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Diagnostic Imaging II > Part 17 > Flashcards

Part 17 Flashcards

1
Q

AVN of lunate

A

Keinbock’s disease

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2
Q

who gets Keinbock’s?

A

people who do manual labor

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3
Q

what is keinbock’s associated with?

A

negative ulnar variance

progressive pain + soft tissue swelling of wrist

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4
Q

radiographic features of Keinbock’s

A 
initially increase in density of lunate
later fragmentation and collapse
mixture of sclerosis and radiolucent
flattening, collapse and fragmentation
altered joint congruity and biomechanics precipitates DJD
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5
Q

what is the possible treatment for Keinbock’s?

A

silastic implants

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6
Q

tarsal navicular AVN

A

Kohler’s

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7
Q

signs and symptoms of Kohler’s

A

localized pain, swelling

navicular patchy, homogenous sclerosis, collapse fragmentation

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8
Q

scheuermann’s disease etiology

A

in question, probably doesn’t represent a necrosis, likely TRAUMA

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9
Q

what is scheuermann’s disease?

A

abnormality of the discovertebral junction
usually in teens
chronic back pain, deformity and early DDD

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10
Q

radiology of scheuermann’s

A 
thoracic and lumbar spine
3 continguous vertebra
5 degree anterior body wedging
irregular end plates
decreased disc space
increased kyphosis
schmorl's nodes
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11
Q

etiology of juvenile discogenic disease

A

failure of embryonic vascular channels, centrum defects, notochord clefts to disappear, leaving endplate defects

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12
Q

juvenile discogenic disease produces?

A

early degeneration, segmental dysfunction, associated pathology of the facet joint

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13
Q

sever’s disease

A

NOT a necrosis
sclerosis and fragmentation of the calcaneal apophysis represents normal anatomy
correlate clinically

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14
Q

calcified medullary infarct

A

serpiginous regions of calcification within the bone medulla

usually associated with arteriosclerosis

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15
Q

DDx of serpiginous regions of calcification within bone medulla

A
  1. enchondroma
  2. chondrosarcoma
  3. calcified medullary infarct
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16
Q

MC hemolytic anemia

A

sickle cell

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17
Q

what demographic MC gets sickle cell anemia?

A

african americans

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18
Q

signs/symptoms of sickle cell anemia

A

pain and swelling in hands and feet
infarct of bowel following obstruction of mesenteric arteries (abdominal crisis)
osseous changes related to infarction, AVN, marrow hyperplasia and retarded growth

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19
Q

those with sickle cell anemia are predisposed to what?

A

salmonella osteomyelitis

gallstone problems

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20
Q

radiographic findings of sickle cell anemia

A 
marrow hyperplasia
coarse trabeculation
osteopenia
long bone undertubulation
hair on end skull
osteonecrosis/infarct
H shaped vertebra
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21
Q

thalassemia AKAs?

A

cooley’s anemia

medeterranean thalassemia

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22
Q

presentation of thalassemia

A 
fatigue due to chronic anemia
splenomegaly
cardiomegaly
gallstones
marrow hyperplasia
extramedullary hematopoiesis
maxillary overgrowth (rodent faces)
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23
Q

radiology of thalassemia

A 
coarsened trabeculation (honecomb/lace like)
osteopenia
erlenmeyer flask deformity
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24
Q

background of hemophilia

A

X chromosome linked bleeding disorder

female the carrier usually manifest in males

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25
Q

imaging for hemophilia

A 
intra-articular soft tissue swelling
radiodense effusion
osteopenia
square femoral condyles
degeneration
epiphyseal overgrowth
erosions
26
Q

clinical features of hemophilia

A

joint pain

hemophilic arthropathy

27
Q

background for leukemia

A

malignant proliferation of WBCs

28
Q

imaging for leukemia

A 
radiolucent submetaphyseal bands
osteopenia
osteolytic destruction of long bone metaphysis and diaphysis
periosteal reactions
growth arrest lines
29
Q

clinical features for leukemia

A 
fever
malaise
joint pain
easily bruised
spontaneous bleeds
30
Q

cellulitits

A

infection of skin, subcutaneous fat or connective tissue

31
Q

osteomyelitis

A

infection of bone (marrow spaces)

32
Q

septic arthritis

A

infection of joint

33
Q

those who are at risk for infection

A 
immunosuppressed
diabetics
post-surgical
vascular insufficiency
sickle-cell anemia
IV drug users
34
Q

where are drug addicts prone to getting infection?

A

spine
sacroiliac
symphysis pubis
sternoclavicular

35
Q

what is the most common organism for an infection?

A

staph aureus

36
Q

modes of infection

A 
trauma/post surgerical
UTI
pneumonia
skin infections
open wounds or cellulitis
heel sticks in infants
37
Q

routes of dissemination

A

hematogenous (MC)
direction extension
direct implantation
postoperative

38
Q

infants and young adults may present with what when they have an infection?

A 
fever
chills
pain
swelling
loss of limb function
elevated ESR
elevated WBC
39
Q

adult patterns of infection

A 
fever
malaise
edema
erythema
pain
40
Q

50% of those with infection previously had?

A

skin, respiratory or genitourinary tract infections

41
Q

suppurative osteomyelitis

A

2-12 years

males

42
Q

infantile pattern of vasuclar anatomy

A

metaphyseal and diaphyseal vessels may penetrate the physis (septic arthritis and osteomyelitis)

43
Q

childhood pattern of vascular anatomy

A

1 year to physis closure, metaphyseal blood flow is slow and turbulent, metaphyseal vesself don’t penetrate physis, separate epiphysis blood supply

44
Q

adult pattern of vascular anatomy

A

metaphyseal vessels penentrate the vanishing physis, reestablishing communication with the subarticular bone end (osteomyelitis and septic arthritis)

45
Q

most common locations of hematogenous infection

A 
knee
hip
ankle (distal tibia)
shoulder
spine
46
Q

two major categories of infections

A

suppurative (pus)- staph

non-suppurative (TB)

47
Q

suppurative osteomyelitis

A 
bone marrow infection by (pyogenic) non tubercular organism (anything but TB)
staph aureus
strep pneumoniae
e coli
pseudomonas
48
Q

clinical features of acutre infections

A 
edema
lyphadenopathy
warm skin
cellulitis
joint pain
49
Q

4 radiographic stages of osteomyelitis

A 
latent stage (1-10 days)
early stage (10-21 days)
middle stage (weeks)
late stage (months)
50
Q

early stage of osteomyelitis

A

spinal lesion may approach 3 weeks
soft tissue edema
osteopenia

51
Q

middle stage of osteomyelitis

A 
permeative or lytic moth eaten descruction
perosteal responase (solid laminated, codman's triangle)
52
Q

buttressing/solid periosteal reaction

A

when additional layers of new bone are added to the exterior creating an expended osseous contour
usually associated with slow growing lesions

53
Q

laminated/layered/onions skin

A

multiple layers of new layers of bone
alternating layers of lucency and opacity with alternating growth
can be thick or thin
can be seen in slow or aggressive lesions
classically associated with ewing’s

54
Q

spiculated

A

linear radiating spicules of new bone

55
Q

hair on end

A

when spiculated bone is perpendicular to the bone

56
Q

sunburst

A

when the spiculated bone is radiating from a central focus

57
Q

codman’s triangle

A

triangular elevation of periosteum seen at the periopheal lesion cortex junction
is one of themost aggressive forms of periosteal reaction
may be seen also with benign tumors, infections or other disorders

58
Q

late stage osteomyelitis

A 
cortical destruction
draining sinus
involucrum
cloaca
sequestrum
sclerosis
debris
loss of joint space
ankylosis
chonic incomplete resolution
immune deficient
59
Q

sequestrum

A

chalky, white area representing isolated dead bone

cortical and medullar infarcts

60
Q

involucrum

A

“bony collar” (chronic periosteal response

pus lifts the periosteum and causes new bone formation, trying to wall off the infection

61
Q

cloaca

A

rare compilation is to devlop a squamous cell carcinoma within the channel of the cloaca

62
Q

malignant transformation of cloaca

A

Majolin’s ulcer

Diagnostic Imaging II (19 decks)

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