Skeletal Path

• -most common form of dwarfism
• inherited disorder of the growth of cartilage
• Results: premature ossification, permanent limitation of skeletal development and also protruding forehead and short, thick arms and legs on a normal trunk
• Radiographic Appearance: progressive narrowing of interpedicular distances; scalloping of posterior margins of lumbar vertebral bodies and skull has a thin growth plate

• inherited disorder of connective tissues
• severe osteoporosis and thin defective cortices characterized by brittle bones
• children are prone to fractures with minimal trauma and severity depends on type

• malformation of the acetabulum causing displacement of the femoral head
• more common in large neonates
• Common Views/Projections: AP pelvis, bilateral frogleg hips, ultrasound for newborns

• posterior defect of the spinal canal most often occurring in the lumbar region but also in the cervical region
• failure of posterior elements to fuse properly resulting in a gap in the lamina (very common at L5 or S1)
• Meningocele: herniation of the meninges
• Myelomeningocele or Myelocele: herniation of the meninges with part of the spinal cord or nerve roots
• various amounts of paralysis and dysfunction can occur
• common projections: AP of affected vertebrae, and lateral of affected vertebrae

• vitamin D deficiency in diet or a lack of exposure to UV radiation with converts sterols in the skin into Vitamin D
• also failure of absorption of calcium and phosphorus because vitamin D necessary for intestinal absorption of calcium and phosporus
• Radiographic Appearance: loss of bone density, cortex is thinned

• child form of osteomalacia
• vitamin D deficiency or lack of sunlight that is most common in premature infants
• Radiographic Appearance: metaphyseal ends of bones become cupped and frayed, sternal ends of ribs have characteristic beading

• increase in blood levels of uric acid leads to deposition of uric acid crystals in the joints, cartilage and kidney
• painful arthritis that initially begins in one joint (usually 1^st metatarsophalangeal joint)
• Radiographic Appearance: punched out defects at the joint margins of the small bones of the hand and foot

• localized deficiency of bone density (decreased bone mass)
• causes: Cushing's Syndrome, prolonged steriod use, disused or immobilized extremities, poor diet, aging, postmenopausal
• Radiographic Appearance: cortical thinning with irregularity and resorption of the inner surfaces which may lead to fractures of one of more vertebral bodies, hips and kyphosis

• chronic metabolic bone disease of the skeleton
• destruction of bone followed by a reparitive process that results in weakened, deformed, and thickened bony structures that tend to fracture easily
• particularly affects the pelvis, femurs, skull, tibias, vertebrae, clavicles and ribs
• Radiographic Appearance: skull - cotton wool appearance, vertebral bodies - ivory vertebrae may occur, pelvis - thickening of pelvic brim

bone has penetrated skin

skin is not penetrated

fracture without angulation or separation

fracture with angulation or separation

bone separates into three or more fragments

fracture extends through entire cortex

fracture with opposite cortex intact

fracture is at right angles to long axis of the bone

fracture parallel to long axis of the bone (lengthwise)

fracture runs obliquely in relation to the long axis of the bone

bone surfaces are forced against each other causing fracture

• results from torsion or twisting and extends in an oblique direction
• longer than an oblique fracture and encircles the shaft

the fractured end of the bone is driven into the other

small bone fragment torn off bony prominence at the site of muscle origin

• result of an abnormal degree of repetitive trauma
• occurs at sites of maximal strain on a bone

occurs in an area of weakness caused by disease, tumor or infection

bone fragments are pushed into organ of tissue

• incomplete fracture that occurs in children under 12 due to the softness of their cancellous bone
• one side breaks and the other side bends

fracture of the floor of the orbit caused by an increase in intraorbital pressure due to traumatic blow

• injury to a part opposite the site of the primary injury
• most common is brain injury
• also eye and lung can occur with Shaken Baby Syndrome

• transverse fracture of the distal radius with posterior displacement of the distal fragment as a result of a fall onto an outstretched hand
• most common wrist fracture
• an avulsion fracture of the ulnar styloid process also occurs in more than half of all Colles' fractures

• a fracture of the radius in with the lower fragment is displaces forward
• also called a reverse Colles' fracture

• fracture of the supracondylar region of the humerus
• common injury seen in children who fall onto their elbow from a height

fracture of the base of the 1^st metacarpal with involvement of the 1^st carpometacarpal joint

fracture of the 5^th and possible 4^th metacarpal caused by a blow to or with the hand

isolated fracture of the shaft of the ulna associated with anterior dislocation of the radius at the elbow

fracture involving both malleoli of the tibia and fibula with dislocation of the ankle joint

fracture involving both the medial malleolus of the tibia and lateral malleolus of the fibula

fracture involving the posterior lip of the tibia in addition to the medial and lateral malleoli of the tibia and fibula

fracture between the greater and lesser trochanter of the hip

stress fracture occurring in the metatarsal of the hip

• five variations or classifications of fractures involving a growth plate of a pediatric done
• rate of growth can be affected

• a partial dislocation often occurring with a fracture
• common sites are acromioclavicular joints

• inflammation of the bone and bone marrow caused by infectious organism
• once it has reached outer margin of the bone, it raises the periosteum of the bone
• does not appear of radiographs until about 10 days after onset, therefore bone scan is more valuable

• degenerative condition of the articular cartilage of a joint with changes occurring in underlying bone and formation of small bone spurs
• primarily age related but can also be due to repeated trauma or stress to joints or disorders of metabolism
• Radiographic Appearance: narrowing of joint space caused by thinning of the articular cartilage and development of small bony spurs along the margins of the articular edges of the bones

• disfiguration of joints dues to subluxation and ankylosing
• Radiographic Appearance: bone demineralization and soft tissue swelling and in later stages, there is cartilage and done destruction, subluxations and deformities

• disease generally affects the sacroiliac joints and progresses upward until the entire vertebral column is affected
• ossification in tissues and ligaments of the spine as well as lateral bony bridges between vertebral bodies limit patient movement

• fluid filled cyst with a wall of fibrous tissue
• asymptomatic
• Radiographic Appearance: expansile lucent lesion that is sharply demarcated from adjacent normal bone; oval configuration

• most often arise in outer table of the skull, the paranasal sinuses (especially frontal and ethmoid) and the madible
• diagnosis incidental
• Radiographic Appearance: well circumscribed, extremely dense, round lesions rarely larger than 2 cm in diameter

• develops in childhood or teen years
• benign projection of bone with a cartilaginous cap that arises usually at or near the knee
• long axis characteristically runs parallel to parent bone and points away from the nearest joint

• found in children and young adults
• involve small bones of the hands and feet
• slow growing benign cartilaginous tumor arising in the medullary canal that destroys normal bone
• often leads to pathologic fractures

• malignant bone tumor generally occurring at the ends of long bones
• occurs in persons 10 to 25 years of age
• Radiographic Appearance: mixed destructive and sclerotic lesion associated with a soft tissue mass, irregular periosteal reaction and reactive new bone formation; classic "sunburst appearance"

• widespread malignancy of marrow plasma cells that infiltrates bone to produce osteolytic lesions throughout the skeleton
• affects people 40-70 years of age
• flat bones primarily affected and tend to have same uniformity in size
• prognosis is poor
• Radiographic Appearance: multiple punched out osteolytic lesions scattered throughout the skeletal system

• most common malignant bone tumor spreading by bloodstream of lymphatic vessels
• most common primary tumors are carcinoma of breasts, lung, prostate, kidney and thyroid
• favorite sites are bones containing red bone marrow - spine, pelvis, ribs, skull, upper ends of humeri and femora

fracture of the arch of C2 anterior to the inferior facet and usually associated with anterior subluxation of C2 and C3 caused by acute hyperextension of the head on the neck

comminuted fracture of the rind of the atlas caused by head trauma (e.g. diving in shallow water)

exaggerated forward rounding of the upper back

exaggerated lumbar curvature of the spine

abnormal lateral curvature of the spine with or without rotation

• weakened or torn annulus fibrosus ruptures allowing nucleus pulposus to protrude and compress spinal nerve roots
• result degenerative disease or trauma
• most common lower l-spine and lower c-spine

spinal degeneration and deformity of the joints of two or more vertebrae that commonly occurs with aging

defect in the pars interarticularis of a vertebra

defect in the pars interarticularis of a vertebra with displacement

• characterized by proliferation of fibrous tissue within the medullary cavity
• involves long bones, ribs, and facial bones
• typically produces a well defined radiolucent area
• long standing disease, affected bone may become bowed or deformed
• disorder begins in childhood and may be confined to a single bone or throughout skeleton

• bone condition that results from poor blood supply to an area of bone causing bone death
• due to trauma, steroid-based medication abuse, alcohol abuse
• bone will be weakened or collapse
• common sites are hip, scaphoid, talus, and humerus

• disease process where articular cartilage and subchondral bone fragment separate from a joint surface
• separated fragment may become avascular and exist as a loose body within the joint (joint mice)

• common form of aseptic avascular necrosis affecting the femoral head
• cause unknown in boys age 5-10 years
• some pain and limp clinically
• Radiographic Appearance: bone in center of epiphysis is fragmented and head of femur is flattened

• incomplete separation of the epiphysis of the tibial tuberosity from the shaft of tibia
• common in males between the ages of 10 and 15 years

lateral deviation of great toe at metatarsophalangeal joint