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Chapman & Nakielny Flashcards

1
Q

What are the 3 most common causes of generalized increased bone density in an adult?

A

Metastasis
Sickle cell disease
Myelofibrosis

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2
Q

The “rugged jersey” sign is associated with what pathology?

A

Hyperparathyroidism

Renal osteodystrophy

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3
Q

Thickened cortices with reduced marrow space is characteristic of which congenital bone dysplasia?

A

Osteopetrosis

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4
Q

Bony expansion with coarsened trabeculae pattern is characteristic of which osseous disease?

A

Pagets disease

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5
Q

Describe Camurati-Engelmann disease

A

Enlargement and sclerosis of long bones

Spares epiphyseal areas

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6
Q

What is another name for Camurati-Engelmann disease?

A

Progressive diaphyseal dysplasia

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7
Q

What is the most common solitary sclerotic bone lesion?

A

Bone island (enostosis)

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8
Q

What is the typical location for a osteoma?

A

Skull and paranasal sinuses

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9
Q

What is Gardner syndrome?

A

Multiple osteomas

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10
Q

In the setting of multiple bone infarcts, which 2 underlying disease must be considered?

A

Sickle cell disease

Gauchers disease

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11
Q

“Long lesion in a long bone” is associated with which pathology?

A

Fibrous dysplasia

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12
Q

What are the most common primary malignancies that produce osteoblastic metastasis in adults?

A

Prostate
Breast
Adenocarcinoma of GI tract
Lymphoma

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13
Q

What are the most common primary malignancies that produce osteoblastic metastasis in children?

A

Medulloblastoma

Neuroblastoma

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14
Q

A rare bone sclerosing dysplasia that produces linear striations along the long axis of long bones is called what?

A

Osteopathia striata (aka Voorhoeve disease)

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15
Q

Ewings sarcoma is often seen with what kind of periosteal response?

A

Onion-skin/lamellated

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16
Q

Osseous metastasis typically do not produce periosteal response with the exception of _____

A

Osteoblastic metastasis from prostate

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17
Q

The “dripping candle wax” appearance is associated with which pathology?

A

Melorheostosis

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18
Q

What is the most common solitary sclerotic bone lesion with a lucent center?

A

Osteoid osteoma/osteoblastoma

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19
Q 
The following diseases can all present with what kind of trabecular pattern? 
Pagets disease
Osteoporosis
Osteomalacia
Haemoglobinopathies
Haemangioma
Gauchers disease
A

Coarsened trabecualar pattern

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20
Q

Which 3 most common types of skeletal metastasis presents as osteolytic?

A

Lung
Breast (usually lytic but can be sclerotic/mixed)
Myeloma

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21
Q

Which 3 most common types of skeletal metastasis presents as osteolytic and expansile?

A

Renal cell carcinoma
Thyroid
Hepatocellular carcinoma

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22
Q

Which 3 most common types of skeletal metastasis presents as osteoblastic?

A

Prostate
Breast (particularly post treatment)
Carcinoid

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23
Q

Multiple myeloma/Plasmacytoma are typically seen in which parts of the skeleton?

A

Axial skeleton and proximal appendicular skeleton

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24
Q

What is the most common grossly expansile lucent bone tumor in an adult?

A

Plasmacytoma

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25
What is the most common grossly expansile lucent bone tumor in a child/young adult?
Aneurysmal bone cyst (usually has a thin, sclerotic border) | Giant cell tumor (often abuts articular surface)
26
What is the name of the syndrome that consists of rheumatoid arthritis with splenomegaly and neutropenia?
Felty syndrome
27
This type of osteosarcoma arises from the outer periosteum, is usually metaphyseal in location, and often has a pedunculated "cauliflower" appearance
Parosteal osteosarcoma
28
This type of osteosarcoma arises from the inner periosteum and is usually diaphyseal in location, and often has a broad base with cortical erosion
Periosteal osteosarcoma
29
What are the 2 most common causes of moth-eaten bony destruction in an adult?
Metastasis | Multiple myeloma
30
Complex regional pain syndrome is usually seen where?
Typically unilateral upper limb | Distal to a previous location of injury
31
The most common cause of regional osteopenia is what?
Disuse | Typical locations: foot, ankle, hand, wrist
32
What is a condition that can mimic osteomalacia/rickets?
Hypophosphatasia
33
What are the 3 most common causes of secondary hypertrophic osteoarthropathy (HOA)?
Lung cancer (> 60%) Bronchiectasis Lung metastasis
34
What is another name for primary hypertrophic osteoarthropathy?
Pachydermoperiostosis
35
Osteonecrosis/avascular necrosis is often caused by which 2 substances?
Corticosteroids (exogenous and endogenous) | Alcohol
36
Which haemoglobinopathy is known to cause osteonecrosis/avascular necrosis?
Sickle cell disease
37
Erosions of the medial metaphysis of the proximal humerus is typically caused by which pathologies?
Chronic rotator cuff tear Hyperparathyroidism Rheumatoid arthritis May be a normal variant
38
What are the 3 most common causes of distal clavicle osteolysis?
Post-traumatic osteolysis Post-operative Rheumatoid arthritis (typically bilateral and symmetrical)
39
What are the 3 main radiographic findings of Madelung deformity?
Short bowed distal radius with increased radoiocarpal angle Long dorsally subluxed ulna V-Shaped proximal carpal row
40
Which 2 carpals are most commonly involved in congenital carpal fusion?
Lunate-triquetral (most common) Capitate-hamate Trapeqium-trapezoid
41
Arachnodactyly is most common associated with which syndrome?
Marfan syndrome
42
Turner syndrome often presents with which 2 hand/wrist anomalies?
Madelung deformity | Lunate-triquetral coalition
43
Fetal alcohol syndrome often presents with which 2 upper extremity anomalies?
Capitate-hamate coalition | Radioulnar synostosis
44
Resorption of the distal tuft (acro-osteolysis) can be seen in the following diagnosis
``` Scleroderma Raynaud syndrome Psoriatic arthritis Hyperparathyroidism Trauma (burns and frostbite) ```
45
What is the most common cause of scoliosis?
Idiopathic (80%)
46
What is the most common cause of a solitary collapsed vertebra?
Osteoporosis
47
Other than osteoporosis, what are other causes of a solitary collapsed vertebra?
Metastasis Multiple myeloma/plasmacytoma Lymphoma
48
In the setting of multiple collapsed vertebrae, the 2 most common causes are which?
Osteoporosis | Malignancy (most common: multiple myeloma)
49
A focal single/multiple enlarged vertebral body is most likely caused by which pathology?
Pagets disease | Benign bone tumor (eg. aneurysmal bone cyst, hemangioma, giant cell tumor)
50
Which location is most common to see congenital block vertebrae in Klippel-Feil syndrome?
C2-3 and C5-6
51
What are 3 differential diagnosis for an ivory vertebra?
Pagets disease Osteoblastic metastasis Lymphoma
52
A rare metabolic condition that can cause intervertebral disc calcification centrally is _____
Ochronosis
53
All of the following can produce posterior vertebral body scalloping
Neurofibromatosis Acromegaly Achondroplasia Tumors within the spinal canal
54
Which types of arthritis presents with osteopenia?
Rheumatoid arthritis Septic arthritis SLE Systemic sclerosis
55
Which types of arthritis presents with preservation of bone density?
Osteoarthritis Gout CPPD Seronegative arthropathies
56
Which types of arthritis presents with preserved or widened joint space?
``` Gout Acromegaly SLE PVNS Any arthritis in early stages ```
57
Which types of arthritis presents with soft tissue nodules?
Rheumatoid arthritis Gout PVNS Synovial chondromatosis
58
"Ivory phalanx" is associated with which type of arthritis?
Psoriatic arthritis
59
What are the 3 most common causes of intra-articular loose bodies?
Synovial osteochondromatosis Ostechondritis dessicans Trauma
60
What are the 4 most common causes of chondrocalcinosis?
Osteoarthritis CPPD Hyperparathyroidism Gout
61
What is the normal range of normal for the pubic symphysis?
> 10mm in early childhood > 6mm in young adults > 3mm in older adults
62
What are some common causes of pubic symphysis diastasis?
Pregnancy (3rd trimester) Trauma Osteitis pubis Septic arthritis
63
What is the most common cause of unilateral protrusio acetabuli?
Trauma
64
What is the most common cause of bilateral protrusio acetabuli?
Rheumatoid arthritis
65
Aside from rheumatoid arthritis, what other pathologies can cause protrusio acetabuli?
Bone softening diseases: Pagets disease Osteomalacia Fibrous dysplasia
66
What is the name of a widened, flattened (toadstool) femoral head?
Coxa magna
67
Haemophilia causes _____ to the distal femoral intercondylar notch
Widening of the femoral intercondylar notch
68
Myositis ossificans soft tissue ossification, caused by _____
Trauma
69
What does myositis ossificans look like in terms of density?
Dense periphery with a less dense center
70
What is the triad associated with Klippel-Trenaunay syndrome?
Anomalous veins (varicosities/slow-flow malformations) Port-wine stain Limb overgrowth
71
The following are all lethal neonatal dysplasias
Thanatophoric dysplasia: short ribs, platyspondyly, small square iliac wings, "telephone handle" femurs, craniosynostosis Osteogenesis imperfecta type 2: crumpled long bones, beaded ribs, deficient skull ossification Achondrogenesis: absent/poor ossification, small chest, very short long bones Hypochondrogensis: milder form of achondrogensis but still lethal
72
What are some radiographic findings of pyknodysostosis?
``` Short stature Hypoplastic lateral ends of clavicles Hypoplastic terminal tufts Bulging cranium Delayed anterior fontanelle closure ```
73
Lead poisoning produces dense osteoblastic bands and what location?
Metaphyseal region of long bones
74
Other than lead poisoning, which other poisonous conditions can cause general increased bone density?
Fluorosis: most common in adults Hypervitaminosis D: increased bone density, followed by osteopenia Hypervitaminosis A: cortical thickening at long bones, especially at the feet
75
The following are pediatric tumors that metastasize to bone
``` Neuroblastoma Leukemia Lymphoma Renal clear cell carcinoma Rhabdomyosarcoma Retinoblatoma Ewing sarcoma (lung metastasis is much more common) Osteosarcoma (lung metastasis is much more common) ```
76
"Bone within bone" appearance can be seen in the following
Osteopetrosis Sickle cell disease Gaucher disease Heavy metal poisoning
77
Fraying and cupping at the metaphysis in a child is characteristic of which pathology?
Rickets
78
What are the 3 most common malignant tumors of the ribs in a child?
Metastasis (most commonly from neuroblastoma) Ewing sarcoma (can arise from bone/chest wall, known as an Askin tumor) Langherhans cell histiocytosis
79
What are some causes of anterior vertebral body beaking?
Mucupolysaccharridoses (with platyspondyly in Morquio) Achondroplasia Muculipidoses
80
What is the most common fibrous soft tissue lesion in children?
Rhabdomyosarcoma (can occur anywhere)
81
What is the most common location for a synovial sarcoma?
Knee (usually seen in adolescents)
82
Describe a Salter Harris type I fracture
Widening of the physis or displacement of the epiphysis
83
Describe a Salter Harris type II fracture
Fracture of the metaphysis extending into the physis (most common type)
84
Describe a Salter Harris type III fracture
Fracture of the epiphysis extending into the physis (common at the distal tibia)
85
Describe a Salter Harris type IV fracture
Fracture through the epiphysis and metaphysis
86
Describe a Salter Harris type V fracture
Physeal plate compression/crush injury (least common, worst prognosis)
87
What is the most common location for an osteochondral defect at the knees?
Lateral aspect of the medial femoral condyle
88
What are the 3 most common locations for an osteochondral defect?
Knee (most common) Talar dome (anterior medial side) Elbow (capitellum, radial head)

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