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Radiography 1 > Diseases of the Bones > Flashcards

Diseases of the Bones Flashcards

1
Q

What is xray good for

A

Bone injuries, easy to visualise cortex

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2
Q

What is CT good for

A

Pinpoint injuries in bony structures & blood supply

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3
Q

What is MRI good for

A

Internal structure of bone, tissue differences (abnormal vs normal), inflammation of soft tissue

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4
Q

What is angiography for in metastatic bone disease

A

To see devascularisation of vascular metastases

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5
Q

What is sclerosis, and what does it look like on an xray

A

Increased bone density, very white, loss of visible structure

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6
Q

What is the name of the disease where blood supply to a bone has been stopped

A

Avascular necrosis of bone

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7
Q

What are the types of metastatic bone disease

A

Diffuse, or focal. Diffuse = uncontrolled osteoblast activity, focal affects cortex or medullary cavity

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8
Q

What is necrosis

A

Death of bone

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9
Q

What are the types of metastases

A

osteoblastic, osteolytic, both

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10
Q

Common primary causes of metastases in bone (cancers)

A

Prostate, breast, lung, kidney

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11
Q

Common originations of osteoblastic (sclerotic) disease

A

Prostate carcinoma, breast carcinoma, colon carcinoma, bladder, soft tissue sarcoma

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12
Q

What is avascular (aseptic) necrosis

A

Damage to blood supply that causes bone collapse

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13
Q

What is paget disease

A

Chronic bone disease, increased bone resorption & formation

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14
Q

Name diseases with decreased bone density (4)

A

Osteoporosis, hyperparathyroidism, rickets, osteomalacia

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15
Q

What are the symptoms of decreased bone density (4)

A

No pain in early stages, pathologic fractures, lucency, compression of vertebral bodies

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16
Q

What are the 2 types of osteoporosis

A

Postmenopausal - osteoclastic activity (less osteoclasts & osteoblasts), Senile - loss of total bone mass

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17
Q

What increases the risk of ostseoporosis

A

Estrogen deficiency, steroids, alcoholism (less Ca absorption), cushing disease

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18
Q

What are osteoporosis treatments

A

Drugs to increase bone density & calcium resorption

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19
Q

What is a trabeculae

A

Tissue element in the middle of the bone that supports it & transfers load away from the cortical bone

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20
Q

What are the 3 forms of hyperparathyroidism (primary, secondary, tertiary)

A

1- hypercalcemia
2- renal disease
3- autonomous hyper secretion

  1. hypercalcaemia due to PTH 2. chronic renal disease due to calcium & phosphorous imbalance 3. autonomous hyper-secretion due to long standing secondary hyperparathyroidism
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21
Q

What’s hyperplasia

A

the enlargement of an organ or tissue caused by an increase in the reproduction rate of its cells, often as an initial stage in the development of cancer.

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22
Q

What is rickets

A

Loss of bone density caused by lack of vitamin D from diet or lack of exposure in sun. Children will have bones that don’t form properly and can’t bear weight. Growth plates won’t close

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23
Q

What is osteomalacia

A

Adult version of rickets. Failure to calcify osteoid matrix, often chronic renal disease. Hallmark is pseudofracture

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24
Q

Where on the skeleton is it common to see osteomalacia

A

iscial rami, metatarsals, calcaneus

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25
Q

Name 3 diseases with focal loss of bone density

A

metatstatic bone disease, multiple myeloma, osteomyelitis, primary benign tumors

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26
Q

What cancers are commonly associated with osteolytic metastatic bone disease

A

Prostate, breast, lung, renal, thyroid, lymphoma

27
Q

What scan identifies metastases in skeletal tissue

A

Radionuclide bone scan

28
Q

What is multiple myloma & how is it detected

A

Proliferation of immune cells in bone marrow, plain radiographs

29
Q

What is osteomyelitis

A

Focal destruction of bone by bacterial infection, usually blood borne

30
Q

How do you differentiate bone tumors

A

Plain radiology

31
Q

Where does osteomyelitis usually grow

A

Growth plate in children, joint space in adults

32
Q

How do you tell the difference between benign & malignant tumors/ lesion

A

Benign has well defined border, not spreading, lack of soft tissue match, still one destruction. Malignant looks permeative, interrupted & wide

33
Q

What is osteoscarcoma

A

Metaphases of long bones especially distal femur

34
Q

What is metaphses

A

Cartilage

35
Q

What is chondrosarcoma

A

Metaphysis & diaphysis of long bones including pelvis

36
Q

Fibrosarcoma?

A

Soft tissue metaphysis of femur & tibia

37
Q

What specific parts of the bone get fractured

A

Diaphysis & epicondyle

38
Q

What are complications of fractures

A

Compound (through skin), involvement of joints

39
Q

What is a complete fracture

A

Both sides of cortex broken

40
Q

Incomplete fracture

A

Soft bone, common in kids, break on one side

41
Q

Torus/buckle fracture

A

Compression of cortex

42
Q

What does torus look like on an x-ray

A

Small bump on bone

43
Q

Look at types of fractures in notes

A
44
Q

Difference between comminuted & simple fractures

A

Simple easy to put back together, comminuted is many little pieces and disrupts blood supply as well

45
Q

Compacted bone fracture

A

Shaft of the bone goes into head of bone. Only bones like humerus

46
Q

Transverse fracture

A

Goes straight across, caused by a bang

47
Q

Oblique fracture

A

Angle straight across, landing with weight

48
Q

Spiral fracture

A

All around the bone

49
Q

Stress fracture

A

Lots of small breaks in the bone that don’t allow it enough time to perform remodelling

50
Q

Common stress fracture locations

A

Proximal femur & tibia, calcaneus, 2nd & 3rd metatarsals

51
Q

Stages of fracture healing

A
  1. Inflammatory - haematoma due to vessel damage. Inflammatory response localises the damage (first day)
  2. Cartilage - Fibrocartilaginous callus formation (within a week), cartliage formation, vascularisation.
  3. Ossification- Reparative (1-4weeks) can be 6 depending on age & complications. Cartilage is resorbed and replaced by bone (ossification). Clumps of osteoid (matrix) that will start to ossify. Still soft tissue.
  4. Lamellar- Remodelling stage. Woven bone replaced by lamellar bone. Months to years.
52
Q

Why are plates & pins added sometimes

A

To stabilise bone while it heals and avoid non union from excess movement

53
Q

Factors affecting bone repair

A

Intact local blood supply - if there is no blood supply it won’t heal & needs to be replaced
Type of fracture - spiral & oblique repair faster than transverse
Fixation - movement slows healing
Age
Concurrent infection, disease, nutrition (lack of Ca in diet)

54
Q

What is the definition of a repair

A

Continuity of cortex, no visible fracture line, bone is calcified (4-6 weeks)

55
Q

What is a callus

A

Lump around a broken bone

56
Q

What is a pathologic fracture

A

One that occurs due to a pre-existing abnormality

57
Q

What is a dislocation

A

Bones that formed the joint are no longer in correct contact

58
Q

What is subluxation

A

Bones that formed the joint are in partial contact

59
Q

What is arthritis

A

Inflammatory condition of joints that almost always causes joint space narrowing

60
Q

What are the 3 types of arthritis

A

Osteo - degeneration of joint cartilage
Inflammatory - immune system attacking joint
Septic - immediate treatment due to bacterial infection in joint

61
Q

What is osteoarthritis –> refer to notes

A

Hypertrophic arthritis that causes bone formation beyond parent bone
Causes subchondral sclerosis & subchondral cysts

62
Q

What is rheumatoid arthritis

A

Erosive arthritis
Causes proliferation of synovial membrane
Erosion of articular cartilage
Soft tissue swelling of affected joints
Deformation of joints
Dry eyes, dry mouth

63
Q

What does multiple myeloma look like on a radiograph

A

Multiple lytic lesions that look like soap bubbles

64
Q

What does osteomyelitis look like on a radiograph

A

Loss of definition of cortex, gas looking appearance of soft tissues e.g. phalanges

Radiography 1 (13 decks)

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