MSK Flashcards
acroosteolysis
PINCH FO (* = band-like)
- psoriasis
- injury (post-traumatic*, thermal burn, frostbite)
- neuropathy (congen insens to pain, DM, leprosy, myelomeningocele)
- collagen vasc (scleroderma, raynaud)
- hyperparathyroidism*
- familial (Hadju Cheney*)
- other: PVC exposure*, scorpion venom, phenytoin, porphyria, epidermolysis bullosa
sclerotic bone metastasis
6 Bees Lick Pollen breast bone (osteogenic carcinoma) bronchus (carcinoid) bladder (TCC) brain (medulloblastoma) bowel (mucinous) lymphoma prostate
vertebra plana
mets/myeloma lymphoma langerhans cell histiocytosis trauma TB
osseous sequestrum
osteomyelitis osteonecrosis lymphoma fibrosarcoma/MFH/UPS langerhans cell histiocytosis osteoblastoma (mimic of sequestrum: osteoid osteoma)
“the 4 horsemen of the apophysis”
chondroblastoma
giant cell tumor (GCT)
aneurysmal bone cyst
infection
epiphyseal lesions
“Chondroblastoma IS AGE - related” Chondroblastoma Infection Subchondral cyst (geode) ABC Giant cell tumor Eosinophilic granuloma (+mets and myeloma in older) clear cell chondrosarcoma
T2 hypointense intra-articular lesion
- PVNS
- gout
- hemophilia (linear hemosiderin deposition, epiphyseal growth disturbance)
- amyloid (bilateral, dialysis)
- tuberculosis
- rheumatoid arthritis
Madelung deformity
HIT DOC
H: Hurler & Morquio mucopolysaccharidosis
I: infection (growth arrest)
T: trauma (growth arrest)
D: dyschondrosteosis (Leri-Weill)
O: osteochondroma (multiple hereditary exostoses)
C: congenital, e.g. Turner, achondroplasia
erosion or absence of distal clavicle
- repetitive microtrauma, posttrauma
- hyperparathyroid (normal acromion)
- postop (subacromial decompression)
- RA (acromial erosions later)
- scleroderma
- gout
- septic arthritis (erosion on both sides of jt)
- myeloma, mets
- cleidocranial dysostosis
- pyknodysostosis
- progeria: any syndrome w premature aging
soft tissue tumour:
T1 hyperintense, no fat suppression
contains methemoglobin:
- hematoma w/wo tumour
contains proteinaceous fluid:
- ganglion
- abscess
contains melanin:
- melanoma
- melanoma metastasis
soft tissue tumour:
T1 hyperintense, with fat suppression
without calcifications:
- lipoma
- lipoma variant
- well-differentiated liposarcoma
- hemangioma
- other fat containing lesion
with calcifications:
- hemangioma (w phleboliths)
- myositis ossificans (w zonal calc’n/oss’n)
soft tissue tumour:
T2 hypointense, with calcifications
- gouty tophi
- dystrophic calcification
soft tissue tumour:
T2 hypointense, without calcifications
containing fibrous tissue:
- fibroma, fibrosarcoma
- desmoid
- leiomyoma
- location specific: plantar fibroma, elastofibroma, GCT-TS, postop scar
containing hemosiderin:
- GCT-TS: giant cell tumour of tendon sheath
- PVNS
- hemorrhagic mass
soft tissue tumour:
T2 hyperintense “cyst-like”, rim enhancement
fluid-containing lesion:
- ganglion
- seroma
- abscess
- epidermal inclusion cyst
- bursa
soft tissue tumour:
T2 hyperintense “cyst-like”, internal enhancement
myxomatous tumour:
- intramuscular myxoma
- myxoid liposarcoma
other:
- synovial sarcoma
- peripheral nerve sheath tumour (PNST)
- necrotic tumour
bullet shaped vertebral bodies
mucopolysaccharidoses (Morquio, Hurler)
achondroplasia
congenital hypothyroidism
H shaped vertebrae
sickle cell disease
Gaucher disease
steroid treatment
widening of interpedicular distance
diastematomyelia syringomyelia conditions that cause dural ectasia: Marfan, EDS, NF1, AS, OI spinal cord tumour: chordoma, ependymoma myelomeningocele, meningocele trauma: Chance #, burst # spinal AVM: juvenile type
subacromial subdeltoid fluid
rotator cuff tear therapeutic injection SASD bursitis: - mechanical - inflammatory arthritis - infection
moth-eaten bone (permeative)
multiple myeloma primary bone lymphoma Ewing sarcoma infection eosinophilic granuloma malignant fibrous histiocytoma metastases, especially: - Burkitt lymphoma - mycosis fungoides (malignant cutaneous primary T-cell lymphoma)
ivory vertebral body
- Paget’s disease
- lymphoma
- blastic mets: breast, prostate, adenocarcinoma GI tract, carcinoid, transitional cell carcinoma bladder
- chronic infection
- chordoma
acetabuli protrusio
Paget disease rheumatoid arthritis ankylosing spondylitis osteomalacia trauma
DDx diffuse sclerosis of Paget’s
chronic renal failure myelofibrosis metastasis lymphoma sickle cell anemia
DDx of trabecular thickening of Paget’s
hemangioma
chronic infection
osteomalacia
fluorosis
DDx of polyostotic lesions of Paget’s
chronic renal failure (hyperparathyroidism) Langerhans cells histiocytosis unusual infection metastasis fibrous dysplasia lymphoma Gaucher mastocytosis
lytic lesion in terminal phalanx
glomus tumour
mets (above diaphragm: lung, breast)
inclusion cyst (less aggressive)
enchondroma (MC lytic lesion in phalanx but terminal phalanx is least common site)
low grade chondroid lesion
enchondroma
low grade chondrosarcoma
bone infarct
cortical lucency + central calcification
Langerhans cell histiocytosis
osteoid osteoma
Brodie abscess
osseous lesions affecting both sides of the joint
arthritis infection PVNS synovial chondromatosis amyloidosis
band-like acroosteolysis
hyperparathyroidism
polyvinyl chloride
Hajdu-Cheney syndrome
Post traumatic
dactylitis
infection - pyogenic - TB sickle cell anemia (50% of children) thermal injury
shortening of 4th/5th metacarpals
Turner syndrome pseudopseudohypoparathyroidism post infection, trauma JIA idiopathic
lumpy bumpy soft tissue swelling (ie asymmetric)
gout xanthomatosis sarcoidosis amyloidosis multicentric reticulohistiocytosis
calcified soft tissue mass
myositis ossificans gout collagen vascular disease hyperparathyroidism, tumoral calcinosis hemangioma soft tissue chondro/osteosarcoma synovial sarcoma
calcium fluid level
tumoral calcinosis
milk alkali syndrome
sacral lesion
GCT/ABC metastasis myeloma/plasmacytoma chordoma neurogenic tumour
diffusely dense bones
Myelofibrosis Fluorosis Pyknodysostosis Metastatic disease Renal osteodystrophy Osteopetrosis Mastocytosis
regional osteopenia
(segmental area of decreased bone mineral density)
disuse (immobilization)
chronic regional pain syndrome (CRPS), reflex sympathetic dystrophy (RSD)
transient osteoporosis (bone marrow edema)
regional migratory osteoporosis
Erlenmeyer flask deformity
chronic anemia (sickle cell disease)
Gaucher disease
osteopetrosis
fibrous dysplasia
Niemann-Pick (enzyme deficiency, storage disorder of sphingolipidoses)
metaphyseal dysplasia (Pyle’s disease, SFRP4 gene mutation, diffuse long bone abN)
bone within a bone appearance
STOP HH sickle cell disease thoratrast administration osteopetrosis Paget disease heavy metal poisoning hypervitaminosis D
dense metaphyseal bands
PRINCES
Poisoning (lead, mercury, bismuth, phosphorus)
Rickets (healed)
Infection (TORCH); Idiopathic hypercalcemia
Normal variant; Neoplasm (leukemia)
Congenital syphilis
Endocrine (congenital hypothyroidism [cretinism])
Sickle cell disease; Scurvy
transverse lucent metaphyseal lines
LINING
Leukemia, lymphoma Infection (congenital syphilis) Normal variant Illness (systemic: rickets, scurvy) Neuroblastoma metastatses Growth arrest lines
frayed metaphyses
CHARMS
Congenital infections (rubella, syphilis) Hypophosphatasia Achondroplasia Rickets Metaphyseal dysostosis Scurvy
diffuse low T1 marrow signal
leukemia diffuse skeletal mets reconversion myelofibrosis myelodysplastic syndrome mastocytosis hemochromatosis Gaucher renal osteodystrophy gout, sarcoidosis, amyloidosis
bone lesion with surrounding edema
any lesion with assoc fracture abscess osteoid osteoma chondroblastoma Langerhans cell histiocytosis lymphoma
soft tissue calcification
metastatic (elevated Ca2+ x PO4 causing precipitation of a calcium salt)
- skeletal deossification
- primary hyperparathyroidism
- renal osteodystrophy
- bone destruction
- hypervitaminosis D
- milk alkali syndrome
dystrophic (tissue damaged, normal Ca2+, PO4 levels)
- trauma (incl. repetitive leading to calcific tendinosis)
- infection
- tumour (e.g. chondroid, osteoid producing)
- vessel or vascular malformation
- collagen vascular disease: scleroderma, SLE, dermatomyositis, polymyositis
idiopathic (elevated PO4)
- calcinosis universalis
- tumoral calcinosis
low signal nodular synovium
PVNS gout amyloid synovial chondromatosis hemophilic arthropathy (hemorrhagic synovitis)
physeal widening and irregularity
rickets
hypophosphatasia
metaphyseal dysostosis
axial hip joint space narrowing
rheumatoid arthritis other inflammatory arthropathies infection hemophilia CPPD
narrowing of interpedicular distance
achondroplasia
thanatophoric dysplasia
