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ST1 Combined > NM > Flashcards

NM Flashcards

1
Q

what factor sof bone affect radiotracaer uptake?

A

vascular supply

osteblastic activity

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2
Q

how does diphosphonates get uptaken?

A

interacts with endogenous calcium to porduce insoluble Tc- calcium

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3
Q

How long for diphosphonates to localise to bone

A

50% within 1 hour

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4
Q

MAXIMAL RADIATION FROM BONE SCAN IS RECEIVED BY WHAT ORGAN>

A

bladder

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5
Q

timing of bone scan?

A

one 2-4 hours after injection to allow soft tissue to disperse

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6
Q

indications for bone scintigraphy?

A

Imaging malignancy (detection and follow-up of osteoblastic skeletal metastases)
Characterisation of bone lesions
Detection of fractures (for example, stress or insufficiency fractures)
Imaging painful prostheses (in cases of infection or loosening)
Osteomyelitis
Complex regional pain syndrome (CRPS)

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7
Q

Bone scan - locations to be wary of?

A

inferior borders of the scapula

ACJ can be variable

SIJ

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8
Q

what is hyperostosis frontalis interna?

A

post menopausal women

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9
Q

what is three phase scintigra[hy

A

images obtained in blood flow, blood pool and delayed

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10
Q

What is dynamic and blood pool in bone scintigraphy?

A

Blood pool - done at 5 minuetes - sees the extracellular fluid witihn the bone

delayed phase - shows osteoblastic activity.

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11
Q

In malignancy, what kind of patterns are there for bone scintigraphy?

A 
Solitary focal uptake
Multiple focal areas of uptake
Diffuse increased uptake
Cold lesions (purely lytic)
False negative
Post-treatment flare phenomenon
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12
Q

Types of rib uptake for fracture vs malignancy?

A

Fracture is focal

Malignancy will be elongated along the rib

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13
Q

A superscan, diffusely observed tracer uptake, can be a result of what?

A

Diffuse malignant disease (breast, prostate, lymphoma)
Metabolic bone disease (hyperparathyroidism, renal osteodystrophy)
Mastocytosis
Myelofibrosis

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14
Q

Bone scintigraphy - what is a flare phenomenon

A

increased lesion intensity after chemo

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15
Q

Osteoblastic activity within a lesion is more suggestive of an active lesion such as

A

a skeletal metastasis

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16
Q

No uptake in a lesion is more suggestive of what kind of lesion

A

Benigin

Enostosis

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17
Q

What is a stress fracture?

A

Normal bone with abnormal stress as cumilative rather than an individual load

18
Q

What are the common locations of stress fractures?

A

Distal third of tibia
Distal fibula
Metatarsal shafts

19
Q

Define insufficiency fracture

A

Normal stress is applied to a bone that lacks the elastic resilience of normal bone

20
Q

Common locations of insufficiency fractures

A 
pelvic ring
spine
sacrum
rtibia 
femoral neck 
distal radius
21
Q

what makes osteomalacia bone weak?

A

defective minerlaisation of osteoid. lack of calcium incorporated into the osteoid protein bone matrix

22
Q

Honda sign on scintigraphy?

A

sacral insufficiency fracture

23
Q

sites where osteonecrosis can occur?

A 
Scaphoid
Navicular
body of talus
humeral head 
distal femur
24
Q

How does osteonecrosis appear on scintigraphy?

A

Photopaneic in acute phase as vascular compromise.

Afterwards with revascularisation massice osteoblastic repair has big uptake.

25
Q

relationship of complex regional pain syndrome and scintigraphy/ treatment

A

if CRPS seen on scintigraphy more likely to be successful treatment with steroids

26
Q

scintigraphy in children - main differnece?

A

major uptake at the growth plates

27
Q

cancers that spread to bone the most

A

Breast and prostate

28
Q

Three-phase uptake around a prosthesis is suggestive of

A

infection

29
Q

How do we define metabolic diseases - two types

A

diffuse and focal

30
Q

What are the main causes of diffuse metabolic bone disease?

A

osteomalacia

Renal osteodystrophy

Primary hyperparathyroidism

31
Q

what can you look for on superscans?

A

Absence of tracer uptake in kidneys and soft tiussues as it will all be in the bone

32
Q

Malignant vs metabolic - involvement of the mandible and the distal skeleton

A

Metabolic

33
Q

what are looser zones

A

insufficiency fractures

will be seen in early osteomalacia as the bone is most weak here

34
Q

Common locations for pagets disease?

A

skull
vertebra
long bones

35
Q

Pagets biochem

A

Urinary hydroxyproline

Raised ALP

36
Q

pattern of uptake in pagets disease?

A

from the ends inwards

37
Q

pagets mickey mouse sign

A

whole vertebra involvement

38
Q

what is fibrous dysplaisa?

A

replacement of bone by fibrous tissue

39
Q

Fibrous dysplasia associated features of the disease - non radiological

can be called mcCune Albright syndrome

A 
cafe au lait
precocious puberty
hyperthyroidism 
excess growth homrone
rickets
40
Q

Tie sign can be what

A

Osteomalacia or renal osteodystrophy (typically)

ST1 Combined (8 decks)

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