Hematologic Diseases

Question 1

Clinical findings of ___ include:

• Doesnt manifest until after 6 months of age
• Weakness, pallor, jaundice
• Abdominal crisis of bowel infarctions
• Organomegaly
• Hand-foot syndrome (children under 2 years)

Answer 1

Sickle Cell Anemia

Question 2

Bony changes in sickle cell anemia are primarily due to _____

Answer 2

ischemia/osteonecrosis

Question 3

Imaging findings of ____ include:

• Fish vertebrae
• “H” vertebrae (Reynolds)
• Hair-on-end skull (uncommon)
• Osteopenia/osteosclerosis

Answer 3

Sickle cell anemia

Question 4

What condition is likely the cause of these findings?

Answer 4

Sickle cell anemia - Hair-on-end

(differential = thalassemia should be first thought)

Question 5

What condition is likely the cause of these findings?

Answer 5

Sickle cell anemia - H vertebra

(differential = thalassemia should be 2nd thought)

Question 6

What condition is likely the cause of these findings?

Answer 6

Sickle cell anemia - H vertebra & fish shaped

Question 7

What condition is likely the cause of these findings?

Answer 7

Sickle cell anemia - osteosclerosis

(differential = osteopetrosis, padgetts, blastometaphysis)

Question 8

Erlenmeyer flask deformity is associated with osteopetrosis & _____

Answer 8

Sickle cell anemia

Question 9

What condition is likely the cause of these findings?

Answer 9

Sickle cell anemia - hand-foot syndrome

Question 10

What condition is likely the cause of these findings?

Answer 10

Sickle cell anemia - osteomyelitis

(aggressive lesion)

Question 11

What condition is likely the cause of these findings?

Answer 11

Sickle cell anemia - Erlenmeyer flask

Question 12

What condition is likely the cause of these findings?

Answer 12

Sickle cell anemia - multiple bone infarcts

Question 13

The following are soft tissue imaging findings associated with ____:

• Gallstones (up to 65%)
• Bowel infarction
• Organomegal
• Auto splenectomy (secondary to infarction and fibrosis)
• Extramedullary hematopoiesis (uncommon)

Answer 13

Sickle cell anemia

Question 14

What condition is likely the cause of these findings?

Answer 14

Question 15

Clinical findings of ____ include:

• Pallor, lethargy, retarded growth
• Organomegaly
• Rodent facies
• Repeated transfusions → hemochromatosis → cardiac failure/death

Answer 15

B-Thhalessemia major

Question 16

What condition is likely the cause of these findings?

Answer 16

B-Thalassemia Major - hair-on-end (most commly occurs in this tradition)

Question 17

What condition is likely the cause of these findings?

Answer 17

B-Thalassemia - hair-on-end

CT

Question 18

What condition is likely the cause of these findings?

Answer 18

B-Thalassemia Major - Honeycomb trabecular pattern

Question 19

What condition is likely the cause of these findings?

Answer 19

B-Thalassemia - Honeycomb trabecular pattern

Question 20

What condition is likely the cause of these findings?

Answer 20

B-Thalassemia Major - Extramedullary hematopoiesis

Question 21

What condition is likely the cause of these findings?

Answer 21

B-Thalassemia Extramedullary Hematopoiesis

Question 22

H-shaped vertebral bodies most common w/ ___ but can be seen with (just less common)

Answer 22

Sickle cell anemia

Thalassemia

Question 23

Most common childhood malignancy (peak age 2-5 years)

Answer 23

Acute childhood leukemia (acute lymphocytic)

Question 24

Imaging findings of ____ include:

• Osteopenia
• Lucent metaphyseal bands
• Periostitis
• Lytic bone lesions
• Splenomegaly
• Chloroma a soft tissue tumor of myeloid tissue (rare)

Answer 24

Acute childhood leukemia

Question 25

What condition is most likely the cause of these findings?

Answer 25

Acute childhood leukemia - lucent metaphyseal bands (other differentials such as rickets)

Question 26

What condition is most likely the cause of these findings?

Answer 26

Acute childhood leukemia - lytic bone lesions (differentials = Ewings, osteomyelitis, etc.)

Question 27

Deficiency of clotting factor VIII =

Answer 27

Hemophilia A (most common)

Question 28

Deficiency in clotting factor IX =

Answer 28

Hemophila B

Question 29

Clinical manifestations of ____ include: - Spontaneous bleeding or bleeding from minimal traum - Bleeding into joint (hemarthrosis) initiates and inflammatory response in the joint - Joint changes visualized on imaging are a result of this inflammatory process and that is why juvenile idiopathic arthritis is a differential diagnosis

Answer 29

Hemophilia

Question 30

Imaging findings of ___ include: - Overgrowth of epiphyses - Squared patella•Widened intercondylar notch - Tibiotalar slant - Osteopenia - Increased soft tissue density around joints (due to hemosiderin deposits into synovium) - Hemophilic pseudotumor (most common in femur and ilium)

Answer 30

Hemophilia

Question 31

What condition is most likely the cause of these findings?

Answer 31

Hemophilia - Widened intercondylar notch

Question 32

What condition is most likely the cause of these findings?

Answer 32

Hemophilia (differential = juvenile idiopathic arthritis)

Question 33

What condition is most likely the cause of these findings?

Answer 33

Hemophilia - tibiotalar slant (differential = juvenile idiopathic arthrophy)

Question 34

What condition is most likely the cause of these findings?

Answer 34

Hemophilia - pseudotumor (not specific)

Question 35

- Overload of iron within tissues (liver most common) - Primary (Inherited) - autosomal recessive deficiency of hepatic xanthene oxidase - Secondary (Acquired)-secondary toalcoholicsiderosis, cirrhosis, repeated iron transfusions

Answer 35

Hemocromatosis

Question 36

- Articular abnormalities occur in 20% to 50% of cases - Due to iron or calcium pyrophosphate crystals deposited into joints

Answer 36

Hemochromatosis

Question 37

The following triad can be seen in \_\_\_\_ - Bronze skin - Diabetes - Cirrhosis

Answer 37

Hemochromatosis

Question 38

Hook-like or beak-like osteophytes at metacarpal phaleangeal joints indicate

Answer 38

Hemachromatosis

Question 39

What condition is most likely the cause of these findings?

Answer 39

Hemachromatosis - hook-like osteophytes

Question 40

- AKA ischemic necrosis, avascular necrosis, bone infarction, bone infarct - Causes include spontaneous (most common), trauma, alcoholism, corticosteroids, hemoglobinopathies, systemic lupus erythematosus, Cushing’s, and radiation exposure

Answer 40

Osteonecrosis

Question 41

Term typically used for necrosis of bone in non-epiphyseal location, usually in medullary space of metaphysis

Answer 41

Bone infarction

Question 42

Term typically used for necrosis in epiphyseal location, usually in of subchondral bone adjacent to joint

Answer 42

Avascular necrosis

Question 43

What condition is most likely the cause of these findings?

Answer 43

Avascular necrosis of femoral head

Question 44

What condition is most likely the cause of these findings?

Answer 44

Avascular necrosis - Crescent sign

Question 45

What is this demonstrating the progression of?

Answer 45

Avascular necrosis

Question 46

\_\_\_ is the best for diagnosis osteonecrosis early on as it is both sensitive & specific

Answer 46

MRI

Question 47

What condition is most likely the cause of these findings?

Answer 47

Avascular necrosis

Question 48

- Appears as a region of serpentine calcification within medullary space - DDX: Enchondroma or Low grade chondrosarcoma

Answer 48

Bone infarct

Question 49

What condition is most likely the cause of thes findings?

Answer 49

Bone infarct - polyostotic

Question 50

What condition is most likely the cause of these findings?

Answer 50

Radiation necrosis | (irregular sclerosis)

Question 51

- Affects the tibial tuberosity - Traction apophysitis from overuse - Clinical diagnosis - Radiographically, can see fragmentation of the tibial tuberosity apophysis, with overlying soft tissue inflammatio - Peak age = 11-15 years, males most common

Answer 51

Osgood-Schlatter

Question 52

What condition is most likely the cause of these findings?

Answer 52

Osgood-Schlatter (not necessarily an abnormality, need hx)

Question 53

- Affects endplates - Most commonly in the thoracic spine - Hereditary factors play an important factor - Over stress of spine at young age, especially in athletes plays a role as well in some - Peak age = 13-16 years

Answer 53

Scheuermann disease

Question 54

Imaging of ____ includes: - Endplate irregularities - Anterior wedging of the vertebral bodies of 5 degrees of more involving three continues levels - Increased anterior to posterior width of the vertebral body - Increased kyphosis

Answer 54

Sceuermann disease

Question 55

What condition is most likely the cause of these findings?

Answer 55

Scheuermann Disease - Wedging of 3 Adjacent levels

Question 56

What condition is most likely the cause of these findings?

Answer 56

Scheuermann disease

Question 57

Identify the findings present and diagnosis or differential diagnosis or category as appropriate

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Question 66

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Question 67

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Question 68

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Question 69

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Question 70

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Question 71

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Question 72

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Question 73

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Question 74

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Question 76

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