Endocrine Imaging Flashcards
what line in the pituitary gland in
midline
where is skull is the pituitary gland
in the sella turcica, is closey related to the sphenoid sinus
what connects the pituitary gland to the brain
the pituitary stalk
what structures surround the pituitary gland
optic chiasms superiorly
carotid arteries laterally
hypothalamis superiorly
what does a bone scan do
makes map of osteoclast activity
what can cause peripheral vision loss
eye, optic nerve, chiasm, optic tract, brain
any pathology/ injury in these areas
what retina does peripheral vision hit
medial retina
which field of vision crosses the optic chiasm
peripheral
when pituitary adenomas are more likely to be hormonally active
microadenoma
what can show whether a pituitary adenoma is functional
contrast scan
why is the thyroid easy to image
as superficial
what is the thyroid anterior to
the trachea and the oesophagus
what is the thyroid deep to
the strap muscles
what is the thyroid medial to
common carotid arteries and internal jugular veins
what nerve runs along the back of the thyroid
recurrent laryngeal nerve
what is at risk in thyroid surgery
parathyroid glands and the recurrent laryngeal nerves
what is inferior to the thyroid
sternum, great vessels and aortic arch
what can cause a midline neck mass in adults
enlarged thyroid gland (benign, malignant, mets), enlarged lymph nodes, thryoglossal cyst, cystic hygroma
what are the diffuse and focal causes of hyperthyroidism
diffuse- graves, thyroiditis
focal- dominant nodule
how do differentiate the cause of hyperthyroidism
radioisotope studies and ultrasound
what can be combined with ultrasound for investigating the thyroid
fine needle aspiration
when in thyroid problems in fine needle aspiration done
in euthyroid patients with goitre/palpable nodules
in hyperthryoid patients with focal masses/ radioisotope uptake
what does thyroid scintigraphy do
show pattern and quantity of tracer uptake
what would thyroid scintigraphy show for graves
homogenously increased tracer uptake
what would thyroid scintigraphy show for hypothyriodism
reduced tracer uptake
what would thyroid scintigraphy show for thyroiditis
homogenously reduced tracer uptake
what would thyroid scintigraphy show for a functional nodule
focal uptake increased
where are the adrenal glands
retoperitoneal, suprarenal
what imaging can show the adrenal glands
CT and MRI
what are the two limbs of the adrenal gland
medial and laternal
where in relation to adrenal glands in the IVC
right adrenal gland lies posterior to the IVC
what does the left adrenal gland lie lateral to
aorta and left diaphragmatic crus
what should you think if there is a SOLID mass in the adrenal glands
metastasis- lung most common
give examples of flat bones
skull, pelvis, sternum
what is trabeculae
cancellous bone- made of spongey, porous bone tissue
loosely packed in the medulla - condense towards the cortex
what is hypertrophic periosteal osteoarthroplasty
when endocrine problem causes the laying done of more bone layers
what bones undergo endochondral ossification
long bones (femur, metatarsal)
describe enchondral ossification
start as cartilage, osteoblasts replace the cartilage with oestoid which mineralises to form bony trabeculae
where do cartilagnous bones ossify
firstly in the diaphysis and then within the epiphysis
how is bone girth increased
cells from periosteum lay down cicrumferential new bone on the periphery of existing cortex
how is bone length increased
cartilage proliferation at the growth plates between the metaphysis and epiphysis
cartilage then ossifies
how do you describe bone abnormalities
diffuse or focal
what are the types of focal bone abnormalities
traumatic, neoplastic (lytic bone destruction or sclerotic bone formation)
inflammatory
degenerative
what are the types of diffuse bone abnormalities
bones too brittles (osteoporosis)
bones too soft (rickets and osteomalacia, pagets)
what is process behind osteoporosis
reduction in trabecular density, common in post menopausal females
what are the secondary causes of osteoporosis
steroids, early menopause, anorexia
where are common sites for osteoporotic fractures
proximal femur, sacrum and pubic rami, thoracolumbar vertevral bodies, distal radius
what does osteoporotic bone look like
lucent
will a vertbral fracture involving the posterior parts of the vertebrae be osteoporotic
no- more likely to be due to a metastatic deposit
what is the cause and outcome of rickets
Vitamin D deficiency Non-ossification of soft osteoid Bone deformity, pain and growth abnormality Widened growth plates Irregular, flared metaphyses
what is the cause and outcome of osteomalacia
Vitamin D deficiency
Non-ossification of soft osteoid
Bone deformity, pain and tendency to partial fractures
Poor cortico-medullary differentiation
what causes pagets
increased bone turnover with unknown cause
what are the features of pagets
single or multiple bones affected initial lytic phase results in well defined lucency latter sclerotic phase with enlarged bone increased density coarse trabecular pattern
what does a lytic bone lesion look like
Medullary lucency and loss of trabeculae
loss of conrtex
what can cause a lytic bone lesion
GCT, metastasis, simple bone cysts, osteomyelitis, +++ loads more
what should you think of in a sclerotic bony metastatic disease in a man
prostate
what are features of a sclerotic bone lesion
Subtle medullary density and loss of trabeculae
Spreading zone of density which includes cortex
Featureless white bone
Expansion beyond normal bone limits, with cortical destruction and potential for pathological fracture
are sclerotic bone lesions malignant or benign
can be both
