MS I Flashcards
When examining xrays remember to think what ?
Think 3-dimensionally
but reminder everything is flat though in a 2 dimensional pancake
Most series of skeletal system come with an ?
AP and lateral view
direction of the beam that is going through an object
Particular views may be added to look at a specific _________ or for a specific __________
structure
pathology
**wrist pain, pain in anatomic snuff box = scaffold fracture - not a hard bone to look at it is is a funny place. Might want to get a PA lateral wrist or even an additional scaffold view **
transverse fracture ?
straight across
oblique fracture ?
diagonal
comminuted fracture ?
in pieces
avulsion fracture ?
“pull away” - tendons connect muscle to bone - when a tendon pulls away from bone and a piece of bone fragment will come with it
avulsion- “pull away” - tendons connect muscle to bone - when a tendon pulls away from bone and a piece of bone fragment will come with it
impacted fractures ?
jumping from a height - crush injury in the middle of the bone
greenstick fracture ?
little kid bones - force injury it will break on one side but the other just bows
Pathologic fracture ?
associated with disease - fracture would not happen if disease wasn’t there - this is probably CA, distal humeral head transverse fracture
Angulation ?
extent to which fracture fragments are not anatomically aligned
in a angular fashion
Convention ?
describe angulation as the direction the apex is pointing relative to anatomical long axis of the bone (e.g. apex medial, apex valgus) or direction of distal fragment
Fatigue fracture ?
happen with normal bone, a NL bone under a lot of stress, foot of a marathon runner, boot camp
Insufficiency fracture ?
happen in abnormal bone that would not happen in normal bone - osteoporosis of the spine having a compression fracture
Recognizing a fracture by what findings?
Break in the continuity of cortex
Radiolucent fracture lines
Overlap of cortical and spongy bone (more white)
Unexplained fragments of bone
Denser area of impaction - looks like a fuzzy halo
Callus of a healing fracture
Fracture healing stages?
Inflammatory phase
Reparative phase
Remodelling phase
Inflammatory phase appears ?
Hours to days
Reparative phase appears when ?
Days to weeks
Remodelling phase appears when ?
Months to years
Inflammation phase ?
soon after a fracture occurs a hematoma forms at the injury site. Marcophages and inflammatory leukocytes move into the dmaaged area to scavenge debris and begin producing the pro-inflammatory agent that initiate healing
Soft Callus ?
inflammatory triggers call divison and the growth of new blood vessels. Among the new cells, chondrocytes secrete proteoglycans, creating fibrocartilage that forms the soft callus
**inflammation starts to trigger some bone repair
Hard Callus ?
Through endochondral ossification and direct bone formation, woven bone replaces the soft callus to create a hard callus around the broken fragments of bone
**and a hard callus and remodeling can last months to years **
Remodeling ?
Overtime, mechanically strong, highly organized cortical bone replaces the weaker disorganized woven bone. Because it is continually remodeled, bone is the only tissue to heal w/o a scar
**and a hard callus and remodeling can last months to years **
________ have a remarkable remodeling capability
children
Dislocation ?
Dislocated from correct position
no communication with the joint surface
Subluxation ?
Partially dislocated
Osteomyelitis - Bony destruction: Lytic lesion ?
lysed - cut away ( radiolucent area on an xray)
Osteomyelitis - Bony destruction: +/- expansile ?
it look slike some remodeling or callus formation - it is just inflammation from the body response
Osteomyelitis - Bony destruction: +/- sclerotic margin ?
body is trying to defend against infection
Osteomyelitis - Bony destruction: +/- periosteal reaction ?
inflammation of the periosteum as well
if you suspected infection in bone it it is important to get an X ray to document the status of the bone ( in a few weeks they come back in then have a comparison to see, it takes about ?
2 weeks for it to show if the bone had been infected )
CRP , ESR ?
sed rates - inflammatory markers are good for osteomyelitis
With Osteomyelitis, bony destruction appears ?
2 weeks after infection
Osteoarthritis ?
NOSS
Narrowing of joint space
no more cartilage layer
Sclerosis of the joint
Osteophyte formation -
spurring of bone off the side of the joints
Small cysts in the bone near the joint - little tiny and more radiolucent areas
just from wear and tear
Rheumatoid Arthritis ?
Soft tissue swelling
Osteoporosis
Narrowing of the joint space
Marginal erosions
Wrists can be fused in advanced cases
**AI process - own body creatingABS TOWARD JOIT SPACE , a lot of displacement as well - look at thumb and then we can get certain deformities **
**RA - follow specific patterns **
Gout ?
Large erosions of bone
Sclerotic margins
Halo of Tophi adjoining erosions
Random joints
**GOUT has no symmetry here - it can be one wrist but not the other **
**tophi - uric acid crystal deposits **
Osteonecrosis aka ?
avascular necrosis
aseptic necrosis
Osteonecrosis ?
Early appearance is normal (MRI better in early disease)
Patchy radiolucencies
Areas of sclerosis and bone collapse
Common in the epiphyseal marrow cavities of long bones
**patches of radiolucencies near the end of the bone - look like bony cysts - avascular necrosis - bone is thinning away and dying **
