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MSK Imaging > Chapman & Nakielny > Flashcards

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
Q

What is the most common grossly expansile lucent bone tumor in a child/young adult?

A

Aneurysmal bone cyst (usually has a thin, sclerotic border)

Giant cell tumor (often abuts articular surface)

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26
Q

What is the name of the syndrome that consists of rheumatoid arthritis with splenomegaly and neutropenia?

A

Felty syndrome

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27
Q

This type of osteosarcoma arises from the outer periosteum, is usually metaphyseal in location, and often has a pedunculated “cauliflower” appearance

A

Parosteal osteosarcoma

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28
Q

This type of osteosarcoma arises from the inner periosteum and is usually diaphyseal in location, and often has a broad base with cortical erosion

A

Periosteal osteosarcoma

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29
Q

What are the 2 most common causes of moth-eaten bony destruction in an adult?

A

Metastasis

Multiple myeloma

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30
Q

Complex regional pain syndrome is usually seen where?

A

Typically unilateral upper limb

Distal to a previous location of injury

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31
Q

The most common cause of regional osteopenia is what?

A

Disuse

Typical locations: foot, ankle, hand, wrist

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32
Q

What is a condition that can mimic osteomalacia/rickets?

A

Hypophosphatasia

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33
Q

What are the 3 most common causes of secondary hypertrophic osteoarthropathy (HOA)?

A

Lung cancer (> 60%)
Bronchiectasis
Lung metastasis

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34
Q

What is another name for primary hypertrophic osteoarthropathy?

A

Pachydermoperiostosis

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35
Q

Osteonecrosis/avascular necrosis is often caused by which 2 substances?

A

Corticosteroids (exogenous and endogenous)

Alcohol

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36
Q

Which haemoglobinopathy is known to cause osteonecrosis/avascular necrosis?

A

Sickle cell disease

37
Q

Erosions of the medial metaphysis of the proximal humerus is typically caused by which pathologies?

A

Chronic rotator cuff tear
Hyperparathyroidism
Rheumatoid arthritis
May be a normal variant

38
Q

What are the 3 most common causes of distal clavicle osteolysis?

A

Post-traumatic osteolysis
Post-operative
Rheumatoid arthritis (typically bilateral and symmetrical)

39
Q

What are the 3 main radiographic findings of Madelung deformity?

A

Short bowed distal radius with increased radoiocarpal angle
Long dorsally subluxed ulna
V-Shaped proximal carpal row

40
Q

Which 2 carpals are most commonly involved in congenital carpal fusion?

A

Lunate-triquetral (most common)
Capitate-hamate
Trapeqium-trapezoid

41
Q

Arachnodactyly is most common associated with which syndrome?

A

Marfan syndrome

42
Q

Turner syndrome often presents with which 2 hand/wrist anomalies?

A

Madelung deformity

Lunate-triquetral coalition

43
Q

Fetal alcohol syndrome often presents with which 2 upper extremity anomalies?

A

Capitate-hamate coalition

Radioulnar synostosis

44
Q

Resorption of the distal tuft (acro-osteolysis) can be seen in the following diagnosis

A 
Scleroderma
Raynaud syndrome
Psoriatic arthritis
Hyperparathyroidism 
Trauma (burns and frostbite)
45
Q

What is the most common cause of scoliosis?

A

Idiopathic (80%)

46
Q

What is the most common cause of a solitary collapsed vertebra?

A

Osteoporosis

47
Q

Other than osteoporosis, what are other causes of a solitary collapsed vertebra?

A

Metastasis
Multiple myeloma/plasmacytoma
Lymphoma

48
Q

In the setting of multiple collapsed vertebrae, the 2 most common causes are which?

A

Osteoporosis

Malignancy (most common: multiple myeloma)

49
Q

A focal single/multiple enlarged vertebral body is most likely caused by which pathology?

A

Pagets disease

Benign bone tumor (eg. aneurysmal bone cyst, hemangioma, giant cell tumor)

50
Q

Which location is most common to see congenital block vertebrae in Klippel-Feil syndrome?

A

C2-3 and C5-6

51
Q

What are 3 differential diagnosis for an ivory vertebra?

A

Pagets disease
Osteoblastic metastasis
Lymphoma

52
Q

A rare metabolic condition that can cause intervertebral disc calcification centrally is _____

A

Ochronosis

53
Q

All of the following can produce posterior vertebral body scalloping

A

Neurofibromatosis
Acromegaly
Achondroplasia
Tumors within the spinal canal

54
Q

Which types of arthritis presents with osteopenia?

A

Rheumatoid arthritis
Septic arthritis
SLE
Systemic sclerosis

55
Q

Which types of arthritis presents with preservation of bone density?

A

Osteoarthritis
Gout
CPPD
Seronegative arthropathies

56
Q

Which types of arthritis presents with preserved or widened joint space?

A 
Gout
Acromegaly
SLE
PVNS
Any arthritis in early stages
57
Q

Which types of arthritis presents with soft tissue nodules?

A

Rheumatoid arthritis
Gout
PVNS
Synovial chondromatosis

58
Q

“Ivory phalanx” is associated with which type of arthritis?

A

Psoriatic arthritis

59
Q

What are the 3 most common causes of intra-articular loose bodies?

A

Synovial osteochondromatosis
Ostechondritis dessicans
Trauma

60
Q

What are the 4 most common causes of chondrocalcinosis?

A

Osteoarthritis
CPPD
Hyperparathyroidism
Gout

61
Q

What is the normal range of normal for the pubic symphysis?

A

> 10mm in early childhood
6mm in young adults
3mm in older adults

62
Q

What are some common causes of pubic symphysis diastasis?

A

Pregnancy (3rd trimester)
Trauma
Osteitis pubis
Septic arthritis

63
Q

What is the most common cause of unilateral protrusio acetabuli?

A

Trauma

64
Q

What is the most common cause of bilateral protrusio acetabuli?

A

Rheumatoid arthritis

65
Q

Aside from rheumatoid arthritis, what other pathologies can cause protrusio acetabuli?

A

Bone softening diseases:
Pagets disease
Osteomalacia
Fibrous dysplasia

66
Q

What is the name of a widened, flattened (toadstool) femoral head?

A

Coxa magna

67
Q

Haemophilia causes _____ to the distal femoral intercondylar notch

A

Widening of the femoral intercondylar notch

68
Q

Myositis ossificans soft tissue ossification, caused by _____

A

Trauma

69
Q

What does myositis ossificans look like in terms of density?

A

Dense periphery with a less dense center

70
Q

What is the triad associated with Klippel-Trenaunay syndrome?

A

Anomalous veins (varicosities/slow-flow malformations)
Port-wine stain
Limb overgrowth

71
Q

The following are all lethal neonatal dysplasias

A

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
Q

What are some radiographic findings of pyknodysostosis?

A 
Short stature
Hypoplastic lateral ends of clavicles 
Hypoplastic terminal tufts 
Bulging cranium 
Delayed anterior fontanelle closure
73
Q

Lead poisoning produces dense osteoblastic bands and what location?

A

Metaphyseal region of long bones

74
Q

Other than lead poisoning, which other poisonous conditions can cause general increased bone density?

A

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
Q

The following are pediatric tumors that metastasize to bone

A 
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
Q

“Bone within bone” appearance can be seen in the following

A

Osteopetrosis
Sickle cell disease
Gaucher disease
Heavy metal poisoning

77
Q

Fraying and cupping at the metaphysis in a child is characteristic of which pathology?

A

Rickets

78
Q

What are the 3 most common malignant tumors of the ribs in a child?

A

Metastasis (most commonly from neuroblastoma)
Ewing sarcoma (can arise from bone/chest wall, known as an Askin tumor)
Langherhans cell histiocytosis

79
Q

What are some causes of anterior vertebral body beaking?

A

Mucupolysaccharridoses (with platyspondyly in Morquio)
Achondroplasia
Muculipidoses

80
Q

What is the most common fibrous soft tissue lesion in children?

A

Rhabdomyosarcoma (can occur anywhere)

81
Q

What is the most common location for a synovial sarcoma?

A

Knee (usually seen in adolescents)

82
Q

Describe a Salter Harris type I fracture

A

Widening of the physis or displacement of the epiphysis

83
Q

Describe a Salter Harris type II fracture

A

Fracture of the metaphysis extending into the physis (most common type)

84
Q

Describe a Salter Harris type III fracture

A

Fracture of the epiphysis extending into the physis (common at the distal tibia)

85
Q

Describe a Salter Harris type IV fracture

A

Fracture through the epiphysis and metaphysis

86
Q

Describe a Salter Harris type V fracture

A

Physeal plate compression/crush injury (least common, worst prognosis)

87
Q

What is the most common location for an osteochondral defect at the knees?

A

Lateral aspect of the medial femoral condyle

88
Q

What are the 3 most common locations for an osteochondral defect?

A

Knee (most common)
Talar dome (anterior medial side)
Elbow (capitellum, radial head)

MSK Imaging (3 decks)

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