Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Tri 6 - Tumors > 1. Roentgen Signs > Flashcards

1. Roentgen Signs Flashcards

1
Q

Advantages of conventional radiography

A 
– Inexpensive
– Easily obtained
– Non-invasive
– Demonstrates anatomy and osseous/ articular
relationships
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Disadvantages of conventional radiography

A

– Poor soft tissue discrimination
– Change in bone density difficult to assess
– Poorly defines small lesions
– Exposure differences between facilities
– Technical and processing artifacts
– Ionizing radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

decrease in bone density needed to see lesion on conventional radiography

A

at least 30-50% and 1-5cm in size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

examples of underlying disease not detected on radiograph

A

Metastatic Disease, Multiple Myeloma, Lymphoma, Fracture,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Time until a lesion is seen by plain film radiography

A

Radiographic Latent Period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Radiographic Latent Period for Osteomyelitis in peripheral bone

A

10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Radiographic Latent Period for Spinal osteomyelitis

A

21 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Radiographic Latent Period for Aggressive Tumors

A

4-6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision
for a specific clinical condition.

A

ACR Appropriateness Criteria (AC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Injection of water soluble iodinated contrast into IVD’s nucleus pulposus via fluoroscopic control in order to determine pain
generator

A

Discography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

a provocational study for discogenic pain and guide for surgical intervention

A

Discography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pattern of Distribution of Contrast during discography

A

fissuring, extravasation and pooling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Performed to visualize internal disc derangement

patterns (annular tears) that are not seen with MRI

A

CT Discography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Disadvantages of discography

A 
– Fluoroscopy increases radiation dose
– Risk of infection (0.1-0.2%)
– Risk of nerve root damage
– Risk of dural trauma and tear
– Chemical meningitis
– Increased pain or exacerbation of pain
– Allergic reactions to contrast (iodine)
– Patient awake during 
procedure to give responses to physician performing examination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Inject 15-20mCi of Technitium-99m-Methylene Diphosphate
(99mTc-MDP) intravenously and wait
30 min - 2 hours

A

Radionuclide Imaging (Bone Scan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3-Phase Bone Scan

A
  1. Blood Pool Phase
  2. Delayed Phase
  3. Delayed/delayed Phase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Bone scan: scan 5 minutes after injection

A

Blood Pool Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

bone scan: scan 2-4 hours after injection

A

Delayed Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

bone scan: scan 24 hours after injection

A

Delayed/delayed Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Isotope half-life for bone scan is _____ and is excreted by the _____

A

6 hours, kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

View areas of bone where bones overlap e.g. pars

interarticularis

A

SPECT Scan: (Single-Photon Emission Computed Tomography)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Takes about 45 – 60 minutes

A

SPECT Scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Bone Scan Applications:

A 
Detection of: 
- Metastatic disease
- Tumors
- Infection
- Arthritis
- Fracture (occult, stress, recent fx)
- Avascular Necrosis (AVN)
- Normal plain film but pain of
unknown origin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Bone Scan Advantages

A

– can detect 3-5% bone destruction/production
– 10x more sensitive than plain film
– Great for early detection of many disease processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Bone Scan Disadvantages:

A

– Measure of activity, quantitative image
– Sensitive, but not specific
– No uptake in Multiple Myeloma unless pathological
fx
– Tracer excreted within 1-3 days
– must stop breast feeding for 24 hours after tracer injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

(Bone Scan)
Multiple “Hot Spots” are seen on bone scan
throughout the skeleton
indicating

A

Metastatic Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

uniform uptake of the tracer

A

normal bone scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

After you receive an injection of radioactive
tracer, a machine containing a ________
passes slowly over your body, recording the
pattern of tracer absorption in your bones.

A

gamma camera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

bone scan takes about

A

30 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Advantages of Diagnostic Ultrasound

A 
– Abdominal and Pelvic imaging
– display of vascular
integrity/flow velocity
– MSK disorders
– masses  (cystic,
solid, or mixed matrix)
– Guiding biopsy and joint aspiration
techniques
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Disadvantages of US

A

– Operator Dependent

– Long learning curve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

advantages of computed tomography (CT)

A
  • Excellent Bone Detail
  • High Radiation Doses
  • 3-dimensional imaging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Each cross sectional slice with CT is between

A

0.5-3.0 cm of body tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

20-25 sequential slices for lumbar CT scan is how many RADS?

A

1-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

advantages of Magnetic Resonance Imaging (MR)

A
  • Excellent soft tissue contrast resolution
  • No ionizing radiation
  • Visualize pathologic tissue directly
  • Extremely sensitive for detecting bone marrow disease
  • Excellent detail of internal joint architecture
    • Excellent for spinal disease, especially disc disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

examples of MR use for spinal disease, especially disc disease

A 
– Disc herniation and degeneration
– Spinal cord
– Nerve roots
– Facets
– Epidural fat
– Ligamentum flavum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Disadvantages of MR

A
  • Claustrophobia/Noisy
  • Metallic clips may not be able to be imaged
  • Intracranial and Aneurysm clips
  • expensive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Do Not MR

A
  • Pacemakers
  • Cochlear implants
  • Pregnan patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

No preformed cartilage stage

A

Intramembranous Ossification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

examples of Intramembranous Ossification

A
  • Skull
  • Clavicles
  • Mandible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Controls width of long bones via activity of periosteum

A

Appositional Bone Growth:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Controls width of long bones via activity of periosteum

A

Appositional Bone Growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Chondroblasts and chondrocytes form and produce a cartilage cast of the definitive bone

A

Enchondral Ossification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Osteoblasts transform cartilage template into bone

A

Enchondral Ossification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

examples of

A

Tubular bones and Vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Results in bone lengthening until skeletal maturity

A

Enchondral Ossification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Enchondral Ossification also occurs at

A

epiphyseal growth centers (physis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

surrounds bone except at ends of bone

A

Periosteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Periosteum is seen on MRI but not seen on

A

x ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Periosteum fracture healing via

A

callus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Located at ends of long bones and preformed in cartilage

A

Epiphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Epiphysis produces and supports

A

articular cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Apophyses are like _______ that are sites of muscle

attachment

A

epiphyses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Consists of layers of progressively maturing cartilage & developing
bone

A

physis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

responsible for longitudinal growth of long bone (enchondral bone formation) and is
radiolucent during skeletal development

A

physis

56
Q

Trauma to physis, and alteration of hormonal/vascular dynamics may alter

A

growth

57
Q

Thin radiopaque line at junction of physis and metaphysis

A

Zone of Provisional

Calcification (ZOPC)

58
Q

what occurs at the Zone of Provisional

Calcification (ZOPC)

A

Calcification of cartilagenous physis

59
Q

growth arrest during systemic disease will cause

A

Harris Growth Arrest (Park) Lines

60
Q

a dens ZOPC could indicate

A

scurvy

61
Q

Most metabolically active region of a bone and therefore most common site for tumors and infection

A

Metaphysis

62
Q

the metaphysis contains calcified weight-bearing

A

stress trabeculae

63
Q

bones appear wider than usual

A

Undertubulation

64
Q

bones appear slender

A

Overtubulation

65
Q

Erlenmeyer Flask appearance indicates

A

Undertubulation of the metaphysis

66
Q

Diaphysis is the

A

Shaft

67
Q
  • Longest part of bone

- Thickened cortex and decreased medullary space

A

Diaphysis (shaft)

68
Q

Provides mechanical strength and contains bone marrow

A

Diaphysis (shaft)

69
Q

Marrow Diseases include

A
  • Multiple myeloma
  • Ewing’s sarcoma
  • Non-Hodgkins lymphoma
  • Adamantinoma (ameloblastoma)
  • Infection
70
Q

Densest and strongest part of bone

A

Cortex

71
Q

Densely packed compact lamellar bone and osteons and is interconnected by Haversion canal systems

A

Cortex

72
Q

cortex includes the

A

Periosteum and Endosteum

73
Q

Always evaluate cortex for integrity/thickness to rule out

A

bone disease

74
Q

Thin interconnecting trabeculae (spongiosa)

which contains Bone Marrow

A

Medullary Cavity

75
Q

Red marrow predominates in all bones in

A

children

76
Q

Adults have red marrow in what 3 places?

A
  1. axial skeleton
  2. epiphyses
  3. metaphyses
77
Q

consists of a
lattice of thin threads of bone called
trabeculae and is less dense than compact
bone.

A

Spongy or cancellous bone

78
Q

The orientation of the trabeculae is affected by

A

mechanical stress

79
Q

surrounded by rings a concentric lamellae of calcified bone matrix

A

Haversian canal

80
Q

The lamellae contain lacuni (holes) where

_______ are located.

A

osteocytes

81
Q

Thin membrane covering diaphysis and metaphysis

A

Periosteum

82
Q

Doesn’t cover epiphysis and doesn’t enter synovial

joint but forms synovial lining of synovial joint.

A

Periosteum

83
Q

In Children the Periosteum is only attached to the

A

metaphysis

84
Q

In adults the periosteum is firmly attachment to the

A

metaphysis and

diaphysis via Sharpe’s fibers

85
Q

Fibrous layer attaches

to bone by Sharpe fibers

A

Outer Layer of the Periosteum

86
Q

Has osteoblastic and osteoclastic

properties

A

inner Layer of the Periosteum (Cambium)

87
Q

produced due

irritation or elevation from bone due to pus, blood or tumors

A

Periosteal Reactions

88
Q

has osteogenic
properties and helps maintain cortical thickness with
periosteum

A

endosteum

89
Q

Trabeculae and inner cortical margins are

covered by

A

endosteum

90
Q

“CATBITES” stands for

A
  • Congenital
  • Arthritis
  • Trauma
  • Blood
  • Infection
  • Tumor
  • Endocrine, Nutritional, Metabolic
  • Soft tissue
91
Q

diaphyseal lesions usually related to

A

marrow disease

92
Q

Thinning of the cortex along the endosteal surface of the

medullary cavity

A

Endosteal Scalloping:

93
Q

Originates in muscle, nerve, arterial, or synovial tissue and may see pressure erosion of
bone with sclerotic margin

A

Extraosseous Lesions

94
Q

Poor, hazy, ill defined margins, long zone of transition and the gradation between normal and abnormal bone occurs gradually

A

Imperceptible Margination

95
Q

Imperceptible Margination

A

Indicates aggressive bone destruction from Infections or Malignancy

96
Q

Definite sclerotic margins and narrow zone of transition

A

Sharp Margination (slow growing)

97
Q

Loss of bone density and structure

A

Osteolytic Lesions

98
Q

• Pressure from tumor
• Hyperemic stimulation of osteoclastic bone destruction
- osteoblastic/osteoclastic
stimulating factors

A

Neoplastic Bone Destruction

99
Q 
– Circumscribed lesion
– Uniformly lytic lesion
– Usually solitary >1cm
– Sharp margin
– Usually slower 
-  usually benign
– May be septated or soap
bubbly
A

Geographic Lesion

100
Q

– Multiple, poorly defined, small radiolucent

lesions aound 2-5mm in size with ragged/irregular margins

A

Moth-Eaten Lesion

101
Q

Aggressive lytic lesions are seen in disease such as

A
  • Metastatic disease
  • Infection
  • Multiple myeloma
102
Q

Numerous, tiny, pinhole size lesions, < 1.0mm in size, with a wide zone of transition

A

Permeative Lesion:

103
Q

Most rapidly aggressive bone tumors and are easily missed on conventional
radiography

A

Permeative Lesion

104
Q

Increased density due to overproduction of bone or calcium laden tissue

A

Osteoblastic Lesions

105
Q

Osteoblastic Lesions are seen in

A
  • Blastic Metastasis
  • Osteosarcoma
  • Paget’s Disease
106
Q

Both Lytic and

Blastic Lesions are called

A

Mixed Lesions

107
Q

Frequently Calcified with
stippled or punctate calcification
• Flocculent Calcification
• Arc and Ring Calcification Matrix

A

Cartilage Matrix

108
Q

Smoky or hazy internal density with ground glass appearance and Fibrous dysplasia

A

Fibrous Tissue Matrix:

109
Q

Latent period for periosteal reactions

A

10-21 days

110
Q

Subperiosteal extension of

A

blood, pus or tumor

111
Q

3 types of Periosteal Reactions

A

Solid, Laminated, and Spiculated

112
Q

elliptical, undulating, and continuous layer of new bone that attaches
to outer cortex

A

Solid Periosteal Reaction

slow and benign

113
Q

Alternating layers of lucent and opaque

densities on external cortical surface

A

Laminated Periosteal Reaction

Onionskin

114
Q

Radiolucent zones contain loose connective tissue and dilated blood
vessels that have not ossified

A

Laminated Periosteal Reaction

115
Q

Laminated Periosteal Reaction is seen in

A
  • Slow and aggressive tumors
  • Infection
  • Ewing’s Sarcoma
116
Q

multiple concentric

layers of periosteal proliferation

A

Laminated periosteal reaction

117
Q

Perpendicular, brushed whiskers, hair on end

A

Spiculated Periosteal

Reactions

118
Q

Sunburst; radiating spicules of bone

from a point source

A

Spiculated Periosteal

Reactions

119
Q

Spiculated Periosteal
Reactions are linear spiculations of new bone
oriented _________ from the cortex

A

perpendicular

120
Q

Periosteal new bone at the peripheral lesion–cortex junction
as result of subperiosteal
extension of lesion

A

Codman’s Triangle:

121
Q

Codman’s Triangles are seen in

A
  • Primary malignant bone tumors
  • Benign bone tumors
  • Infections
122
Q

elevation of
distal anterior and posterior distal
humeral capsular fat pads by

A

intraarticular effusion due to Fx

123
Q

a synovial sarcoma will cause an Increased

A

soft tissue density and calcification

124
Q

Articular Changes

Tumors typically do not

A

break the
articular cortex, or spread into the joint,
or invade the apposite articular cortex,
in contrast to infection

125
Q

Increased tendency of rbc’s to precipitate out due to increased concentrations of fibrinogen and serves as a good lab for inflammation

A

ESR: Erythrocyte Sedimentation Rate

126
Q

Released by liver due to inflammatory changes or tissue necrosis

A

C-Reactive Protein (CRP)

127
Q

Disorders of bone destruction and increased parathormone

activity will elevate

A

Serum Calcium

128
Q

Indicator of bone destruction and bone activity

Inverse relationships to calcium levels

A

Serum Phosphorus

129
Q

Reflects an increase in

osteoblastic activity…like seen in Paget’s, Metastates, Healing fractures, and Lymphoma

A

Alkaline Phosphatase

130
Q

Increased in Prostate metastasis and Gaucher’s disease

A

Acid Phosphatase

131
Q

metastatic lesions in bone and soft tissue liberate

A

acid phosphatase

132
Q

often indicates metastatic disease or multiple myeloma

A

Elevated total serum protein

133
Q

which proteins are elevated in multiple myeloma?

A
  • IgG. IgA, and Bence Jones proteins
134
Q

what % of patients with MM have Bence Jones proteinuria

A

(40%)

135
Q

Bone Marrow Biopsy and Aspiration is usually from

A

sternum or ilium

136
Q

disadvantage of aspiration

A

does not reprepsent all cells

Tri 6 - Tumors (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions