ALL Flashcards
Generalised inc bone density
12
Mets
SCD
Myelofibrosis
renal osteodystrophy
osteopetrosis
pagets
mastocytosis
Fluorosis pyknodysostosis hypopara 10% prog diaphyseal dysplasia ( camurati) Myeloma POEMS
Solitary sclerotic bone lesion
15
bone island enchondroma mets callus bone infarct
pagets osteoma OO/osteoblastoma healed lesion - mets ets primary bone sarcoma FD chronic osteomyelitis CRMO Lymphoma cement/bone graft
Multiple sclerotic bone lesions
16
Mets
multiple healed bone lesions
pagets- poly
bone infarcts stress fractures lymphoma osteopoikilosis multifocal osteosarc multiple osteomas FD CRMO/SAPHO
osteopathia striata erdheim chester-metadiap myeloma 3% TS intramedullary osteosclerosis
Bone sclerosis with a periosteal reaction
13
healing fracture mets OO/osteoblast chronic ostemyeltis osteosarcoma Ewings chondrosarcoma lymphoma CRMO/SAPHO Infantile cortical hyperostosis - <6m, mand,ribs,clav
melerheostosis
tertiary syphilis
Solitary sclerotic bone lesion with a lucent centre
9
OO/osteoblast
brodies
medullary bone infarct
stress fracture
loosers zone
liposclerosis myxofibrous tumour
TB
Syphilis
Yaws :papillomas, t pallidum pertunue
Coarse trabecular pattern
6
pagets osteoporosis ostemalacia haemoglobinopathies haemangioma Gauchers
Lytic skeletal metastases
5
Lung Breast myeloma non mucinous adeno GI most other primary
Lytic expansile skeletal mets
5
RCC thyroid HCC melanoma phaeo
Sclerotic skeletal mets
7
Breast Prostate Mucinous adeno GI TCC carcinoid small cell lung lymphoma - rare
Mixed skeletal mets
8
breast lung lymphoma cervix testis TCC melanoma neuroblastoma paeds
lucent bone lesion with welldefined sclerotic margin 1A
12
NOF, BFH (>25) SBC/ABC FD chondroblastoma/Clear cell chondrosarc >20yrs Brodies Healings mets/primary Osteoblastoma IO lipoma Liposclerosisng myxo adamantinoma/OFD CMF haemophilic pseudotumour
Lucent bone lesion
well defined non sclerotic margins 1B
9
Mets myeloma/plasma low grade chondral lesions GCT SBC/ABC EG Browns lytic phase pagets desmoplastic fibroma
Lucent bone lesions
poorly defined margins
1C
7
mets myeloma osteomyelitis bone lymphoma primary bone sarcomas EG < 30yrs GCT - 20-50yrs
Grossly expansile lucent bone lesion
12
plasmacytoma mets ABC GCT telangiectatic osteosarc FD- fusiform Browns Haemangioma Chordoma Haemophilic slow growing central sarcoma Hydatid
Lucent epiphyseal bone lesion
7
related to jt path - geode,ganglion,erosion,ocd, pvns
GCT
chondroblastoma
Infection - brodies
clear cell chondrosarcoma
location sp - IO lipoma, SBC, osteoblastoma
lesions that occur anywhere-mets,browns,lymph,myelo,haemo
Lucent bone lesions with calcium or bone
enchondroma OO/osteoblastoma AVN/bone infarction mets chondroblastoma chondrosarcoma osteosarc FD ostemyelitis EG IO lipoma haemangioma liposclerosis UPS/fibrosarc
exophytic/juxta cortical bone lesions
callus
osteochondroma
heterotopic ossif/myositis ossificans
surface osteosarc : paros, perios, high grade
Perisoteal chondroma/chondrosarc
cortical desmoid
parosteal lipoma-bony excresece
BPOP - perios hands
moth eaten bone
8
mets MM sarcomas lymphomas LCH OM osteoporosis hyperparathyroidism
Regional osteopenia
8
disuse CRPS inflamm arthropathy septic transient osteoporiss reginal migratory osteo haemophilic arthro soft tissue AVM
Gen osteopaenia
4
osteoprosis
diffuse iniltrative bone disease eg MM
osteomala/rickets
hyperparathyroidism
osteoporosis causes
primary 3
secondary 6
postmenopausal
age related
juvenile 8-12
endocrina disuse iatrogenic deficiency states chronic disease congenital
osteomal/rickets
causes
5
Vit D deficiency renal disease: glom/tubular hepatic disease anticonvulsants: pheno/pheno tumour assoc - benign phosphaturic tumour
osteomalacia/rickets
<6 months
4
biliary atresia
metabolic bone disease of prematurtiy
hypophosphatasia
Vit D dependent rickets
periosteal reaction parallel spiculated hair on end
3
Ewings
Caffeys
Syphilis
periosteal reaction divergent spiculated
7
Osteosarc mets ewings haemangioma meningioma TB tropical ulcer
codman triangle
2
aggressive bone tumour
osteomyelitis
periosteal reaction solitary and localised
4
Trauma
insuff/stress #
inflammatory
neoplastic : malig/benign + #
periosteal reaction
BL symmetrical
6
HPOA vascular insufficiency - venous thyroid acropachy Pachydermoperiostitis fluorosis hypervitaminosis A
periosteal reaction
BL asymm
8
mets osteomyelitis reactive/psoriatic NAI osteoporosis osteomalacia bleeding diathesis sickle cell dactylitis
secondary HPOA
causes 23
lung 9
GI 7
cardiac 1
other malignancy 6
LUNG: lung carcinoma >60% bronchiectasis lung mets pleural fibroma mesothelioma pulmonary fibrosis sarcoidosis chronic lung infection pulmonary AVM
GI: IBS coeliac Whipples polyposis malignancy cirrhosis HB malignancy
Cardiac - cyanotic CHD
other malignancy:
lymphoma, NPC, RCC, phyllodes, thymic ca, melanoma
XS callus formation
8
hypertrophic fracture non union
neuropathic arthropathy
steroid/cushings
Osteogenesis paralysis renal osteodystrophy MM NAI
AVN causes
13
corticosteroids alcohol idiopathic - perthes fractures chemotherapy
haemoglobinopathies - SCD radiotherapy metabolic/endocrine CTD/CVD Toxins - nsaid, immuno haemopoetic disorders thrombotic/embolic Others : pancreat, burns, amyloid
erosion of medial metaphysis of humerus
6
normal chronic rotator cuff tear hyperpara RA malignancy lysosomal storage disorder
erosion/absence outer end of clavicle
10
post traumatic
post op
RA
malignancy septic hyperpara cleidocranial dysplasia pyknodysostosis scleroderma gour
Madelung
causes
5
Growth arrest -injury/infection multiple hereditary exostoses Turner :+ lunatotriq coa achondroplasia leri Weill dyschondroseosis
most common isolated carpal fusion
lunato-triquetral 1%
acquired carpal fusion
5
inflammatory arthritis - JIA/RA pyogenic arthritis chronic TB post traumatic post surgical
short MC/MT
5
idiopathic post traumatic post infarction turner pseudo and pseudopseudohypo
Acro osteolysis
11
scleroderma raynaud psoriatic hyperpara Trauma
peripheral neuropathy Other arthritis : FIA,Reactive, multicentric Other skin : dermato, epidermy phenytoin toxicity snake/scorpion venom pyknodysosto - mimic
distal phalangeal destruction - resorption of midportion
hyperpara
PVC cleaners
Hadju Cheney
lytic lesions of phalanges
7
osteomyelitis
mets - lung mc
enchondroma joint based implant dermoid glomus sarcoid other rare : fd, abc,gct,sbc,brown, lch
F-F levels in bone lesions
ABC chondroblastoma GCT SBC FD
telangiectatic osteosarc
any necrotic bone tumour
pharyngeal mucosal space lesions
Nasopharynx
6
NPC - post LN, mets 20%, petct Lymphoma : NHL Lymphoid hyperplasia : tiger stripe CE Tornwaldt cyst - ML Juvenile angiofibroma minor salivary gland malignancy
pharyngeal mucosal space lesions
Oropharynx
5
Tonsil SCC- II/III LN, HPV
Palatine tonsil inflamm/abscess
Lymphoma : NHL, waldeyers
Minor salivary gland malig
Crohns : rare
Masticator space lesions
7
Abscess
Bony lesions of mandible
Incidental benign conditions :
masticator muscle hypertrophy (>1.5cm)
incidental small masticator muscles
pterygoid venous plexus asymmetry
Motor denervation CN VII : acute,SA, chronic
Sarcoma
Perineural tumour extension : SCC, mela, sarc, NHL, ad cystic parotid
Schwannoma V
Focal parotid space lesions
5
Pleomorphic adenoma: hypoec, post enh, homogeneous +/- Ca, T2 low rim, myxoid types
Warthins : tail, B/L 20%, 6th decade,, smokers, hetero, cystic change, hypervascular, no Ca, mural nodule suggestive, minmal CE
Nodal mets
Salivary gland carcinomas : mucoepi, adenoid cystic, ill defined, T2 low, perineural sp
First branchial cleft cyst
Diffuse parotid enlargement
5
PArotitis
Sjogrens : look MALT lym, other glands involved cf HIV
Benign lymphoepithelial lesions HIV : reactive adeno
Sarcoidosis : mimics sjogrens, no nhl risk, medisat LN
Lymphoma : NHL systemic
Carotid space lesions
6
Carotid body paraganglioma: check Xd :MEN,carney,NF,vHL
salt pepper appearnce
Vagal Schwannoma :
Jugular vein thrombosis : see Lemierre Xd
Glomus vagale : 2cm below skull base, ICA ant, IJV post
Pseudoaneurysm
Neurofibroma
Pre vertebral space lesions
5
Vertebral body mets
Infection
Schwannoma check neural foramen
Chordoma - rare in CS
Plexiform NF
Posterior cervical space lesions
6
Lymphadenopathy
Third branchial cleft cyst : posterolateral to cartoid space
Nerve sheath tumour
Nodular fasciitis: SC, muscular fascia
Thoracic duct cyst - Left SC fossa
Venous diverticulum : IJV:SC
Focal retropharyngeal space lesions
6
Reactive LN
Metastatic LN
Lypmhoma
MNG
Ectopic parathyroid adenoma
Schwannoma
Diffuse retropharyngeal space lesions
5
Abscess
Effusion
Suppurative adenopathy
Longus colli tendonitis:C1-2, calcific pathog
Hypopharyngeal SCC
Oral mucosal space lesions
3
SCC
minor salivary gland Ca
Radiation mucositis
Sublingual space lesions
7
Ranula
Abscess
Sublingual gland sialadenitis
SL gland carcinoma: mucoep, adenocys, recur late, 90% SL malignant
Sialocoele
Dermoid : ecto/meso
Epidermoid:ectoderm
Submandibular space lesions
9
SMG sialadenitis
DivingRanula
Pleomorphic adenoma SMG
SMG carcinoma
Sjogrens
Benign lymphoepithelial lesions
Accessory salivary tissue
Second branchial cleft cyst
Kuttner pseudotumour : ch sclerosing sialdenitis, IgG4
Root of tongue lesions
5
Abscess
SCC invasion
Thyroglossal cyst
Dermoid/epidermoid
Ectopic thyroid tissue
Foregut duplication cyst:bowel layers on USS
Transpatial neck lesions
6
Venous malformation:slow flow, phleboliths
Venolymphatic malf : lymp > FF levels
Infection
SCC
Lymphatic malformaton:bld fluid levels no CE
Plexiform NF
Laryngeal lesions
13
SCC VC paralysis LAryngocoele Laryngeal reflux Other tumours : chondrosarc, para, papilloma, melanoma, infla pseudo
Wegeners : subglott sten, PNS
RA : cricoary, cricothy
Amyloidosis : mc supragl
OTHERS thyrogloss duct cyst lymphadenopathy parathyroid adenoma 4th branchial cleft cyst : adj or within thyroid Thymic remnant
Thyroid enlargement
9
- MNG
- Thyroiditis : Autoimmune >Hashimoto : pappl ca, NHL
Graves
Riedels: Ig4, woody, mimic anaplas
Postpartum 5-9%
De Quervains : viral URTI, tender painful
Suppurative thyroiditis: rare - Primary thyroid Carcinoma
Papillary : 3-4th decade, fine microca , F>M, ill defined, 50% LN , cystic, I 123 +ve, pertech negative
Follicular: 5-6th, late LN, conc pertech, not I 123; resect
Medullary: 5%, 3-4th, MEN 2A/B, coarse Ca, raised calcitonin
Anaplastic : 1-2%, 6-7th, 5yr 5%, LN/mets common - Thyroid adenoma
5> Lymphoma : NHL, Hashimotot RF, 50-70s
- Thyroid mets: br, rcc, colon,lung
- Paraganglioma
- 4th Branchial
- Parathyroid adenoma mimic
LN assessment features
Size Shape : round/oval Echogenicity Nodal border Hilum Calcification Necrosis Vascular pattern Other : matting, oedema ST
Cystic bony lesions of the mandible/maxilla
10
Periapical/radicular cyst : < 1cm, apex of dead tooth
Nasopalatine duct cyst: central incisive canal, heart shaped
Dentigereous cyst : crown of unerupted tooth, mandible, third molar, uniloc
Odontogenic keratocyst : benign, aggresive,recur, post mandible, 3rd molar, gorlin goltz, near crown, solitary, uniloc, keratin signal
Ameloblastoma : benign, aggress, 30-50, mandible, third molar, MULTILOCULAR BUBBLY EXPANSILE CE NODULE/SEPTA, No Ca
malig 1%
Residual cyst : site of extraction
SBC : 10-30y, trauma 50%, uniloc, marg scl FFL
ABC : <20, ramus, uni multi, FFL, bubbly, honeycomb CE no nodules
Primordial cyst : dental follicle without tooth
Stafne cyst : mimic , medial cortical defect, fat/SG, post mandible < 2cm
Solid lesions of mandible/maxilla
LYTIC 12
Malignant infiltration by adjacent tumour
Myeloma : post mandible
Metastases : mand > max
Lymphoma
Leukaemia
EG
Ewings : 5-25y
Other malignant: odonto, amelo,sarc
Giant cell granuloma: benign
Ameloblastic fibroma: multiloc or uni, crown of unerupted
Odontogenic myxoma : multiloc, sim amelo
Nerve sheath tumour
Intra osseous AVM : multiloc
Solid lesions of mandible/maxilla
Sclerotic/calcified/ossified
3/3
unrelated to teeth
Osteoma
Mets
Exostosis/torus
Related to teeth
Condensing osteitis
Odontoma : benign hamartoma, impacted tooth
Cementoblastoma : paed/young adults, well def, round,fused to tooth apex
Solid lesions of mandible/maxilla
GG/mixed density
8 / 5
Unrelated to teeth 8
FD: mono 25%, 50% poly; max>mand>rest of skull
Osteonecrosis : 6-12 mnths post Rt peak
Renal osteodystrophy: floating teeth
Osteosarcoma
Pagets : max>mand
Ossifying fibroma : well def, solitary, expansile,GG; multiple - hyperpara-jaw tumour Xd
Osteoblastoma/OO : painful
<20yrs
Intra osseous haemangioma
Related to teeth
Osteomyelitis : Garre’s scl
Cemento osseous dysplasia : benign hamar, afro/asian
Pindborg tumour : rare, well def, driven snow appearance of trabecular Ca
Adenomatoid odontogenic : rare, well def, lucent, Ca + flakes
Ameloblastic fibroodontoma: rare, well def, lucent, dense mass of enamel
Nasal septal perforation 10 Iatro 3 inflamm 2 infection 2 neoplastic 3
Trauma
Cocaine necrosis
Rhinitis medicamentosa
Wegeners : T2 low rel to mucosa, CE ST masses
Sarcoidosis
Nasal septal abscess
Invasive fungal sinusitis
Sinonasal SCC
Lymphoma
Melanoma : 50-90, CE ++
PNS lesions without bone destruction
INFLAMMATORY 9
Chronic rhinosinusitis: > 12 wk
Acute rhinosinusitis
Retention cyst
Mucocoele
Sinonasal polyposis
Solitary sinonasal polyp : antrochoanal MC
Allergic fungal sinusitis
Mycetoma : T2 low
Silent sinus Xd : ch occlusion, retraction, enoph
PNS lesions without bone destruction
Neoplastic 5
Osteoma : gardner multiple
Inverted papilloma : benign, entrapped bone, tumorous ca, 40-70yrs, midd meatus, focal hyperostosis, cerebriform CE
Juvenile angiofibroma
Pleomorphic adenoma ; minor SG
Nerve sheath tumour
PNS lesions with bone destruction 9
Sinonasal SCC
Invasive fungal sinusitis : acute, granulomatous, chronic
Olfactory neuroblastoma : peritumoral cyst, dumbell shaped, two peaks, recur later
Wegeners
Lymphoma
Other carcinomas
Sarcoidosis
Osteosarcoma : 30-50y
Chondrosarcoma
Lesions of GLOBE
13
Haemorrhage Retinal (V)/choridal detachment Orbital pseudotumour Melanoma Endohthalmitis Ocular calcification : Drusen, choroidal osteoma, phthisis Surgical inserts : scleral buckle, silicone oil Staphyloma (acq)/ coloboma ( congenital) : post outpouchings Choroidal haemangioma Lymphoproliferative lesions Ocular mets Sarcoidosis Retinoblastoma
Lesions of ON or sheath
6
ON sheath meningioma : tram track, ca, CE, spares distal end
Optic pathway glioma: ca rare
Optic neuritis : 15-50, MS 50%
Orbital pseudotumour
- Lymphoproliferative lesions ‘tram-track’ enhancement.
- Sarcoidosis*— May ‘tram-track’ enhancement
Intraconal fat orbital lesions
Orbital pseudotumour
cavernous haemangioma
venous varix : valsalva, intense CE, phelob
Lymphoproliferative
Sarcoidosis
Erdheim chester - T1/T2 low
Nerve sheath tumour
Conal lesions
Thyroid oph : AI, Graves, IM SLO EOM involvement, > 5mm belly
Orbital pseudo:painful, unilat SR/MR/SO, Ig4
Lymphoprolifer
Sarcoid
Mets
Extra ocular myositis
Rhabdomyosarcoma <15y
Extraconal lesions
arising within orbital cavity
7
Lymphoproliferative lesions : > 60y, T1/T2 high
Orbital pseudotum : lacrimal, Tolosa Hunt
Pleomorphic adenoma
Malignant lacrimal gland tumour : ad cystic
Sarcoidosis
Sjogrens
Dacrocystocoele
Extraconal lesions
arising within wall
Subperiosteal abscess
Mucocoele
Sinonasal SCC
Mets
Dermoid/Epi
Sphenoid wing dysplasia: NF1, empty orbit sign
FD
Pagets
Intra osseous meningioma
EAC lesions
9
wax
cholesteatoma: no CE
Carcinoma : SCC
Necrotising OE : elderly,DM,immuno
Congenital ear malformations
Osteoma : junction
Exostosis: ch water exposure
Medial canal fibrosis: BL50%, cresc fibrous tissue
Keratosis obturans: abnor acc keratin, BL 50%
ME lesions
8
Chronic OM
Acq cholesteatoma : DWI+, T1 low, T2 high, no CE
Cholesterol granuloma : ch OM, T1 high, T2 high, no CE
Glomus tympanicum : coch promontory paragangl, 40-60
Glomus jugulare : jug foramen, multiple - MEN,NF1, salt pepper appearance MRI
Acute otomastoiditis with abscess
Dehiscent jugular bulb:sigmoid plate dehis
Aberrant ICA : petrous portion
Intra osseous meningioma
ME Schwannoma: Iry/IIry
Perineural spread of tumour VII
Endolymphatic sac tumour : spora/vHL
Petrous apex lesions
normal variants 3
Asymm marrow
Trapped fluid : prev otomastoi
Petrous apex cephalocoele
Petrous apex lesions :
well defined, expansile, remodelling
5
Cholesterol granuloma: MC
Epidermoid
mucocoele
CN V scwannoma
Petrous ICA aneuryms
Petrous apex lesions : DESTRUCTIVE 5
Mets : apex MC site
Petrous apicitis:Gradenigo Xd
Chondrosarcoma
Plasmacytoma
LCH
Petrous apex lesions : others 3
Meningioma
Pagets
FD
Diffuse or multifocal skull base lesions
8
METS
Pagets
FD
Myeloma
OSteomyelitis
LCH: bevelled, button
Intracranial inflamm pseudotum(Tolosa)
Lymphoma : nasal/PNS, homogen ST mass
Unifocal skull base lesion
7
Any multifocal
Meningioma
Chondrosarcoma : synchondroses, often low grade
ICA aneurysm
Ossifying fibroma
Haemangiopericytoma : rare, meninges tumour, CE ++, no Ca/hyperostosis, 30-40y
GCT: v rare, 3-4th, sphenoid, T2 low haemosiderin
Clivus lesions
6
Skull base lesions not sp for clivus : FD,pagets,mets,lym MM
NPC
Pituitary macroadenoma
Chordoma
Chondrosarcoma : paramidline
Ecchordosis physaliphora : notochordal, stalk
Jugular foramen lesions
4
Glomus jugulare
Schwannoma
Necrotising OE
Skull base lesions non sp
