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Tri 6 - Tumors > Roentgen Signs > Flashcards

Roentgen Signs Flashcards

1
Q

5 Radiographic Densities

A 
– Air
– Fat
– Water
– Bone
– Metal
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2
Q

______ determines if further imaging

is indicated

A

Plain film radiography

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3
Q

Need at least ______ decarse in bone density to see lesion in Conventional Radiography

A

30-50%

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4
Q

Need a lesion at least _____ in size to detect

Conventional Radiography

A

1-5cm

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5
Q

Time until a lesion is seen by plain film radiography

A

Radiographic Latent Period

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6
Q

Osteomyelitis in peripheral bone radiographic latent period

A

10-14 days

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7
Q

Spinal osteomyelitis radiographic latent period

A

21 days

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8
Q

Aggressive tumors radiographic latent period

A

4-6 weeks

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9
Q

– Trauma – Unexplained weight loss – Night pain – Motor deficit – Malignancy

A

red flag

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10
Q

– Inflammatory arthritis – Fever of unknown origin – Abnormal blood results – Deformity

A

red flag

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11
Q

– Failure to respond to therapy – Medicolegal concerns

A

red flag

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12
Q

– >50 yo – Drug or alcohol abuse – Corticosteroid use – Old or lost previous x rays – Research

A

yellow flag

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13
Q

– Systemic disease – Recent immigration – Rule out contraindications – Therapeutic response

A

yellow flag

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14
Q

– Patient education – Routine screening – Habit – Discharge status assessment – Routine biomechanical analysis – Pre-employment status

A

non indicators

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15
Q

– Physical limitations of patient – Inadequate equipment – Non-trained personnel – Financial gain – Recent high-level radiation exposure – Pregnancy

A

non indicators

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16
Q

evidence-based guidelines to assist referring
physicians and other providers in making the
most appropriate imaging or treatment decision for a specific clinical condition.

A

The ACR Appropriateness Criteria

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17
Q

Injection of water soluble iodinated contrast into IVD’s nucleus
pulposus via fluoroscopic control in order to determine pain
generator

A

Discography

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18
Q

Radionuclide Imaging

A

Bone Scan

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19
Q

used to identify pars fractures (gymnastic athletes)

A

SPECT Scan

“Single-Photon Emission Computed Tomography”

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20
Q

detects:
Metastatic disease
Tumors Infection Arthritis Fracture (occult, stress, recent fx) Avascular Necrosis (AVN)

A

bone scan

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21
Q

– Detects as little as 3-5% bone destruction/production
– 10x more sensitive than plain film radiography
– Great for early detection of many disease processes

A

bone scan

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22
Q

No uptake in Multiple Myeloma unless pathological

fracture

A

bone scan

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23
Q

vascular dz
msk disorders
abdominal and pelvic imaging

A

diagnostic ultrasound

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24
Q

high level of radiation dose

excellent bone detail

A

Computed Tomography (CT)

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25
Q

Mathematical Data from Axial Images is Reformatted rendering Sagittal Lumbar Spine Image

A

Computed Tomography (CT)

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26
Q

excellent for soft tissue resolution
very sensitive for detecting bone marrow dz
great for spinal dz, especially disc dz

A

MR

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27
Q

Model of bone structure formed by condensed mesenchymal cells after which bone is formed
• Skull
• Clavicles
• Mandible

A

Intramembranous Ossification

28
Q

Controls width of long bones via activity of periosteum

A

Appositional Bone Growth

29
Q

– Osteoblasts transform cartilage template into bone
• Tubular bones
• Vertebrae
– Chondroblasts and chondrocytes form and produce a
cartilage cast of the definitive bone

A

Enchondral Ossification

30
Q

surrounds bone except at ends of bone

A

Periosteum

31
Q

Located at ends of long bones

A

Epiphysis

32
Q

Consists of layers of progressively maturing cartilage & developing bone

A

Physis

33
Q

Harris Growth Arrest (Park) Lines

A

growth arrest during systemic disease

34
Q

Thin radiopaque line at junction of

physis and metaphysis

A

Zone of Provisional Calcification (ZOPC)

35
Q
  • Most metabolically active region of a bone

* Most common site for tumors and infection

A

Metaphysis

36
Q

(bones appear wider than usual)

A

Undertubulation

37
Q

(bones appear slender)

A

Overtubulation

38
Q

• Longest part of bone • Thickened cortex and decreased medullary space • Provides mechanical strength and contains bone
marrow

A

Diaphysis = Shaft

39
Q

• Densest and strongest part of bone • Densely packed compact lamellar bone and osteons
and is interconnected by Haversion canal systems

A

Cortex

40
Q

predominates in all bones in children

A

Red marrow

41
Q

Adults have red marrow only in

A

axial skeleton,

epiphyses, and metaphyses

42
Q

• Does not cover epiphysis; does not enter synovial
joint. Forms synovial lining of synovial joint.
• Thin membrane covering diaphysis and metaphysis

A

Periosteum

43
Q

produced due to pus, blood or tumors
produced due
irritation or elevation from bone

A

Periosteal Reactions

44
Q

Trabeculae and inner cortical margins are
covered by ______ that has osteogenic
properties

A

endosteum

45
Q

– May be separated from bone by a thin layer of soft tissue
– Originates in muscle, nerve, arterial, or synovial tissue
– May see pressure erosion of bone with sclerotic margin
– Do not originate in bone

A

Extraosseous Lesions - bone dz

46
Q 
– Lytic lesions such as fibrous
dysplasia, and cartilaginous
lesions
the endosteal surface of the medullary cavity
– Thinning of the cortex along
A

Endosteal Scalloping - bone dz

47
Q 
– Poor, hazy, ill defined margins,
long zone of transition
– Gradation between normal and
abnormal bone occurs gradually
– Indicates aggressive bone
destruction
• Infections • Malignancy
A

Imperceptible Margination - bone dz

48
Q

– Definite and sclerotic margins
– Narrow zone of transition
– Clear identification between normal and abnormal bone
– Usually slow growing lesion

A

Sharp Margination - bone dz

49
Q

Loss of bone density and structure

A

Osteolytic Lesions

50
Q

– Circumscribed lesion – Uniformly lytic lesion – Usually solitary – >1cm – Sharp margin – Usually slower growing
and are usually benign – May be septated or soap
bubbly

A

Geographic Lesion

51
Q

– Multiple, poorly defined, small radiolucent
lesions – 2-5mm in size – Ragged irregular margins of lesions – Confluence of lesions occurs – Aggressive lytic lesions
• Multiple myeloma • Metastatic disease • Infection

A

Moth-Eaten Lesion

52
Q 
– Numerous, tiny, pinhole size
lesions
– < 1.0mm in size
– Wide zone of transition
– Most rapidly aggressive bone
tumors
– Easily missed on conventional
radiography
A

Permeative Lesion

53
Q

– Increased density due to
overproduction of bone or calcium laden tissue
– Blastic Metastasis – Osteosarcoma – Paget’s Disease

A

Osteoblastic Lesions

54
Q

– Continuous layer of new bone that attaches

to outer cortex – Usually benign process – Slow disease process – Elliptical, undulating, continuous

A

Solid Periosteal Reaction

55
Q

– Slow and aggressive tumors – Infection – Ewing’s Sarcoma
– Alternating layers of lucent and opaque densities on external cortical surface
– Radiolucent zones contain loose
connective tissue and dilated blood
vessels that have not ossified

A

Laminated: Lamellated, Onionskin

56
Q 
– Perpendicular, brushed whiskers, hair on
end
– Sunburst: radiating spicules of bone
from a point source
– Aggressive tumors
– Fine linear spiculations of new bone
perpendicularly oriented away from
cortex
A

Spiculated Periosteal

Reactions

57
Q 
Periosteal new bone at the
peripheral lesion – cortex junction
as result of subperiosteal
extension of lesion
• Primary malignant bone tumors • Benign bone tumors • Infections
A

Codman’s Triangle

58
Q

Increased soft tissue density

A

Synovial Sarcoma

59
Q

Soft Tissue Calcification

A

Synovial Sarcoma

60
Q

– Increased tendency of rbc’s to precipitate out due to
increased concentrations of fibrinogen
– Nonspecific index for disease
– Especially good for Inflammatory Diseases

A

ESR: Erythrocyte Sedimentation Rate

61
Q

– Due to inflammatory changes or tissue necrosis – Released by liver – Nonspecific

A

CRP: C - Reactive Protein

62
Q

– Normally within strict limits – Disorders of bone destruction – Disorders of increased parathormone
activity

A

Serum Calcium

63
Q

– Indicator of bone destruction – Important indicator of bone activity – Inverse relationships to calcium levels

A

Serum Phosphorus

64
Q

– Reflects an increase in osteoblastic activity

– Paget’s disease – Metastatic disease – Healing fractures – Lymphoma

A

Alkaline Phosphatase

65
Q 
• Metastatic lesions in bone and soft tissue liberate acid phosphatase
– Located in prostate gland
– Increased in Prostate metastasis
and Gaucher’s disease
– Capsule of prostate must be
disrupted
A

Acid Phosphatase

66
Q

– Multiple Myeloma:
• IgG spike
• IgA spike
• Bence Jones proteinuria (40%) of patients with MM
– Elevated total serum protein often indicates metastatic disease or multiple myeloma

A

Total Protein

Tri 6 - Tumors (5 decks)

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