DI 2 Final - Nutritional/Metab/Endo

Question 1

3 presentations/types of osteoporosis.

Answer 1

Generalized (old)
Regional (immobilized)
Localized (infx)

Question 2

How does generalized osteoporosis present?

Answer 2

INC bone radiolucency
Cortical thinning (pencil)
Radiopaque endplates
Trabeculae: no horz, lots vert
Pancake vertebrae
Schmorl's nodes

Question 3

How does regional osteoporosis present?

Answer 3

Acute! Pain!
One area distal to trauma
Hyperemia
Patchy, mottled
Metaphyseal location
NO JT

Question 4

What’s most common cause of generalized osteoporosis?

Answer 4

AGE

Question 5

What’s standard imaging modality to quantify bone mineral density?

Answer 5

DEXA

Question 6

What causes rickets and osteomalacia?

Answer 6

RICKETS: vitamin D DEC

OSTEOMALCIA: ABN Ca, PO4 metab

Question 7

2 Forms of Rickets?

Answer 7

Renal osteodystrophy & tubular defect

Question 8

What are classic radiographic features of rickets?

Answer 8

Osteopenia (bowed)
Wide growth plates
Rachitic rosary (beads sternum)
Paintbrush & cupped metaphyses

Question 9

What causes scurvy and what are classic radiographic features?

Answer 9

DEC Vit C

White line of Frankel (dense zone of provisional calcification)
Wimberger’s sign
Pelken’s spurs**
Trummerfield zone

Question 10

Classic radiographic features of hyperparathyroidism in spine, skull, hand?

Answer 10

Hand: subperiosteal resorption (radial prox/mid phalanx 2-3)
Skull: salt & pepper
Spine: osteopenia, rugger jersey spine

Question 11

What are the face, skull, foot changes w/acromegaly?

Answer 11

Face: prominent forehead, sinus overgrowth*
Skull: lrg sella turcica, malocclusion
Foot: heet pad >20mm*

Question 12

What osseous changes might long term corticosteroids cause?

Answer 12

Osteoporosis of Cushing Dz: thin cortices*, DEC density, deformity, biconcave

Osteonecrosis: femoral/humoral heads, distal femur/talus, gas in vertebra, avascular necrosis, vertebrae collapse*