Ch. 6 Lower Limb Pathology

Question 1

benign, neoplastic bone lesions filled with clear fluid that most often occur near the knee joint in children and adolescents, generally not detected on radiographs until pathologic fracture occurs

Answer 1

bone cysts

Question 2

appear as lucent areas with a thin cortex and sharp boundaries

Answer 2

bone cysts

Question 3

involves softening of the cartilage under the patella, which results in erosion of this cartilage, causing pain and tenderness in this area; cyclists and runners are vulnerable to this

Answer 3

chondromalacia patellae (runner’s knee)

Question 4

malignant tumors of the cartilage that usually occur in the pelvis and long bones of men older than 45 years

Answer 4

chondrosarcomas

Question 5

slow-growing benign cartilaginous tumors that most often are found in small bones of the hands and feet in adolescents and young adults

Answer 5

enchondroma

Question 6

well-defined radiolucent-appearing tumors with a thin cortex, often lead to pathologic fracture with only minimal trauma

Answer 6

enchondroma

Question 7

common primary malignant bone tumor that arises from bone marrow in children and young adults, symptoms are similar to osteomyelitis - low grade fever and pain, generally occurs in diaphysis of long bones

Answer 7

Ewing sarcoma

Question 8

appears as an onion peel due to stratified new bone formation

Answer 8

Ewing sarcoma

Question 9

benign, neoplastic bone lesion that is caused by consolidated overproduction of bone at a joint, usually the knee; the tumor grows parallel to the bone and away from the adjacent joint, tumor growth stops after epiphyseal plates close

Answer 9

exostosis (osteochondroma)

Question 9

form of arthritis that may be hereditary in which uric acid appears in excessive quantities in the blood and may be deposited in the joints and other tissues; common initial attacks occur in the first MTP joint of the foot. Later attacks may occur in other joints, such as the first MCP joint of the hand, but generally these are not evident radiographically; most cases occur in men, and first attacks rarely occur before the age of 30

Answer 9

gout

Question 10

accumulated fluid in the joint cavity, synovial or hemorrhagic; signs of an underlying condition

Answer 10

joint effusion

Question 11

large band that spans the articulation of the medial cuneiform and the 1st and 2nd metatarsal base

Answer 11

Lisfranc ligament

Question 12

range from sprain to fracture-dislocations of the bases of the 1st and 2nd metatarsals

Answer 12

Lisfranc joint injury

Question 13

characterized by an abnormal separation between the 1st and 2nd metatarsals

Answer 13

moderate sprain of the Lisfranc ligament

Question 14

what projection must be performed in order to see a Lisfranc joint injury

Answer 14

weight-bearing AP and lateral foot projections

Question 15

most common type of primary cancerous bone tumor, highly malignant, generally affecting those between 40-70 years old. Occur in various parts of the body, but arises from bone marrow or marrow plasma cells.

Answer 15

multiple myeloma

Question 16

radiographically appears as punched out osteolytic lesions scattered throughout the affected bone

Answer 16

multiple myeloma

Question 17

involves inflammation of the bone and cartilage of the anterior proximal tibia, most common in boys 10-15 years old. occurs when large patellar tendon detaches part of the tibial tuberosity to which it is attached

Answer 17

Osgood-Schlatter diease

Question 18

noninflammatory joint disease that is characterized by gradual deterioration of the articular cartilage with hypertrophic (enlargement or overgrown) bone formation. Most common type of arthritis

Answer 18

osteoarthritis (degenerative joint disease)

Question 19

benign lesions that typically occur in the long bones of young adults; usually occur in the proximal tibia or distal femur after epiphyseal closure

Answer 19

osteoclastomas (giant cell tumors)

Question 20

appear on radiographs as large bubbles separated by thin strips of bone

Answer 20

osteoclastomas (giant cell tumors)

Question 21

highly malignant primary bone tumors that occur from childhood to young adulthood (peak 20 years); neoplasm usually is seen in long bones adn may cause gross destruction of bone

Answer 21

osteogenic sarcomas (osteosarcomas)

Question 22

benign bone lesions that usually occur in teenagers or young adults; symptoms include localized pain that typically worsens at night but is relieved by OTC anti-inflammatory or pain medications. Tibia and fibula most likely locations of these lesions

Answer 22

osteoid osteomas

Question 23

caused by lack of bone mineralization secondary to a deficiency of calcium, phosphorus, or vitamin D in the diet or an inability to absorb these minerals. This softening of bones may cause bowing defects in weight-bearing parts

Answer 23

osteomalacia (Rickets in children)

Question 24

one of the most common disease of the skeletal system, most common in midlife and twice as common in men than women; nonneoplastic bone disease that disrupts new bone growth, resulting in overproduction of very dense yet soft bone. Lesions typically occur in skull, pelvis, femurs, tibias, vertebra, clavicles, and ribs

Answer 24

paget disease (osteitis deformans)

Question 25

most common initial site for paget disease

Answer 25

pelvis

Question 26

affects the sacroiliac joints and lower limbs of young men, radiographic hallmark is a specific area of bony erosion at the Achilles tendon insertion on the posterosuperior margin of calcaneus, involvement is usually bilateral; caused by previous infection of the GI tract such as salmonella or by an STI

Answer 26

Reiter syndrome

Question 27

exposure adjustment for osteoarthritis

Answer 27

slight decrease

Question 28

exposure adjustment for osteomalacia

Answer 28

decrease

Question 29

exposure adjustment for paget disease

Answer 29

increase

Question 30

the result of repeated stresses to a bone that would not be injured by isolated forces of the same magnitude

Answer 30

stress fracture (fatigue/march)

Question 31

fracture that extends along the length of the bone

Answer 31

linear/longitudinal fracture

Question 32

involves both malleoli with dislocation of the ankle joint

Answer 32

pott’s fracture

Question 33

a transverse fracture at the base of the 5th metatarsal, avulsion injury that results from plantar flexion and inversion of the foot

Answer 33

jones’ fracture

Question 34

inflammation of the bone and bone marrow caused by infectious organisms that reach the bone

Answer 34

osteomyelitis