Radio Flashcards
pathology of sickle cell disease
abnormal hemoglobin s
kidney uts results for scd
renal pyramids appear bright
skeletal findings in scd
expansion of medullary spaces
femoral flattening = avascular necrosis
axial ct findings in scd
auto-splenectomy
vertebral xray in scd
scalloping or concave deformity of the endplates (can also be seen in ct)
vertebral ct in scd
h shaped appearance of vertebra
what is sickle cell dactylitis
severe inflammation of finger and toe joints from infarcts of bone marrow and cortical bone
occur in first two years of life, little/no residual damage
pathology in thalassemia
reduction in the rate of globin chain synthesis = abnormal hemoglobin molecules
skeletal findings in thalassemia
- expansion of medulla
- thinning of cortical bone
- resorption of cancellous bone
skull: hair on end appearance
facial bones: rodent facies
rib within a rib appearance (anteior ribs is larger or more bulbous, posterior is smaller)
extra-medullary hematopoiesis
gi findings in thalassemia
cholelithiasis
hemosiderosis
coronal ct of knee in thalassemia
marrow changes = area of interspersed hypointense signals
hand xray in thalassemia
marrow proliferation = carpals and phalanges appear extended and lucent
scalloping of metacarpals, looking flattened or squared
characteristics of fanconi anemia
progressive bone marrow failure
congenital abnormalities
predisposition to malignancies
most common type of inherited marrow failure syndrome
radiologic findings in fanconi anemia
horseshoe kidney
radial ray anomalies (no thumb and radius; extra digits)
triphalangeal thumb
types of hemophilia
A = FACTOR 8 B = FACTOR 9
hallmark of hemophilia
hemorrhage
- hemophilic arthropathy
- hemophilic pseudotumor
- soft tissue hematoma
skeletal findings in hemophlia
- enlargement of epiphysis of radial head
- hemarthrosis (fluid collection in joints like elbow or feet)
- intercondylar notch appears widened and enlarged
- sunrise view (knee has wide intercondylar notch and displaced patella)
axial ct in hemophilia
kidney can be larger with hemorrhagic collection within (hyperdensity)
patho in aplastic anemia
immune mediated reduction in pluripotent hematopoietic stem cells
mri findings in aplastic anemia
low signal areas interspersed with high signal areas on spine
what does hemochromatosis look like in t1
hypointensity, mostly in liver
primary hemochromatosis on ct
calcifications and metal components = dark
spleen = isodense
secondary hemochromatosis on ct
liver and spleen are dark
skeletal findings in hemochromatosis
- severe joint space narrowing throughout the hand, most marked at metacarpophalangeal joints
- sclerosis of mcp joints + large osteophytes off metacarpal heads = degenerative disease
- chondrocalcinosis
- cppd
imaging modality of choice for hemochromatosis
mri
what is myelofibrosis
replacement of bone marrow with collagenous ct
- extramedullary hematopoiesis
- progressive splenomegaly
- anemia
- variable change in # of granulocytes and platelets
radiologic features of myelofibrosis
lymphadenopathy osteosclerosis (>50 yo) hepatomegaly splenomegaly portal hypertension
most common primary mediastinal neoplasm in adults
lymphoma
what is lymphoma
mediastinal lymph node enlargement, bilateral and asymmetric
hodgkin lymphoma and non-hodgkin lymphoma*
lymphoma type with higher change of thoracic involvement
hodgkin disease
more likely lymphoma with intrathoracic involvement + mediastinal enlargement
hodgkin disease
% of patients with disease limited to mediastinum
hd = 25% nhd = 10%
nodal groups for each lymphoma type
hd = anterior and hilar nhd = middle mediastinal, hilar, juxtaphrenic and posterior
more unpredictable and widespread lymphoma
nhd = chemotherapy
hd uses radiation therapy
most common primary malignant bone neoplasm in adults
multiple myeloma
patho in multiple myeloma
monoclonal proliferation of malignant plasma cells (produce igg, infiltrate hematopoietic locations)
clinical findings in multiple myeloma
bone pain
anemia
renal failure/proteinuria
how to distinguish bone metastasis from multiple myeloma
bm = affects vertebral pedicles > vertebral bodies, rarely involves mandible and distal axial skeleton
patterns of multiple myeloma
- multiple well-defined “punched-out” lytic lesions affecting axial skeleton
- diffuse skeletal osteopenia
- solitary plasmacytoma (vertebral body or pelvis)
- osteosclerosing myeloma
