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[PBR] MSK Radiology > Metabolic Bone Disease > Flashcards

Metabolic Bone Disease Flashcards

1
Q

defined as diminished bone quantity in which the bone is otherwise normal

A

osteoporosis

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2
Q

bone quantity is normal but the quality of the bone is abnormal in that it is not normally mineralized

A

osteomalacia

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3
Q

results in excess nonmineralized osteoid

A

osteomalacia

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4
Q

most common cause of osteoporosis

A

aging

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5
Q

Main radiographic finding in osteoporosis is

A

Thinning of cortex

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6
Q

Osteoporosis is most reliably demonstrated in what bone

A

Second metacarpal at the middiaphysis

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7
Q

Normal metacarpal cortical thickening should be approximately

A

1/4 to 1/3 the thickness of the metacarpal

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8
Q

Measurement of bone mineral content for the purposes of predicting fracture risk and monitoring response to therapy is usually done by means of _______ which compares a patient’s bone mineral density of the spine and hip wirh that of a healthy 30 year old adult

A

Dual-energy x-ray absorptiometry (DXA)

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9
Q

True or false: calcium additives have not been shown to reverse the process of primary osteoporosis

A

True

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10
Q

Can alleviate postmenopausal osteoporosis

A

Estrogen

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11
Q

Drugs that inhibit osteoclastic acitvity and thus slow bone loss and are commobky prescribed to treat osteoporosis and to prevent bony complications related to osseous metastatic disease as they reduce fracture risk

A

Biphosphonate drugs

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12
Q

A type of osteoporosis that can be seen in a patient of any age is

A

Disuse osteoporosis

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13
Q

Radiographic appearance of disuse osteoporosis that is due to osteoclastic resorption in the cortex causing intracortical holes

A

Patchy appearance of bone

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14
Q

Form of osteoporosis that can mimic a permeative lesion because of multiple cortical holes that project over the medullary space, thus resembling a medullary permeative process

A

Aggressive osteoporosis

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15
Q

2 Other causes of pseudopermeative process aside from disuse osteoporosis

A

Hemangioma and radiation

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16
Q

Hemangioma can cause cortical holes in 2 ways, namely

A

From focal hyperemia causing focal osteoporosis or by the blood vessels themselves tunneling through the cortex

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17
Q

Radiation can cayse cortical holes in bone and mimic a permeative process because of

A

Death of cortical osteocytes, which can enlarge lacunae in the cortex

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18
Q

3 Differential diagnosis of permeative lesion in young people (<30 yo)

A

Ewing sarcoma, infection, eosinophilic granuloma

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19
Q

3 Differential diagnosis of permeative lesion in older patients

A

Multiple myeloma, metastatic carcinomatosis, primary lymphoma of bone

MML

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20
Q

Result of too much nonmineralized osteoid

A

Osteomalacia

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21
Q

Most common cause of osteomalacia

A

Renal osteodystrophy

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22
Q

Only finding that is pathognomonic for osteomalacia is a

A

Looser fracture

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23
Q

Fracture through large osteoid seams

A

Looser fracture

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24
Q

Looser fracture tend to occur in what body parts (3)

A

Femur, pelvis, scapula

FPS

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25
Q

Osteomalacia in children is called

A

Rickets

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26
Q

Causes epiphyseal playes to become flared and irregular and the long bones to undergo bending from bone softening

A

Rickets

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27
Q

Occurs from excess parathyroid hormone

A

Hyperparathyroidism

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28
Q

Hormone that causes osteoclastic resorption in bone, which leads to osteoporosis and osteomalacia

A

Parathyroid hormone

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29
Q

Primary HPT are caused by

A

Parathyroid adenomas and hyperplasia

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30
Q

Most common cause of HPT is from

A

Renal disease

31
Q

Radiographic sign that is Pathognomonic for HPT is

A

Subperiosteal bone resorption

32
Q

Subperiosteal bone resorption in HPT is seen most commonly on the (3)

A

MRS

  • Radial aspect of middle phalanges of the hand,
  • medial aspect of proximal tibia and
  • subchondral bone resorption at sacroiliac joints
33
Q

Rugger jersey spine is seen in

A

Hyperparathyroidism

34
Q

Cystic lesions in hyperparathyroidism that are often expansile and aggressive in apearance

A

Brown tumors

35
Q

2 Few skeletal changes seen in hypoparathyroidism

A

Calvarial thickening and calcification in the basal ganglia

36
Q

Caused by congenital failure of tissues to respond to PTH. Parathyroid glands are normal in these cases

A

Pseudohypoparathyroidism

37
Q

4 Characteristic appearance of patients with pseudohypoparathyroidism

A

Obesity, round facies, short stature and brachydactyly

38
Q

Hypothyroidism is a ______ problem, pseudohypoparathyroidism is a ______ problem, and pseudopseudohypoparathyroidism is a ____

A

Hypothyroidism- parathyroid gland problem
Pseudohypoparathyroidism- end organ problem
Pseudopseudohypoparathyroidism is a mimicker of pseudohypoparathyroidism morphologically

39
Q

A secreting adenoma or hyperplasia of the anterior lobe of the pituitary gland will result in

A

Accelerated bone growth

40
Q

3 Skull findings in acromegaly

A

Calvarial thickening, enlarged sinuses, enlarged sella turcica

41
Q

Appearance of jaw in acromegaly

A

Prognathic

42
Q

Terminal tufts of distal phalanges in acromegaly appears as

A

Spade appearance/shovel

43
Q

Has been used as a sign of acromegaly

A

Thickening of heel pad adjacent to calcaneus

44
Q

Rare manifestation of hyperthyroidism that occurs only after prior thyroidectomy

A

Thyroid acropachy

45
Q

Useful differential point that can be used to tell thyroid acropachy from other causes of diffuse periostitis

A

Periostitis involving the ulnar aspect of fifth metacarpal

46
Q

Decreased thyroid secretion

A

Cretinism

47
Q

Epiphyses appears stippled in this metabolic disease

A

Thyroid gland hypofunction or cretinism

48
Q

Diffuse increase in bone density

A

Osteosclerosis

49
Q

By far most common disease in which osteosclerosis is seen

A

Renal osteodystrophy

50
Q

The sine qua non of renal osteodystrophy is

A

Subperiosteal bone resorption

51
Q

Subperiosteal bone resorption in renal osteodystrophy is reliably seen at the

A

Radial aspect of middle phalanges of hands

52
Q

Fish vertebrae is seen in

A

Sicke cell disease

53
Q

Bone infarcts and step-off deformities of vertebral body endplates, avascular necrosis of the hip are seen in

A

Sickle cell disease

54
Q

Also called angogenic myeloid dysplasia, it is caused by progressive fibrosis of the marrow in patients older than 50 years of age

A

Myelofibrosis

55
Q

Myelofibrosis leads to

A

Anemia with marked splenomegalynand extramedullary hematopoiesis

56
Q

Hereditary abnormality that results in extremely dense bones throughout the skeleton

A

Osteopetrosis

57
Q

2 forms of osteopetrosis

A

Congenita and tarda

58
Q

Form of osteopetrosis that can be lethat

A

Congenita

59
Q

Form of osteopetrosis that is milder

A

Tarda

60
Q

Characteristic finding is bone-in-bone appearance often seen in the vertebral bodies in which vertebrae have a small replics of the vertebral body inside the normal one

A

Osteopetrosis

61
Q

Sandwich vertebrae is seen in

A

Osteopetrosis

62
Q

Sandwich vertebrae in osteopetrosis can be differentiated from rugger jersey spine in rickets by noting that

A

The bands of sclerosis in sandwich vertebrae are denser

63
Q

Other congenital abnormality with dense bomes that shoild be considered in the differential diagnosis of osteosclerosis. These patients are typically short and have hypoplastic mandibles

A

Pyknodysostosis

64
Q

Distinguishing radiographic finding of pyknodysostosis

A

Acroosteolysis with sclerosis

acro = point; osteo = bone; lysis = dissolve

65
Q

In this condition, the distal phalanges often have the appearance of chalk that has bern put into a pencil sharpener

A

Pyknodysostosis

66
Q

Pyknodysostosis is aka

A

Toulouse-Lautrev syndrome

67
Q

Can cause uniformly increased bone density, thickened small bowel folds with nodules and urticaria pigmentosa

A

Mastocytosis

68
Q

Paget’s disease classically causes

A

Bony enlargement

69
Q

Paget’s disease commonly occur in

A

Pelvis, with thickened iliopectineal line on pelvic brim

70
Q

3 Distinct radiographic phases of Paget’s disease

A

Lytic, sclerotic and mixed lytic and sclerotic phase

71
Q

Lytic phase of Paget disease usually present as

A

Sharp leading edge called flame-shaped or blade-of-grass leading edge

72
Q

In a long bone, with sole exception of the tibia, Paget disease always starts at the

A

End of bone

73
Q

Radiographic finding that patients with fluorosis often have is

A

Ligamentous calcification

74
Q

Calcification of sacrotuberous ligament is said to be characteristic of

A

Fluorosis

[PBR] MSK Radiology (12 decks)

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