Chapter 4 Clinical Indicatiom Flashcards
refers to transfer of disease or cancerous lesions from one organ or part that may not be directly connected. All malignant tumors have the ability to metastasize, or transfer malignant cells from one body part to another, through the bloodstream or lymphatic vessels or by direct extension. Metastases are the most common of malignant bone tumors.
Bone metastases
is inflammation of the bursae or fluid-filled sacs that enclose the joints; the process generally involves the formation of calcification in associated tendons, which causes pain and limited joint movement.
Bursitis (ber-sy-tis)
is a common painful disorder of the wrist and hand that results from compression of the median nerve as it passes through the center of the wrist; it is most commonly found in middle-aged women.
Carpal (kar-pul) tunnel syndrome
is a break in the structure of bone caused by a force (direct or indirect).4 Numerous types of fractures have been identified; these are named by the extent of frac-ture, direction of fracture lines, alignment of bone fragments, and integrity of overlying tissue (see Chapter 15 for additional trauma and fracture terminology). Some common examples are as follows:
Fracture (frak-chur)
Fracture and dislocation of the posterior lip of the distal radius involving the wrist joint.
Barton fracture:
Fracture of the base of the first metacarpal bone, extending into the carpometacarpal joint, complicated by subluxation with some posterior displacement.
Bennett fracture:
Transverse fracture that extends through the metacarpal neck;
most
commonly
seen in
metacarpal.
the fifth
Boxer fracture:
Transverse fracture of the distal radius in which the distal fragment is displaced posteriorly; an associated ulnar styloid fracture is seen in 50% to 60% of cases.
Colles fracture:
Reverse of Colles fracture, or transverse fracture of the distal radius with the distal fragment displaced anteriorly.
Smith fracture:
(synovial or hemor-rhagic) in the joint cavity. It is a sign of an underlying condition, such as fracture, dislocation, soft tissue damage,
inflammation.
Joint effusion refers to accumulated fluid
is a noninflammatory joint disease characterized by gradual deterioration of the articular cartilage with hypertrophic (enlarged or overgrown) bone formation.
Osteoarthritis (os*-te-o-ar-thry-tis), also known as degenerative joint disease (DJD),
is a local or generalized infection of bone or bone marrow that may be caused by bacteria introduced by trauma or surgery. However, it is more commonly the result of an infection from a contiguous source, such as a diabetic foot ulcer.
Osteomyelitis (os”-te-o-my*-e-ly-tis)
is a hereditary disease marked by abnormally dense bone. It commonly occurs as a result of fracture of affected bone and may lead to obliteration of the marrow space. This condition is also known as marble bone.
Osteopetrosis (os-te-o-pe-tro-sis)
refers to reduction in the quantity of bone or atrophy of skeletal tissue. It occurs in postmeno-pausal women and elderly men, resulting in bone trabeculae that are scanty and thin. Most fractures sustained by wome older than 50 years are secondary to osteoporosis.
Osteoporosis (os’-te-o-po-ro-sis)
is a common chronic skelet disease; it is characterized by bone destruction followed by reparative process of overproduction of dense yet soft bone that tend to fracture easily. It is most common in men older tha age 40. The cause is unknown, but evidence suggests involve ment of a viral infection. Paget disease can occur in any bon but most commonly affects the pelvis, femur, tibia, skull, verte brae, and clavicle.4
Paget disease (osteitis deformans)
is a chronic systemic disease with inflammatory changes throughout the connective tissues, the earliest change is soft tissue swelling that is most prevalent around the ulnar styloid of the wrist. Early bone erosions typically occur first at the second and third MCP joints or the third PIP joint. Rheumatoid arthritis is three times more common in women than in men.
Rheumatoid (ru-ma-toyd) arthritis
involve the ligament that connects the scaphoid to the lunate bone. It is a common ligament injury of the carpal bone region. Tears are evident by a widening of the space between the scaphoid and lunate of 3 to 4 mm or greater. These tears are best demonstrated with the bilateral PA stress (clenched PA) projection of the wrists.5
Scapholunate ligament injuries
is a sprain or tear of the ulnar collateral ligament of the thumb near the MCP joint of the hyperextended thumb.
The sprain or tear may result from an injury such as falling on an outstretched arm and hand, which causes the thumb to be bent back toward the arm. (The PA stress projection of bilateral thumbs [Folio method] best demonstrates this condition.)
Skier’s thumb
(neoplasms, bone neoplasia) are most often benign (non-cancerous) but may be malignant (cancerous). CT and MR are helpful in determining the type and exact location and size of the tumor. Specific types of tumors are listed on p. 137.
Tumors
is the most common primary cancerous bone tumor. Multiple myeloma generally affects persons between ages 40 and 70 years. As the name implies, these tumors occur in various parts of the body, arising from bone marrow or marrow plasma cells. Therefore, these are not truly exclusively bone tumors. They are highly malignant and usually are fatal within a few years. The typical radiographic appearance includes multiple “punched-out” osteolytic (loss of calcium in bone) lesions scattered throughout the affected bones.4
Multiple myeloma
is the second most common type of primary cancerous bone tumor and generally affects persons aged 10 to 20 years but can occur at any age.
It may develop in older persons with Paget disease.
Osteogenic sarcoma (osteosarcoma)
is a common primary malignant bone tumor in children and young adults that arises from bone marrow. Symptoms are similar to symptoms of osteomyelitis with low-grade fever and pain. Stratified new bone formation results in an “onion peel” appearance on radiographs. The prognosis is poor by the time Ewing sarcoma is evident on radiographs.
Ewing sarcoma
is a slow-growing malignant tumor of the cartilage. The appearance is similar to that of other malignant tumors, but dense calcifications are often seen within the carti-aginous mass.
Chondrosarcoma
is a slow-growing benign cartilaginous tumor most often found in small bones of the hands and feet of adolescents and young adults. Generally, enchondromas are well-defined, radiolucent-appearing tumors with a thin cortex that often lead to pathologic fracture with only minimal trauma.
Enchondroma
is the most common type of benign bone tumor, usually occurring in persons aged 10 to 20 years. Osteochondromas arise from the outer cortex with the tumor growing parallel to the bone, pointing away from the adiacent joint. These are most common at the knee but also occur on the pelvis and scapula of children or young adults.
Osteochondroma (exostosis)
