MSK Flashcards
osteitis deformans is also called
Pagets
what is the pathology of Pagets?
Osteclastic activity.
abnromal and excessive new bone with vascularity
common sites for pagets to affect
Skull
spine
pelvis
femur
Pagets radiological appearance
Osteolysis
Cortical thickening
Loss of corticomedullary differentiation
Coarsening of trabeculae
Increased density
Bony expansion
Deformity
Osteoclstic activity causes what?
resoprtion of the bone
phases of pagets
Actuive phase
intermediate phase - osteblast and osteclast activity
late inactive - heavy sclerosis
pagets in the vertebra
picture frame
sclerosis all the way around
what area of sclerosis is specific to the pelvis in Pagets
Heavy sclerosis of the ileopectineal line
why is sclerosis of the ileopectineal line important
it allows for some distinction from amlignancy
imaging options in pagets
Scinitigraphy
- see burden
- also see active areas
- see a leading edge
When comparing pagets disease to possible sarcoma on MRI what aspect of the marrow signla is important
in Pagets marrow signal is preserved
complications of Pagets
osseous deformity
fracture
neoplastia (sarcoma)
soft tissue mass
osteomyelitis
gout
Extramedullary haematopoiesis
deg joint disease
Neural compression
osteomyelitis in pagets - what bug
increased incidence of salmonella
why gout in pagets
associated hypuricaemia
with hand lesions what are the questions to be asking one self
Bilateral
Birth / childhood
Symptomatic
Density
Affected area
subluxations
erosiions
FHx
normal variant
features of acro-osteolysis
destruction of the terminal phlaanges.
osteoporosis
hyphoscoliosis
Bizarre Parosteal Osteochondromatous Proliferation
heterotopic ossification arising from, but not disrupting, the cortical bone to which it is attached.
driller wrist
how does it occurt
The intense vibrations are thought to lead to microfractures allowing synovial fluid to create cysts (Fig 1). In severe cases, where occupational exposure persists, carpal fragmentation can eventually occur.
hyper parathyroidism changes in the hands
subperiosteal resorption
Also resorption of the distal clavicles and lamina dura of the teeth.
what is madelungs deformity
dysplasia of the radius resulting in an exaggerated radial inclination, a short forearm, dorsal dislocation of the ulnar head and a V- shaped proximal carpal row
Melorheostosis
thickneing and fibrosis of overlying skin
centred on a diaphysis
Ollier’s disease
non-hereditary failure of cartilage ossification leading to the presence of multiple enchondromata.
ucencies are seen in the diaphyses of long bones.
What are the endocrine and biochemcial causes of disc calcification?
acromegaly
alkaptuonuria
calcium pyrophosphate dihydrate crystal deposition
hyperparathyroidism
haemachromatosis
Which sytstemic disease causes disc clacification?
Amyloidosis?
Which conditions result in immobilisaiton or fusion of the spine?
Poliomyelitis
Ank spond
Juvenile chronic arthritis
Trauma
What are the two locations for disc calcification?
nucleus polposus and annulus fibrosis
Causes of nuc pulposis include?
Degen spondylosis
ank spnd
Juvenile chronic arthritis
DISH
Gout
Alkaptonuria tria of
homogentisic aciduria
arthritis
ochronsis
What is ochronosis?
MSK manifestations of alkatonuira.
large joint arthrosis.
How does alkatonuria and ank spond differ on lumber xr
If no osteophytes and intervertebral ligaments are calcified then think of alkaptonuria
what are the different types of juvenile idiopathic arthritis?
Systemic arthritis
Oligoarthritis
Polyarthritis
Enthesis related arthritis
Psoriatic arthritis
which joint is most affected by JIA
knee
Osteochondrosis - what is it
deranged growing skeleton
focal disturbanc of endochondral ossificaiton
paediatric AVN
causes of avascular necrosis
PLATIC RAGS
pancreatitis, prengnancy
lupus
alcohol
steroids
trauma
idiopathic
caisson disease, collagen vascular
radiation, rheumatoid
amyloid arthropathy
gaucher disease
sickle cell disease
causes categorised for avascular neocrosis
vascular interruption
glboal - systemic inflammatory
intraluminal emboli - local thomrubs
intrinsice
extrinisc
types of osteonecrosis of the knee
primary
secondary
post athroscopic
What is SONK / Ahlback
spontaenous osteonecrosis of the knee
now called a subchondral insufficiency fracture
Secondary ON affects who
younger patients
co moribd
location of scondary ON
can affect anywhere
osteochondritis dissecans cause
still not known
