Exam 1, Ch. 4, Skeletal Pathologies Flashcards
1
Q
Spina Bifida (definition and cause)
A
- posterior defect of the spinal cord in which posterior elements do not fuse properly
- moderate and severe forms have herniation of meninges (meningocele) or meninges and spinal cord (myelomengingocele)
- associated neurological deficits
2
Q
Spina Bifida (on an image)
A
- herniated spinal column seen as soft tissue mass
- large bony defects
- absence of laminae
3
Q
Osteogenesis Imperfecta (definition and cause)
A
- inherited
- connective tissue disorder
- bones break easily
4
Q
Osteogenesis Imperfecta (on an image)
A
- because of multiple fractures and defective cortices, the bones heal with exuberant callus formations
- bones may appear deformed due to amount of fractures
5
Q
Achondroplasia (definition and cause)
A
- hereditary
- most common form of dwarfism
- diminished perforation of cartilage in the growth plates
6
Q
Achondroplasia (on an image)
A
- progressive narrowing of interpedicular distances from above downward
- long bones appear short and thick
7
Q
Congenital Hip Dysplasia (definition and cause)
A
- incomplete acetabulum formation due to mechanical and hormonal reasons
- more common in females
- tendons and ligaments responsible for proper femoral head alignment are affected
8
Q
Congenital Hip Dysplasia (on an image)
A
- both AP and Cleaves (bilateral frog-leg) required for diagnosis
- AP: shows slightly wider joint space
- Cleaves: shows hip dislocation (usually superiorly and posteriorly)
9
Q
Reiter’s Syndrome (definition and cause)
A
- form of rheumatoid arthritis
- primarily affects young adult men
- normally occurring after venereal or GI infections
- affects SI joints, heels, and toes
10
Q
Reiter’s Syndrome (on an image)
A
- ankylosing (fusing) of SI joints bilateral but asymmetric
- ankylosing usually affects feet (not hands)
- only minimal changes to spine
11
Q
Osteoarthritis (definition and cause)
A
- also called degenerative bone disease
- loss of joint cartilage and reactive new bone formation
- 2 causes: (1) part of normal wear and tear process of aging; (2) a repeatedly traumatized or abnormal stress on a joint due to deformity
12
Q
Osteoarthritis (on an image)
A
- weight-bearing joints (spine, hip, knee, ankle) and IP joints of fingers
- narrowing of joint space
- periarticular sclerosis (articular ends of bones become more dense)
- cystlike lesions with sclerotic margins on articular surfaces
- spurs with well-defined bony protuberances
13
Q
Infectious Osteoarthritis (definition and cause)
A
- also called pyogenic osteoarthritis
- pyogenic organisms gain entry into joints by way of hematogenous route, trauma, or adjacent osteomyelitis
- often caused by migratory Lyme Disease
14
Q
Infectious Osteoarthritis (on an image)
A
- soft tissue swelling
- periarticular edema displaces or obliterates adjacent tissue fat planes
- severe infections: extensive destruction and loss of cortical outline
15
Q
Osteomalacia (definition and cause)
A
- excessive osteoid formation (less common) or insufficient mineralization of osteoids (more common)
- due to lack of absorption or intake of calcium, phosphorus, or vitamin D
- renal disease may be cause too (calcium gets excreted in urine)
16
Q
Osteomalacia (on an image)
A
- loss of bone density
- bone cortex appears more dense in contrast to the deossified medullary
- bowing deformities in pelvis, vertebral column, thorax, and/or prox. extremities
17
Q
Rickets (definition and cause)
A
- infant (or early childhood) equivalent to Osteomalacia
- deficient in vitamin D due to diet or lack of exposure to UV radiation (sunshine which converts sterols in skin to vitamin D)
18
Q
Rickets (on an image)
A
- best seen on the fastest growing bones (radius/ulna, sternal end of ribs, prox. tibia/humerus)
- more distance between ossified epiphysis and shaft
- metaphyseal ends of bone appear “cupped” or “frayed”
19
Q
Gout (definition and cause)
A
- disorder in the metabolism of purine
- increase in blood level of uric acid leads to deposition of uric acid crystals in the joints, cartilage, and kidney
- caused by overproduction in uric acid (primary gout)
- or by drugs, increased turnover of nucleic acids, or decrease in excretion of uric acids
20
Q
Gout (on an image)
A
- acute gout primarily affects first metatarsophalangeal joint
- joint effusion and periarticular swelling
- erosions on articular surface appear as cystlike lesions; often look like a “rat bite”
21
Q
Osteoporosis (definition and cause)
A
- generalized or localized deficiency of bone matrix; bone mass is decreased but normal in composition
- caused by accelerated resorption of bone or, in some cases, decreased bone formation
- caused by aging and postmenopausal hormone changes
- to visualize on x-ray, use lowest practical kVp
- DEXA is used more often
22
Q
Osteoporosis (on an image)
A
- 50-70% of bone loss needs to be present before radiolucencies are seen on radiographs
- because of endosteal resorption, cortex appears thin and dense; causing “picture frame” appearance
- commonly seen on spine and pelvis; and sella turcica and dorsum sellae
23
Q
Paget’s Disease (definition and cause)
A
- also called osteitis deformans
- one of most common chronic metabolic diseases of skeleton
- destruction and reparation of bone causes thickened bony structures that fracture easily
- usually starting at middle age, affects men twice as often as women
24
Q
Paget’s Disease (on an image)
A
- coarsening of trabeculae of pelvic iliac margins which causes thickening of pelvic brim
- in lone bones: cortical thickening, destruction of bony trabeculae, and accentuation of secondary trabeculae
25
Q
Bacterial Osteomyelitis (definition and cause)
A
- inflammation of bone and bone marrow
- caused by infectious organisms by route of hematogenous spread, adjacent infection site, or by direct introduction (thru trauma or surgery)
26
Q
Bacterial Osteomyelitis (on an image)
A
- begins as abscess of bone
- in long bones: deep, soft tissue swelling adjacent to metaphysis
- after acute infection, bone appears thickened and sclerotic with irregular outer margin
27
Q
Osteochondroma (definition and cause)
A
- benign growth of bone with a cartilaginous cap (called exostosis); usually in knee
- usually forms in childhood or teen years
- exostosis grows laterally from epiphysis
28
Q
Osteochondroma (on an image)
A
exostosis characteristically runs parallel to long bone and away from parent bone
29
Q
Giant Cell Tumor (definition and cause)
A
- also called osteoclastoma
- usually benign
- tumor arising from distal femur or proximal tibia in young adults after epiphyseal closure (20-40 years old)
30
Q
Giant Cell Tumor (on an image)
A
- begins as radiolucent lesion
- as tumor extends into shaft, characteristic appearance a of large bubble separated by thin strips of bone
31
Q
Osteoid Osteoma (on an image)
A
- small, round or oval, lucent center
- less than 1 cm in diameter
- surrounded by a large, dense sclerotic zone of cortical thickening
32
Q
Osteogenic Sarcoma (definition and cause)
A
- malignant tumor consisting of osteoblasts
- generally occurs in metaphysis of long bone, usually the knee
- primarily affects people between ages 10-25
- can affect older people esp. with a history of Paget’s
33
Q
Osteogenic Sarcoma (on an image)
A
- mixed destructive and sclerotic lesion
- with a soft tissue mass
- elevation of periosteum with subsequent new bone formation called Codman’s Triangle
34
Q
Chondrosarcoma (definition and cause)
A
- malignant tumor of cartilaginous lesion
- may form from preexisting cart. lesion or form anew
- develops at later age than Osteogenic Sarcoma (35-60)
35
Q
Chondrosarcoma (on an image)
A
- bone destruction
- amorphous calcification within cartilaginous matrix. layman’s terms: looks like random spotting of calcifications in tumor
36
Q
Ewing’s Sarcoma (definition and cause)
A
- malignant tumor arising in bone marrow of long bones
- primarily affects young adults (rare after 30)
37
Q
Ewing’s Sarcoma (on an image)
A
- ill-defined permeative area of bone destruction (underlying medullary destruction)
- in central portion of shaft
- runs parallel to shaft
38
Q
Scoliosis (definition, cause, on an image)
A
- abnormal twisting and curving of spine
- twists vertebral bodes laterally/horizontally
- cause unknown
- S curve appearance
- should include entire spine down to hips
39
Q
Spondylolithesis (definition and image)
A
- defect in pars interarticularis WITH displacement of vertebra
- commonly affects L5
- displacement demonstrated well on lateral L-spine
- cleft (separation) of pars interarticularis seen well on oblique L-spine
- neck of Scottie dog appears detached from body
