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Skeletal Radiology A > Radiographic signs: Periosteal rxn > Flashcards

Radiographic signs: Periosteal rxn Flashcards

1
Q

Pathological lifting of the periosteum away from bone due to stimulation.

A

PEriosteal rxn

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2
Q

Stimulants of periosteal rxn

A

Extension of blood, pus or tumor

Hyperemia

Inflammation

Edema

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3
Q

Which layer of periosteum is involved in periosteum rxn

A

Inner cambium

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4
Q

T/F: We don’t see the periosteum in normal or abnormal conditions. However we see the bone produced.

A

True

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5
Q

3 types of periosteal rxn pattern

A

Solid

Laminated

Spiculated

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6
Q

PEriosteal rxn:

Single layer of bone layed longitudinally parallel to cortex

Appears smooth, wavy or chunking

Slow growing/Benign

Local or diffuse (tubular bones)

Responds to insult or irritation

A

Solid

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7
Q

Causes of solid periosteal rxn

A 
Local:
Infection
Benign bone neplasm
Eosinophillic granuloma
Fracture healing

Diffuse:
Hypertrophic Osteoarthropathy

Variscosities (lower extremities

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8
Q

Example of Local benign bone neoplasm that is a very localized solid periosteal rxn.

Very dense area of cortical thickening

Very common classic bone forming bone tumor

A

Osteoid osteoma-bone tumor from osteoblast

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9
Q

Causes of solid periosteal rxn:

Local

Stimulated by chronic inflammation

Produced by granulation tissue

Cause of compression fx in spine

A

Eosinophillic granuloma

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10
Q

Causes of solid periosteal rxn:

Diffuse excess of bone and joint growth

A

Hypertrophic Osteoarthropathy

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11
Q

Causes of periosteal rxn:

Venous stasis of blood leading to bone pain that causes periostitis in the tibia, fibula and metatarsals

A

Variscosities

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12
Q

CAuses of periosteal rxn:

Callous formation helps produce new collar of new bone

A

Fracture healing

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13
Q

Direct stimulus from an underlying bone lesion (intrinsic); mc fracture
healing, infection, and benign bone neoplasm

A

Localized periosteal rxn

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14
Q

Systemic diseases and the periosteum is reacting; mc hypertrophic
osteoarthropathy

A

Wide spread periosteal rxn

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15
Q

If more than 1 tubular bone shows a periosteal reaction, is it local or diffuse?

A

Diffuse

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16
Q

Cause of Diffuse SOLID Perioteal rxn:

Clinical syndrome consisting digital clubbing

Skin thickening and
Periosteum

3-5% of cases

Radiographically diffuse widespread symmetrical periostitis involving DIAPHYSIS AND METAPHYSES

A

Primary hypertrophic osteoarthropathy

17
Q

Cause of Diffuse SOLID Perioteal rxn:

Clinical triad of digital clubbong, periositis, synovitis

Found in bronchogenic carcinoma patients

95% of cases

A

Secondary hypertrophic osteoarthropathy

18
Q

Cause of Diffuse SOLID Perioteal rxn:

Usually seen after tx for hyperthyroidism when pt are euthyroid or hypothyroid.

Pt shows exopthalmos, digital clubbing pretibial myxedema and periostitis

A

Thyroid acropachy

19
Q

Cause of Diffuse SOLID Perioteal rxn:

Uncommon disorder of infancy usually middle of the first year characterized by sudden onset of fever, hyperirratibility and swelling especially over the mandible!

A

Infantile cortical hyperostosis AKA Caffey’s disease

20
Q

Cause of Diffuse SOLID Perioteal rxn:

Acute overdose of vitamin A associated with nausea, vomitting, headache and irratibility.

Periostitis involving tubular bones especially the ulna and metatarsals

NOT in mandible

A

Hypervitaminosis A

21
Q

Cause of Diffuse SOLID Perioteal rxn:

Periostitis occurs in children related to subperiosteal bleeding

Capillary fragility related to hypovitaminosis C

Gum bleeding

A

Scurvy

22
Q

Cause of Diffuse SOLID Perioteal rxn:

Mutliple areas of solid periosteal new bone associated with multiple fractures at different stages of healing

A

Battered children

23
Q

Cause of Diffuse SOLID Perioteal rxn:

Excessive growth hormone production stimulating solid periosteal bone formation

A

Acromegaly

24
Q

Cause of Diffuse SOLID Perioteal rxn:

Multiple areas of bone desrtuction associated with adjacent periostitis

A

Leukemia

25
Q

Cause of Diffuse SOLID Perioteal rxn:

Young children under two years show normal physiological new bone formation

A

Normal

26
Q

Periosteal rxn:

Demonstrates multiple concentric parallel layers of new bone adjacent to the cortex

May transform to solid but never form full cortex

Mostly in diaphysis

A

Laminated

27
Q

Causes of laminated rxn

A

Ewing (Classic cause)

Eosiniophilic granuloma

Osteomyelitis

leukemia

28
Q

Top 5 primary malignant bone cancer?

A

MOCEF

Multiple myeloma

Osteosarcoma

Chondrosarcoma

Ewings

Fibrosarcoma

29
Q

T/F: Osteomyelitis can produces any periosteal rxn

A

True

30
Q

Periosteal rxn:

Most aggressive

Fine, linear spicules oriented perpendicular to cortex

Parallel or radiating

Rapidly growing lesions(5-6 weeks)

Characteristic of Osteomasarcoma

A

Spiculated AKA

perpendicular, brushed whiskers, hair-on-end, and sunburst

31
Q

Cause of spiculated periosteal rxn

A

Osteomyelitis

Osteosarcoma

Ewings

chondrosarcoma

Fibrosarcoma

Lymphoma (Non-Hodgkin)

Leukemia

32
Q

Periosteal rxn subset that can be in any of the three types.

Is typically with the aggressive rxn

Typicall at the ends/edge of periosteal rxn

@diaphysis

A

Codman’s angle, periosteal cuff, or buttress

Skeletal Radiology A (5 decks)

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