MUSCULOSKELETAL Flashcards

1
Q

What is the physiological response of bone to injury?

A

A: Increased turnover, which can be imaged with bone-seeking radiotracers.

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2
Q

What is the most common bone-seeking radiotracer used in South Africa?

A

A: 99mTc Methylene Diphosphonate (MDP).

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3
Q

Which PET agent is used for bone imaging?
A: 18F Sodium Fluoride (18F NaF).

A

Which PET agent is used for bone imaging?
A: 18F Sodium Fluoride (18F NaF).

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4
Q

: What processes increase during bone remodeling?

A

:

Increased blood flow.
Increased extraction of ions onto the bone.
Increased binding of ions to hydroxyapatite crystals.

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5
Q

What are the conditions in which 99mTc MDP is commonly used?
A

A

Osteoblastic bone metastases.
Osteomyelitis.

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6
Q

Name a radiotracer specific for bone infection imaging.

A

A: 99mTc-labeled white blood cells.

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7
Q

Why can inflammatory and cancer cells be imaged using 18F FDG?
.

A

A: Because they have a high number of glucose transporters and increased hexokinase activity.

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8
Q

What are the four methods of tumor cell transport to the bone?

A

Hematogenous route (venous or arterial).
Lymphatic route.
Direct spread (e.g., sternum in breast cancer).
Intra-spinal route.

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9
Q

Which route is most common for hematogenous spread of bone metastases?

A

A: Venous route through Batson’s vertebral plexus.

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10
Q

What are the characteristics of Batson’s vertebral plexus?

A

Thin-walled veins.
Low intraluminal pressure.
Valveless veins.
Intercommunicating system.

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11
Q

What are the patterns of bone response to metastases?

A

Bone resorption (increased osteoclastic activity or tumor destruction).
Bone formation (reactive).

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12
Q

What are the types of bone metastases?

A

Osteolytic (e.g., renal, adrenal, acute leukemias).
Osteoblastic (e.g., prostate, neuroblastoma).
Mixed (e.g., lung, breast cancer).

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13
Q

Where does osteomyelitis commonly occur, and why?

A

A: In the metaphysis of long bones due to:

Rich and sluggish blood flow.
Porous bone structure.

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14
Q

: What is sequestrum in osteomyelitis?

A

A: Necrotic bone formed when blood supply to the bone is impaired.

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15
Q

What is involucrum in osteomyelitis?

A

A: New bone formed around the infection.

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16
Q

How is non-violated bone osteomyelitis diagnosed in nuclear medicine?

A

A: Using a 3-phase bone scan (flow, blood pool, and delayed imaging).

17
Q

How is violated bone osteomyelitis diagnosed in nuclear medicine?

A

A: Using 99mTc-labeled white cell imaging.

18
Q

How can septic and aseptic loosening of prosthetic joints be differentiated?

A

A: By combining radiolabeled white blood cell imaging and bone marrow imaging.

19
Q

What conditions, besides metastases, are bone scans useful for?

A

Metabolic bone diseases (e.g., Paget’s disease).
Avascular necrosis of the bone.
Soft tissue calcification (e.g., heterotrophic calcification).
Arthropathies (inflammatory/degenerativ

20
Q

What is the greatest utility of nuclear medicine in musculoskeletal imaging?

A

A: Early detection of bone metastases and whole-body imaging with low radiation doses.

21
Q

: Name a PET radiotracer used for infection and bone metastases imaging.

A

A: 18F FDG.

22
Q

Which type of bone metastases is predominantly caused by prostate cancer?

A

A: Osteoblastic.

23
Q

Q: True or False: Bone scans can detect metabolic bone diseases.

A

A: True.

24
Q

Q: True or False: A 3-phase bone scan is useful for diagnosing osteomyelitis in violated bone.

A

A: False.

It requires 99mTc-labeled white cell imaging.

25
Q
A