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Diagnostic Imaging II Final > AVN > Flashcards

AVN Flashcards

1
Q

What part of a long bone is likely to be affected by AVN?

A

Epiphysis (try to remember that suppurative infection SPARES the epiphysis)

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2
Q

What specific bone of the bone is more likely to develop AVN?

A

Femur head and humeral head

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3
Q

What are some synonyms for AVN?

A

Osteonecrosis, ischemic necrosis, osteochondrosis

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4
Q

When does epiphyseal necrosis become clinically evident?

A

With articular surface collapse

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5
Q

What is the clinical latent period of AVN?

A

Weeks to a year

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6
Q

What is the most common etiology category for AVN?

A

Spontaneous/idiopathic (others include surgery, trauma, alcoholism, corticosteroid usage)

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7
Q

What causes AVN?

A

Obstruction of extra- and intraosseous vessels by arterial embolism, venous thrombosis, traumatic disruption, or external compression

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8
Q

What is the time frame from initial infarction to healed deformity for AVN?

A

2-8 years

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9
Q

What causes of AVN fall under the etiology category of external vessel compression?

A

Trauma, steroids, infection, gaucher’s disease, hyperlipidemia

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10
Q

What causes of AVN fall under the etiology category of vessel wall disorders?

A

RA, LE, radiation, polyarteritis nodosa

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11
Q

What causes of AVN fall under the etiology category of thrombo-embolic disorders?

A

Alcoholism, steroid, trauma, sickle-cell, caisson’s

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12
Q

What is caisson’s disease?

A

Decompression sickness

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13
Q

What are the four stages of AVN?

A

Avascular, revascularization, repair, deformity

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14
Q

What happens in the avascular stage of AVN?

A

Obliteration of epiphyseal blood supply, altered growth, altered cartilaginous growth

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15
Q

The altered cartilage seen with AVN can lead to what further condition?

A

DJD

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16
Q

Most X-ray findings of AVN are seen during which stage?

A

Revascularization

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17
Q

What is the term for when deposition occurs and new bone is deposited directly on dead bone therefore thickening the trabeculation and increasing bone density with AVN during the revascularization phase?

A

Creeping substitution

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18
Q

What is the radiographic sign that is definitive for AVN?

A

Crescent sign

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19
Q

What is the best procedure of choice to diagnose AVN?

A

MRI

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20
Q

During which phase of AVN can we see the mushroom deformity and sagging rope sign?

A

Repair/remodeling phase

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21
Q

What is the major factor in residual deformity following AVN?

A

How much compressive force is exerted on the necrotic bone during revascularization and repair phases

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22
Q

What is the trabecular pattern seen with AVN?

A

Mottled appearance: thickened irregular pattern traversing the necrotic areas usually in revascularization and repair phases

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23
Q

What is the name of the condition of AVN in the adult femoral head?

A

Chandler’s disease

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24
Q

What is most likely the condition at hand with BILATERAL C-shaped lesions all over the distal femur and proximal tibia?

A

Metaphyseal/diaphyseal infarcts from AVN

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25
Q

What is the gender and age bias for Chandler’s disease?

A

Males ages 30-70

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26
Q

What is the radiographic sign of a necrotic area that tends to be wedged or semilunar shaped with a central apex seen in Chandler’s disease?

A

“Bite sign”

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27
Q

What are the radiographic signs of AVN?

A

Snow cap sign, crescent/rim sign, mushroom deformity, hanging rope sign

28
Q

What imaging study is best to visualize AVN?

A

T1 MRI

29
Q

What is the condition of AVN of the femoral capital epiphysis before closure?

A

Legg-Calve-Perthes Disease

30
Q

What is the age and gender bias for Legg-Calve-Perthes Disease?

A

Males 4-8 YOA

31
Q

Which ROM are commonly decreased with LCPD?

A

Abduction and internal rotation

32
Q

Where is the referred pain in kids with LCPD?

A

Knee

33
Q

What is unique about the joint space of LCPD?

A

INCREASED joint space (Kohler’s teardrop)

34
Q

What are the 3 major radiographic findings associated with LCPD?

A

Soft tissue swelling, small epiphysis, lateral displacement of ossification center

35
Q

When gender has a worse prognosis with LCPD?

A

Females

36
Q

What is osteochondritis dissecans?

A

Focal subchondral infarction of sub-articular bone

37
Q

What is the age and gender bias for osteochondritis dissecans?

A

Males 11-20 YOA

38
Q

What is the most common location for osteochondritis dissecans?

A

Knee

39
Q

Osteochondritis will lead to what other condition later on?

A

DJD

40
Q

What is the specific location of the knee commonly affected by osteochondritis dissecans?

A

Lateral margin of medial femoral condyle (intracondylar tunnel)

41
Q

What is the term for osteochondritis dissecans of the capitulum of the elbow?

A

Panner’s disease

42
Q

What is the second most common location for osteochondritis dissecans besides the knee?

A

Distal tibia

43
Q

What type of injury/alternative name is Osgood Schlatter’s Disease?

A

AKA traction apophysitis

44
Q

When Osgood Schlatter’s Disease also involves the inferior pole of the patella, what is it then called?

A

Sindig-Larsen-Johanssen disease (ridiculous)

45
Q

What is the gender and age bias for Osgood Schlatter’s Disease?

A

Males 11-15

46
Q

What is the mechanism of injury for traction apophysitits?

A

Repetitive microtrauma

47
Q

When do the symptoms of localized pain, tenderness, and soft tissue swelling over the tibial tubercle with Osgood’s go away?

A

By 18 YOA

48
Q

What condition may be related to wearing high heels and involves AVN of the second metatarsal head?

A

Freiberg’s disease

49
Q

What’s the gender and age bias for Freiberg’s disease?

A

Females 13-18

50
Q

What condition represents AVN of the lunate?

A

Kienbock’s disease

51
Q

What is the gender and age bias for Kienbock’s disease?

A

Males 20-40

52
Q

What usually causes AVN of the lunate?

A

Manual labor

53
Q

Kienbock’s disease is usually associated with what other radiographic finding?

A

Negative ulnar variance (75%)

54
Q

What condition is AVN of the navicular bone?

A

Kohler’s disease

55
Q

Is Scheuermann’s disease really AVN?

A

Probably not (likely trauma abnormality of the discovertebral junction)

56
Q

What age group is usually affected by Scheuermann’s disease?

A

Teens

57
Q

What’s another name for Scheuermann’s?

A

Juvenile discogenic disease

58
Q

What are the signs and symptoms of juvenile discogenic disease?

A

Chronic back pain, deformity, early DDD

59
Q

How many contiguous vertebrae must be affected to diagnose juvenile discogenic disease?

A

3 Schmorl’s nodes in a row

60
Q

What appears to be the cause of juvenile discogenic disease?

A

Failure of embryologic vascular channels, centrum defects, and notochord clefts to disappear leaving endplate defects

61
Q

How common is Scheuermann’s disease?

A

20-40% of those presenting to MRI with back pain have it

62
Q

What condition represents sclerosis and fragmentation of the calcaneal apophysis but it NOT technically a necrosis?

A

Sever’s disease

63
Q

What is Sever’s disease without the presence of pain?

A

A normal varient (pain must be present for Sever’s!)

64
Q

Calcified medullary infarct could be confused with which bone cancer?

A

Enchondroma or chondrosarcoma

65
Q

Calcified medullary infarct is usually associated with what other condition?

A

Arteriosclerosis

66
Q

How can we differentiate between calcified medullary infarct of the proximal humerus and a chondrosarcoma?

A

Chondrosarcoma would present with pain; calcified medullary infarct would be asymptomatic

67
Q

What does the hanging rope sign represent?

A

Healed AVN

Diagnostic Imaging II Final (3 decks)

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