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
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
3
Q
Describe lacunar skull (aka Luckenschadel skull)
A
Multiple radiolucent areas of calvarial thinning seen in newborns/infants
4
Q
What are some conditions that are associated with lacunar skull?
A
Arnold-Chiari malformations
Meningoceles
Encephalocele
5
Q
What are some causes of lenticular calcification (lens of the eyes calcification)?
A
Injury
Inflammation
Old age
6
Q
Which sutures are most involved when it comes to wormian bones?
A
Lambdoidal
Posterior sagittal
Tympanosquamosal
7
Q
Where would you find the epitransverse processes?
A
Superior aspect of the transverse processes of C1
Extending superiorly towards occiput
8
Q
Approximately what percentage of people with Down syndrome demonstrate laxity at the transverse ligament?
A
6-20%
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
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)
11
Q
What are some common features of a congenital block vertebra?
A
“Wasp waist” deformity
Remnant disc
Fusion/partial fusion of posterior elements
12
Q
Describe the “clasp knife” deformity
A
Combination of caudal elongation of L5 spinous process and spina bifida occulta at S1
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
14
Q
Where would an Oppenheimer ossicle be located?
A
At the superior/inferior tip of an articular process
15
Q
What part of the spin is the most common location for an Oppenheimer ossicle?
A
Lumbar spine
16
Q
What is the most common type of carpal coalition?
A
Lunotriquetral
17
Q
Approximately what percentage of radioulnar synostosis is bilateral?
A
60%
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
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
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
21
Q
What is the most common condition that causes dwarfism?
A
Achondroplasia
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
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
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
25
What is the Putti's triad of developmental dysplasia of the hip (DDH)?
Delayed epiphysis
Widened acetabular angle
Superior-lateral displacement of the femur
26
Diastrophic dysplasia is known for some of the following characteristics
Twisted appearance of spine and extremities
Scoliosis (may be progressive)
Contractures
Subluxations/dislocations
27
In which country is diastrophic dysplasia most common in?
Finland
28
Chondrodysplasia punctata is characterized by the following
Stippled calcification at developing epiphysis
4 distinct forms of the disease have been reported
Shortening of tubular bones
Expanded metaphysis
29
What are some characteristics of multiple epiphyseal dysplasia (MED)?
Dwarfism
Brachydactyly
Epiphyseal Centers that lead to early, severe osteoarthritis
30
What is another name for multiple epiphyseal dysplasia type I?
Fairbank disease (MED type I)
31
What is another name for multiple epiphyseal dysplasia type II?
Ribbing form (MED type II)
32
Spondyloepiphyseal dysplasia typically demonstrates the following
Dwarfism
Short trunk
Generarlized platyspondyly
Epiphyseal dysplasia
33
How multiple epiphyseal dysplasia compare to spondyloepiphyseal dysplasia?
MED results in short, stubby digits and dwarfing
| Generally milder than SED due to the lack of spinal involvement
34
What is another name for dysplasia epiphyseal hemimelica?
Trevor disease
35
What is the most common place for Trevor disease to manifest?
Medial aspect of the ankles
| A form of localized cartilage overgrowth causing asymmetric limb deformity
36
What condition does dysplasia epiphyseal hemimelica often resemble?
Osteochondromas
37
What is the clinical triad of findings associated with Klippel-Feil syndrome?
```
Short neck (often webbed at the base)
Low hairline
Restricted cervical range of motion
```
38
Approximately what percentage of patients with Klippel-Feil syndrome present with the classic clinical triad?
50%
39
What are some skeletal features of Marfans syndrome?
```
Scoliosis
Protrusio acetabuli
Pectus excavatum
Tubular bones appear thing and long
Arachnodactyly
```
40
Melorheostosis typically affects what part of the skeleton?
Lower extremities
41
Thick, flowing, candle wax appearance of new periosteal new bone is used to describe which condition?
Melorheostosis
42
Mucopolysaccharidosis (MPS) is characterized by a number of skeletal findings including the following
```
Anterior beaks at the vertebral bodies
Increased acetabular angles
Widened appearance of acetabular roofs
Delayed ossification of femoral heads
Cortical thinning with osteopenia
```
43
Clinical findings of MPS include the following
```
Macroglossia
Mental retardation
Abnormal dentition
Adenoid hyperplasia
Short stature
Cardiomegaly
Hepatosplenomegaly
```
44
Imaging findings of osteogenesis imperfecta often demonstrates the following
```
Osteopenia
Gracile bones often with bowing deformities
Pathological fractures
Large skull
Delayed ossification centers
Wormian bones
Kyphoscoliosis
```
45
What are 2 other names for osteoporosis?
Marble bone disease
| Albers-Schonberg disease
46
Those with a more severe form of osteopetrosis often suffers from what hematological condition?
Anemia due to lack of bone marrow
47
Characteristics of pyknodysostosis includes the following
```
Diffuse osteosclerosis
Below-average height
Frontal and occipital bossing
Hypoplastic mandible
Wormian bones
Acro-osteolysis at the distal tufts
```
48
What is the most common skeletal anomaly associated with Turner syndrome?
Shortened 4th metacarpal
49
What is the most common inflammatory arthritis?
Rheumatoid arthrits
50
Rheumatoid arthritis characteristically manifests with inter-phalangeal joint misalignments. Which name signs are associated with these deformities?
"Swan neck" deformity
"Boutonniere" deformity
"Hitch hiker's thumb" deformity
51
"Rat bite" erosions of rheumatoid arthritis are typically seen where?
The "bare areas" of the synovial joint that are unprotected by articular cartilage
52
What is one of the earliest signs of rheumatoid arthritis at the wrist?
Tendonitis of the wrist
53
Rheumatoid arthritis at the hip typically presents with the following
Bilateral and symmetric involvement
Axial migration of the femoral head
Bilateral acetabular protrusion is common
54
What are some common lung manifestations of rheumatoid arthritis?
```
Pleural involvement (most common, usually asymptomatic)
Pulmonary fibrosis
Constrictive bronchiolitis
Bronchiectasis
Pulmonary nodules
```
55
What is the required diagnosing criteria for Scheuermanns disease?
3 connective segments
| > 5% anterior wedging
56
The "malaria rash" is associated with what type of arthritis?
Systemic lupus erythematosus (SLE)
57
How are the joint spaces affected in SLE?
Typically joint spaces are not narrowed
58
Avascular necrosis is a common complication of SLE, which locations are most commonly involved?
Femoral head
Tibial condyle
Femoral condyle
Humeral head
59
Is there a gender predilection for SLE?
Females > males (7:1)
60
The majority of skeletal abnormalities seen in scleroderma is at which part of the skeleton?
Hands
61
What are some common imaging findings for scleroderma?
Soft-tissue atrophy
Osseous resorption
Subcutaneous calcification
62
What population have a higher rate of SLE?
African American women
63
What percentage of those with rheumatoid arthritis have cervical spine involvement?
80%
64
Scleroderma is caused by increased of what kind of deposit?
Collagen deposits
65
Which type of arthritis is associated with CREST syndrome?
Scleroderma
66
What are some common findings at the hands in an individual with scleroderma?
Atrophy of soft tissues of the fingertips (acral tapering)
Acro-osteolysis
Soft tissue calcification
67
Which other body system is frequently involved in scleroderma?
Gastrointestinal tract
| Involvement of the esophagus is seen in up to 85%
68
After the GI system, which other internal organ is most commonly involved in scleroderma?
Lungs
69
What is the age range in which we typically see development of scleroderma?
30-50 years old
70
Jaccoud arthritis (aka Jaccoud arthropathy/disease/syndrome) is a rare complication of what condition?
Rheumatic fever
71
Describe the arthropathy seen with Jaccoud syndrome
Nonerosive
Relatively asymptomatic
Deforming arthropathy of the hands and feet
72
What is another name for ankylosing spondylitis?
Marie-Strumpell disease
73
What is another name for diffuse idiopathic skeletal hyperostosis (DISH)?
Forestier disease
74
What is the classic site of initial involvement for ankylosing spondylitis?
Sacroiliac joints
75
What is the gender ratio for reactive arthritis?
15:1 (M > F)
76
Vertebral endplate destruction that manifests due to ankylosing spondylitis is called _____
Andersson lesion
| Mimics an infection
77
What are some appendicular sites of the skeleton that is affected by ankylosing spondylitis?
Hips
Shoulders
Knees
Small joints of the hands and feet
78
Lung fibrosis is seen predominantly in which lung zone when associated with ankylosing spondylitis?
Upper lobe interstitial fibrosis
79
What is the typical age of onset for ankylosing spondylitis?
Between 15-35 years old
80
Ankylosing spondylitis lab tests include testing positive for which marker?
HLA-B27
| Elevated ESR
81
"Mouse ear" erosions are associated with with type of arthritis?
Psoriatic arthritis
82
What is the main target site for psoriatic arthritis?
DIP joints of the hands
83
The "pencil in cup" deformity is associated with which type of arthritis?
Psoriatic arthritis
84
Which type of arthritis is known to cause involvement in a "ray pattern"?
Psoriatic arthritis
| Involvement of the DIP, MCP, PIP joints in a single finger
85
What is the most commonly involved site for reactive arthritis (aka Reiter syndrome)?
Feet (especially the calcaneus)
86
The onset of reactive arthritis usually occurs after how many weeks post GI/GU infection?
2-6 weeks
87
What is the most common organism associated with reactive arthritis?
Chlamydia trachomatis
88
Which tendon is usually involved in reactive arthritis?
Achilles tenosynovisits is the most common site of involvement
89
Gouty arthritis is caused by elevated levels of serum _____
Serum urate: uric acid
90
What are the 4 phases of gout?
Asymptomatic tissue deposition
Acute gouty arthritis
Intercritical gout
Chronic tophaceous gout
91
What are the 3 most common places for osteochondritis dessicans?
Knee: lateral aspect of medial femoral condyle (95%)
Talus: medial talar dome
Elbow: capitellum
92
What is Panner disease?
Osteochondrosis of the capitellum
93
In what age group do we see osteochondrosis?
Children and adolescents who are still growing
94
What is Sever disease?
Ostechondrosis of the calcaneus
95
What is Sinding-Larsen-Johansson disease?
Chronic traction injury at the proximal end of the infra-patellar tendon
96
What other condition is closely related to Sinding-Larsen-Johansson disease?
Osgood-Schlatter disease
97
Some people classify Sinding-Larsen-Johansson disease as the pediatric version of what other condition?
Jumper's knee
98
"Kissing contusions" at the medial aspect of the patella and lateral femoral condyle is associated with what traumatic event?
Patella dislocation
99
Why does osteochondritis dessicans (OCD) require an MRI referral?
Check for instability: if there is fluid surrounding the fragment, it is considered unstable
100
What is injured in the "unhappy triad of O'Donoghue"?
Anterior cruciate ligament
Medial meniscus
Medial collateral ligament
101
Spontaneous osteonecrosis of the knee (SONK) is most common seen in which location?
Lateral femoral condyle
102
Spontaneous osteonecrosis of the knee (SONK) is often associated with what other injury?
Meniscal tear
103
The Berndt & Harty classification system is used for what?
Osteochondral defects
104
Describe the 4 surgical categories of osteochondritis dessicans
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
What is another name for spontaneous osteonecrosis of the knee (SONK)?
Ahlback disease
106
Avascular necrosis of the radial head is called _____
Brailsford disease
107
Avascular necrosis at the heads of the metacarpals is called _____
Dietrich disease
108
Avascular necrosis at the head of the second metatarsal head is called _____
Frieberg disease
109
What is Friedrich disease?
Avascular necrosis of the medial clavicle
110
What is Hass disease?
Avascular necrosis of the humeral head
111
What is Iselin disease?
Avascular necrosis at the base of the 5th metatarsal
112
What is Keinboch disease?
Avascular necrosis at the lunate
113
Avascular necrosis at the navicular is called _____
Kohler disease (in a child)
114
Avascular necrosis at a vertebral body is called _____
Kummell disease
115
Avascular necrosis at the greater trochanter is called _____
Mandl disease
116
Avascular necrosis at the metacarpal heads is called _____
Mauclaire disease
117
Legg-Calve Perthes disease is avascular necrosis at what location?
Femoral head
118
Mueller-Weiss disease is avascular necrosis at what location?
Navicular (in an adult)
119
Piercer disease is avascular necrosis at what location?
Pubic symphysis
120
Avascular necrosis of the scaphoid is known as _____
Preiser disease
121
Describe the stages of the Berndt & Harty classification system of osteochondral injury of the talus
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
