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633: Human Imaging II > Radiologic Evaluation, Search Patterns, and Diagnosis > Flashcards

Radiologic Evaluation, Search Patterns, and Diagnosis Flashcards

1
Q

What 3 things does alignment (A) analysis include?

A
  • General Skeletal Architecture
  • General Contour of Bone
  • Alignment of Bones Relative to Adjacent Bones
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2
Q

When analyzing general skeletal structure, what should you look for?

A
  • Aberrant size of bones
  • Supernumerary bones
  • Congenital anomalies
  • Absence of any bones
  • Developmental deformities
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3
Q

Sharp angles in the cortex may be a sign of _____ fractures.

A

impaction

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4
Q

If there is noted trauma at the attachment sites of muscles, tendons, and ligaments it may be a sign of an _____ fracture

A

avulsion

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5
Q

What 3 things does bone density (B) analysis include?

A
  • General Bone Density
  • Textural Abnormalities
  • Local Density Changes
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6
Q

A healthy bone cortex shows up with _____ density than cancellous bone and appears ____.

A

greater

white

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7
Q

What bony feature should you asses when looking for textural abnormalities?

A

trabeculae

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8
Q

What does fluffy trabeculae represent?

A

random proliferation of both osteoblastic and osteoclastic activity

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9
Q

What types of diseases are fluffy trabechulae present?

A

In the skulls of patients with Paget’s disease and in hyperparathyroidism

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10
Q

Smudged trabeculae is a characteristic of what disease?

A

osteomalacia

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11
Q

What types of diseases are coarsening trabechulae present?

A

patients with chronic renal failure and osteoporosis

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12
Q

Why do trabeculae appear coarsened?

A

The loss of surrounding trabeculae cause remaining trabeculae to appear prominent

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13
Q

Lacy or delicate trabeculae is a characteristic of what disease?

A

thalassemia (Cooley’s anemia)

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14
Q

Sclerosis is a sign of what?

A

Repair

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15
Q

When does reactive sclerosis occur?

A

When the body acts to surround and contain a diseased area, such as a tumor or infection

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16
Q

What 3 things does cartilage spaces (C) analysis include?

A
  • Joint Space Width
  • Subchondral Bone
  • Epiphyseal Plates
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17
Q

How can you tell the difference between degenerative arthritides (OA) and inflammatory arthritides (RA or gout) on a plain film?

A
  • In OA subchondral bone becomes increasingly sclerotic as new bone formed to help withstand increased stresses directed at it because of loss of articular cartilage
  • In RA or gout there is erosion of the subchondral bone and formation of radiolucent cysts
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18
Q

What are the 4 types of periosteal reactions?

A
  • solid
  • laminated/onion skin
  • spiculated/sunburst
  • Codman’s triangle
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19
Q

What does a solid periosteal reaction indicate?

A

a benign process

- seen in fracture healing and osteomyelitis

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20
Q

What does a laminated/onion skin periosteal reaction indicate?

A

repetitive injury

- seen in battered child syndrome and sarcomas

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21
Q

What does a spiculated/sunburst periosteal reaction indicate?

A

malignant bone lesions

- seen in osteogenic sarcomas and in metastatic squamous cell tumor

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22
Q

What does Codman’s triangle periosteal reaction indicate?

A

Present in a variety of conditions, including tumor, subperiosteal hemorrhage, and battered child syndrome

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23
Q

What does gas in soft tissue indicate?

A

gas gangrene or trauma

24
Q

What are calcifications within soft tissue the result of?

A

old trauma whereby bloody hemorrhage has coagulated and calcified

25
Q

What are the 6 basic categories of pathology in classification of skeletal diseases?

A
  • Congenital
  • Inflammatory
  • Metabolic
  • Neoplastic
  • Traumatic
  • Vascular
26
Q

What are the 3 types of lesion distributions? Explain each…

A
  • Monostotic or monoarticular: affect only one bone or one joint
  • Polyostotic or polyarticular: affect multiple bones or multiple joints
  • Diffuse: affect all or nearly all bones or joints
27
Q

What are the only 2 disease categories that can occur diffusely?

A

Neoplastic or Metabolic

28
Q

How many predictor variables may be applied to any bone or joint lesion to assist in making a diagnosis?

A

11

29
Q

What are the 3 descriptors a bone lesion may occur as?

A
  • Osteolytic
  • Osteoblastic
  • Mixture
30
Q

What are the 3 forms in which an osteolytic lesion can take on?

A
  • Geographic destruction
    Moth-eaten appearance
  • Permeative destruction
31
Q

Describe geographic destruction of bone

A

Large areas of bone are destroyed and appear as radiolucent lesion.

32
Q

Sharply defined geographic borders are indicative of a _____ lesion

A

benign

33
Q

Ragged moth-eaten borders are indicative of a _____ lesion

A

malignant

34
Q

Describe permative destruction of bone

A

There is very fine destruction of bone through the haversian system, sometimes requiring magnifying lens to recognize on film

35
Q

Poorly defined permative borders are indicative of a _____ lesion

A

malignant

36
Q

Where do gout and RA typically manifest?

A

primarily in small joints of the hands and feet

37
Q

Where foes typically manifest?

A

in the knees

38
Q

Arthritides have characteristic lesion locations on the articular surfaces of bone. However, what is the difference between the 2?

A

Osteoarthritis affects weight-bearing areas, whereas rheumatoid arthritis affects entire joint surface

39
Q

In general, margins either sharp and ____ defined or wide and ____ defined.

A

clearly

poorly

40
Q

Sharp, clearly defined, sclerotic borders characteristic of what?

A

slow-growing or benign lesions

41
Q

Wide, poorly defined borders with minimal or absent reactive sclerosis are characteristic of what?

A

fast-growing or malignant lesions

42
Q

Lesions that are longer than are wider are likely to be _____. Why?

A

Benign, because the lesion has grown slowly along with bone

43
Q

Lesions that are wider than they are long are likely to be _____. Why?

A

Malignant, because they are extending into soft tissue aggressively

44
Q

Do tumors (benign or malignant) cross joint spaces or epiphyseal growth plates?

A

No

45
Q

What does cross joint spaces?

A

inflammation

46
Q

What are the 3 types of boy reactions?

A
  • periosteal
  • sclerosis
  • buttressing
47
Q

What is sclerosis?

A

new bone growth established to fortify an area subjected to increased stress, as in sclerosis of subchondral bone in osteoarthritis

48
Q

What is buttressing?

A

formation of bony exostoses or osteophytes at joint margins, which serve to strengthen architecture of joint

49
Q

A periosteal reaction to a neoplasm is usually characterized as one of what 2 things?

A

interrupted or uninterrupted

50
Q

What does an interrupted periosteal response suggest?

A

Either malignant or non-malignant but highly aggressive lesions

51
Q

What does an uninterrupted periosteal response suggest?

A

benign processes

52
Q

What do uninterrupted periosteal responses look like?

A

Solid density, either longitudinal, undulated, or buttressing in pattern

53
Q

What is matrix?

A

intercellular tissue produced by some bone tumors

54
Q

What are the 3 types of tumor matrixes?

A
  • chondroid (cartilaginous)
  • osteoid (bony)
  • mixed (combination of cartilaginous and bony)
55
Q

What do chondroid matrixes appear as?

A

stippled, popcorn-like, or comma-shaped calcifications seen in tumors invading soft tissues

56
Q

What do osteoid matrixes appear as?

A

white, cloud-like, fluffy density within medullary cavity and in adjacent soft tissue

633: Human Imaging II (11 decks)

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