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Image Interp > Metabolic & Endocrine Disorders > Flashcards

Metabolic & Endocrine Disorders Flashcards

1
Q

Normal bone quality, decreased bone quantity =

A

Osteoporosis

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2
Q

Females are affected by osteoporosis __:__ over males

A

4:1

(After 80, females = males)

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3
Q

Secondary causes of ____ include metastasis, multiple meyloma, alcoholism, endocrine disorders, etc.

A

OSteoporosis

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4
Q

Clinical presentation of ____ include:

  • Clinically silent
  • Increased kyphosis as disease progresses
  • Symptoms become apparent when there are fractures
A

Osteoporosis

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5
Q

Radiographs are ____ (good/not good) are grading osteoporosis

A

Not good

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6
Q

Radiographic findings of ____ include:

  • Osteopenia (on radiographs this is a descriptive term ie. less dense, DEXA scan it is diagnosis)
  • Loss of 2° stress trabeculae, accentuation of 1° trabeculae
  • Vertical striations in VBs (pseudohemangiomas)
  • Pencil thin cortices
  • Compression fractures (anterior wedge, fish vertebra)
A

Generalized Osteoporosis

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7
Q

What are is the likely cause of these findings?

(Normal on left)

A

Generalized Osteoporosis - CT w/ Fish Verterbra

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8
Q

What is the likely cause of these findings?

A

Generalized Osteoporosis - Accentuated Vertical Striations (pseudohamangiomas)

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9
Q

What is the likely cause of these findings?

A

Generalized Osteoporosis - Accentuated Vertical Striations, anterior wedging, and gas bubble

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10
Q

What is the likely cause of these findings?

A

Generalized Osteoporosis - Anterior compression fracture as a result of hyperkyphosis

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11
Q

What is the likely cause of these findings?

A

Generalized Osteoporosis - Ward’s Triangle

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12
Q

What is the likely cause of these findings?

A

Generalized Osteoporosis - Pencil thin cortices

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13
Q

What is the likely cause of these findings?

A

Generalized Osteoporosis - Insufficiency Fracture

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14
Q

____ is gold standard for osteoporosis diagnosis, ____ is most accurate but expensive

A

DEXA scan

Quantitative CT

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15
Q

____ is the most common cause of regional osteoporosis

Other causes are ___ & ____

A

Disuse (common following immobilization)

Complex Regional Pain Syndrome (CRPS) & Transient osteoporosis of hip (TROH)

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16
Q

Regional osteopenia can be seen within _____ in disuse regional osteoporosis, _____ following CRPS

A

7-10 days

3-4 months

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17
Q

What is the most likely cause of these findings?

A

Regional Osteoporosis - Disuse

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18
Q
  • Relatively normal bone quantity, poor bone quality
  • Results in soft bones

Imaging findings include:

  • Generalized osteopenia
  • Trabecular coarsening & indistinctness
  • Fracture deformites (fish vertebrae, Triradiate pelvis, kyphoscoliosis, etc.)
  • Pseudofractures (insufficiency fractures in unusual locations)
A

Osteomalacia

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19
Q

What is the most likely cause of these findings?

A

Osteomalacia - but NOT associated specifically, can be seen in any condition with decreased bone density (quantity, quality or both)

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20
Q

What is the most likely cause of these findings?

A

Osteomalacia - Pseudofractures

(Can also be seen in Padgets or Fibrous dysplasia)

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21
Q
  • Vitamin D related
  • Primarily a disease of growth plates (seen w/ osteomalacia)
  • Clinically, may see bowing deformities, overgrowth of cartilage near joints, “rachitic rosary”
A

Rickets

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22
Q

Image findings of ____ include:

  • “Paint brush” metaphysis
  • Splayed/cupping of metaphysis
  • Non-calcified zone of provisional calcification → widened growth plate
A

Rickets

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23
Q

What is the most likely cause of these findings?

A

Rickets - Non-calcific zone of provisional calcification & cupped appearance

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24
Q

What is the most likely cause of these findings?

A

Rickets - Paint brush metaphysis

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25
Q

What is the most likely cause of these findings?

A

Rickets - Rachitic Rosary

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26
Q

What is the most likely cause of these findings?

A

Rickets - Bowing Deformities

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27
Q

What is the most likely cause of these findings?

A

Scurvy

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28
Q

Dense zone of provisional calcification in scurvy =

A

White line of Frankel/scurvy

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29
Q

Well defined ring around epiphysis seen in scurvy =

A

Wimberger’s ring

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30
Q
  • Arise from metaphyseal margins
  • Due to collapse of the scorbutic zone
  • Seen in Scurvy
A

Pelken’s spurs

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31
Q

Lucent region adjacent to the zone of provisional Ca++ seen in scurvy

A

Scorbutic/Trummerfeld zone of attrition

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32
Q

What is the most likely cause of these findings?

A

Scurvy

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33
Q
  • Osseous changes seen following long term megadoses of Vitamin A
  • Vitamin A regulates osteoclastic and osteoblastic activity
  • Clinical findings include dermatitis, puritis, alopecia, and hepatosplenomegaly

Imaging findings include:

  • Osteopenia
  • Solid periosteal reaction
A

Hypervitaminosis A

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34
Q

What is the most likely cause of these findings?

A

Hypervitaminosis A (but there are many other differentials)

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35
Q
  • Soft tissue changes seen following long term mega doses of Vitamin D

Imaging Findings include:

  • Periarticular calcification (referred to as tumoral calcinosis bc large mass of calcification)
  • Renal & vascular calcification
A

Hypervitaminosis D

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36
Q

What is the most likely cause of these findings?

A

Hypervitaminosis D - Tumoral Calcinosis

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37
Q

Clinically can see abdominal pain, encephalopathy & paralysis

Imagining findings include:

  • Dense linear bands along the zone of provisional calcification
  • Wide sutures from brain swelling
A

Lead poisoning

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38
Q

What is the most likely cause of these findings?

A

Lead poisoning - sclerotic metaphyseal bands

39
Q

What is the most likely cause of these findings?

A

Lead poisoning - multiple sclerotic metaphyseal bands

40
Q
  • Secondary to excessive growth hormone secretion
  • In adults results In predominate soft tissue & membranous bone overgowth
  • In adolescence results in increased length of bone (gigantism)

Clinical findings include:

  • Broad, large hands/feet
  • Prominent forehead
  • Nerve compression syndromes
  • Arthritis
A

Acromegaly

41
Q

What is the most likely cause of these findings?

A

Acromegaly - Enlarged Sella Turcica

42
Q

What is the most likely cause of these findings?

A

Acromegaly - Enlarged frontal sinus

43
Q

What is the most likely cause of these findings?

A

Acromegaly - Spade like distal tufts

44
Q

What is the most likely cause of these findings?

A

Acromegaly - increased heel pad thickness

45
Q

Imaging findings of ____ include:

  • Generalized osteopenia is main finding
  • May see increase incidence of fractures
  • Physical findings include enlarged neck, rapid HR, weightloss, proptosis
A

Hyperthyroidism

46
Q

Clinical findings include:

  • Coarse dry skin & hair
  • Farigue, lethargy

Imaging findings include:

  • Delayed skeletal maturation (hallmark)
  • Wormian bones
  • Fragmented epiphyses
  • Sail vertebra w/ gibbous deformity
A

Hypothyroidism

47
Q

What is the most likely cause of these findings?

A

Hypothyroidism - Sail vertebra

48
Q

What is the most likely cause of these findings?

A

Hypothyroidism - Delayed skeletal maturation

49
Q
  • Females affected 3:1 over males
  • Peak age 30-50 years
  • Increased osteoclastic activity w/ fibrous tissue replacement
  • Hypercalcemia and hypophosphatemia
A

Hyperparathyroidism

50
Q

_____ hyperparathyroidism = due to overproduction of parathormone 2º to parathyroid adenoma

A

Primary

51
Q

_____ hyperparathyroidism = due to overproduction of parathormone 2º to chronic renal disease (most common)

A

Secondary

52
Q

____ hyperparathyroidism = seen in dialysis patients, long term renal disease; parathyroid gland acts independent of calcium levels

A

Tertiary

53
Q

Imagining findings of ____ include:

  • Osteopenia
  • Salt & pepper skull (granular appearance)
  • Rugger jersey spine
  • Resorption of lamina dura of mandible
  • Endplate irregularities
  • Widened SI joints & symphysis
A

Hyperparathyroidism

54
Q

What is the most likely cause of these findings?

A

Hyperparathyroidism - Salt & Pepper skull

55
Q

What is the most likely cause of these findings?

A

Hyperparathyroidism - loss of lamina dura

56
Q

What is the most likely cause of these findings?

A

Hyperparathyroidism - Rugger Jersey Spine

(Also small vessel calcification which = hyperparathyroidism or diabetes)

57
Q

Which is rugger jersey vs. sandwich vertebra?

A

Left = sandwich, Right = Rugger jersey

58
Q

What is the most likely cause of these findings?

A

Hyperparathyroidism - Subchondral bone resorption

59
Q

Subperiosteal resoprtion on the radial aspect of 2nd & 3rd middle phalanges is diagnostic for ____

A

Hyperparathyroidism

60
Q

Brown tumors (osteoclastoma)

  • Soap bubbly & expansile

are associated with what condition?

A

Hyperparathyroidism

61
Q

What is the most likely cause of these findings?

A

Hyperparathyroidism - Distal tuft resorption

62
Q

What is the most likely cause of these findings?

A

Hyperparathyroidism - Subperiosteal resorption

63
Q

What is the most likely cause of these findings?

A

Hyperparathyroidism

64
Q

What is the most likely cause of these findings?

A

Hyperparathyroidism - Browns tumor

65
Q

What is the most likely cause of these findings?

A

Hyperparathyroidsm - Small vessel calcification (differential = diabetes)

66
Q

What is the most likely cause of these findings?

A

Hyperparathyroidism - Tumoral Calcinosis (w/ small vessel calcification)

67
Q

What is the most likely cause of these findings?

A

Hyperparathyroidism - Chondrocalcinosis (depositional w/ secondary degenerative changes)

68
Q
  • Manifestations are due to decreased vascular integrity, particularly in lower extremitiy

Imagining findings:

  • Cellulitis, osteomyelitis & septic arthritis
  • Neuropathic arthropathies
  • Osteopenia
  • Vascular calcification (Monkeberg’s arteriosclerosis)
  • Vas deferens calcifcation
A

Diabetes

69
Q

What is the most likely cause of these findings?

A

Diabetes - Neuropathic Arthropathy (Septic Arthritis is differential)

70
Q
  • Can take on the follow patterns:
  • Hypertrophic
  • Atrophic
  • Mixed hypertrophic & antrophic pattern
A

Neuropathic anthropathy

71
Q

What is the most likely cause of these findings?

A

Diabetes - Neuropathic Arthropathy

72
Q

What is the most likely cause of these findings?

A

Diabetes - Smal vessel calcification (differential = hyperparathyroidism)

73
Q

What is the most likely cause of these findings?

A

Diabetes - cellulitis

74
Q

What is the most likely cause of these findings?

A

Diabetes - Vas Deferens calcification

75
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