Final exam

Question 1

Drug addicts are prone to infections by unusual organisms and unusual sites. Where and what are they?

Answer 1

“S” joints-spine, sacroiliac, symphysis pubis and sternoclavicular
Salmonella is the mechanism

Question 2

Most common mode of infection is what?

Answer 2

staphylococcus aureus (90%)

Question 3

What is the most common route of dissemination?

Answer 3

hematogenous

Question 4

Growth plates inhibit what kind of spread?

Answer 4

hematogenous

Question 5

Where is the most common location of infection?

Answer 5

knee

hip, ankle(distal tibia), shoulder and spine

Question 6

What are the two major categories of infection?

Answer 6

suppurative (pus)-staph

non-suppurative-TB**

Question 7

What is a bone marrow infection by (pyogenic) non-tubercular organism (anything but TB)?

Answer 7

suppurative osteomyelitis (from staph. aureus)

Question 8

What are the four radiographic stages of infection in the bone?

Answer 8

latent (hidden): 1-10 days
early stage: 10-21 days
middle stage: weeks
late stage: months

Question 9

What is the name given to chalky, white area representing isolated dead bone?

Answer 9

sequestrum (like nidus of osteoid osteoma)

Question 10

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?

Answer 10

involucrum

Question 11

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?

Answer 11

Mariolin’s ulcer

Question 12

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

Answer 12

Brodie’s abscess (OO are 1cm)

Question 13

Name the lytic distraction that crosses joint space?

Answer 13

septic arthritis

Question 14

What should the tear drop distance be?

Answer 14

should not be >11mm and

Question 15

On a T1 weighted MRI, osteomyelitis will have what kind of intensity?

Answer 15

decreased signal intensity

Question 16

On a T2 weight MRI, osteomyelitis will have what kind of intensity?

Answer 16

increased signal intensity

Question 17

What is the most common treatment for infection?

Answer 17

antibiotics or surgery

Question 18

Name the non-suppurative osteomyelitis and it’s AKA.

Answer 18

Pott’s disease (TB of the spine)

Question 19

What is the most common cause of infection-related death worldwide?

Answer 19

Tuberculosis (non-suppurative osteomyelitis)

Question 20

What is called the “king of disease” because no one is spared?

Answer 20

tuberculosis

Question 21

Where does secondary tuberculosis most commonly occur?

Answer 21

in the spine-specifically the TL junction

Question 22

What is the name give to the acute angular change is the spine due to TB?

Answer 22

Gibbous formation

Question 23

Tuberculosis can cause septic arthritis, what is the name of the triad and where are the three most common involved issues?

Answer 23

Phemister’s triad

juxtarticular osteoporosis, marginal erosions, and slow joint space loss

Question 24

Where are the most common spots of AVN?

Answer 24

epiphyseal predisposition (especially femur and humeral head)

Question 25

What is the most common category of AVN?

Answer 25

spontaneous idiopathic

Question 26

If an AVN was not treated, it would take how long to heal?

Answer 26

2-8 years

Question 27

What phase of AVN included growth alteration; epiphyseal growth slows or stops and articular cartilage continues?

Answer 27

avascular phase

Question 28

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?

Answer 28

creeping substitution

Question 29

What are the hallmark signs of an AVN?

Answer 29

Rim and crescent sign

Question 30

What is the name given to AVN of an adult femoral head?

Answer 30

Chandler's disease (4:1 males)

Question 31

Varying degrees of sclerosis and cystic radiolucencies is called?

Answer 31

mottled bone density (AVN)

Question 32

What are the signs of AVN?

Answer 32

snow cap sign, crescent/rim sign, mushroom deformity, hanging rope sign

Question 33

MRI scans demonstrate a loss of marrow signal, particularly on the T1-weighted scan-what is this?

Answer 33

AVN

Question 34

What is the name given to an AVN of the femoral capital epiphysis before closure?

Answer 34

Legg-Calve-Perthes disease (boys 5:1) | -increased tear drop distance

Question 35

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.

Answer 35

osteochondritis dissecans

Question 36

Where is the most common location of osteochondritis dissecans?

Answer 36

knee-medial femoral condyle close to fossa, lateral aspect of the medial femoral condyle

Question 37

On an x-ray, this pathology looks like a lesion at the lateral aspect of the medial femoral condyle.

Answer 37

osteochondritis dissecans

Question 38

What pathology has localized pain, tenderness and soft tissue swelling over the tibial tubercle and is diagnosed clinically?

Answer 38

osgood schlatter's disease (MC in males)

Question 39

Freiberg's disease is more common in which sex?

Answer 39

females ("F" for females)

Question 40

Individuals involved in manual labor get this pathology and it is more common in 20-40 year old men than women?

Answer 40

Kienbock's disease

Question 41

This pathology involves the tarsal navicular and is questionable to be a vascular insufficiency or a normal variant.

Answer 41

Kholer's disease

Question 42

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.

Answer 42

Scheuermann's disease | -AKA Juvenile Discogenic Disease

Question 43

Must be three contiguous vertebra to be diagnosed this?

Answer 43

Scheuermann's disease

Question 44

What is the ddx of calcified medullary infarcts?

Answer 44

enchondroma and chondrosarcoma

Question 45

Sickle cell anemia patients are more prone to this kind of poisoning?

Answer 45

salmonella

Question 46

Osteopenia is commonly seen on radiographs in this disease?

Answer 46

sickle cell anemia

Question 47

"H" vertebrae (Lincoln log vertebrae) and Reynold's phenomenon are all associated with?

Answer 47

sickle cell anemia

Question 48

What is another name for thalassemia?

Answer 48

Cooley's anemia

Question 49

Erlenmeyer flask deformity is associate with?

Answer 49

thalassemia

Question 50

Hemophilia is most commonly found where?

Answer 50

in the knee

Question 51

Radiolucent submetaphyseal bands are seen with?

Answer 51

leukemia, scurvy, neuroblastoma, syphilis and sever systemic disease