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Radiology #2 > 11.11 diff diag of soft tissue calcifications > Flashcards

11.11 diff diag of soft tissue calcifications Flashcards

1
Q

what are the mechanisms of calcifications

A

Dystrophic and metastic

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2
Q

Dystrophic calicification

A
  • normocalcemic
  • Dead, dying, diseased, damaged or degenerating tissue
  • increase in local alkalinity
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3
Q

Metastatic calicification

A
  • Hypercalcemic
  • normal tissue
  • hyperparathyroidism or any other disease that increases calcium levels
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4
Q

Calcified Lymph nodes

A
  • prior infection of inflammation
  • granulomatous disorders, deep fungal infection, lymphoma
  • irregular, cauliflower-shaped
  • solitary or chains
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5
Q

sioliths in the parotid

A

are never solitary, multiple will always exist

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6
Q

treatment of sialoliths

A
  • depends on location, if it’s near the orifice, take it out

- -if it’s in the middle, settle the inflammatory reaction down, then excise

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7
Q

“chaining” (calcification of lymph nodes) will most likely occur in…

A

patients that have TB

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8
Q

what is the outline shape of sioliths?

A

smooth outline, solitary

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9
Q

the patient has sioliths and when they are getting ready to eat, they get a swelling. This happens bc the ducts are plugged and the salivary glands are stimulated, but can release all the saliva

A

chronic obstructive sialadenitis

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10
Q

Tonsilloliths

A
  • Detrich’s plugs (?)
  • they kind of look like parotid sioliths on radiographs, but more over the bone and underneath the mandibular canal and oropharyngeal airspace
  • often these patients will often present with terribly bad breath
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11
Q

Rhinoliths

A
  • foreign body rxn with granulomatous and necrotic tissue in the nose
  • kids like to stick things up their nose (exogenous)
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12
Q

how far does the styloid process have to stick out to be considered pathologic?

A

past the soft tissue of the ear

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13
Q

types of calcified styloid processes

A
  • elongated
  • segmented
  • pseudoarticulated
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14
Q

symptomatic patients with Eagles syndrome have what types of symptoms

A
  • post-tonsillectomy
  • throat pain, dysphagia, foreign body sensation
  • pain on yawning
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15
Q

carotid artery syndrome

A
  • no history of tonsillectomy
  • carotidynia from mechanical irritation of sympathetic tissue in arterial wall
  • external carotid artery: pain on turning head, otalgia, vertigo, tunnitus, otitis media
  • internal carotid artery: terning head produces syncope (they faint)
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16
Q

Laryngeal cartilage calcfications

A
  • don’t need to be treated
  • triticeous (“grain of rice”) cartilage
  • superior cornu of thyroid
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17
Q
  • extraskeletal benign bone-producing neoplasm
  • majority form in posterior dorsal tongue
  • firm, asymptomatic, sessile masses
  • radiopaque nodule with cortical rim and internal cancellous bone
  • simple excision
A

intraoral osseous choristoma

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18
Q
  • multiple, small round radiopacities with radiolucent centers
  • superficial in skin
A

miliary osteomas

-don’t need treatment

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19
Q
  • Hx of trauma
  • hemorrhage organizes and mineralizes (follows the muscle fibers)
  • patients may develop sever trismus
  • calcification follows direction of muscle fibers
  • surgical excision once osteoblastic phase is complete
A

Myositis ossificans

20
Q

tape worm eggs eaten

A

Cysticercosis Cellulosae

21
Q

complicastion of dermatomyositis, scleroderma and raynaud’s disease
-seen on the tips of the fingers

A

-Calcinosis cutis

22
Q

CREST syndrome

A

ulcerating, calcinotic masses

-seen on timps of fingers and elbows

23
Q

calcinosis of muscle and subcutaneous tissues

A

dermatomyositis

24
Q

calcifications in metastases

A

prostate most common, also in lung, thyroid…

25
Q
  • unilateral nasal obstruction
  • pain, epistaxis (nose bleed)
  • fetid rhinorrhea
  • post-nasal drip
A

antroliths

can be endogenous or exogenous

26
Q
  • intravascular thrombi (calcification within a vein)

- associated with hemangiomas

A

phleboliths

27
Q

prominent high to low shunt

A

-cavernous hemangioma (phleboliths)

28
Q

bullsete/targeted appearance

A

phleboliths, round bc they are veins in cross section

29
Q

arterial calcifications

A
  • Monckeberg’s medial calcinosis

- calcified atherosclerotic plaque

30
Q
  • arteriosclerosis caused by deposition of calcium around fragmented elastic fibers in medial coat -FREQUENT IN HYPERPARATHYROIDISM AND CHRONIC RENAL FAILURE
  • radiographically looks like Pipestem/ Tram-track calcifications
  • track treatment w/ serial radiographs to see decrease in number of calcifications
A

-Monckeberg’s medial calcinosis

31
Q

what conditions are common in Monckeberg’s medial calcinosis?

A

frequent in hyperparathyroidism and chronic renal failure

32
Q
  • occurs in a mature plaque
  • first and worst at vessel Bifurcations – due to turbulence in the area
  • Site = Common Carotid, approx C3-C4 vertebrae or below Hyoid Bone
  • will be irregular verticolinear radiopacities
A

Calcified Atherosclerotic Plaques

33
Q

two syndromes assoc with calcified stylohyoid ligament:

A

a. )Classic Styloid Syndrom/Eagle’s Syndromepost-tonsillectomy
- throat pain, dysphagia, foreign body sensation, pain on yawning b.) Carotid Artery Syndrome  no tonsillectomy
- pain on turning head, vertigo, otitis media = ECA -turning head causes syncope = ICA

34
Q

post-tonsillectomy

-throat pain, dysphagia, foreign body sensation, pain on yawning

A

Classic Styloid Syndrom/Eagle’s Syndrome

35
Q

no tonsillectomy

-pain on turning head, vertigo, otitis media = ECA -turning head causes syncope = ICA

A

Carotid Artery Syndrome

36
Q

what is the common site for calcified atherosclerotic plaques?

A

common carotid, approx C3-C4 vertebrae or below hyoid bone

37
Q

calcification of which part of the carotid artery produces fainting (syncope)?

A

Internal carotid artery, occurs when turning the head

38
Q
  • calcification of the Triticeous Cartilage bilateral on the Thyroid cartilage
  • Look like a grain of wheat
  • innocous, no treatment, and the Triticeous cartilage is prone to calcify
A

Laryngeal Cartilage Calcifications

39
Q
  • bone producing neoplasm most common on posterior Dorsal Tonge -firm, asymptomatic sessile mass
  • Radiographically = nodule w/ cortical rim and internal cancellous bone -Treat= surgical excision
A

intraoral osseous Choristoma

40
Q

-superficial on skin but show up radiographically as multiple, round radiopacities w/ radiolucent centers -pt might have history of cystic acne

A

Miliary Osteoma

41
Q

myositis ossificans (bone forming in muscle)

A
  • Hx of trauma
  • hemorrhage organizes and mineralizes
  • patients may develop severe trismus
  • calcification follows direction of muscle fibers
  • surgical excision once osteoblastic phase is complete
42
Q
  • tapewormxmt by food grown where animals defecate
  • tapeworm settles into any tissue, but prefer Skeletal m. -WILL NOT SHOW UP UNTIL LARVAE HAS DIED (NONVIABLE LARVAE) -treat w/ Proziquonto
A

Cysticerosis Cellulosae

43
Q

3 main calcifying Auto Immune disorders

A

a. ) dermatomyositis – calcinosis of muscle and subcutaneous tissue
b. ) Scleroderma-part of CREST syndrome, w/ ulcerating, calcinotic masses
c. ) Raynaud’s disease-poor circulation to extremities when even think of cold (excessive vasoconstriction

44
Q

Calcifications related to Meniscal Replacements

A
  • calcifications around the now unused Silastic and Proplast TMJ meniscus replacements
  • device becomes brittle, fragments and causes foreign body response leading to a dystrophic calcification
45
Q

miscellaneous soft tissue calcifications

A
  • calcified scar
  • calc hemangioma
  • histoplasmosis
  • coccidiomycosis
  • filariasis
  • soft tissue osteosarcoma
  • nevoid basal cell carcinoma syndrome

Radiology #2 (5 decks)

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