HIGH YIELD I

Question 1

this is generally due to abnormal systemic stimuli (biochemical, endocrine, electrolyte abnormalities)

Answer 1

MBD

Question 2

T/F, silent until patient presents with fracture?

Answer 2

T

Question 3

what are the common denominators of MBD?

Answer 3

systemic disorders
disturbances of bone formation or resorption
mineralization defects (trabecular variations)

Question 4

what are the key orthopedic disorders?

Answer 4

osteoporosis
rickets
osteomalacia
hyperparathyroidism
renal osteodystrophy
pagets disease
osteosclerosis

Question 5

this is the most common metabolic bone disease and most prevalent assoc with aging?

Answer 5

osteoporosis

Question 6

how does osteoporosis present on the plain film (percent loss)?

Answer 6

qualitative, 30-50% loss of bone mass requisite to demonstrate effects on cancellous bone

Question 7

what are the patterns of involvement due to osteoporosis?

Answer 7

generalized 
-primary (idiopathic)
--post menopausal
--age-related or senile
-secondary (many causes)
--endocrine
--congenital
--nutritional
--drug related
regional
-disuse, RSD
-transient regional
-inflammatory arthritis
localized 
-tumors, infection

Question 8

what kind of scan do we use for osteoporosis?

Answer 8

bone densitometry

• dual-energy x ray absorptiometry (DXA)
• quantitative CT (QCT)

peripheral bone mass assays

sahara clinical bone sonometer

Question 9

osteopenia equals osteoporosis, T/F?

Answer 9

true

Question 10

what are the disorders assoc with osteoporosis?

Answer 10

anorexia nervosa
malabsorption syndrome
primary hyperparathyroidism 
post transplantation 
chronic renal failure
prolonged immobilization
hyperthyroidism
cushing's syndrome

Question 11

radiographic features of osteoporosis?

Answer 11

decreased bone density
accentuation
cortical thinning
insufficiency fractures
reinforcement lines

Question 12

significance of trabecular bone like surface area and metabolic rate?

Answer 12

8x surface area
higher metabolic rate

red>yellow, more vascular

*more sensitive to imbalances of formation and resorption and 1st to be affected by metabolic disorders

Question 13

so moving into osteopenia, where is it 1st evident radiographically?

Answer 13

vertebrae
pelvis
ribs
ends of long bones
tarsal bones

Question 14

how are plain film radiographic assessments qualitative?

Answer 14

they look at spongiosa in appendicular skeleton

patterns of spongy bone resorption (appendicular skeleton)

Question 15

how does osteoporosis affect the body regionally?

Answer 15

disuse
transient regional
inflammatory arthritis

Question 16

s/s of talar neck fracture?

Answer 16

hawkins sign

partial hawkins sign

Question 17

pattern not unique to a given disorder but usually seen with?

Answer 17

disuse osteoporosis
RSD
hyperparathyroidism

Question 18

what are the resorptive envelopes of cortical bones?

Answer 18

endosteal envelope
intracortical envelope
periosteal envelope

Question 19

what are the radiologic anomalies?

Answer 19

axial deformities
fractures
-vertebral bodies
-femoral neck
-distal radius
-humeral neck
-metatarsal bones

Question 20

sclerotic lines through diaphysis of osteoporotic bone, usually perpendicular to trabecular pattern

Answer 20

reinforcement lines