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Chapman Aids to differentials flashcards > Bones > Flashcards

Bones Flashcards

1
Q

Generalised increased bone density

A

Myeloproliferative - myelosclerosis

Metabolic - renal osteodystrophy

Poising - Fluorosis

Malignant - Osteblastic mets, lymphoma, mastocytosis

Idiopathic
- Pagets

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2
Q

Solitary sclerotic bone lesion

A

Developmental - enostosis, FD

Neoplastic - mets, lymphoma, osteoma, healed bone lesion, primary bone sarcoma

Vascular - bone infarct

Traumatic. - callus

Infective - osteomyelitis of Garre

Idiopathic - pagets

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3
Q

Multiple scloertotic bone lesions

A

Developmental - FD, Osteopoikilosis, osteopathia striata, TS

Neoplastic - mets, lympomha, mastocytosis, healed lesions, MM, osteoma, multifocal osteosarcoma

Idiopathic - pagets

Vascular - bone infarcts

Traumatic - callus

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4
Q

Bone sclerosis with a periosteal reaction

A

Trauma - healing

Neoplastic - mets, lympoma, OO/Ob, osteosarcoma, Ewings, chondrosarcoma

Infective - OM, syphilis

Idiopathic - Cafffeys, meloheostosis

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5
Q

Solitary sclerotic lesion with LUCENT centre

A

Neoplastic - OO/Ob.

Infective - brodies abscess, syphilis,yaws, TB

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6
Q

Conditions involving skin AND bone

  • osteolytic bone lysions
A

Congenital
- NF, Basal cell naevus syndrome, angiodysplasias

Acquired
- Scleroderma, RA, Gout, Leprosy, Syphilis, Actinomycosis, LCH, Sarcoidosis, Mastocytosis, Pancreatitits with osteonecrosis.

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7
Q

Conditions involving skin AND bone

OsteoSCLEROTIC bone lesions

A

Congenital
- Osteopoikilosis
- osteopathia striata
-melorheostosis
gardners syndrome

Acquired
- Reiter syndrome
SAPHO
Kymphoma
sarcoid
haemangiomatosis
lipoatrophic diabetes mellitus

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8
Q

What is SAPHO

A

Synovitis, acne, pustulosis , hyperostosis, osteitis

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9
Q

Conditions involving skin AND bone

  • mixed Osteolytic and osteosclerotic
A

Gauchers
Psoritatic artheitis
SAPHO
Reiters Sarcoid
Pnacreatic bone lesions

Tumnours
- Maffuci
FD
Haemangioma

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10
Q

Coarse trabecular pattern

A

Pagets
Osteoporosis
Osteomalacia
Haemoglobinopathies
haemangioma
gauchers

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11
Q

Skeletal mets appearance of

Lung

A

Carcinoma - lytic
carcinoid - sclerotic

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12
Q

Skeletal mets appearance of

Breast

A

Lytic or mixed

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13
Q

Skeletal mets appearance of

Genitourinary

A

RCC - lytic

Wilms - lytic

Bladder 0 lytic (sometimes sclerotic)

Prostate - sclerotic

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14
Q

Skeletal mets appearance of

Reproductive

A

Cervix - lytic/mixed
Uterus - lytic
ovary - lytic
Testic - lytic, sometimes sclerotic

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15
Q

Skeletal mets appearance of

Thyroid

A

lytic - expansile

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16
Q

Skeletal mets appearance of

GI

A

Stomach - sclerotic or mixed

colon - lytic, rarely sclerotic

rectum - lytic

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17
Q

Skeletal mets appearance of

adrenal

A

phaeo - lytic and expansile

carcinoma - lytic

Neuroblastoma. - lytic, sometimes sclerotic

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18
Q

Skeletal mets appearance of

Skin

A

SCC - lytic

Melanoma - lytic, expansile

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19
Q

Sites of origin for different tumours

Diaphysis

A

adamantionoma
Osteoid osteoma
Chondromyxoid fibroma
Fibrous dysplasia

Ewings
Lymphoma
Lyeloma
Central
Chondrosarcoma

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20
Q

Metaphyis cancer

A

Peripheral chondrosarcoma
osteosarcoma

osteoblastoma
simple bone cyst

Enchondroma
chondrosarcoma

Giant cell tumour

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21
Q

epiphysis cancer

A

Chondroblastoma

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22
Q

DDx for

Lucent bone lesions
- medulla
- well defined
- marginal sclerosis
- no expansion

A

Geode (arthirits)
Healing lesion
brodies abscess
benign - simple bone cyst, enchondroma, chondroblastoma

Fibrous dysplasia

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23
Q

DDx for

Lucent bone lesions
- medulla
- well defined
- NO marginal sclerosis
- no expansion

A

absence of reactive bone formation suggests fast growth rate

mets
MM
EG
Brown tumour

Enchondroma
Chondroblastoma

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24
Q

Lucent lesion in medulla - ILL defined

A

aggressive pattern

mets
MM
OM
Lymphoma
Sarcomas (Osteo, Ewings, Central chondro, Fibro)

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25
Lucent lesion in medulla well defined eccentric expansion
Giant cell tumour ABC Enchondroma NOF Chondromyxoid fibroma
26
Lucent lesion - grossly expansile
Malignant - mets, plasmacytoma, central chdonrosarcoma/lymphoma/fibrosarcoma or telangioectatic osteosarcoma Benign - ABC, Giant cell tumour, enchondroma NON NEOPLASTIC - FD, haemophiliac pseudotumour brown tumour hydatid
27
subarticular lucent bone lesion
Arthritides - Osteoarthritis - RA - CPPD - Gout - Haemophilia Neoplastic Mets / MM ABC Giant Cell Tumour Chondrobasltoma Pigmented villonodular synovitis
28
lucent bone lesion - containing calcium or bone NEOPLASTIC
neoplastic - mets (breast) cartilage neoplasms - benign, enchondroma, chondroblastoma, chondromyxoid fibroma bone neoplasms - bengin - OO/ob - malignantn - osteosarcoma. fibrous tissue neoplasms - malignant, fibrosarcoma and malignant fibrous hisitiocytoma
29
lucent bone lesion - containing calcium or bone Non neoplastic causes
FD Pagets (osteoporosis circumscripta) AVN and bone infarction OM with sequestrum EG Introsseous lipoma !
30
Moth eaten bone in an adult
Neoplastic - Mets, MM, leukaemia, Long bone sarcoma, LCH Infective - OM,
31
Regional Osteopenia
Disuse Sudecks atrophy - complex regional pain syndrome. Tranient osteoporosis of the hip Regional migratory
32
generlaised osteopenia
Osteoporosis osteomalaicia hyperparathyroidims diffuse infiltrative bone disease (MM / leukaemia)
33
Osteoporosis features
low bone density cortical thinning accentuation of trabecular stress lines brittle bones
34
osteoporosis causes endocrine
Hypogonadism - menopausal, eunuchoidism, tunrners Cushings DM Acromegaly Addisons HyperPTH mastocytosis (mast cells produce heparin)
35
Osteoporosis casues disuse
Iatrogenic - steroids, heparin, Deficiency - vit c, protein
36
Congenital causes of osteoporosis
Osteogenesis imperfecta turners Homocystinuria Neurmuscular disease Mucoplysacharidoses Trisomy 13 and 18 Pseudo and pseduo pseuo hyperparathyroidism Glycogen storage diseases Progeria
37
Causes of osteomalacia / rickets
Vit D - diet/malabsorption Renal disease - GLomerular disease - tubular diease, renal tubular acidosis, fanconi, familial hypophosphataemia Hepatic Parenchymal failure, obstructive jaundie Anticonvulants - phenytoin, phenobarbitol tumour - soft tissues, haemangiopericytoma - bone - NOF< Giatn cell tumour, osteoblasotma. osteosarcoma
38
mimicks of rickets / osteomalacia
hypophasphatasia - low alp metaphyseal chondrodysplasiaic
39
mimicks of rickets in under 6 months
Biliary atresia Metabilic bone odisease of prematurity hypophosphatemia vitamin D tickets
40
Paralell spiculated hair on end appearnce
Ewings syphilis Caffeys
41
Sunray periosteum
Osteosarcoma mets ewings haemangioma meningioma TB Tropical ulcer
42
Codman triangle angle
aggressive tissue extending into soft tissue malignant or infeciton
43
isolated and solitary periosteal reaction
Trauma inflammatory neoplasm
44
Periosteal reaction - bilaterally symmetrical in adult
Hypertrophic osteoathropathy Pachydemoperiostosis Vascular insufficency Thyroid acropachy FLuorosis DISH (Anterior x4 vert)
45
what is DISH
diffuse idiopathic skeletal hyperostosis
46
Periosteal reaction - bilateral asymmetrical
mets OM Arthritides Osteoporosis Osteomalacia NAI Bleeding diathesis Hand foot syndrome.
47
Hypertrophic osteoarthropathy Puomonary causes
Carcinoma of bornchus lymphoma abscess bronchiectasis mets
48
Hypertrophic osteoarthropathy Pleural
PLeural fibroma mesothelioma
49
Hypertrophic osteoarthropathy cardiovascualr casues
Cyanotic congenital heart disease - clubbing, rarely perisoteal reaction
50
Hypertrophic osteoarthropathy GI causes
UC Crohns Dysentry Lymphoma Whipples disease Coeliac Cirrhosis Nasopharyngeal carcinomas - schminckes tumour Juvenile polyposis
51
causes of excessive callus formation
Steroid athropathy / cushings Neuropathic artheropathy ostegenesis imperfeta NAI paralytic states renal osteodystropy MM
52
causes of AVN
Toxic - steroids, EtoH, immunosupressants, anti inflams (indometacin). Trauma - idiopathic, fractures, radiotherapy, heat, fat embolism. Inflammatory - RA, SLE, scleroderma, infeciton, pancreatitis Metabolic - pregnancy, Diabetes, cushings, hyperlipidaemias, Gout Haemopoietic - Haemaglobinopathies Polycathaemia rubra vera Gauchers haemophilia Thrombotic and embolic - Dysbaric osteonecrosis arteritis
53
Erosions of the medial metaphysis of the proximal humerus
normal variant leukameia mets neuroblastoma gauchers hurlers glyocgen storate disease Niemann-Pick Hyperparathyroidism RA
54
erosion or absence of the outer end of the clavicle
RA Post traumatic osteolysis MM Mets Hyperparathyrodism Cleidocranial dysplasia Pyknodystostosis
55
focal rib lesion solitary or multiple Neoplastic causes
commonest. Malignant --> primary --> benign Mets - f, breast. m, bronchus, kidney, prostate Primary malignant - MM, plasmacytoma, chonsdrosarcoma, askin. benign - osteochondroma, enchondroma, LCH
56
focal rib lesion solitary or multiple non neoplastic causes
Healed fracture FD Pagets Brown tumour Osteomyeltisi
57
rib inferior surface notching
Arterial - Coarc, aortic thrombosis, sublcavian obstruction, pulmonary oligaemia Venous - superior vena caval obstruction Arterioenous - pulmonary avm, chest wall avm Neurogenic - NF. ribbon ribs,
58
rib superor surface notching
Connective tissue - TA SLE Scleroderma Sjogrens metabolic - hyperparathyroidism Misc. - NF, restrictive lung disease, poliomyeltis, marfans, osteogenesis imperfecta, progeria
59
wide / thick ribs
Chronic anaemias FD Pagers Healed fracture Achondroplasia Mucopolysacharidoses
60
What is Madelung deformity
short distal radius with ulnar curve. Triangular radius epiphyisis dorsal subluxation of the distal ulna. enalrged ulnar head
61
types of madelung deformity
1. isolated - bilatearl, asymmetrical, adolescent and young women 2. dyschondrosteosis - LERI WEIL disease. - bilateral with mesomelic limb shortnening. AD. Males. 3. Diaphyseal aclasis 4. Turners 5. Post traumatic 6. Post infective
61
Carpal fusion - isolated causes
Triquetral lunate Capitate hamate Trapezium - trapezoid
62
carpal fusion syndrome related
Massive carpal fusion. APerts syndrome Arthrogryposis multiplex congenita Ellis Van Crevald Syndrome Holt Oram Syndrome Turners Symphalangism
63
carpal fusion acquired
inflammatory arthritides (juvenile and RA) Pyogenic arthritis Chronic TB arthritis Post trauma post surgery
64
Short metacarpal or mettarsal
Idiopathic Post trauma Post infarction - sickle cell Turners Pseudohypoparathyroidism.
65
Causes of arachnodactyly
Marfans Homocystinuria - lens dislocats down, also they are dumb.
66
distal phalangeal destruction tuft
scleroderma Raunauds Psoriatic arthropathy neuopathic disease, DM, leprosy. Thermal injuries Trauma Hyperparathryrodism, Epidermolysis bullosa porphyria phenytoin toxicity snake venom
67
distal phalangeal destruction mid portion
Polyvinyl chloride tank cleaners Acro-osteolysis of Hajdu and Cheney Hyperparathyroidism
68
distal phalangeal destruction Periarticular
psoriatic arthropathy erosive osteoarthritis hyperparathyroidism thermal injuries scleroderma multicentric reticulohistiocystosis
69
distal phalangeal destruction poorly defined lytic lesions
OM mets - bronchus. Temrinal tuft can be solitary mets. MM ABC Giant cell tumour leprosy
70
distal phalangeal destruction well defined lytic lesions
Epidermoid cuyst enchondroma sacoid - lace like destruciton GLomus tumour Osteoid osteoma fibrous dysplasia
71
fluid filled levels on CT/ MRI Benign
ABC Chondroblastoma Giant cell tumour Simple bone cyst fbirous dysplasia
72
fluid filled levels on CT/ MRI malignant
Telangiectactic osteosarcoma malignant fibrous histiocytoma necrotic bone tumours
73
increased uptake on bone scans
mets - axial joint disease - cervical, hips, hands, traumatic - aligned rib fractures. post surgery. pagets superscan - absent kidneys metabolic bone disease dental diease, extraction or inflammation infection. vascular and blood pool phases.
74
increased uptake in bone scan NOT RELATED TO BONE DISEASE
artefacts patient - urine, sweat, injeciton site, scars, breast shadow. edge effect. Physiological variants - epiphyses in kids inferior angle of scapula calc of cartilage bladder diverticulum nipples reanl pelvis
75
increased uptake in bone scan soft tissue uptake ddx
Calc related - Myositis ossificans soft tissue osseous metaplasia soft tissue tmours with calc vascular calc calcific tendonitis abscess other - acute infarction malignant pleural effusion inflammatory carcinoma of the breast hepatic necrosis hepatic mets tumour uptake
76
bone scans visualisation of normal organs with Free pertechnetate
Thyorid stomach salivary glands
77
bone scans visualisation of normal organs with Colloid formation
Liver spleen sometimes lung
78
photopenic areas on bone scans
Artefacts Avascular lesions - cyst MM - could be rasied Mets - lytic Leukameia - could be raised Haemangioma of spinke, sometimes increased

Chapman Aids to differentials flashcards (5 decks)

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