- >5 mm = medical emergency.
- Generally increasing 2mm/ year.
- Calcification in relation to the (hemi)diaphragm:
- -Above: descending thoracic aorta.
- -Below: abdominal aorta.
- Use 3 dots to outline the aneurysm.
- 50% of plain film radiographs will not show aneurisms.
- Three signs of rupture:
- 1. Severe pain: lower abdomen, flank, LB.
- 2. Tachycardia: 200+ beats/min.
- 3. Sharp drop in BP.
- Below the junction of L4/L5 = common iliac A.
: proximal femur & ribs.
"Soap bubble lesion"
- Geographic lesion.
- Monostotic: one bone, benign.
- Polyostotic: 2+ bones.
- -proximal femur & ilium on same side = more likely to be malignant.
Aneurysmal bone cyst (ABC)
"soap bubble lesion"
- Found in children.
- Commonly in the posterior spine.
See 3 sacral N's on one side, should see 3 on the other side...
- Avascular necrosis...
- Obliterated Kholer's Teardrop...
- Chondrocalcinosis: cartilage calcification.
- Femoral A calcification...
- Shepard's Crook: greater trochanter level with femoral head, results from all bone softening diseases.
- Calcification of the ALL: not to be mistaken with intercalary bone (composed of disc material which is not attached).
- Phleboliths: concretions in veins... clinically insignificant.
- Bridging osteophyte.
- Splenic A calcification.
Medullary Bone Infarct:
- Form of vascular (ischemic, asceptic, osseous) necrosis.
- Cassion's Disease...
- Decreased definition of iliac crest with multiple lesions.
- Cortical thickening = increased size & opaque.
- Coarsened trabeculation: coarsening/trabeculae. "Trabecular Ascentuation).
- -Unilateral: US & Canada.
- -Bilateral: Europe, Australia, etc.
- Window appearance: squared & oblong.
- Shepard's Crook: similar to a cane... bowing of femur.
- Obliterated Kholer's Teardrop ("Brim Sign").
- Posterior element of the spine.
- Compare bilaterally.
- Soap bubble lesion.
- Larger & rounder SP.
- Normal: 2.5-3mm.
- Due to transverse ligament damage or rupture = C1/C2 instability.
- Posterior atlantao-dental interval: <18mm = spinal stenosis.
- Anterior soft tissue space between C7 & tetrotracheal line: <22 mm.
- Space between ant. C2 & retropharyngeal line: <7mm.
- -greater due to: blood, edema, infection/abscess, SOL.
- 4+ continuous segments without narrowing of the disc space, & without posterior joint fusion.
- 20% have undiscovered diabetes.
Calcification of the stylohyoid ligament + excruciating pain = CN encroachment associated with ringing of the ears.
- 1. Eye pain.
- 2. Head pain.
- 3. Jaw pain.
- 4. Ear pain.
- 5. Neck pain.
- 6. Throat pain.
Compression Fracture: appears as a small indentation or large dip.
- Thin end plates = chronic fracture (>6 weeks).
- Should disappear within 4-6 weeks in adults, 2 weeks in children.
: numerous small opacities found near & in joints.
- Shoulders, wrist, ankle, knee, SI-joint.
- Asymptomatic, clinically insignificant.
Avascular Necrosis (AVN)
- Snow capping: increased opacity at the upper part of the femoral head.
- Radiolucencies in the femoral head.
- Crescent sign: thin pencil line of radiolucency in close proximity to the top of the femur head.
Sickle Cell Anemia
- H-shaped vertebral body.
- End plates = cod fish vertebrae.
- Almost always on the right side, anterior to the spine.
- Confirmed by lateral film.
- May develop into cancer.
Cervical rib: joint space presnet.
Elongated TP: lateral to margin of T1.
Malignant soft tissue tumors.
Baastrup's Disease (Syndrome)
- Pain disease.
- Manifests as sclerosis of end points of SP's.
- Soap bubble lesion.
- Longer than it is wide.
- Loculations: spaces (within tumor).
Hemispheric Spondylosclerosis: helmet dome shaped.
- Severely degenerated disc.
- Vaccum phenomenon: dark like with migratory opacity.
Calcification of the Longus Coli Tendon
- Under the anterior arch of C1.
- Due to auto accident.
- Self resolving condition within 3-4 weeks.
- Accompanied by pain.
Calcified leiomyomas: fibroids.
Osteitis Condensans Ilii
- Area of ilium that is increased in opacity.
- Somewhat triangular.
- Women that have been pregnant 2+ times.
Large osteophytes due to:
- 1. Psoriatic arthritis.
- 2. Rieter's Syndrome (reactive arthritis).
- Present in individuals that have gone deep sea diving.
- Results in nitrogen bubbles within the blood vessels.
- Winds up as infarcts in the bone marrow.