ration 1:1, 3. bence jones proteinuria, 4. elevated ESR,
    • test- bone scan cold
  17. Metastatic Disease
    • lytic and blastic
    • MC malignant tumor of bone
  18. Lytic Metastatic
    • >40 yo recent unexplained weight loss, skeletal pain, worse at night
    • trabeculae reabsorbed turns the bone darker in color
    • moth eaten or permeative pattern of destruction
    • eats away pedicle of bone
    • swiss cheese appearance in the skull
    • labs: alkaline phophatase
    • special test: bone scan- hot
  19. Hodgkin's Disease
    • MC metastasis in 20-40 yo males
    • bone becomes more radiopaque in color: ivory white vertebrae with anterior body scalloping
    • unilateral hilar lymphadenopathy in caucasians seen on the PA chest view
    • need biopsy to confirm
    • Reed Sternberg Cells
  20. Blastic Metastasis
    • >40 yo ivory white vertebrae
    • MC cause is from prostatic carcinoma
    • Labs: increased alkalkine phosphatase
    • special test bone scan-hot
  21. Paget's aka osteitis deformans
    • males >50 yo
    • stages: 1. lytic or destructive 2. combined 3. sclerotic 4. malignant
    • causes cortical thickening bone expansion, picture frame vertebrae bowing deformities
    • labs: increased alkaline phosphatase and urinary hydroxyproline
    • tests: bone scan- hot
  22. Osteosarcoma
    • MC malignancy found in children
    • ages 10-30
    • periosteal rxn that is spiculated, radiating, sunburst in appearance
    • labs: increased alkaline phosphatase
    • hot bone scan
  23. Chondrosarcoma and Fibrosarcoma
    >40 yo creates a spiculated radiating sunburst periosteal rxn of bone
  24. Ewings Sarcoma
    10-25 yo MC found in diaphysis of long bones. Permeative lesion that causes a multiparalleled onion skin type of periosteal rxn. Bone expansion, codman's triangle, saucerization
  25. Chordoma
    • >40 yo aberrant notochordal cell tumor.
    • MC found in Sacrum
    • 2nd MC location is skull
  26. Scoliosis
    • Females 13-19 names for the side of the major convexity
    • Rotatory Scoliosis- sp deviated to concavity
    • Simple Scoliosis- sp deviate to convexity
    • Cobb's and risser ferguson's to measure
    • measurments for 25 yo and younger:
    • under 20- adjust and monitor
    • 21-40 send to orthopedist for bracing
    • over 40 is surgical
    • over 50 is cardio pulmonary compromise
    • monitor scoliosis1. risser's sign, wrist films, tanner stages
  27. Rheumatoid Arthritis or Still's Disease in children
    • Bilateral uniform loss of joint space, rat bite erosions, pannus formation, localized periarticular osteoporosis, symmetrical distribution, atlanto-axial instability
    • Bouchards PIP, Haygarth MCP DIP is spared Swan neck and boutonneire deformity, ulnar deviation, baker's cyst
    • MC cause of bilateral protrusio acetabuli
    • Labs: RA latex, FANA, ESR, CRP, normocytic normochromic anemia
    • dry eyes and mouth presented is called Sjogrens
  28. Ankylosing Spondylitis AKA Marie Strumpell
    • Males 15-35 yo starts in SI joints, LBP, morning stiffness, Forester's bowstring and Lewin's supine iritis
    • Si joints bilateral fusion
    • shiny corner sign, bilateral marginal syndesmophytes, squaring of body, bamboo spine, dagger sign, trolley track sign
    • labs: HLAB27 adn ESR
  29. Enteropathic Arthropathy
    • Identical to AS with GI Dysfxn
    • chrons, diverticulitis, ibs
  30. Psoriatic Arthritis
    • males 20-50 yo silver scales and pitted nails cocktail sausage digits
    • increased joint space, pencil in cup deformity, mouse ear deformity, ray sign, atlantoaxial instability, non marginal syndesmophytes
    • HLAB27 positive
  31. Reiter's
    • males 20-30 plus or minus, cant see cant pee cant dance with me
    • HLAB27 positive
  32. Systemic Lupus Erythematosus
    • females, sunlight precipitates a skin rash (malar or butterfly rash) alopecia, raynaud's penomenon can cause ulnar deviation of the phalanges
    • LE prep, FANA, RA latex ESR
  33. Scleroderma aka Progressive Systemic Sclerosis
    • females 30-50 yo CREST syndrome erosions of the distal tufts
    • labs: FANA, RA latex
  34. Osteitis COndensans Ilia
    • multiparous females
    • 20-40 yo bialteral symmetric triangular sclerotic areas on the lower half of the ilium
    • joint space is normal
    • self resolving
    • no labs
    • trochanteric belt
  35. DJD (OA0
    • non inflammatory, MC in fingers and weight bearing joints, usually stiffens with rest adn improves with activity
    • complications inclue spinal stenosis and ivf encraochment
    • MC at C5/C6
    • heberden's DIP and Bouchard's PIP
    • asymmetrical non uniform loss of joint space
  36. DISH
    • males >40 yo associated with diabetes mellitus
    • candle was drippings, 4 contguous segments infolved ALL
  37. Neurogenic Arthropathy
    • Secondary to impaired sensory fx in joints. seen wtih diabetes, tabes dorsalis, syphilis and syringomyelia
    • 6D's: distention, density of subchondral sclerosis, debris, dislocation, disorganization, destruction of bone
  38. Synoviochonrometaplasia
    • MC join affected in the knee
    • Results in multiple loose bodies within the joint that are round or ovoid in shape
    • popcorn like look in the knee
  39. Gout
    • males >40 yo.
    • overproductoin of uric acid
    • foods high in purines
    • MTP of the big toe (podagra)
    • overhanging margin: juxta articular erosions
    • Labs: increased uric acid, esr
    • take: acute-colchicine, chronic allopurinol
  40. Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD Pseudogout)
    • thin linear calcification parallel to the articular cortex within the joint space.
    • called chondrocalcinosis when affecting carilage
    • MC in the knee
  41. Hydroxyapatite Deposition Disease HADD
    • MC affects shoulder joint
    • round or oval calcifications near the insertion of a bursa or tendon
  42. Septic Arthritis
    • fever, chills, history of trauma, surgery and warm tender swollen joint
    • WBC Count
  43. Preiser's
    AVN of carpal scaphoid
  44. Osgood Schlatter's
    AVN of tibial tuberosity
Card Set
Dx Imaging
dx imaging, nbce