Hematological and vascular disorder

Question 1

death of osseous cellular and marrow components of bone

Answer 1

avascular necrosis

Question 2

synonyms for avascular necrosis

Answer 2

osteonecrosis, ischemic necrosis, osteochondrosis

Question 3

what makes epiphyseal necrosis clinically evident

Answer 3

articular surface collapse

Question 4

etiology for AVN

Answer 4

spontaneous/idopathic are most common.

Question 6

what happens to marrow space pressure in AVN

Answer 6

increases

Question 7

AVN is caused by obstruction of extra- and intra- osseous vessels

Answer 7

obstruction of extra- and intra- osseous vessels by: arterial embolism, venous thrombus, traumatic disruption, external compression

Question 8

four stages of AVN

Answer 8

avascular, revascularization, repair, deformity

Question 9

which phase of AVN does obliteration of epiphyseal blood supply precipitating death of the osteocyte and bone marrow cells occur

Answer 9

avascular phase

Question 10

growth is altered in which phase of AVN

Answer 10

avascular phase

Question 11

TRUE or FALSE: in the avascular phase, epiphyseal and articular cartilage growth slows down or stops

Answer 11

FALSE; epiphyseal growth slows but articular cartilage growth continues

Question 12

in which phase of AVN does deposition and resorption of bone occur

Answer 12

revascularization phase

Question 13

during the revascularization phase of AVN, deposition occurs and new bone is deposited directly on dead bone, thickening the traveculation and increasing density… this phenomenon is known as

Answer 13

creeping substitution

Question 14

resoprtion is secondary to ___, ___. ___ and produces bony fragmentation

Answer 14

phagocytosis, fibrosis, infiltration

Question 15

in which phase of AVN is bony resorption replaced by bony deposition

Answer 15

repair and remodeling phase

Question 16

in which phase of AVN does restitution of the epiphysis to its normal configuration occur

Answer 16

deformity phase

Question 17

residual deformity is due to

Answer 17

how much force is exerted on the necrotic bone during revascularization and repair phases

Question 18

general radiological features of epiphyseal infarction

Answer 18

collapse of articular cortex, fragmentation, mottled trabecular pattern, sclerosis, subchondral cysts, subchondral fracture

Question 19

represents impaction fracture of necrotic bone, loss of normal smooth contour

Answer 19

collapse of articular cortex

Question 20

a manifestation of resorption and weakening, radiolucent clefts appear

Answer 20

fragmentation

Question 21

reveals a thickened irregular pattern traversing the necrotic areas

Answer 21

mottled trabecular pattern

Question 22

mottled trabecular pattern is most likely seen in which phases of AVN

Answer 22

revascularization and repair

Question 23

occurs with revascularization of new bone, deposited around dead trabeculae. typically occurs centrally, peripherally cortical margin or maybe a homogenous/patchy increase in density

Answer 23

sclerosis

Question 24

patchy well circumscribed areas of rarefaction identical to DJD cysts

Answer 24

subchondral cysts

Question 25

result from weakened subchondral bone, separates articular cortex from cancellous bone

Answer 25

subchondral fractures

Question 26

subchondral fractures have which radiological signs associated with them

Answer 26

rim sign or crescent sign

Question 27

where are metaphyseal and diaphyseal infarcts most likely seen

Answer 27

distal femur, proximal tibia, proximal humerus. usually medullary

Question 28

AVN of adult femoral head

Answer 28

chandler's disease

Question 29

who is more prone for chandler's disease

Answer 29

4:1 males

Question 30

necrotic area tends to be wedged or semilunar shaped, apex centrally, involving anterior superior margin in which disease

Answer 30

chandler's disease

Question 31

bite sign most likely indicates which disease

Answer 31

chandler's disease

Question 32

subchondral bone collapse is indicated by which sign

Answer 32

crescent sign

Question 33

AVN of the humeral head is indicated by which sign

Answer 33

snow cap sign

Question 34

a healed AVN in the femoral head is indicated by which sign

Answer 34

hanging rope sign

Question 35

articular deformity leading to early DJD, acetabular dysplasia, along with trochanteric overgrowth is indicative of

Answer 35

healed femoral head AVN

Question 36

loss of marrow signal on the T1 weighted MRI may indicate

Answer 36

AVN

Question 37

SLE is a risk factor for

Answer 37

AVN

Question 38

legg-calve-perthes disease

Answer 38

AVN of the femoral capital epiphysis before closure (in children)

Question 39

are boys or girls more affected by legg-calve-perthes disease

Answer 39

boys 5:1

Question 40

symptoms of legg-calve-perthes

Answer 40

groin pain, limping, limitation of motion particularly abduction and internal rotation

Question 41

radiographic findings for legg-calve-perthes disease

Answer 41

soft tissue swelling, small epiphysis (fragmented), lateral displacement of ossification center, flattening, fissuring and fracture of the ossification center, metaphyseal widening and foreshortened, widened irregular physis, intraepiphyseal gas.

Question 42

osteochondrosis dessicans of the tibia

Answer 42

osgood schlatter's disease

Question 43

osteochondrosis dessicans is most likely found where

Answer 43

medial femoral condyle

Question 44

local, focal AVN

Answer 44

osteochondrosis dessicans

Question 45

what is the fragmetation due to osteochondrosis dessicans called

Answer 45

joint mice

Question 46

where does osteochondrosis dessicans normally affect the ankle joint

Answer 46

medial side of the talus

Question 47

fragmentation of the apophysis of the tibial tuberosity

Answer 47

osgood schlatter's disease

Question 48

involvement of the inferior pole of the patellar

Answer 48

sindig-larsen-johanssen disease

Question 49

fragmentation and flattening deformity, usually of the seconds MTP joint

Answer 49

freiberg's disease

Question 50

common in females, possibly due to wearing high heeled shoes

Answer 50

freiberg's disease

Question 51

AVN of lunate

Answer 51

kienbock's disease

Question 52

who is at risk for developing kienbock's disease

Answer 52

individuals engaged in manual labor

Question 53

disease associated with ulna minus variant or negative ulnar variance (short ulna)

Answer 53

keinbock's disease

Question 54

describe affects of kienbock's disease

Answer 54

initially lunate increases in density, later fragmentation and collapse, mixture of sclerosis and radiolucency, flattening, collapse, and fragmentation, altered joint congruity and biomechanics that precipitates DJD.

Question 55

increased lunate density is an indication of

Answer 55

kienbock's disease

Question 56

a short ulna is an indication of

Answer 56

keinbock's disease

Question 57

patchy, homogenous sclerosis of navicular. could also have collapse and fragmentation

Answer 57

kohler's disease

Question 58

AVN of navicular

Answer 58

kohler's disease

Question 59

thoraco-lumbar scheuermann's disease

Answer 59

juvenile discongenic disease

Question 60

is severs disease a necrosis

Answer 60

no

Question 61

is severs disease AVN

Answer 61

no

Question 62

TRUE or FALSE: sclerosis and fragmentation of the calcaneal apophysis represents normal anatomy

Answer 62

TRUE; severs disease (phenomenon, not really a disease)

Question 63

serpiginous regions of calcification within the bone medulla that are usually associated with arteriosclerosis

Answer 63

calcified medullary infarct

Question 64

what is a differential diagnosis for calcified medullary infarct

Answer 64

enchondroma or chondrosarcoma

Question 65

most common sickle cell anemia

Answer 65

hemolytic anemia

Question 66

pain and swelling in the hands and feet (hands and feet syndrome) are indicative of

Answer 66

sickle cell anemia

Question 67

patients with sickle cell anemia have a predisposition to

Answer 67

salmonella osteomyelitis

Question 68

radiological findings for sickle cell anemia

Answer 68

marrow hyperplasia, coarse trabeculation, osteopenia, hair on end skull, H shaped vertebrae.

Question 69

hair on end skull is indicative of

Answer 69

sickle cell anemia

Question 70

H shaped vertebrae are indicative of

Answer 70

osteonecrosis due to sickle cell anemia

Question 71

reynold's phenomenon is indicative of

Answer 71

sickle cell anemia

Question 72

reynold's phenomenon

Answer 72

H shaped vertebrae

Question 73

what should be done when H shaped vertebrae are seen on a radiograph

Answer 73

blood test for sickle cell anemia

Question 74

cooley's anemia

Answer 74

thalassemia

Question 75

group of genetic blood disorders with abnormal hemoglobin in people particularly of mediterranean origin that present with maxillary overgrowth and hair on end skull

Answer 75

thalassemia

Question 76

rodent faces are indicative of

Answer 76

thalassemia

Question 77

fatigue due to chronic anemia, splenomegaly, cardiomegaly, and gallstones is indicative of

Answer 77

thalassemia

Question 78

structure in the skull homologous to the medullary cavities in long bones

Answer 78

diploic space

Question 79

wide intercondylar notches are indicative of

Answer 79

hemophilia

Question 80

which gender is usually the carrier of hemophilia

Answer 80

female

Question 81

which gender does hemophilia usually manifest in

Answer 81

male

Question 82

malignant proliferation of WBCs

Answer 82

leukemia

Question 83

radiolucent submetaphyseal bands, osteopenia, and growth arrest lines are radiologic indications for

Answer 83

leukemia