New material for Final Part 2

Question 1

T/F: Brodie’s abscess formations may be sterile with no mcroorganisms cultured.

Answer 1

True

Question 2

What is the main way to differentiate infections from tumors on xray?

Answer 2

infections do not respect growth plates or joint spaces

Question 3

What is the proper treatment for bone infections?

Answer 3

coffee enemas

…jk it’s antibiotics.

Question 4

Joint effusion, juxtaarticular osteoporosis, erosions, joint space loss, and lytic destruction that CROSSES THE JOINT space…what is this?

Answer 4

septic arthritis

Question 5

How many mm is the teardrop distance?

Answer 5

> 11mm and >2mm difference from the opposite joint

Question 6

unilateral sacroilitis

Answer 6

think infection

Question 7

Where do spinal infections begin in adolescents?

In adults?

Answer 7

in the disc (still vascular);

anterior endplates then disc then soft tissue (paraspinal mass)

Question 8

Where are spinal infections most common?

Answer 8

lumbars

Question 9

What joints have a higher incidence of infection in IV drug users?

Answer 9

SI joints

Question 10

What are some early radiographic features of bone infection?

Answer 10

rapid disc space loss and/or endplate destruction

Question 11

T/F: Osteomyelitis typically shows up in the first week on plain films.

Answer 11

False;

Question 12

t/F: Osteomyelitis may show up on bone scintigraphy within hours.

Answer 12

True

Question 13

What type of imaging gives a direct view of intramedullary disorders and may precede bone scan findings?

Answer 13

MRI

Question 14

T/F: Osteomyelitis findings on MRI will show increased (white) signal intensity on T1 and decreased on T2.

Answer 14

False; white is right on T1 so pathology findings are dark or decreased on T1, increased on T2

Question 15

What is the classic finding associated with osteomyelitis in the spine?

Answer 15

disc space loss with endplate destruction

Question 16

Word association: Nonsuppurative osteomyelitis, Pott’s disease, and mycobacterium

Answer 16

Tuberculosis

Question 17

What is the most common cause of infection-related death in the world, with 15 million people infected in the US?

Answer 17

Tuberculosis

Question 18

T/F: Only 1-3% of TB cases involve the skeleton, but this is the most common secondary form of TB

Answer 18

true

Question 19

TB in the skeleton usually involves weight-bearing joints and multiple levels. What is the most common area for TB in the skeleton?

Answer 19

TL junction

Question 20

How does TB of the spine look different than osteomyelitis?

Answer 20

multiple level involved and paraspinal cold abscesses with Ca+

Question 21

Word association: weight loss, fever, chills, night sweats, Gibbous formation and granulomas on chest film in 50%

Answer 21

TB

Question 22

What is the Phemister’s Triad?

Answer 22

sign of tuberculosis septic arthritis:

Juxtarticular osteoporosis, marginal erosions, and slow joint space loss

Question 23

What is the term for death of osseous cellular and marrow components of bone with an epiphyseal predispostion, especially of the femur head and humeral head?

Answer 23

Avascular Necrosis

Question 24

What are some synonyms for avascular necrosis (AVN)?

Answer 24

osteonecrosis, ischemic necrosis, or osteochondrosis

Question 25

When does epiphyseal necrosis (AVN) become clinically evident?

Answer 25

with articular surface collapse

Question 26

Surgery, trauma, alcoholism, and corticosteroid use are common etiologies for AVN but what is the most common etiology?

Answer 26

spontaneous/idiopathic

Question 27

What is the term for AVN in children?

Answer 27

Legg-Perthes disease

Question 28

The acronym PLASTIC RAGS is used to list the different causes of AVN. What does it stand for?

Answer 28

``` Pancreatitis/pregnancy Legg-Perthes disease/Lupus Alcoholism/Atherosclerosis Steroids Trauma Idiopathic/Infection Caisson disease/Collagen disease Rheumatoid arthritis/Radiation treatment Amyloid Gaucher disease Sickly cell disease/spontaneous ```

Question 29

What is the time frame from initial infarction to healed deformity with AVN?

Answer 29

2-8 years

Question 30

During the revascularization phase of AVN, new bone is deposited directly onto dead bone, thickening the trabeculation and increasing bone density. What is this termed?

Answer 30

"creeping substitution"

Question 31

What are some general radiological feature of epiphyseal infarction?

Answer 31

``` mottled trabecular pattern fragmentation collapse of articular cortex sclerosis subchondral cysts subchondral fracture ```

Question 32

When are mottled trabeculation patterns associated with AVN most commonly seen?

Answer 32

during the revascularization and repair phases

Question 33

"Rim Signs" or "Crescent Signs" are aunt minnie signs associated with AVN. What do these signs indicate?

Answer 33

subchondral fractures separating articular cortex from cancellous bones