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Mahoney Radiology EBM > Bone Diseases > Flashcards

Bone Diseases Flashcards

1
Q

T score used for

A

Postmenopausal women and men over 50

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2
Q

Z score used for

A

Premenopausal women and men under 50

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3
Q

Risk of lumbar fracture

A

2^(t score)

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4
Q

Risk of femoral neck fracture

A

3^(t score)

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5
Q

When to start treating based on FRAX score

A

T score between -1 and -2.5 at femoral neck or spine and a 10 year probability of hip fracture at or greater than 3% or a 10 year probability of a major osteoporosis related fracture of greater than 20%

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6
Q

How much bone loss for every change in T score

A

each value of 1 on the t score means 10% loss

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7
Q

Bisphosphonates MOA

A

inhibits bone resorption

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8
Q

Bisphosphonates side effects

A

Osteonecrosis of jaw or atypical femur fracture
Must take drug hiatus after 3-5 years for 3 years
Wicked esophagitis

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9
Q

Estiva effects

A

Similar to estrogen but without the side effects

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10
Q

Denosumab MOA and effects

A

RANKL inhibitor do reduce resorption

Shot every 6 months

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11
Q

Teriparatide (Forteo)

A

BUILDS BONE

Similar to PTH and daily injection under skin

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12
Q

Effects on bone of prolonged imobilization

A

Moth eaten appearance of cancellous bone around joints
Ill defined transverse bands of decreased density
Subperiosteal bone resorption

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13
Q

Cortical changes in chronic osteopenia

A

Endosteal resorption
Intracortical tunneling
Subperiosteal resorption

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14
Q

Cancellous changes in chronic osteopenia

A

Prominent primary trabeculations (lines running along stress lines, must be viewed on DP view)

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15
Q

Etiology of osteomalacia (ricketts)

A

Vitamin D deficiency

Hypophosphatemia

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16
Q

Osteomalacia (ricketts) signs

A

Bowing of long tubular bones

Looser’s zones (incomplete radiolucencies)

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17
Q

Rickets signs

A

Widening of physis
Irregularity of physeal margin (paint brush appearance or fraying)
Widening or cupping of metaphysis

18
Q

Scurvy cause

A

Vitamin C deficiency

19
Q

Scurvy radiologic signs

A

Transverse line of increased density near growth plate with adjacent line of decreased density

Small beak like outgrowths near margin

Supepiphyseal infraction in area of brittle and decreased trabeculae (Corner or Angle sign)

20
Q

Hypophosphatasia characterized by

A

reduced levels of alkaline phosphatase

21
Q

Radiographic findings of hypophosphatasia

A

Shortening of long tubular bones and osteochondral spurring

Chondrocalcinosis

22
Q

Primary hyperparathyroidism characterized by

A

Hypercalcemia due to tumor secretion of PTH

23
Q

Secondary hyperparathyroidism characterized by

A

Hypocalcemia

Vitamin D deficiency

24
Q

Tertiary hyperparathyroidism characterized by

A

Hyperplasia of parathyroid glands and lose of response to serum Ca levels

Seen in renal failure patients

25
Q

Radiographic findins of hyperparathyroidism

A

Subperiosteal resorption

Brown tumors (radiolucent lytic lesions)

26
Q

Signs of renal osteodystrophy

A

Hyperphosphatemia producing osteoCLAST activity

Calcium deposits in vessels

27
Q

Acromegaly signs

A

Increased heel pad thickness
Widened joint space
Prominent bones (metatarsal heads and distal phalanx)
Spurs at entheses

28
Q

Osteogenesis imperfecta radiographic signs

A

Diminished bone girth
Diffuse osteopenia
FLARING OF METAPHYSIS

29
Q

Hypoparathyroid signs

A

Shorter and wider bones

Hypocalcemia
Hypercalciurea
Hyperphosphatemia

30
Q

Paget’s disease signs

A 
Flaming lesions (blade of grass)
Saber shin

High alkaline phosphatase and proline

31
Q

Fluorosis signs

A

Thickened cortex at expense of medulla
Periosteal reaction
Ossification of ligaments, tendons, interosseous membranes

32
Q

Melorheostosis

A

SINGLE LIMB
Hyperostosis along periphery of bone
CANDLE WAX FLOWING DOWN ENDOSTEUM

33
Q

Hypervitaminosis D

A

Metastatic calcification

Periarticular calcification and cortical thickening

34
Q

Dystrophic calcifications

A

Damaged tissue calcification due to tumor, inflammatino, trauma

35
Q

Metastatic calcifications

A

Disturbance in calcium or phosphate metabolism

36
Q

Generalized calcifications

A

Skin and subcutaneous tissue

37
Q

Myositis ossificans often confused with

A

Osteogenic sarcoma

Radiolucent zone between lesion and adjacent bone can help distinguish from sarcoma

38
Q

Erhlenmeier flask

A

Osteogenesis imperfecta

Osteopetrosis

39
Q

Phleboliths

A

Venous stasis

40
Q

Periungual fibroma

A

Tuberous sclerosis

41
Q

Wavy periostitis

A

Tuberous sclerosis

Mahoney Radiology EBM (3 decks)

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