Roetgen Signs

Question 1

How much of a decrease in bone density do you need in order to see a lesion on an X-ray?

Answer 1

30-50%

Question 2

How big does the lesion have to be in order to be seen on an X-ray?

Answer 2

1-5cm

Question 3

What is the radiographic latent period for osteomyelitis in peripheral bone?

Answer 3

10-14 days

Question 4

What is the radiographic latent period for spinal osteomyelitis?

Answer 4

21 days

Question 5

What is the radiographic latent period for aggressive tumors?

Answer 5

4-6 weeks

Question 6

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

Answer 6

ACR Appropriateness criteria

Question 7

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

Answer 7

Discography

Question 8

What is the pattern of Distribution of Contrast for Discography?

Answer 8

fissuring, extravasation, pooling of contrast

Question 9

What phase of the bone scan is when you scan 5 minutes after the injection?

Answer 9

Blood Pool Phase

Question 10

What phase of the bone scan is when you scan 2-4 hours after injection?

Answer 10

Delayed Phase

Question 11

What phase of the bone scan is when you scan 24 hours after injection?

Answer 11

Delayed/delayed Phase

Question 12

What views areas of bone where bones overlap e.g. pars

interarticularis?

Answer 12

SPECT scan

Question 13

What imaging system is extremely sensitive for detecting bone marrow disease?

Answer 13

MRI

Question 14

What kind of cells partake in intramembranous ossification?

Answer 14

Mesenchymal cells

Question 15

What kind of bone growth controls width of long bones via activity of periosteum?

Answer 15

Appositional bone growth

Question 16

T/F: Not seen on x ray, but seen on MRI

Answer 16

True

Question 17

What is a thin radiopaque line at junction of physis and metaphysis?

Answer 17

Zone of Provisional Calcification (ZOPC)

Question 18

What is the most metabolically active region of a bone and the most common site for tumors and infection?

Answer 18

Metaphysis

Question 19

What is the term used when bones appear wider than usual?

Answer 19

Undertubulation

Question 20

What is the densest and strongest part of bone?

Answer 20

cortex

Question 21

Where is the red bone marrow in adults located?

Answer 21

axial skeleton, epiphyses, and metaphyses

Question 22

What type of lesion involves thinning of the cortex along the endosteal surface of the medullary cavity?

Answer 22

endosteal scalloping

Question 23

Is Imperceptable margination lesion slow or aggressive type of lesion?

Answer 23

Aggressive

Question 24

Is sharp margination lesion slow or aggressive type of lesion?

Answer 24

Slow

Question 25

What type of lesion contains multiple, poorly defined, small radiolucent lesions, 2-5mm in size, and are aggressive lytic lesions?

Answer 25

Moth-eaten lesion

Question 26

What type of lesion is the most rapidly aggressive bone tumors that contains numerous, tiny, pinhole size lesions?

Answer 26

Permeative lesion

Question 27

What type of lesion contains an increased density due to overproduction of bone or calcium laden tissue?

Answer 27

Osteoblastic lesion

Question 28

What type of reaction involves a continuous layer of new bone that attaches to outer cortex and is slow growing?

Answer 28

Solid Periosteal Reaction

Question 29

What type of reaction involves an alternating layers of lucent and opaque densities on external cortical surface and is aggressive?

Answer 29

Laminated Reaction (onion skin)

Question 30

What type of reaction is Perpendicular, brushed whiskers, hair on end and are aggressive tumors?

Answer 30

Spiculated Periosteal Reactions

Question 31

What is known as a periosteal new bone at the peripheral lesion – cortex junction as result of subperiosteal extension of lesion?

Answer 31

Codman's Triangle

Question 32

What type of laboratory test has an Increased tendency of rbc’s to precipitate out due to increased concentrations of fibrinogen and is especially good for Inflammatory Diseases?

Answer 32

ESR

Question 33

What laboratory test is from being released by the liver and is due to inflammatory changes or tissue necrosis?

Answer 33

CRP

Question 34

What lab test is used with disorders of bone destruction and disorders of increased parathormone activity?

Answer 34

Serum Calcium

Question 35

What lab test is an Indicator of bone destruction and an important indicator of bone activity?

Answer 35

Serum Phosphorus

Question 36

What lab test reflects an increase in osteoblastic activity and is increased in Paget's disease and METs?

Answer 36

Alkaline Phosphatase

Question 37

What lab test is increased in Prostate metastasis | and Gaucher’s disease and is located in the Prostate gland?

Answer 37

Acid Phosphatase

Question 38

What does an elevated total serum protein indicate?

Answer 38

METs or Multiple Myeloma