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RRC DDx > MSK > Flashcards

MSK Flashcards

1
Q

acroosteolysis

A

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
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2
Q

sclerotic bone metastasis

A 
6 Bees Lick Pollen
breast
bone (osteogenic carcinoma)
bronchus (carcinoid)
bladder (TCC)
brain (medulloblastoma)
bowel (mucinous)
lymphoma
prostate
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3
Q

vertebra plana

A 
mets/myeloma
lymphoma
langerhans cell histiocytosis
trauma
TB
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4
Q

osseous sequestrum

A 
osteomyelitis
osteonecrosis
lymphoma
fibrosarcoma/MFH/UPS
langerhans cell histiocytosis
osteoblastoma
(mimic of sequestrum: osteoid osteoma)
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5
Q

“the 4 horsemen of the apophysis”

A

chondroblastoma
giant cell tumor (GCT)
aneurysmal bone cyst
infection

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6
Q

epiphyseal lesions

A 
“Chondroblastoma IS AGE - related”
Chondroblastoma
Infection
Subchondral cyst (geode)
ABC
Giant cell tumor
Eosinophilic granuloma
(+mets and myeloma in older)
clear cell chondrosarcoma
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7
Q

T2 hypointense intra-articular lesion

A
  • PVNS
  • gout
  • hemophilia (linear hemosiderin deposition, epiphyseal growth disturbance)
  • amyloid (bilateral, dialysis)
  • tuberculosis
  • rheumatoid arthritis
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8
Q

Madelung deformity

A

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

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9
Q

erosion or absence of distal clavicle

A
  • 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
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10
Q

soft tissue tumour:

T1 hyperintense, no fat suppression

A

contains methemoglobin:
- hematoma w/wo tumour

contains proteinaceous fluid:

  • ganglion
  • abscess

contains melanin:

  • melanoma
  • melanoma metastasis
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11
Q

soft tissue tumour:

T1 hyperintense, with fat suppression

A

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)
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12
Q

soft tissue tumour:

T2 hypointense, with calcifications

A
  • gouty tophi

- dystrophic calcification

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13
Q

soft tissue tumour:

T2 hypointense, without calcifications

A

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
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14
Q

soft tissue tumour:

T2 hyperintense “cyst-like”, rim enhancement

A

fluid-containing lesion:

  • ganglion
  • seroma
  • abscess
  • epidermal inclusion cyst
  • bursa
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15
Q

soft tissue tumour:

T2 hyperintense “cyst-like”, internal enhancement

A

myxomatous tumour:

  • intramuscular myxoma
  • myxoid liposarcoma

other:

  • synovial sarcoma
  • peripheral nerve sheath tumour (PNST)
  • necrotic tumour
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16
Q

bullet shaped vertebral bodies

A

mucopolysaccharidoses (Morquio, Hurler)
achondroplasia
congenital hypothyroidism

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17
Q

H shaped vertebrae

A

sickle cell disease
Gaucher disease
steroid treatment

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18
Q

widening of interpedicular distance

A 
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
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19
Q

subacromial subdeltoid fluid

A 
rotator cuff tear
therapeutic injection
SASD bursitis:
- mechanical
- inflammatory arthritis
- infection
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20
Q

moth-eaten bone (permeative)

A 
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)
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21
Q

ivory vertebral body

A
  • Paget’s disease
  • lymphoma
  • blastic mets: breast, prostate, adenocarcinoma GI tract, carcinoid, transitional cell carcinoma bladder
  • chronic infection
  • chordoma
22
Q

acetabuli protrusio

A 
Paget disease 
rheumatoid arthritis 
ankylosing spondylitis 
osteomalacia
trauma
23
Q

DDx diffuse sclerosis of Paget’s

A 
chronic renal failure
myelofibrosis
metastasis
lymphoma 
sickle cell anemia
24
Q

DDx of trabecular thickening of Paget’s

A

hemangioma
chronic infection
osteomalacia
fluorosis

25
Q

DDx of polyostotic lesions of Paget’s

A 
chronic renal failure (hyperparathyroidism)
Langerhans cells histiocytosis 
unusual infection
metastasis 
fibrous dysplasia 
lymphoma 
Gaucher 
mastocytosis
26
Q

lytic lesion in terminal phalanx

A

glomus tumour
mets (above diaphragm: lung, breast)
inclusion cyst (less aggressive)
enchondroma (MC lytic lesion in phalanx but terminal phalanx is least common site)

27
Q

low grade chondroid lesion

A

enchondroma
low grade chondrosarcoma
bone infarct

28
Q

cortical lucency + central calcification

A

Langerhans cell histiocytosis
osteoid osteoma
Brodie abscess

29
Q

osseous lesions affecting both sides of the joint

A 
arthritis
infection
PVNS
synovial chondromatosis
amyloidosis
30
Q

band-like acroosteolysis

A

hyperparathyroidism
polyvinyl chloride
Hajdu-Cheney syndrome
Post traumatic

31
Q

dactylitis

A 
infection
- pyogenic 
- TB
sickle cell anemia (50% of children)
thermal injury
32
Q

shortening of 4th/5th metacarpals

A 
Turner syndrome 
pseudopseudohypoparathyroidism
post infection, trauma 
JIA
idiopathic
33
Q

lumpy bumpy soft tissue swelling (ie asymmetric)

A 
gout
xanthomatosis
sarcoidosis
amyloidosis
multicentric reticulohistiocytosis
34
Q

calcified soft tissue mass

A 
myositis ossificans
gout
collagen vascular disease
hyperparathyroidism, tumoral calcinosis
hemangioma
soft tissue chondro/osteosarcoma 
synovial sarcoma
35
Q

calcium fluid level

A

tumoral calcinosis

milk alkali syndrome

36
Q

sacral lesion

A 
GCT/ABC
metastasis
myeloma/plasmacytoma
chordoma
neurogenic tumour
37
Q

diffusely dense bones

A 
Myelofibrosis
Fluorosis
Pyknodysostosis
Metastatic disease
Renal osteodystrophy
Osteopetrosis
Mastocytosis
38
Q

regional osteopenia

A

(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

39
Q

Erlenmeyer flask deformity

A

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)

40
Q

bone within a bone appearance

A 
STOP HH
sickle cell disease
thoratrast administration 
osteopetrosis
Paget disease 
heavy metal poisoning
hypervitaminosis D
41
Q

dense metaphyseal bands

A

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

42
Q

transverse lucent metaphyseal lines

A

LINING

Leukemia, lymphoma
Infection (congenital syphilis)
Normal variant
Illness (systemic: rickets, scurvy)
Neuroblastoma metastatses
Growth arrest lines
43
Q

frayed metaphyses

A

CHARMS

Congenital infections (rubella, syphilis)
Hypophosphatasia
Achondroplasia
Rickets
Metaphyseal dysostosis
Scurvy
44
Q

diffuse low T1 marrow signal

A 
leukemia
diffuse skeletal mets
reconversion
myelofibrosis
myelodysplastic syndrome
mastocytosis
hemochromatosis
Gaucher
renal osteodystrophy
gout, sarcoidosis, amyloidosis
45
Q

bone lesion with surrounding edema

A 
any lesion with assoc fracture 
abscess
osteoid osteoma
chondroblastoma
Langerhans cell histiocytosis 
lymphoma
46
Q

soft tissue calcification

A

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
47
Q

low signal nodular synovium

A 
PVNS
gout
amyloid
synovial chondromatosis
hemophilic arthropathy (hemorrhagic synovitis)
48
Q

physeal widening and irregularity

A

rickets
hypophosphatasia
metaphyseal dysostosis

49
Q

axial hip joint space narrowing

A 
rheumatoid arthritis 
other inflammatory arthropathies
infection 
hemophilia 
CPPD
50
Q

narrowing of interpedicular distance

A

achondroplasia

thanatophoric dysplasia

RRC DDx (12 decks)

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