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Skeletal Radiology 1 CUKC > Sickle Cell > Flashcards

Sickle Cell Flashcards

1
Q

What inherited disorder is nearly exclusive to Blacks?

A

Sickle cell anemia

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2
Q

Fragile sickled RBC’s lead to what?

A

increased blood viscosity, stasis,
clots and
lowered pH

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3
Q

Clinical and radiographic features of sickle cell relate to what kind of occlusion?

A

vascular occlusion
tissue infarction
marrow hyperplasia

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4
Q

Hand-foot syndrome is caused by vascular occlusive leads to what?

A

ischemia

infarction of distal parts of extremities

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5
Q

Sickle cell crisis in the abdomen are due to which of the following symptoms?

A

mesenteric vascular thrombosis

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6
Q

Name clinical symptoms observed sickle cell anemia?

A 
Congestive heart failure
Dactylics aka welling in fingers/toes 1st yr of life
crisis 
jaundice
cholelithiasis
bone pain
anemia
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7
Q

Sickle cell manifesting as a vaso-occlusive crises resulting in what 2 things?

A

bone infarcts and subperiosteal hemorrhages

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8
Q

What is the presentation of osteomyelitis in sickle cell anemia?

A

local pain and systemic features of infection

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9
Q

What are the radiographic features of SCA in long bones?

A

osteopenia coarsened trabeculae, widened metaphysis, thin cortices, bone infarcts

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10
Q

What are the radiographic features of SCA in spine bones?

A

osteopenia, endplate infarction (H-shaped vertebra), collapse, widened vascular notch, extra-medullary hematopoiesis

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11
Q

Radiographic features from marrow hyperplasia, ischemia, necrosis and osteomyelitis in sickle cell anemia are mc in what location?

A

long bones

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12
Q

Sickle infections are a result of what bacteria?

A

Salmonella

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13
Q

Radiographic features of infarction in short tubular bone with sickle cell anemia are as follows

A

ST welling
diaphyseal linenear periostitis
cortical spitting (bone in bone)

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14
Q

Name the MC location within short tubular bones for manifestation of an infarction?

A

metaphysical and diaphyseal medullary infarcts

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15
Q

What is the MC location of epiphyseal necrosis in sickle cell anemia short tubular bones?

A

Femoral

Note: features are growth disturbances, patch areas of lucency/sclerosis, bone fragmentation

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16
Q

What is the mc location of acute osteomyelitis?

Where w/in bone does this condition begin?

A

Femur, large tubular bone

metaphysis

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17
Q

a. What pediatric symptom is expected in acute osteomyelitis?
b. ID the specific symptom/sign observed in acute osteomyelitis to distinguish adults from pediatric.

A

a. Acute Hight fever

b. Insidious onset

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18
Q

Name the pathologic feature associated with acute osteomyelitis.

A

early detection on MRI

Irreversible cartilage damage w/in 48 hrs

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19
Q

What is an the early radiologic feature seen in acute osteomyelitis?

A

ST edema

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20
Q

Name radiologic feature expected in septic arthritis.

A

periarticular swelling
early widened joint space
late narrowed joint space

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21
Q

Destruction in septic arthritis is seen in what part of the bone?

A

Metaphyseal or Epiphyseal in infants and adults d/t blood supply in both areas

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22
Q

Prognosis of acute osteomyelitis is dependent upon what?

A

stage, location and pt immune status

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23
Q

What is the MC location of low grade/chronic osteomyelitis?

A

Tibia

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24
Q

An ill defined lucency, sclerosis, cortical thickening, No periosteal reaction or ST well, and presence of cloaca radiologic features are observed in what condition?

A

low grade/chronic osteomyelitis

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25
Q

What is PLASTIC RAGS and what condition is this nemonic associated with?

A 
Pancreatitis
Lupus
Alcoholism, Atherosclerosis
Steroid Therapy
Trauma
Idiopathic
Caisson’s Disease
Radiation, RA (steroids)
Amyloid
Gaucher’s Dz
Sickle Cell Dz

associated w/ostenecrosis

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26
Q

What is the time frame of ischemia for marrow elements, bone cells and marrow fat?

A

6-12 hrs
12-24 hrs
2-5 days

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27
Q

A decrease of blood flow lead to what just before bone infarction?

A

bone ischemia

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28
Q

Provide at least 2 patho-mechanic mechanisms of infarction.

A

intra-luminal obstruction
arterial wall dz
vascular compression
physical disruption of vessel

29
Q

True or False

Osteonecrosis is not visible on radiograph until the removal, remodeling and deposition stage.

A

True

30
Q

Which of the following is the result of an articular surface collapse?

A

step defect

31
Q

Define subchondral collapse

A

frx of trabecular cancellous bone just below the subchondral bone plate w/out articular surface disruption.

32
Q

What is the aka for subchondral collapse?

A

crescent sign

33
Q

what is the pathognomonic of late osteonecrosis?

A

Subchondral collapse

34
Q

What’s the order of late osteonecrosis? In other words which is worst Crescent sign or step defect?

A

Step defect

35
Q

What is the MC hematologic condition of bone?

A

osteonecrosis

36
Q

Osteochondritis dissecans has what kind of necrosis occurring in pads?

A

focal

37
Q

Avascular necrosis involvement is what type of necrosis?

A

junta-articular

usually in epiphysis

38
Q

Early osteonecrosis will have what radiographic findings?

A

joint effusion
patchy density changes (lucency, sclerosis)
Bite sign

39
Q

Reactive interface line, double line sign and rim sign are MRI T2 weighed findings associated with what condition?

A

Osteonecrosis in femoral head

40
Q

What is the MC location of osteonecrosis?

A

femoral head

males 40-60 yrs old

41
Q

Osteonecrosis in the femur head Signs/symptoms are asymptomatic seen early.. True or False

A

True

Note: pain in hip, butt, groin later in dz.

42
Q

ID sign/symptoms of femoral head osteonecrosis?

A

Hip, butt, groin pain
Reduced motion
m. atrophy

43
Q

Radiographic features seen in early osteonecrosis of the femur are what?

A

joint effusion
patchy density changes
bite sign

44
Q

Radiographic features seen in late osteonecrosis of the femur are what?

A 
subchondral collapse (crescent sign), articular collapse (step defect)
deformity
45
Q

What is the exact location for the development of knee osteonecrosis?

A

medial condyle of distal femur pt over 60 yrs old

46
Q

What S/S of knee osteonecrosis?

A

sudden onset of knee pain

47
Q

What are the radiographic features of osteonecrosis in the knee

A

articular cortex flattening/collapse
altered subchondral bone density
loose bodies
articular degeneration

48
Q

What radiographic features are observed during the avascular stage of leg-calve-perthes?

A

joint effusion
medial space widening aka waldenstom’s sign
sign of joint effusion
small epiphysis

49
Q

What does BME stand for?

A

Bone Marrow Edema

50
Q

What MRI finding is associated w/pain?

A

Bone Marrow Edema

51
Q

MR is most sensitive and demonstrates changes earlier than XR. What findings are noted on MRI?

A

reactive interface line
double line sign
rim sign

52
Q

What is the alternating signal intensity on T2 weighted MRI and is diagnostic?

A

double line sign

53
Q

True or False

Infarcts imply bone death but are Not at risk of bone fracture or joint frx because it stays in medullary cavity.

A

True

54
Q

What are the radiographic signs of medullary infarct?

A

sclerotic lesion in metaphysis of long bone that have snakes like outlines (aka serpentine)

55
Q

Osteonecrosis in the knee has what appearance?

A

Flattening of convex articular surface
altered subchondral bone density
subchondral frx
step defect (articular surface frx)

56
Q

Osteonecrosis in head of the second metatarsal

A

Freiburg infraction

57
Q

Osteonecrosis in humeral head

A

Hass dz

58
Q

Kienbock dz is Osteonecrosis activity in what bony structure?

A

lunate

59
Q

What bone structure is effected in Kohler dz?

A

navicular in children

60
Q

Kummell dz is ostenecrotic active in what structure?

A

vertebral body

61
Q

Osteonecrosis to the scaphoid is called?

A

preiser dz

62
Q

Necrotic activity to the capitellum of the humerus is called?

A

Panner dz

63
Q

Calcaneal epiphysis is damage known as?

A

Sever dz

64
Q

What locations are location specific sub-articles for ANV?

A

Hip avascular necrosis

Scaphoid avascular necrosis

65
Q

Name the MC sites of osteonecrosis

A

femoral head
femoral condyle
humeral head
scaphoid

66
Q

What conditions are self limiting?

A

Legg-Calve-Perthes

Osgood-Schlatter’s

67
Q

What self limiting conditions is caused by osteonecrosis?

A

Legg-Calve-Perthes

68
Q

What are 3 correlations of deformity in legg-calve-perthes?

A 
coxa vara
Lg femoral head aka coxa magna
fattened head aka mushroom deformity
Lg greater trochanter
Sagging rope

Skeletal Radiology 1 CUKC (15 decks)

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