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Bone/MSK > Lists To Memorise > Flashcards

Lists To Memorise Flashcards

1
Q

Generalised increased bone density (adult)

A
  1. Met (eg: prostate, breast)
  2. Sickle cell disease
  3. Myelofibrosis
  4. Paget’s disease
  5. Renal osteodystrophy
  6. Osteopetrosis
  7. Systemic mastocytosis
  8. Hypoparathyroidism
  9. Myeloma
  10. Fluorosis
  11. Progressive diaphyseal dysplasia
  12. Pyknodysostosis
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2
Q

Mnemonic - diffuse bony sclerosis

3 M’s PROOF

A 
Malignancy (osteoblasts met, lymphoma, leukaemia)
Myelofibrosis 
Mastocytosis 
Sickle cell disease 
Pager disease/Pkknodysotosis 
Renal osteopeniadystrophy 
Osteopetrosis 
Other (hypoparathyroidism, hyperthyroidism, sclerotic dysplasia, athletes)
Flurosis
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3
Q

Mnemonic - protrusion acetabuli

My PROTRUSIO

A

Marfan syndrome
Paget disease & Primary protrusio acetabuli
Rheumatoid arthritis
Osteogenesis imperfecta
Trauma
Ricket
Unknown (idiopathic)
S = (p)soriatic arthritis / sickle cell anaemia
Inflammatory arthritis (eg: ankylosing spondylitis) / Infection
Osteomalacia

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4
Q

Mnemonic - Rickets

RICKETS

A 
Reaction of periosteum
Indistinct cortex
Coarse trabeculation
Knee, wrist, ankle mainly
Epiphyseal plates widening and irregular 
Tremendous metaphysis 
Spur (metaphyseal)
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5
Q

Solitary sclerotic bone lesion

A
  1. Bone island (enostosis)
  2. Enchondroma
  3. Metastasis
  4. Callus
  5. Bone infarct
  6. Paget’s disease
  7. Osteoma
  8. Osteoid osteoma / osteoblastoma
  9. Fibrous dysplasia
  10. Chronic osteomyelitis
  11. Healed / healing bone lesion
  12. Primary bone sarcoma
  13. Lymphoma
  14. Cement and bone graft substitutes
  15. Chronic recurrent multifocal osteomyelitis (CRMO)
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6
Q

Multiple sclerotic bone lesion

A
  1. Met
  2. Multiple healed bone lesion
  3. Paget’s disease
  4. Multiple bone infarcts
  5. Multiple stress fractures (callus formation)
  6. Lymphoma
  7. Osteopoikilosis
  8. Multifocal osteosarcoma
  9. Multiple osteomas (Gardner syndrome)
  10. Fibrous dysplasia
  11. CRMO, SAPHO
  12. Osteopathia striata (Voorhoeve disease)
  13. Erdheim-Chester disease
  14. Multiple myeloma
    15 Tuberous sclerosis
    16 Intramedullary osteosclerosis
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7
Q

Bone sclerosis with periosteum reaction

A
  1. Healing fracture
  2. Met
  3. Osteoid osteoma/osteoblastoma (Solid/lamellated periosteal reaction)
  4. Chronic osteomyelitis (look for sequestrum)
  5. Osteosarcoma (classically sunray spiculation)
  6. Ewing sarcoma (onion-skin/lamellated periosteal reaction)
  7. Chondrosarcoma (Chondroid matrix with endochondral ossification)
  8. Lymphoma
  9. CRMO
  10. SAPHO - similar to CRMO but in adult (anterior chest wall and pelvic involvement predominate)
  11. Infantile cortical hyperosteosis (Coffey’s disease)
  12. Melorheostosis
  13. Tertiary syphillis
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8
Q

Coarse trabecular pattern

A 
Paget’s disease 
Osteoporosis 
Osteomalacia 
Haemoglobinopathies
Haemangioma
Gaucher disease
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9
Q

Solitary sclerotic bone lesion with a lucent centre

A
  1. Osteoid osteoma / osteoblastoma
  2. Brodie’s abscess
  3. Medullary bone infarct
  4. Stress fracture
  5. Looser’s zone of osteomalacia
  6. Liposclerosing myxofibrous tumour (intertrochanteric region of femur)
  7. TB
  8. Syphillis
  9. Yaws
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10
Q

Skeletal met

A
  • 80% from prostate, breast, lung, kidney
  • mainly involves the axial and proximal appendicular skeleton (red marrow)
  • met to distal appendicular bone are rare (usually from lung/breast)

Lytic:

  1. Lung
  2. Breast (can be sclerotic/mixed)
  3. Myeloma
  4. Nonmucinous adenocarcinoma of GI
  5. Most other primary sources

Sclerotic:

  1. Prostate
  2. Breast (particularly post treatment)
  3. Carcinoid
  4. Mutinous adenocarcinoma of GI
  5. TCC
  6. Small cell lung cancer
  7. Lymphoma

Lytic and expansive:

  1. RCC
  2. Thyroid
  3. HCC
  4. Melanoma
  5. Phaeochromocytoma

Mixed:

  1. Breast
  2. Lung
  3. Lymphoma
  4. Cervix
  5. Testis
  6. TCC
  7. Melanoma
  8. Neuroblastoma (in children)
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11
Q

Lucent bone lesion - well-defined, sclerotic margin

A
  1. Non-ossifying fibroma
  2. Bone cyst
  3. Fibrous dysplasia
  4. Chondroblastoma
  5. Brodie’s abscess
  6. Healing met or primary malignant bone
  7. Osteoblastoma
  8. Intraosseous lipoma
  9. Liposclerosing myxofibrous tumour
  10. Adamantinoma / osteofibrous dysplasia (OFD)
  11. Chondromyxoid fibroma
  12. Haemophilic pseudotumour
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12
Q

Lucent bone lesion - well-defined, non-sclerotic margin

A
  1. Met
  2. Myeloma / plasmacytoma
  3. Low grade chondral lesion
  4. Giant cell tumour
  5. Simple/aneurysmal bone cyst
  6. Eosinophilia granuloma
  7. Brown tumour
  8. Lytic phase of Paget’s disease
  9. Desmoplastic fibroma
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13
Q

Lucent bone lesion - poorly defined margin

A
  1. Met
  2. Myeloma
  3. Osteomyelitis (in acute phase)
  4. Bone lymphoma (with soft tissue mass)
  5. Primary bone sarcoma
  6. Eosinophilia granuloma
  7. Giant cell tumour
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14
Q

Grossly expansive lucent bone lesion

A
  1. Plasmacytoma
  2. Metastases
  3. Aneurysmal bone cyst
  4. Giant cell tumour
  5. Telangiectatic osteosarcoma
  6. Fibrous dysplasia
  7. Brown tumour
  8. Hemangioma
  9. Chordoma
  10. Haemophilic pseudotumour
  11. Slow growing central bone sarcoma
  12. Hydrated cyst
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15
Q

Lucent epiphyseal bone lesion

A
  1. Lesions related to joint pathology (eg: geode, intraosseous ganglion, erosion, osteochondral defect, PVNS)
  2. Giant ell tumour (*nonsclerotic margin)
  3. Chondroblastoma
  4. Infection
  5. Location-specific lesions (intraosseous lipoma, simple bone cyst, osteoblastoma in talus)
  6. Clear cell Chondrosarcoma (mimic chondroblastoma but in pt >20yo)
  7. Bone lesions that can occur anywhere (met, brown tumour, lymphoma, myeloma, haemophilic pseudotumour)
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16
Q

Lucent bone lesion containing calcium or bone

A
  1. Enchondroma
  2. Osteoid osteoma & osteoblastoma
  3. Avascular necrosis & bone infarct
  4. Met
  5. Chondroblastoma (chondroid matrix, epi)
  6. Chondrosarcoma (chondroid matrix. Metaphyseal)
  7. Osteosarcoma (osteoid matrix, meta)
  8. Fibrous dysplasia (GG or sclerotic)
  9. OM with sequestrum
  10. Eosinophilia granuloma (button sequestrum)
  11. Intraosseous lipoma
  12. Haemangioma (coarseness trabeculae)
  13. Liposclerosing myxofibrous tumour
  14. Fibrosarcoma / undifferentiated pleomorphic sarcoma
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17
Q

Exophytic and juxtacortical bone lesions

A
  1. Callus
  2. Osteochondroma
  3. Heterotopic ossification and myositis ossifican
  4. Surface osteosarcoma
  5. Periosteal Chondrosarcoma / Chondrosarcoma
  6. Cortical Desmoid
  7. Parosteal lipoma
  8. Bizarre parosteal osteochondromatous proliferation (BPOP)
  9. Trevor’s disease
  10. Melorheostosis
  11. Osteoma
  12. Subperiosteal abscess
  13. Subperiosteal haemorrhage
  14. Periarticular lesions
  15. Other rare lesions not specific to this site eg: met, subperiosteal osteoid osteoma, ABC
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18
Q

Moth-eaten bone in adult

Multiple scattered licences of variable size with no major central lesion

A
  1. Met
  2. Multiple myeloma
  3. Bone sarcoma
  4. Bone lymphoma
  5. Osteomyelitis
  6. Osteoporosis
  7. Langerhans cell histocytosis
  8. Hyperparathyroidism
19
Q

Regional osteopenia

A
  1. Disuse
  2. Complex regional pain syndrome (typically unilateral upper limb)
  3. Inflammatory arthropathy
  4. Septic arthritis
  5. Haemophilic arthropathy
  6. Soft tissue AVM
  7. Regional migratory osteoporosis
  8. Transient osteoporosis of hip
20
Q

Generalised osteopenia

A
  1. Osteoporosis
  2. Diffuse infiltration bone disease eg: MM, leukaemia
  3. Osteomalacia/rickets
  4. Hyperparathyroidism
21
Q

Osteoporosis - radiologic findings

2.5 standard deviation below peak bone mass

A
  1. Increased radiolucency of bone
  2. Cortical thinning
  3. Prominent secondary trabeculae
  4. Vertebral fractures
  5. Insufficiency fractures
22
Q

Osteoporosis - causes

A

Primary

  1. Post-menopausal
  2. Age-related
  3. Juvenile

Secondary

  1. Endocrine
  2. Disuse
  3. Iatrogenic
  4. Deficiency states (vit C, protein, chronic renal/liver disease)
  5. Chronic and systemic disease
  6. Congenital (osteogenesis imperfecta, Turner syndrome, glycogen storage disease, trisomy 13 & 18)
23
Q

Osteomalacia & ricket

A
  1. Vitamin D deficiency
  2. Renal disease (glomerular or tubular disease)
  3. Hepatic disease
  4. Anticonvulsant (phenytoin)
  5. Tumour associated (paraneoplastic phenomenon)

Mimics:

  1. Hypophosphatasia
  2. Metaphyseal chondrodysplasia

In infant < 6mo

  1. Biliary atresia
  2. Metabolic bone disease of prematurity
  3. Hypophosphatasia
  4. Vitamin D dependent rickets
24
Q

Periosteal reaction - continuous with destroyed cortex

A

-seen in an expansile lesion (see expansile bone lesion list)

25
Q

Periosteal reaction - parallel spiculated (‘hair on end’)

A
  1. Ewing sarcoma
  2. Infantile cortical hyperostosis
  3. Syphilis
26
Q

Periosteal reaction - Divergent spiculated ‘sunray’

A
  1. Osteosarcoma
  2. Met
  3. Ewing sarcoma
  4. Haemangioma
  5. Meningioma
  6. Tuberculosis
  7. Tropical ulcer (foot and lower leg)
27
Q

Periosteal reaction - Codman triangle (single lamina or lamellated)

A
  1. Aggressive malignant bone tumour

2. Osteomyelitis

28
Q

Periosteal reaction - solitary and localised

A
  1. Trauma
  2. Insufficiency & stress fracture
  3. Inflammatory
  4. Neoplastic
29
Q

Periosteal reaction - bilaterally symmetrical in adult

A
  1. HOA - hypertrophic osteoarthropathy
  2. Vascular insufficiency
  3. Thyroid acropachy
  4. Pachydermoperiostosis
  5. Fluorosis
  6. Hypervitaminosis A
30
Q

Periosteal reaction - bilaterally aysmmetical

A
  1. Met
  2. OM
  3. Reactive and psoriatic arthritis
  4. Non accidental injury
  5. Osteoporosis
  6. Osteomalacia
  7. Bleeding diathesis
  8. Sickle cell dactylitis (due to infarction of persistent red marrow in long bone)
31
Q

Hypertrophic osteoarthropathy

A 
Primary: pachydermoperiostosis 
Secondary: 
1. Lung cancer 
2. Bronchiectasis 
3. Lung met
  1. Other pleuropulmonary causes (pleural fibroma, mesothelioma, COPD, pulmonary fibrosis, sarcoidosis, chronic infection, pulmonary AVM)
  2. GI disorder (irritable bowel disease, coeliac disease, Whipple’s disease)
  3. Cyanosis congenital heart disease
  4. Cirrhosis and hepatobiliary malignancies
  5. Other malignancies
32
Q

Excessive callus formation

A
  1. Hypertrophic fracture nonunion
  2. Neuropathic arthropathy
  3. Steroid therapy and Cushing’s syndrome
  4. Osteogenesis imperfecta
  5. Paralysis
  6. Renal osteodystrophy
  7. Multiple myeloma
  8. NAI in children
33
Q

Osteonecrosis / AVN

A
  1. Corticosteroid
  2. Alcohol
  3. Idiopathic eg: Perthes disease in kids
  4. Fractures
  5. Chemotherapy
  6. Haemoglobinopathies
  7. Radiotherapy
  8. Metabolic and endocrine
  9. Connective tissue disease eg: SLE, RA, scleroderma
  10. Toxic eg: immunosuppressive, NSAIDs
  11. Haemopoietic disorders eg: haemophilia, polycythaemia vera
  12. Thrombotic and emboli eg: vasculitis, fat embolism
  13. Others: pancreatitis, severe burb, amyloidosis
34
Q

Erosion of medial metaphysis of proximal humerus

A
  1. Normal variant
  2. Chronic rotator cuff tear
  3. Hyperparathyroidism (subperiosteal resorption)
  4. Rheumatoid arthritis
  5. Malignancy: leukaemia, metastases
  6. Lysosomal storage disorder
35
Q

Erosion or absence of outer end of clavicle

A
  1. Post-traumatic osteolysis
  2. Post-operative
  3. Rheumatoid arthritis
  4. Malignancy eg: myeloma, met
  5. Septic arthritis
  6. Hyperparathyroidism (typically bilateral and symmetrical)
  7. Gout
  8. Scleroderma (juxtaarticular soft tissue calcification)
  9. Pyknodysostosis
  10. Cleidocranial dysplasia
36
Q

Madelung deformity

A

Primary: congenital, often associated with Vicker’s ligament

  • short bowed distal radius with increased radiocarpal angle
  • long dorsally subluxed ulna
  • V-shaped proximal carpal row

Secondary:

  • growth arrest following radial growth plate injury or infection
  • multiple hereditary exostoses
  • Turner syndrome
  • Achondroplasia
  • Leri-Weill dyschondrosteosis
37
Q

Carpal fusion

A

Congenital:

  • normally isolated to same carpal row
  • lunate-triquetral; capitate-hamate; trapezium-trapezoid

Syndrome-related:
-affect bones in different rows

Acquired:

  1. inflammatory arthritides (eg: juvenile idiopathic arthritis and RA)
  2. Pyogenic arthritis
  3. Chronic tuberculous arthritis
  4. Post-traumatic
  5. Post-surgical
38
Q

Short metacarpal or metatarsal

A
  1. Idiopathic
  2. Post-traumatic
  3. Post-infarct
  4. Turner syndrome
  5. Pseudo and pseudopseudohypoparathyroidism (4th & 5th metacarpal)
39
Q

Arachnodactyly

Spider finger

A
  1. Marfan syndrome
  2. Normal variant
  3. Ehlers-Danlos syndrome
  4. Klinefelter syndrome
  5. Homocystinuria
  6. MEN 2B
  7. Myotonic dystrophy
40
Q

Distal phalangeal destruction

A

Resorption of tuft (acroosteolysis):

  1. Scleroderma (soft tissue thinning and calcification)
  2. Raynaud disease & SLE
  3. Psoariatic arthropathy
  4. Hyperparathyroidism (subperiosteal resorption)
  5. Trauma (burns, frostbite)
  6. Peripheral neuropathy (diabetes, leprosy)
  7. Other arthritides (juvenile idiopathic arthritis, reactive arthritis)
  8. Other skin disorders (dermatomyositis …)
  9. Phenytoin toxicity
  10. Snake and scorpion venom
41
Q

Lytic lesions of the phalanges

A

Poorly defined:

  1. OM (also consider TB, sickle cell, syphilitic dactylitis)
  2. Met

Well-defined:

  1. Enchondroma
  2. Joint based lesions eg: geode, erosion
  3. Implantation epidermoid (palmar scalloping, distal phalanx only)
  4. Glomus tumour (dorsal scalloping, distal phalanx only)
  5. Sarcoidosis (multiple well-defined lace-like lytic lesion)
  6. Others not specific to this location: fibrous dysplasia, ABC, GCT, SBC, brown tumour, LCH, fibrous cortical defect)
42
Q

Fluid-fluid level in bone lesion (CT/MRI)

A

Benign:

  1. ABC
  2. Chondroblastoma
  3. Giant cell tumour
  4. Simple bone cyst
  5. Fibrous dysplasia

Malignant:

  1. Telangiectatic osteosarcoma
  2. Any necrotic bone tumour
43
Q

Osteonecrosis - mnemonic

A

PLASTIC RAGS

Pancretitis
Lupus
Alcohol abuse
Steroid
Trauma
Idiopathic including Perthes
Connective tissue/collagen disease
Radiation therapy/Rheumatoid
Amyloidosis
Gaucherie disease
Sickle cell anaemia

Bone/MSK (2 decks)

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