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MSK Flashcards

1
Q

Well-Defined Lytic Lesions

A
  • Mets (RCC, Thyroid)
  • Multiple myeloma/Plasmacytoma
  • GCT
  • Enchondroma (hands/feet)
  • Clear cell chondrosarcoma
  • Desmoid
  • FD
  • Brown tumor
  • Hemophiliac pseudotumor
  • Subacute OM (Brodie’s abscess)
  • Osteoblastoma
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2
Q

Only in Pts < 30yo

A
  • ABC
  • SBC
  • Non-ossifying fibroma
  • Chondroblastoma
  • Chondromyxoid fibroma
  • EG
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3
Q

Automatics Based on Age

A

< 30yo

 - EG
 - Infection

> 40yo

 - Mets
 - Multiple myeloma
 - Infection
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4
Q

Multiple Lesions

A
  • FD
  • EG
  • Enchondromas
  • Mets/Myeloma
  • Brown tumors
  • Infection
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5
Q

Lesions w/o Pain

A
  • FD
  • Enchondroma
  • NOF
  • UBC
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6
Q

Diffuse Periostitis (Adults)

A
  • Hypertrophic osteoarthropathy
  • Venous stasis
  • Hypervitaminosis A
  • Thyroid acropachy
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7
Q

Lesions w/ Fluid-Fluid Levels

A
  • ABC
  • GCT
  • Chondroblastoma
  • Osteoblastoma
  • Telangiectatic osteosarcoma
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8
Q

Madelung Deformity

A
  • Trauma (Salter-Harris)
  • Infection
  • Turner’s syndrome
  • Mucopolysaccharidoses (Morquio)
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9
Q

Enlarged Bones/Focal Gigantism

A
  • Paget’s
  • NF1
  • Acromegaly
  • Klippel-Trenaunay-Weber
  • Macrodystrophia lipomatosis
  • Fibrolipomatous hamartoma
  • Ollier’s/Maffucci’s
  • JIA/Hemophilia (epiphyseal overgrowth)
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10
Q

Acro-Osteolysis

A

Distal Predominant

  • Scleroderma
  • Psoriatic arthritis
  • HyperPTH
  • Thermal injury
  • Pyknodysostosis

Band-Like

  • HyperPTH
  • PVC exposure
  • Hadju-Cheney syndrome
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11
Q

Lucent Metaphyseal Bands

A
  • Leukemia/Lymphoma
  • Neonatal syphilis (Wimberger’s sign)
  • Neuroblastoma mets
  • Early stage rickets/scurvy
  • Growth arrest lines
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12
Q

Dense Metaphyseal Bands

A
  • Growth arrest/stress lines
  • Chronic anemia (SCD, Thalassemia)
  • Lead poisoning
  • Chemotherapy
  • Osteopathia striata
  • Osteopetrosis
  • Healing stages rickets/scurvy
  • Hypothyroidism
  • HypoPTH
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13
Q

Bone Bowing

A
  • Paget’s
  • Osteogenesis imperfecta
  • Osteomalacia/Rickets
  • FD
  • Growth plate injury (Salter-Harris)
  • NF1
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14
Q

Posterior Element Lesions

A
  • TB
  • OO/Osteoblastoma
  • ABC
  • Mets
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15
Q

Vertebral Body Lesions

A
  • Hemangioma
  • Mets/Myeloma
  • OO/Osteoblastoma
  • GCT
  • EG
  • Chordoma
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16
Q

Ivory Vertebrae

A
  • Lymphoma
  • Mets
  • Paget’s
  • Chronic OM
  • Osteosarcoma
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17
Q

Bullet-Shaped Vertebrae

A
  • Achondroplasia
  • Hypothyroidism
  • Down syndrome
  • Mucopolysaccharidoses
    • Morquio’s –> middle
    • Hurler’s —> inferior
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18
Q

Iliac Wing Lesions

A
  • FD
  • SBC
  • Brown tumor
  • GCT
  • Chondrosarcoma
  • Ewing sarcoma
  • Mets/Myeloma
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19
Q

Soft Tissue Calcification

A
  • Metastatic
    • HyperPTH
    • Renal osteodystrophy
  • Dystrophic
    • Trauma
  • Calcinosis
    • Scleroderma
    • Dermatomyositis
    • Tumoral calcinosis
    • SLE
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20
Q

Periarticular Soft Tissue Calcification

A
  • Hydroxyapatite deposition
  • Gout
  • Scleroderma/SLE/Dermatomyositis
  • Hypercalcemia
    • HyperPTH
    • Renal failure
    • Hypervitaminosis D
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21
Q

Rib Lesions

A
  • FD
  • ABC
  • Mets/Myeloma
  • EG
  • Enchondroma
  • Chondrosarcoma
  • Ewing’s sarcoma (Askin)
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22
Q

Expansile Lytic Lesions

A
  • Mets (thyroid, RCC)
  • Multiple myeloma (ribs)
  • ABC
  • GCT
  • Brown tumor
  • Enchondroma
  • NOF
  • Fibrous dysplasia
  • SBC
  • Hemophiliac pseudotumor
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23
Q

Epiphyseal Lytic Lesion (< 30yo)

A
  • GCT
  • ABC
  • Chondroblastoma
  • EG
  • Infection (Brodie’s abscess)
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24
Q

Epiphyseal Lytic Lesion (> 40yo)

A
  • GCT
  • Infection
  • Mets/Myeloma
  • Geode
  • Clear cell chondrosarcoma
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25
Q

Lesions w/ Sequestrum

A
  • OM
  • EG
  • Fibrosarcoma
  • Lymphoma
  • Mets
  • Osteoid osteoma (pseudosequestrum)
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26
Q

Gracile Bones (Overtubulation)

A

1) NF1
2) JRA
3) OI
4) Immobilization or Paralysis
- Congenital CNS lesions
- Birth palsies
5) Muscular dystrophy

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27
Q

Epiphyseal Equivalents

A
  • Greater trochanter
  • Patella
  • Carpal bones
  • Calcaneus
  • Subarticular Flat bones
    • Acetabulum
    • Glenoid of scapula
    • Around SI jts
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28
Q

Ribbon Ribs

A 
"HORNS"
H - HyperPTH
O- OI
R - RA
N - NF1
S - Scleroderma
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29
Q

Mets

A

1) Lytic
- Lung
- Kidney
- Breast
- Thyroid
- GI
- Neuroblastoma
2) Blastic
- Prostate
- Carcinoid
- Medulloblastoma
3) Mixed
- Lung
- Breast
- GI
4) Lysis w/ Blowout
- Thyroid
- RCC

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30
Q

Dactylitis

A

1) SCD
2) Psoriatic arthritis
3) TB

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31
Q

Avascular Necrosis

A

“ASEPTIC”

  • Anemia from SCD
  • Steroid use, SLE, Scleroderma
  • Ethanol
  • Pancreatitis
  • Trauma
  • Infection/Idiopathic (Blount, Keinbock, Panner’s, L-C-P)
  • Caisson’s dz
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32
Q

Finger Masses

A

1) Bone Centered (Non-Aggressive)
- Enchondroma
- Epidermoid inclusion cyst
- BPOP
- Juxtacortical chondroma
- Osteochondroma
- Subungual exostosis
2) Bone Centered (Aggressive)
- Mets
- Myeloma
- Infection
3) Soft Tissue Centered
- Giant cell tumor of tendon sheath
- Lipoma
- Ganglion cyst
- Glomus tumor
- PNST

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33
Q

Non-Specific Soft Tissue Mass (XR)

A

1) Lipoma
2) PNST
3) Hematoma
4) Epidermal lesion
5) Sarcoma

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34
Q

Erosion of Distal Clavicle

A

1) Bilateral
- RA
- HyperPTH
- Cleidocranial dysplasia
- Gorlin disease/Vanishing bone disease
2) Unilateral
- Septic arthritis
- Post-traumatic osteolysis
- Mets/Myeloma

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35
Q

High Riding Humerus

A

1) Rotator cuff tear
2) RA
3) CPPD

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36
Q

Erlenmeyer Flask Deformity

A

1) Gaucher’s dz
2) Osteopetrosis
3) Hemoglobinopathies (Thalassemia, SCD)
4) FD
5) Multiple hereditary exostoses
6) Enchondromatosis

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37
Q

Diffuse Osteosclerosis

A

1) Mets - breast, prostate
2) Renal osteodystrophy
3) Osteopetrosis
4) Mastocytosis
5) Myelofibrosis
6) Pyknodysostosis
7) SCA
8) Paget’s
9) Lymphoma
10) Fluorosis

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38
Q

Sacral Tumors

A

1) Chordoma
2) Chondrosarcoma
3) GCT
4) Mets/Myeloma
5) Tarlov cyst
6) Sacrococcygeal teratoma (paeds)

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39
Q

Epiphyseal Overgrowth

A

1) Hemophilia
2) JIA
3) Paralysis
4) TB arthritis

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40
Q

Coarse Trabeculation

A

1) Osteopenia
2) Hemangioma
3) Paget’s
4) Thalassemia
5) Plasmacytoma (mini-brain appearance)

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41
Q

Diffuse Osteopenia

A

1) Osteoporosis
2) Multiple myeloma
3) Leukemia
4) Thalassemia
5) Gaucher’s

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42
Q

Regional Osteoporosis

A

1) Disuse
2) AVN
3) Periarticular from Arthritis
- RA, septic arthritis, SLE, RSD
4) AVN
5) Transient osteoporosis of the hip
6) Regional migratory osteoporosis
7) Ill-defined lytic lesions

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43
Q

Cortical Striation/Tunneling (Rapid Bone Turnover)

A

1) HyperPTH
2) Renal Osteodystrophy
3) Osteomalacia
4) Disuse
5) Paget’s

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44
Q

Multifocal Sclerotic Lesions

A

1) Blastic mets
2) Osteopoikilosis
3) TS
4) Fluorosis
5) Mastocytosis
6) Paget’s

45
Q

Ill-Defined Lytic Lesions

A

1) Mets/Myeloma
2) Lymphoma/Leukemia
3) Acute OM
4) EG
5) Hemangioma
6) Ewing’s
7) Telangiectatic osteosarcoma
8) Fibrosarcoma

46
Q

Multiple Lytic Lesions

A

1) Mets/Myeloma
2) OM
3) FD
4) Brown tumors
5) EG
6) Lymphoma/Leukemia
7) Enchondromas

47
Q

Intertrochanteric Tumor

A

1) Lipoma
2) Liposclerosing myxofibrous tumor
3) FD
4) SBC

48
Q

Well-Defined Sclerotic Lesion

A

1) Mets
2) Bone island
3) Osteoid osteoma
4) Osteoblastoma
5) Mature bone infarct
6) Enchondroma
7) FD
8) Healing stress fracture
9) Involuted NOF

49
Q

Ill-Defined Sclerotic Lesion

A

1) Met
2) Immature bone infarct
3) Osteosarcoma
4) Chondrosarcoma
5) Stress #
6) Paget’s
7) Chronic OM

50
Q

Focal Periostitis/Cortical Hyperostosis

A

1) Stress #
2) OM
3) Melorrheostosis
4) Myositis ossificans
5) Tumor
- Osteoma
- Osteoid osteoma
- Osteoblastoma
- Chondroblastoma
- Parosteal osteosarcoma

51
Q

Diffuse Periostitis (Kids)

A

1) Physiologic
2) Caffey’s dz
3) NAI
4) Prostaglandin Rx
5) Malignancy
6) Congenital syphilis

52
Q

Heterotopic Ossification

A

1) Trauma
2) Neurologic injury (TBI, Stroke, Spinal cord injury)
3) Burns
4) Myositis ossificans progressiva

53
Q

Extensive Callous Formation

A

1) Steroids
- Exogenous
- Cushing’s dz
2) OI
3) Infection
4) Trauma
5) Paralysis/Neuromuscular disorder

54
Q

Cortically-Based Lesions

A

1) Cortical desmoid
2) Osteoid osteoma
3) NOF
4) Parosteal osteosarcoma
5) Cortical FD
6) Adamantinoma
7) Ossifying fibroma

55
Q

Short Metacarpal/Metatarsal

A

1) Idiopathic
2) JIA
3) Turner’s
4) Muccopolysacharidoses
5) Hypoparathyroidism
6) Trauma
7) SCD

56
Q

Diaphyseal Bone Lesion

A

“FEMALE”

  • FD
  • EG
  • Met
  • Adamantinoma/Ossifying fibroma
  • Lymphoma/Leukemia
  • Ewing’s
57
Q

Coxa Magna/Coxa Breva/Coxa Plana

A

1) Trauma
2) Prior Legg-Calve-Perthes
3) DDH

58
Q

Subchondral Cysts

A

1) Degenerative jt dz
2) CPPD
3) RA
4) Ischemia/AVN

59
Q

Acetabular Protrusion

A

1) RA
2) JIA
3) Trauma
4) Infection
5) Osteomalacia
6) Paget’s
7) AS

60
Q

Permeative Lesion

A

1) OM
2) Small round blue cell tumors
- Ewing’s
- Lymphoma/Leukemia
- Neuroblastoma
- Multiple myeloma
3) EG

61
Q

Premature Closure of Physis

A

1) Truma
2) JIA
3) Infection
4) Hemophilia
5) Accelerated Skeletal Maturation
- McCune-Albright
- Hyperthyroidism

62
Q

Well-Formed Bone Spurs

A

1) Degenerative enthesopathy
2) DISH
3) Acromegaly

63
Q

Poorly-Defined Bone Spurs

A

1) Psoriatic arthritis
3) Reactive arthritis
4) Avulsion injury
5) AS

64
Q

Tenosynovitis

A

1) Post-traumatic
2) Overuse
3) CTD (RA, SLE)
4) Infection

65
Q

Monoarticular Arthritis

A

1) Trauma
2) Septic arthritis
3) PVNS
4) Synovial chondromatosis
5) Crystal Arthritides
- Gout
- CPPD
- Calcium hydroxyapatite deposition dz

66
Q

Purely Erosive Arthritis

A

1) RA
2) Septic (acute)
3) TB (indolent)

67
Q

Erosive & Proliferative Arthritis

A

1) Psoriatic
2) Reactive
3) AS
4) Erosive OA

68
Q

Arthritis w/ Preserved Jt Space

A

1) Gout
2) TB (indolent course)
3) Juvenile chronic arthritis
4) Hemophilia
5) Amyloidosis
6) Synovial chondromatosis
7) SLE, Jaccoud’s
8) Reactive Synovitis - Infection, IBD, Neoplasms

69
Q

Accelerated OA

A

1) Trauma
2) Infection
3) CPPD
4) Hemochromatosis
5) Acromegaly
6) Articular dysplasia

70
Q

Calcified Intra-Articular Loose Body

A

1) Synovial osteochondromatosis
2) Detached osteophyte
3) Acute osteochondral #
4) Unstable OCD fragment

71
Q

Non-Calcified Intra-Articular Loose Body

A

1) Synovial chondromatosis
2) Rice body (RA, TB)
3) Lipoma arborescens

72
Q

DDx Joint Effusion

A

1) Trauma
2) Infection
3) Seronegative spondyloarthropathy
4) RA/JIA
5) Tarsal/Carpal coalition
6) Effusion Mimics
- Amyloid
- PVNS
- Hemophilia

73
Q

Olecranon Bursitis

A

1) Overuse, Dialysis
2) Trauma
3) Infection
4) RA
5) Gout
6) CPPD

74
Q

Ulnar Deviation of MCPs

A

1) RA
2) SLE
3) Jaccoud’s arthropathy

75
Q

Radial Deviation of MCPs

76
Q

Hooked Osteophytes

A

1) CPPD (2-3 MCPs)

2) Hemochromatosis (diffuse)

77
Q

Osteochondral Lesion

A

1) Trauma
2) Subchondral insufficiency #
3) AVN collapse
4) OCD
5) OA

78
Q

Sacroiliitis

A

1) AS
2) HyperPTH
3) Septic arthritis
4) Reactive arthritis
5) Psoriatic arthritis
6) Enteropathic arthropathy

79
Q

Arthropathy w/ Soft Tissue Mass

A

1) Gout
2) Amyloidosis (no blooming, low T1/T2)
3) PVNS (blooming, low T1/T2)
4) Hemophilia (bloom, low T1/T2, wide physes)

80
Q

Amyloidosis vs. PVNS

A

Osteopenia in amyloidosis

81
Q

PVNS vs. Giant Cell Tumor of Tendon Sheath

A

GCTTS located in soft tissue near jt

82
Q

Periarticular Soft Tissue Calcification

A

1) Hydroxyapatite deposition
2) Gout
3) Scleroderma
4) Tumoral Calcinosis
- HyperPTH
- Renal failure
- Hypervitaminosis D
- Sarcoidosis

83
Q

Soft Tissue Calcification

A

1) Metastatic
- HyperPTH
- Renal osteodystrophy
2) Scleroderma
3) Dermatomyositis/Polymyositis
4) SLE
5) Dystrophic (trauma)

84
Q

Chondrocalcinosis

A

1) CPPD
2) OA
3) Gout
4) HyperPTH
5) Hemochromatosis

85
Q

Spondylolisthesis

A

1) Spondylolysis
2) Facet degeneration
3) Degenerative disc dz
4) trauma
5) Ligamentous Laxity
- Marfan’s
- Ehlers-Danlos

86
Q

Atlantoaxial Subluxation

A

1) Trauma
2) Arthritis
- RA
- CPPD
3) Congenital
- Down
- Morquio’s
- Congenital hypoplasia of dens/ Os odontoideum
4) Ligamentous Laxity
- Marfan’s
- Ehlers-Danlos
5) Adjacent infection (tonsilitis, pharyngitis)

87
Q

Paravertebral Ossification

A

1) Asymmetric
- Psoriatic arthritis
- Reactive arthritis
2) Symmetric
- AS
- Enteropathic arthropathy
3) DISH (anterior)
4) TB (focal mass)

88
Q

Disc Calcification

A

1) Degenerative disc dz
2) CPPD
3) AS
4) Surgical fusion

89
Q

Enlarged Vertebrae

A

1) Paget’s
2) ABC
3) Acromegaly

90
Q

Posterior Scalloping of Vertebrae

A

1) Inc Spinal Pressure
- Neoplasm (lipoma, ependymoma, schwannoma)
- Syrinx
- Long standing hydro
2) Dural Ectasia
- NF1
- Marfan’s
- Ehlers-Danlos
3) Achondroplasia
4) Acromegaly

91
Q

Anterior Scalloping of Vertebrae

A

1) Aortic aneurysm
2) LNs
3) TB

92
Q

Absent Pedicle

A

1) Met
2) ABC
3) Congenital absence (contralateral hypertrophy)

93
Q

Dense Pedicle

A

1) Osteoblastic met
2) Osteoblastoma
3) Congenital absence of contralateral pedicle

94
Q

Dense Vertebral Endplates

A

1) Degenerative disc dz
2) Renal Osteodrystrophy
3) Osteopetrosis

95
Q

Increased Interpedicular Distance

A

1) Trauma
2) Syrinx
3) Intraspinal tumor
4) Dysraphism
5) AVM

96
Q

Gibbus Deformity

A

1) Congenital (achondroplasia)
2) TB (Pott’s dz)
3) Fracture
4) Vertebra plana

97
Q

Expansile Sternal Lesion

A

“MAC”
Mets/Myeloma
ABC
Chondrosarcoma

98
Q

Floating Teeth

A

1) EG
2) Lymphoma/Leukemia
3) Periapical abscess
4) 1ry mandibular tumor

99
Q

Focal Marrow Edema

A

1) Trauma (contusion, stress #)
2) Osteoid osteoma
3) AVN
4) Transient regional osteoporosis
5) Infection
6) Other neoplasm

100
Q

Cyst Like Masses (Low T1, High T2)

A

1) Hematoma
2) ABscess
3) Bursa
4) Synovial cyst
5) Ganglion cyst
6) Myxoid Tumors
- Myxoma
- Myxoid liposarcoma
- MFH
- Chondrosarcoma

101
Q

Soft Tissue Neoplasm

A

1) Lipomatous
2) Sarcoma (MFH, Synovial)
3) Angiomatous
4) Neurogenic
5) Fibromatosis
6) PVNS

102
Q

Bilateral Tendon Tears

A

1) Steroid use
2) Renal failure
3) DM
4) CTD (SLE, RA)

103
Q

Cortical Based Tumors

A

1) Mets
2) Myeloma
3) NOF
4) Osteoid Osteoma
5) ABC
6) Chondromyxoid Fibroma
7) Adamantinoma
8) EG

104
Q

Malignant Transformation of Bone Tumors

A

1) FD –> Osteosarcoma, Fibrosarcoma
2) Paget’s –> Osteosarcoma
3) OM w/ Draining Sinus –> SCC
4) Radiation –> OSA, Chondrosarcoma, MFH
5) Bone Infarct –> Fibrosarcoma, MFH
6) Ollier’s/Maffucci –> Chondrosarcoma
7) Hereditary Exostosis –> Chondrosarcoma

105
Q

Radial Hypoplasia

A

1) VACTERL
2) Holt-Oram
3) Fanconi’s anemia

106
Q

Widened Pubic Symphysis

A

1) Congenital
- Bladder exstrophy
- Cleidocranial dysplasia
- GU or anorectal malformations
2) Bone Resorption/Destruction
- Pregnancy
- Osteitis pubis
- Infection
- Mets
- HyperPTH

107
Q

Platyspondyly

A

1) Diffuse
- Dwarf syndromes
- OI
- Morquio’s
2) Solitary
- Leukemia
- EG
- Mets/Myeloma
SCD

108
Q

Acquired Lucent Ribs

A

1) Acromegaly
2) Cushing’s dz
3) Scurvy

Radiology (15 decks)

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