Lower Limb 1 Flashcards
Bipartite patella
Failure of complete ossification can result in isolated segments
- small fragment at the superolateral patella
Differentiate between fracture and bipartite patella
- No sclerotic changes
- smooth bony margins
- Location at superolateral patella
Osteogenesis Imperfecta
4 major Diagnosis criteria
- Osteoporosis with abnormal fragility
- Blue Scelera with white Saturn’s ring
- Abnormal dentition (Dentinogenesis Imperfecta
- Premature otosclerosis resulting in deafness
Radiographic finding for osteogenesis imperfecta
Knee joint:
- Pencil-thin or ‘gracile’ corticles (cortex) **
- Indistinct trabecular bone
- Overal impression of severe osteopenia
Skull:
Basillar impression indicate platybasia
Lower leg:
- Bowing Deformities **
- Multifocal bulcous deformity / Enlargement of long bones = callus formation **
Hip joint:
- Protusio acetabuli **
- Deformity of pelvic rim due to osteopenia
- possibility of fracture
Spine lateral view:
- Codfish vertebra (biconcave vertebra body) **
- pencil-thin cortex **
Features to differentiate osteogenesis imperfecta from non-accidental trauma (abuse) include
- the presence of osteopenia
- bowing or remodeling of bones
- the presence of Wormian bones
Osteopetrosis
rare disorder that causes bones to grow abnormally and become overly dense
Radiographic features for Osteopetrosis
SPINE—several presentations
* Sandwich vertebra w/ dense endplates **
* Bone-within-a-bone **
* Uniformly dense
* Complications: Path spondylolysis, spinal stenosis w/ myelopathy
LONG BONES
* Club-shaped osteosclerotic metaphysis***
* Homogenous sclerosis–without distinction between cortical/cancellous bone
* Bone-within-a-bone appearance
SKULL
* Bone-within-a-bone esp. occiput, sphenoid
* Macrocephaly, hydrocephaly, prognathism
Osteoarthritis of knee
Mostly affect medial knee joint (narrowed) and cause bow-leg (genu varum or valgum bowing)
Marginal osteophytes
Subchondral sclerosis
Sharpened tibial eminences
Chondromalacia Patellae
the softening and breakdown of the tissue (cartilage) on the underside of the kneecap (patella)the softening and breakdown of the tissue (cartilage) on the underside of the kneecap (patella)
Osteomalacia means softening of bone
Synoviochondrolmetaplasia
Synovial tissue undergoing metaplastic transformation to produce foci of cartilage
cause multiple loose bodies within the joint
male more common than female, common site at knee joint
Radiographic features or synoviochondrolmetaplasia
Maybe normal if the loose bodies are not calcified or ossified
If calcified or ossified
Loose bodies
- Round to ovoid, smooth faceted, laminated or stippled, may have internal trabeculae
a lot loose bodies called joint mice
Radiographic features for Rheumatoid Arthritis
- Joint effusion
- Tri-compartmental cartilage loss (Hallmark)
- Marginal erosion
- Baker’s cysts - frequent complication
CPPD radiographic features
- chondrocalcinosis
rheumatic disease characterized by the excessive accumulation of calcium crystals in the cartilage of joints - co-existing or isolated unusual compartmental involvement
Pellegrini-Stieda and its radiographic features
Hydroxyapatite deposition disease (HADD)
ossifications of the medial collateral ligament (MCL) at or near its proximal insertion on the medial femoral condyle
Features:
Linear or curvilinear like ossification adjacent to the medial femoral condyle, which is the site of proximal insertion of the medial femoral collateral ligament usually following trauma
2 types of Osteochondritis Dessicans
In situ
* Arc like radiolucent cleft
* Opposed and aligned fragment
Displaced
* Concave defect at site of origin
* Displaced fragment (may resorb)
Giant Cell Tumour
Subarticular eccentric lytic expansile geographic lesion with a narrow zone of transition but no sclerotic margin
