Final exam Flashcards
Drug addicts are prone to infections by unusual organisms and unusual sites. Where and what are they?
“S” joints-spine, sacroiliac, symphysis pubis and sternoclavicular
Salmonella is the mechanism
Most common mode of infection is what?
staphylococcus aureus (90%)
What is the most common route of dissemination?
hematogenous
Growth plates inhibit what kind of spread?
hematogenous
Where is the most common location of infection?
knee
hip, ankle(distal tibia), shoulder and spine
What are the two major categories of infection?
suppurative (pus)-staph
non-suppurative-TB**
What is a bone marrow infection by (pyogenic) non-tubercular organism (anything but TB)?
suppurative osteomyelitis (from staph. aureus)
What are the four radiographic stages of infection in the bone?
latent (hidden): 1-10 days
early stage: 10-21 days
middle stage: weeks
late stage: months
What is the name given to chalky, white area representing isolated dead bone?
sequestrum (like nidus of osteoid osteoma)
What is the name given to a “bony collar”-chronic periosteal response-pus lifts the periosteum and causes new bone formation, trying to wall off the infection?
involucrum
Rare complication is to develop a squamous cell carcinoma within the channel of the cloaca; the ulcerative channel with malignant transformation has been called what?
Mariolin’s ulcer
What is the name given to a localized, aborted form of suppurative osteomyelitis with localized pain that is worse at night (mimics osteoid osteoma)? located in the metaphyseal, especially distal tibia
Brodie’s abscess (OO are 1cm)
Name the lytic distraction that crosses joint space?
septic arthritis
What should the tear drop distance be?
should not be >11mm and
On a T1 weighted MRI, osteomyelitis will have what kind of intensity?
decreased signal intensity
On a T2 weight MRI, osteomyelitis will have what kind of intensity?
increased signal intensity
What is the most common treatment for infection?
antibiotics or surgery
Name the non-suppurative osteomyelitis and it’s AKA.
Pott’s disease (TB of the spine)
What is the most common cause of infection-related death worldwide?
Tuberculosis (non-suppurative osteomyelitis)
What is called the “king of disease” because no one is spared?
tuberculosis
Where does secondary tuberculosis most commonly occur?
in the spine-specifically the TL junction
What is the name give to the acute angular change is the spine due to TB?
Gibbous formation
Tuberculosis can cause septic arthritis, what is the name of the triad and where are the three most common involved issues?
Phemister’s triad
juxtarticular osteoporosis, marginal erosions, and slow joint space loss
Where are the most common spots of AVN?
epiphyseal predisposition (especially femur and humeral head)
What is the most common category of AVN?
spontaneous idiopathic
If an AVN was not treated, it would take how long to heal?
2-8 years
What phase of AVN included growth alteration; epiphyseal growth slows or stops and articular cartilage continues?
avascular phase
Deposition occurs and new bone is deposited directly on dead bone, thickening the trabeculation and increasing bone density happens in the revascularization phase and it referred to as?
creeping substitution
What are the hallmark signs of an AVN?
Rim and crescent sign
What is the name given to AVN of an adult femoral head?
Chandler’s disease (4:1 males)
Varying degrees of sclerosis and cystic radiolucencies is called?
mottled bone density (AVN)
What are the signs of AVN?
snow cap sign, crescent/rim sign, mushroom deformity, hanging rope sign
MRI scans demonstrate a loss of marrow signal, particularly on the T1-weighted scan-what is this?
AVN
What is the name given to an AVN of the femoral capital epiphysis before closure?
Legg-Calve-Perthes disease (boys 5:1)
-increased tear drop distance
These have unknown etiology, represents a focal subchondral infarction of sub-articular bone. The necrotic bone may heal spontaneously or become a free floating fragment separated from the parent bone.
osteochondritis dissecans
Where is the most common location of osteochondritis dissecans?
knee-medial femoral condyle close to fossa, lateral aspect of the medial femoral condyle
On an x-ray, this pathology looks like a lesion at the lateral aspect of the medial femoral condyle.
osteochondritis dissecans
What pathology has localized pain, tenderness and soft tissue swelling over the tibial tubercle and is diagnosed clinically?
osgood schlatter’s disease (MC in males)
Freiberg’s disease is more common in which sex?
females (“F” for females)
Individuals involved in manual labor get this pathology and it is more common in 20-40 year old men than women?
Kienbock’s disease
This pathology involves the tarsal navicular and is questionable to be a vascular insufficiency or a normal variant.
Kholer’s disease
This pathology has an etiology that is in question but probably does not represent a necrosis. It is usually seen in teens with chronic low back pain, deformity and early DDD.
Scheuermann’s disease
-AKA Juvenile Discogenic Disease
Must be three contiguous vertebra to be diagnosed this?
Scheuermann’s disease
What is the ddx of calcified medullary infarcts?
enchondroma and chondrosarcoma
Sickle cell anemia patients are more prone to this kind of poisoning?
salmonella
Osteopenia is commonly seen on radiographs in this disease?
sickle cell anemia
“H” vertebrae (Lincoln log vertebrae) and Reynold’s phenomenon are all associated with?
sickle cell anemia
What is another name for thalassemia?
Cooley’s anemia
Erlenmeyer flask deformity is associate with?
thalassemia
Hemophilia is most commonly found where?
in the knee
Radiolucent submetaphyseal bands are seen with?
leukemia, scurvy, neuroblastoma, syphilis and sever systemic disease
