PATH 179 LO 2 Flashcards
What is spina bifida?
defect of the posterior elements, lamina fail to fuse.
What are the three different types of spina bifidas and what are they?
- spina bifida Occulta (mild)=splitting at L5-S1
- Meningocele (severe) C or L spine= splitting with hernination of meningies
- Myelomeningiocele (very severe) C or L spine = splitting with hernination of meningies and spinal cord or nerve root protrusion
What is the cause of spina bifida?
Lack of folic acid during prenatal care
What are the signs and symptoms of spina bifida?
muscular abnormalities, bowel/bladder - loss of control, dimpling of the skin, tuft of hair over site, club feet, gait disturbances, bladder incontinence
What are the radiographic examinations for spina bifida?
AP and Lateral L spine.
- CT
- MRI
What is the radiographic appearance of spina bifida?
- absence of laminae
- More serious cases use CT or MRI to demonstrate presence of cord/nerve roots in herninated sac
What is the treatment for spina bifida?
- prenatal intervention involves folic acid
- surgical repair may be needed depending on the size and location of the protrusion.
What is the other name for osteogenesis Imperfecta?
Brittle Bone
What is osteogenesis imperfecta?
Bone easily breakable. Inadequate amount of bone collagen
adult usually wheelchair bound
What is the cause of osteogenesis imperfecta?
inherited, connective tissue disorder
What are the signs and symptoms of osteogenesis imperfecta?
- multiple fractures
- severe osteoporosis
- BLUE EYE SCLERA (white of the eye has a blue tint)
what is the radiographic examinations for osteogenesis imperfecta?
body part related to area of interest
What is the radiographic appearance for osteogenesis imperfecta?
- repeated fractures
- Fractures heal with a callus
- cortical bone loss
- Skull ossification progresses slowly, leaving wide sutures and wormian bones
What is the treatment for osteogenesis imperfecta?
- surgical rod placement
- Extra care to minimize fracture
- -Meds to regulate the osteoclastic formation, keeping the bone density more normal
What is Achondroplasia?
Normal conversion of cartilage cells during bone growth does not occur, so long bones do ot grow to there correct length. Bones are short but thick and strong
What is the cause of achondroplasia?
autosomal dominant gene
What are the signs and symptoms of achondroplasia?
- less than 4 ft tall
- Lumbar spine lordosis
- Bowed legs
- Bulky face
What is the radiographic examination for achondroplasia?
- x-ray
- CT is beneficial to see the changes in the spinal column
What is the radiographic appearance for achondroplasia?
- skull has thin growth plate
- Widening of the proximal and distal ends
- Scalloping of posterior margins of vertebral bodies
What is the treatment of achondroplasia?
no treatment, live normal independent life.
What is Congenital Hip dislocation?
The head of the femur slips out of the acetabulum because of incomplete acetabulum formation
What is another name for congenital hip dislocation?
dysplasia
What is the cause for congenital hip dislocation?
- increased hormone levels during delivery
- when the fetus grows amniotic fluid decreased and places gentle pressure on the infant
What are signs and symptoms of congenital hip dislocation?
- Diagnosed during pediatric assessment, may pop or click
- If not diagnosed early, will WADDLE LIKE A DUCK
What are the radiographic examinations for congenital dip dislocation?
- AP Pelvis: appears almost normal
- -Bilateral Cleaves (frog leg): hip usually dislocates SUPERIORLY AND POSTERIORLY
- rechecks
- US
What is the radiographic appearance for congential hip dislocation?
hip will dislocate superior and posterior
What is the treatment for congenital hip dislocation?
No treatment, live a normal independent life.
What is Rheumatoid Arthritis?
Begins as synovial membrane that lines the joints. Affects small joints of hands and feet.
What is the cause of rheumatoid arthritis
Chronic systemic disease of unknown cause. Genetic factors are believed to predispose an individual to RA
What are the signs and symptoms of rheumatoid arthritis?
- Pain
- swelling
- Stiffness
What are the radiographic examinations for rheumatoid arthritis?
- x-ray of erlated body part
- CT might be performed to assess alantoaxial articulation
What is the radiograpghic appearance of rheumatoid arthritis?
- Periarticular swelling
- Periarticular osteoporosis
- Narrowing of the joint spaces
- May progress to ankloysis
What is the treatment for rheumatoid arthritis?
medication
What is ankylosing Spondylitis
- Progressive form of arthritis
- Begins in the SI joints and progresses upwards
What is the cause of ankylosing spondtlitis?
Believed to have a genetic predisposition
What are the signs and symptoms of ankylosing spondylitis?
- low back pain
- low grade fever
- Fatigue
- weight loss
What are the radiographic examinations of ankylosing spondylitis?
- x-ray
- CT
What is the radiographic appearance for ankylosing spondylitis?
- ossification (bone formation) in the paravertebral (beside or adjacent) tissues and longitudinal spinal ligaments (poker spine) and extensive bony bridges to produce ‘bamboo spine’
- Osteoporosis
- Fractures
- Spinal stenosis
What is the treatment for ankylosing spondylitis?
- Treatment
- Therapeutic exercise
- Postural training
What is another name for Osteoarthritis?
Degenerative jt. disease
What is osteoarthritis?
loss of joint cartilage and new bone formation. Affects weight bearing joints
What causes osteoarthritis?
occurs in joints that have been repeatedly traumatized or abnormal stresses because of orthopedic deformities
What are the signs and symptoms of osteoarthritis?
- pain
- stiffness of affected joint
What are the radiographic examinations for osteoarthritis?
- x-rays
- weight bearing x-rays
What is the radiographic appearance for osteoarthritis?
- narrowing of the joint space
- Small bone spurs (osteophytes)
- Articular ends of the long bones become increasingly dense
- Distal IP joints - spurs that are palable
- Asymmetrical narrowing in hip and knee
What is the treatment for osteoarthritis?
- medication
- Exercise
- Heat
- Surgical prosthetic joint replacement
What is bursitis?
inflammation of the bursae (small sacs that reduces friction in a joint)
What causes bursitis?
repeated physical activity, trauma, RA, gout and infections
What is the radiographic appearance for bursitis?
not visualized
what muscles make up the rotator cuff?
teres minor, infraspinatus, supraspinatus and subscapularis muscles
How is rotator cuff tears diagnosed?
arthrography or MRI
What is the sign and symptoms of tears of the menisci of the knee?
knee pain
What causes tears of the menisci of the knee?
result of acute trauma reflect degenerative process cause by chronic trauma
How is tear of the menisci of the knee diagnosed?
demonstrated with MRI
What is bacterial osteomyelitis?
inflammation of the bone and bone marrow
What causes bacterial osteomyelitis?
broad spectrum of infections
Where does bacterial osteomyelitis occur in infants or children?
affects femur and tibia
where does bacterial osteomyelitis occur in adults?
vertebrae
What are the signs and symptoms of bacterial osteomyelitis?
- fever, localized warmth, swelling, tenderness
- Adults, localized back pain and muscle spasms
What are the radiographic examinations for bacterial osteomyelits?
- x-ray
- CT
- MRI
What is the radiographic appearance for bacterial osteomyelitis?
- ragged moth eaten appearance
- Bone necrosis
- Vertebral ostermyelitis=erosion of the bony plate with loss of cortical outline
- Plain radiographs cannot determine if the disease process is acute
What causes osteomyelitis of the skull?
paranasal sinuses, mastoid air cells or scalp
What is the treatment for bacterial osteomyelitis?
- antibiotics
- Surgery
What is osgood schlatters?
incomplete separation of the epiphysis of the tibial tuberosity
What causes osgood schlatters?
patients that are doing activities where they repeatedly flex their knee more than 90
What are the sign and symptoms of osgood schlatters?
- pain
- tenderness
- bump inferior to the patella
What are the radiographic examinations for osgood schlatters?
-x-ray
what are the radiographic appearance for osgood schlatters?
- raised area of bone in the tibial tuberosity
- Soft-tissue swelling in front of the tibial tuberosity
- BEST DEMONSTRATED ON LATERAL KNEE X-RAY
What is the treatment for osgood sclatters?
- ice
- meds
- brace
What is osteochondritis Dessicians (OCD)
joint condition where a piece of cartilage, along with a thin layer of bone beneath it comes loose from the end of the bone
What is the cause of osteochondritis dessicans (OCD)?
decrease blood flow to the end of the bone
What are the signs and symptoms of osteochrondrits Dessicans (OCD)?
- Pain
- Joint locking
- Weakness
What are the radiographic examinations for osteochondritis dessicans?
- x-ray
- Tunnel view may show this good
What is the radiographic appearance for osteochondritis dessicans?
-Flattening or radiolucency above the cortical line
What is the treatment for osteochondritis dessicans?
if unstable fragment then removal and immobilization will occur.
Surgical repair may be needed if fragement gets jammed between moving parts of the joint
What is osteoporosis?
Generalozed or localized defieciency of bone matrix, mass of bone per volume is decreased but normal composition
What causes osteoporosis?
- accelerated resorption of bone
- aging, postmenopausal hormonal changes
What are the signs and symptoms of osteoporosis?
- increased fractures
- Crippling deformity
- Kyphosis
What are the radiographic examinations for osteoporosis?
- x-ray (use lowest possible kVp)
- CT
What is the radiographic appearance for osteoporosis?
- cortical thinning
- Decreased bone density
- Anterior wedging in the spine and compression fracture
What is the treatment for osteoporosis?
- hormone replacement therapy
- Increase of calcium and vitamin D
What is gout?
Increase in blood uric acid levels causes deposition of uric acid crystals in joints, cartilage and kidneys
What are the signs and symptoms of gout?
-painful arthritis that usually starts with the 1st MTP joint
What are the radiographic exams for gout?
- x-ray
- MRI
What is the radiographic appearance for gout?
- early gout will NOT show up on x-ray, only late stage
- joint effusion, periarticular swelling
- Tophi (clumps of urate crystals) for along the articular cortex and eats the joint and underlying bone
What is the treatment for gout?
Antihyperuricemic drugs
What is Pagets?
- Destruction/regrowth of bone
- Affects pevis, femur, skull, tib fibs, vertebrae, clavicles, ribs
- Common chronic metabolic disease
What are the signs and symptoms of pagets disease?
- Pain
- Bone weakness
What are the radiograhic exams for pagets disease?
- usually skeletal survey
- Nuc med scan
- CT and MRI
What is the radiographic appearance of pagets disease?
- sharply defined radiolucency which signifies the destructive phase
- Islands of sclerosis and cortical thickening form in the repair phase, produce ‘cotton wool’ appearance.
- SPINE; increased
- PELVIS: coarse trabeculae along iliac margins > thickening of pelvic brim
- SKULL: ‘cotton wool’ skull from patchy sclerosis.
What is the treatment of pagets disease?
- no cure
- Disease can be slowed by bisphosphonates
What is ischemic necrosis of the bone?
loss of blood supply. Femoral head is most common site.
What causes ischemic necrosis of the bone?
thrombosis, disease of surrounding bone, single or repeated trauma.
What are the signs and symptoms of ichemic necrosis of the bone?
- pain
- May be asymptomatic and an incidental finding
What are the radiographic examinations for ichemic necorsis of the bone?
- x-ray
- Nuc med
- CT
- MRI
What is the radiographic appearance of ischemic necrosis of the bone?
- First sign: radiolucent subcortical band (crescent sign) represents a fracture line
- Progression: fragmentation, compression and resorption of dead bone, proliferation of graular tissue, revascularization and production of new bone
What is the treatment for ischemic necrosis of the bone>
- Surgical rod placement
- Extra care to minimize fracture
- Meds to regulate the osteoclastic formation, keeping the bone density more normal
What is another name Legg-Calve-Perthes
Coxa plana or osteochrondritis deformans
What is the cause of Legg-Calve-Perthes?
- Aseptic necrosis due to interuption of blood supply for no apparent reason
- Affects the hip joint in children, between 4-10 years old and occurs in families
What are the radiographic exams for Legg-Calve-Perthes?
AP and frog leg hip
What is the radigraphic appearance for Legg-Calve-Perthes?
- Epiphysis fragments and head femur flattened
- Bone contains sclerotic bone and osteolytic regions
