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MSK Imaging > J. Mandell & D. Marchiori > Flashcards

J. Mandell & D. Marchiori Flashcards

1
Q

What does the dural venous sinus often look like on a skull radiograph?

A

Seen on the lateral skull view

A radiolucent band is seen at the posterior-inferior aspect

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2
Q

What is hyperostosis frontal interna?

A

Idiopathic thickening of the internal table of the frontal bone
Progresses slowly over time
Typically spares the midline
Seen best on lateral view

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3
Q

Describe lacunar skull (aka Luckenschadel skull)

A

Multiple radiolucent areas of calvarial thinning seen in newborns/infants

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4
Q

What are some conditions that are associated with lacunar skull?

A

Arnold-Chiari malformations
Meningoceles
Encephalocele

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5
Q

What are some causes of lenticular calcification (lens of the eyes calcification)?

A

Injury
Inflammation
Old age

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6
Q

Which sutures are most involved when it comes to wormian bones?

A

Lambdoidal
Posterior sagittal
Tympanosquamosal

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7
Q

Where would you find the epitransverse processes?

A

Superior aspect of the transverse processes of C1

Extending superiorly towards occiput

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8
Q

Approximately what percentage of people with Down syndrome demonstrate laxity at the transverse ligament?

A

6-20%

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9
Q

The secondary ossification center at the tip of the odontoid process (dens) presents at around age 3, and should fuse by approximately what age?

A

12 years old

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10
Q

If the secondary ossification at the tip of the dens does not fuse, what is it called?

A

Os terminale (aka Os terminale of Bergmann)

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11
Q

What are some common features of a congenital block vertebra?

A

“Wasp waist” deformity
Remnant disc
Fusion/partial fusion of posterior elements

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12
Q

Describe the “clasp knife” deformity

A

Combination of caudal elongation of L5 spinous process and spina bifida occulta at S1

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13
Q

What is the typical location for a limbus bone?

A

Anterior-superior corner of the vertebral body

Caused by separation of the ring epiphysis

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14
Q

Where would an Oppenheimer ossicle be located?

A

At the superior/inferior tip of an articular process

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15
Q

What part of the spin is the most common location for an Oppenheimer ossicle?

A

Lumbar spine

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16
Q

What is the most common type of carpal coalition?

A

Lunotriquetral

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17
Q

Approximately what percentage of radioulnar synostosis is bilateral?

A

60%

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18
Q

The supracondylar process at the anteromedial surface of the distal humerus has a fibrous band, what is the band called?

A

Struthers ligament

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19
Q

A femoral herniation pitt (aka Pitt’s pitt) is usually seen where?

A

Typically at the femoral neck, approximately 1-2cm in diameter
Radiolucent with a rim of sclerosis

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20
Q

What is Morton syndrome of the foot (aka Morton toe)?

A

Hereditary presentation of a short first metatarsal

Results in increased proportion of body weight-bearing bone by the second metatarsal

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21
Q

What is the most common condition that causes dwarfism?

A

Achondroplasia

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22
Q

What is the general appearance of the trunk and extremities in someone with achondroplasia?

A

Near-normal trunk length

Rhizomelic micromelia at the extremities

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23
Q

What are some characteristics of chondroectodermal dysplasia (Ellis-van Crevald syndrome)?

A

Short-limb dwarfing dysplasia
Polydactyly
Congenital heart anomalies
Ectodermal dysplasia evident at birth

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24
Q

Cleidocranial dysplasia is characterized by the following

A 
Midline deformities:
Delayed suture closure
Widening at pubic symphysis 
Spina bifida occulta
Hypoplasia/agenesis of clavicles 
Accessory ossification center at the index finger
Wormian bones
Poor dentition
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25
Q

What is the Putti’s triad of developmental dysplasia of the hip (DDH)?

A

Delayed epiphysis
Widened acetabular angle
Superior-lateral displacement of the femur

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26
Q

Diastrophic dysplasia is known for some of the following characteristics

A

Twisted appearance of spine and extremities
Scoliosis (may be progressive)
Contractures
Subluxations/dislocations

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27
Q

In which country is diastrophic dysplasia most common in?

A

Finland

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28
Q

Chondrodysplasia punctata is characterized by the following

A

Stippled calcification at developing epiphysis
4 distinct forms of the disease have been reported
Shortening of tubular bones
Expanded metaphysis

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29
Q

What are some characteristics of multiple epiphyseal dysplasia (MED)?

A

Dwarfism
Brachydactyly
Epiphyseal Centers that lead to early, severe osteoarthritis

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30
Q

What is another name for multiple epiphyseal dysplasia type I?

A

Fairbank disease (MED type I)

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31
Q

What is another name for multiple epiphyseal dysplasia type II?

A

Ribbing form (MED type II)

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32
Q

Spondyloepiphyseal dysplasia typically demonstrates the following

A

Dwarfism
Short trunk
Generarlized platyspondyly
Epiphyseal dysplasia

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33
Q

How multiple epiphyseal dysplasia compare to spondyloepiphyseal dysplasia?

A

MED results in short, stubby digits and dwarfing

Generally milder than SED due to the lack of spinal involvement

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34
Q

What is another name for dysplasia epiphyseal hemimelica?

A

Trevor disease

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35
Q

What is the most common place for Trevor disease to manifest?

A

Medial aspect of the ankles

A form of localized cartilage overgrowth causing asymmetric limb deformity

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36
Q

What condition does dysplasia epiphyseal hemimelica often resemble?

A

Osteochondromas

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37
Q

What is the clinical triad of findings associated with Klippel-Feil syndrome?

A 
Short neck (often webbed at the base)
Low hairline
Restricted cervical range of motion
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38
Q

Approximately what percentage of patients with Klippel-Feil syndrome present with the classic clinical triad?

A

50%

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39
Q

What are some skeletal features of Marfans syndrome?

A 
Scoliosis
Protrusio acetabuli
Pectus excavatum 
Tubular bones appear thing and long
Arachnodactyly
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40
Q

Melorheostosis typically affects what part of the skeleton?

A

Lower extremities

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41
Q

Thick, flowing, candle wax appearance of new periosteal new bone is used to describe which condition?

A

Melorheostosis

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42
Q

Mucopolysaccharidosis (MPS) is characterized by a number of skeletal findings including the following

A 
Anterior beaks at the vertebral bodies
Increased acetabular angles
Widened appearance of acetabular roofs
Delayed ossification of femoral heads 
Cortical thinning with osteopenia
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43
Q

Clinical findings of MPS include the following

A 
Macroglossia 
Mental retardation 
Abnormal dentition
Adenoid hyperplasia 
Short stature
Cardiomegaly 
Hepatosplenomegaly
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44
Q

Imaging findings of osteogenesis imperfecta often demonstrates the following

A 
Osteopenia
Gracile bones often with bowing deformities
Pathological fractures
Large skull
Delayed ossification centers
Wormian bones 
Kyphoscoliosis
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45
Q

What are 2 other names for osteoporosis?

A

Marble bone disease

Albers-Schonberg disease

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46
Q

Those with a more severe form of osteopetrosis often suffers from what hematological condition?

A

Anemia due to lack of bone marrow

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47
Q

Characteristics of pyknodysostosis includes the following

A 
Diffuse osteosclerosis
Below-average height
Frontal and occipital bossing
Hypoplastic mandible 
Wormian bones
Acro-osteolysis at the distal tufts
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48
Q

What is the most common skeletal anomaly associated with Turner syndrome?

A

Shortened 4th metacarpal

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49
Q

What is the most common inflammatory arthritis?

A

Rheumatoid arthrits

50
Q

Rheumatoid arthritis characteristically manifests with inter-phalangeal joint misalignments. Which name signs are associated with these deformities?

A

“Swan neck” deformity
“Boutonniere” deformity
“Hitch hiker’s thumb” deformity

51
Q

“Rat bite” erosions of rheumatoid arthritis are typically seen where?

A

The “bare areas” of the synovial joint that are unprotected by articular cartilage

52
Q

What is one of the earliest signs of rheumatoid arthritis at the wrist?

A

Tendonitis of the wrist

53
Q

Rheumatoid arthritis at the hip typically presents with the following

A

Bilateral and symmetric involvement
Axial migration of the femoral head
Bilateral acetabular protrusion is common

54
Q

What are some common lung manifestations of rheumatoid arthritis?

A 
Pleural involvement (most common, usually asymptomatic)
Pulmonary fibrosis
Constrictive bronchiolitis 
Bronchiectasis
Pulmonary nodules
55
Q

What is the required diagnosing criteria for Scheuermanns disease?

A

3 connective segments

> 5% anterior wedging

56
Q

The “malaria rash” is associated with what type of arthritis?

A

Systemic lupus erythematosus (SLE)

57
Q

How are the joint spaces affected in SLE?

A

Typically joint spaces are not narrowed

58
Q

Avascular necrosis is a common complication of SLE, which locations are most commonly involved?

A

Femoral head
Tibial condyle
Femoral condyle
Humeral head

59
Q

Is there a gender predilection for SLE?

A

Females > males (7:1)

60
Q

The majority of skeletal abnormalities seen in scleroderma is at which part of the skeleton?

A

Hands

61
Q

What are some common imaging findings for scleroderma?

A

Soft-tissue atrophy
Osseous resorption
Subcutaneous calcification

62
Q

What population have a higher rate of SLE?

A

African American women

63
Q

What percentage of those with rheumatoid arthritis have cervical spine involvement?

A

80%

64
Q

Scleroderma is caused by increased of what kind of deposit?

A

Collagen deposits

65
Q

Which type of arthritis is associated with CREST syndrome?

A

Scleroderma

66
Q

What are some common findings at the hands in an individual with scleroderma?

A

Atrophy of soft tissues of the fingertips (acral tapering)
Acro-osteolysis
Soft tissue calcification

67
Q

Which other body system is frequently involved in scleroderma?

A

Gastrointestinal tract

Involvement of the esophagus is seen in up to 85%

68
Q

After the GI system, which other internal organ is most commonly involved in scleroderma?

A

Lungs

69
Q

What is the age range in which we typically see development of scleroderma?

A

30-50 years old

70
Q

Jaccoud arthritis (aka Jaccoud arthropathy/disease/syndrome) is a rare complication of what condition?

A

Rheumatic fever

71
Q

Describe the arthropathy seen with Jaccoud syndrome

A

Nonerosive
Relatively asymptomatic
Deforming arthropathy of the hands and feet

72
Q

What is another name for ankylosing spondylitis?

A

Marie-Strumpell disease

73
Q

What is another name for diffuse idiopathic skeletal hyperostosis (DISH)?

A

Forestier disease

74
Q

What is the classic site of initial involvement for ankylosing spondylitis?

A

Sacroiliac joints

75
Q

What is the gender ratio for reactive arthritis?

A

15:1 (M > F)

76
Q

Vertebral endplate destruction that manifests due to ankylosing spondylitis is called _____

A

Andersson lesion

Mimics an infection

77
Q

What are some appendicular sites of the skeleton that is affected by ankylosing spondylitis?

A

Hips
Shoulders
Knees
Small joints of the hands and feet

78
Q

Lung fibrosis is seen predominantly in which lung zone when associated with ankylosing spondylitis?

A

Upper lobe interstitial fibrosis

79
Q

What is the typical age of onset for ankylosing spondylitis?

A

Between 15-35 years old

80
Q

Ankylosing spondylitis lab tests include testing positive for which marker?

A

HLA-B27

Elevated ESR

81
Q

“Mouse ear” erosions are associated with with type of arthritis?

A

Psoriatic arthritis

82
Q

What is the main target site for psoriatic arthritis?

A

DIP joints of the hands

83
Q

The “pencil in cup” deformity is associated with which type of arthritis?

A

Psoriatic arthritis

84
Q

Which type of arthritis is known to cause involvement in a “ray pattern”?

A

Psoriatic arthritis

Involvement of the DIP, MCP, PIP joints in a single finger

85
Q

What is the most commonly involved site for reactive arthritis (aka Reiter syndrome)?

A

Feet (especially the calcaneus)

86
Q

The onset of reactive arthritis usually occurs after how many weeks post GI/GU infection?

A

2-6 weeks

87
Q

What is the most common organism associated with reactive arthritis?

A

Chlamydia trachomatis

88
Q

Which tendon is usually involved in reactive arthritis?

A

Achilles tenosynovisits is the most common site of involvement

89
Q

Gouty arthritis is caused by elevated levels of serum _____

A

Serum urate: uric acid

90
Q

What are the 4 phases of gout?

A

Asymptomatic tissue deposition
Acute gouty arthritis
Intercritical gout
Chronic tophaceous gout

91
Q

What are the 3 most common places for osteochondritis dessicans?

A

Knee: lateral aspect of medial femoral condyle (95%)
Talus: medial talar dome
Elbow: capitellum

92
Q

What is Panner disease?

A

Osteochondrosis of the capitellum

93
Q

In what age group do we see osteochondrosis?

A

Children and adolescents who are still growing

94
Q

What is Sever disease?

A

Ostechondrosis of the calcaneus

95
Q

What is Sinding-Larsen-Johansson disease?

A

Chronic traction injury at the proximal end of the infra-patellar tendon

96
Q

What other condition is closely related to Sinding-Larsen-Johansson disease?

A

Osgood-Schlatter disease

97
Q

Some people classify Sinding-Larsen-Johansson disease as the pediatric version of what other condition?

A

Jumper’s knee

98
Q

“Kissing contusions” at the medial aspect of the patella and lateral femoral condyle is associated with what traumatic event?

A

Patella dislocation

99
Q

Why does osteochondritis dessicans (OCD) require an MRI referral?

A

Check for instability: if there is fluid surrounding the fragment, it is considered unstable

100
Q

What is injured in the “unhappy triad of O’Donoghue”?

A

Anterior cruciate ligament
Medial meniscus
Medial collateral ligament

101
Q

Spontaneous osteonecrosis of the knee (SONK) is most common seen in which location?

A

Lateral femoral condyle

102
Q

Spontaneous osteonecrosis of the knee (SONK) is often associated with what other injury?

A

Meniscal tear

103
Q

The Berndt & Harty classification system is used for what?

A

Osteochondral defects

104
Q

Describe the 4 surgical categories of osteochondritis dessicans

A

Stage I: stable, lesion in continuity with host bone, covered by intact cartilage

Stage II: stable on probing, partial discontinuity of lesion with host bone

Stage III: unstable on probing, fragment not dislocated, complete discontinuity of the dead “in situ” lesion

Stage IV: dislocated fragment

105
Q

What is another name for spontaneous osteonecrosis of the knee (SONK)?

A

Ahlback disease

106
Q

Avascular necrosis of the radial head is called _____

A

Brailsford disease

107
Q

Avascular necrosis at the heads of the metacarpals is called _____

A

Dietrich disease

108
Q

Avascular necrosis at the head of the second metatarsal head is called _____

A

Frieberg disease

109
Q

What is Friedrich disease?

A

Avascular necrosis of the medial clavicle

110
Q

What is Hass disease?

A

Avascular necrosis of the humeral head

111
Q

What is Iselin disease?

A

Avascular necrosis at the base of the 5th metatarsal

112
Q

What is Keinboch disease?

A

Avascular necrosis at the lunate

113
Q

Avascular necrosis at the navicular is called _____

A

Kohler disease (in a child)

114
Q

Avascular necrosis at a vertebral body is called _____

A

Kummell disease

115
Q

Avascular necrosis at the greater trochanter is called _____

A

Mandl disease

116
Q

Avascular necrosis at the metacarpal heads is called _____

A

Mauclaire disease

117
Q

Legg-Calve Perthes disease is avascular necrosis at what location?

A

Femoral head

118
Q

Mueller-Weiss disease is avascular necrosis at what location?

A

Navicular (in an adult)

119
Q

Piercer disease is avascular necrosis at what location?

A

Pubic symphysis

120
Q

Avascular necrosis of the scaphoid is known as _____

A

Preiser disease

121
Q

Describe the stages of the Berndt & Harty classification system of osteochondral injury of the talus

A

Stage I: osteochondral defect

Stage II: small portion of the lesion detaching from host bone with fluid at the site of detachment

Stage III: a larger portion of the lesion detaching from the host bone with fluid at the site of detachment

Stage IV: complete separation of the lesion with fluid surrounding the fragment, but fragment remains in situ

Stage V: displacement of the osteochondral fragment

MSK Imaging (3 decks)

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