Intro to Radiologic Diagnosis Flashcards
localized means?
confined to one location
multifocal means?
in multiple isolated location
generalized means
throughout the jaws or bone
usually associated with metabolic or endocrine
epicenter means?
tissue of origin
- assuming it grew equally in every direction
*lesions have a tendency to be found in certain locations
a central lesion usually arises within?
bone
epicenter when coronal to a tooth
odontogenic EPITHELIUM
epicenter when above the IAC
ODONTOGENIC tissue
epicenter when below the IAC
non-odontogenic
epicenter when within the IAC
neural or vascular
epicenter when in condylar region
cartilagenous lesions and osteochondromas
epicenter when in maxillary antrum
non- odontogenic
- maybe like a pseudocyste
epicenter when in alveolar process of maxilla
odontogenic
arising in sinus? what will border look like
usuaully if within sinus - sinus border still intact - not something coming into it
localization of central giant cell granulomas?
demographics?
MORE ANTERIOR IN THE MANDIBLE - like anterior to the first molar (over maxilla)
anterior to the cuspids in the maxilla
alot of people describe this lesion as ‘crossing the midline’ as it occurs more anteiror
also more likely to occur in younger pt’s
multi-focal vs generalized
generalized will effect all the bone everywhere where multifocal will be bad in a few major spots
which lesions tend to be multifocal (6 examples)
- osseous dysplasia
- basal cell nevus
- cherubism
- metastic lesions
- multiple myeloma
- leukemic infiltrates
well - defined lesions tend to be?
BENIGN
ill-defined lesions
describe
tend to be?
difficult to delineate the border of the lesion
tend to be malignan or inflammatory
define corticated and implication on type of lesion
describing the periphery (usually in well-defined)
Corticated is a thin radio-opaque line surrounding the lesion
this is a small region of ACTIVE BONE FORMATION – the body is trying wall off the offending entity with bone
so means it is a slow growing lesion if rate of bone formation is able to keep up with it – so usually means it is benign
cortication usually associated with?
cysts and benign tumors
punched out think?
mutliple myeloma
four major well-defined periphery descriptions
- corticated
- punched out
- sclerotic
- soft tissue capsule
define punched out
sharp boundary but NO adio-opaque border
surrounding bone appears normal
describe sclerotic
associated with well - defined
THICKER THAN CORTICATED – so radio-opaque border of REACTIVE BONE
indicates slow growth, potential of the lesion to stimulate production of bone
think what when see/ mention of sclerotic?
inflammatory – CHRONIC STAGE
soft-tissue capsule
associated with well-defined border and has a RADIO-LUCENT line at the periphery
usually indicated a benign tumor like odontoma or cementoblastoma
ill-defined periphery broken down to
think what?
blending and invasive
think MALIGNANCY
general description of ill-defined
means bone destruciton is occuring more rapidly
seems to spread through the marrow space, thinning the trabecular pattern and enlarging the marrow
follows path of least resistance
blending?
ill-defined!
gradual transition between adjacent normal and abnormal bone
focuses on trabecule not marrow
does blending indicate malignancy since ill-defined
no -
invasive?
focus on?
area of few or no trabeculae
focus on marow spaces creating finger-like projections
rapid growth
malignancy
is punched out corticated or non
non-corticated
usually WD, multi-focal
size importance?
honeslty not the most helpful one
but can be helpful with differentiating
which things tend to get large in size?
ameloblastoma and ossyfying fibroma
synonyms for circular shape
circular/round/ovoid/ HYDRAULIC/CYSTIC
hydraulic shape indicates
a cyst
- although benign tumors can appear similar
scalloping? describing?
shape – kinda outline
like scalloping between roots of teeth
scalloping a lot of the times associated with which lesions?
KOT and SBC’s (simple bone cysts)
irregular mean malignant?
no - its not very desciptive term and depends on how it looks
internal structure usually descriptions
modaility for each?
hypo or hyper dense –> CBCT
radio-lucent (dark) vs radio-opaque (light)–> typical radiogrpahs
hypo or hyper dense depends on? example
depends on what you are comparing it to
air and fluid appear more hypo dense but when comparing to each other fluid is hyper dense compared to the air
descriptions of abnormal trabecular patterns
internal - mixed appearance
‘orange peel’
‘ground glass’
can have different number, length, width and orientation
stimulation of new bone foramtion, thick trabeculation
internal septation most seen with?
benign tumors
describe internal septation
strands of bone
can divide lesion into compartments- multinocular
can be curved or straight, corase o fine
soap bubble think
ameloblastoma
straight septation think
myxoma
dystorphic calcification can occur in?
ANY LONG STANDING LESION
- most often in cysts
describe dystrophic clacification
occurs in damaged soft tissue – any long standing lesion
- can look like cauliflower
lymph node, chronically inflammed cyst
- most often in cysts
most important aspect when determining malignant or benign
look at PERIPHERY
- ill-defined vs well defined
well-defined majority will be benign
describe amorphous bone
internal - mixed situation
- another osseous dysplasia
homogenous, dense amorphous structure
- not really a trabecular pattern
internal tooth structure looks
like an ill-formed tooth
can see the enamel, dentin and pulp
like odontoma
BASIC description of cysts
well-defined and more radiolucent than opaque
BASIC description of benign tumors
WD and more radiolucent than opaque
T/F inflammatory can be RO or RL
True - depending on stage usually
chronic/ sclerotic stage - more opaque
effects on other structures infers its?
BEHAVIOR
tumor or cyst more likely to bodily displace a tooth
benign tumor over cyst
general affect of inflammatory on other structures
can stimulate bone resorption or formation
- why you see mixed
general affect of cyst or benign tumor on other structures
more space occupying and slow growing lesions which can displace structures
general affect of malignancy on other structures
faster-growing, more destructive lesions resorb bone but leave teeth
cherubism sign
displacing posterior teeth more anteriorly - strong sign
what usually will apically displace something
follicular cyst ot odontomas
what usually will superiorly displace something
lymphoma, leukemia, langerhan’s
think of the three L’s
typical resorption pattern of benign lesion
straight, flat or curved
more likely to cause tooth resorption
tooth resorption seen with?
slow-growing, chronic conditions
chronic inflammation
more commonly benign but malignant on occasion
if malignant resorbs roots what is the pattern?
it will resorb from the sides and leave a spindle shape to the root
orthodontic tooth movement effect on structure
uniform with intact lamina dura
widened pdl can be from
if uniform = ortho movement
irregular with destruction of lamina dura –> malignancy, quickly grows throughout the pdl space (like a lymphoma)
teeth floating in the air is sign of?
malignancy
if there is superior movement of the inferior alveolar canal this is strongly associated with?
fibrous dysplasia
what causes / stimulates peripheral bone reaction
osteoblastic activity
expanding cortex is usually associated with what type of lesions vs missing outer cortex
slow growing –> expanded
rapidly growing lesion –> missing outer cortex
describe what could happen in a periosteal reactoin
think of?
exudate from inflammatory lesion
lifts periosteum off the surface
when it occurs mutiple times, can result in onion-skin appearance
is seen most with osteomyeleits and infections
think either inflammatory o malignant
