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radiology 1 quizlet > systemic bone diseases > Flashcards

systemic bone diseases Flashcards

1
Q

hormones and nutrients that stimulate bone production

A

GH, T3 & T4, calcitonin, vit D, vit C

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2
Q

hormones inhibiting bone production

A

PTH, cortisol

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3
Q

all encompassing definition for increased radiolucency of bone

A

osteopenia

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4
Q

most common etiology for osteopenia

A

osteoporosis

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5
Q

other common etiologies for osteopenia besides osteoporosis

A

osteomalacia (vit D deficiency), hyperparathyroidism, rickets (vit D deficiency in a child), scurvy (vit C deficiency), neoplasm

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6
Q

if there is a radiolucency in bone does that automatically mean that it is osteoporosis

A

no, could be other factors

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7
Q

TRUE or FALSE: osteopososis is qualitatively normal but quantitatively deficient in bone

A

TRUE

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8
Q

looser’s lines indicate what

A

osteomalacia

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9
Q

primary osteoporosis

A

senile osteoporosis, postmenopausal osteoporosis, transient or regional osteoporosis

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10
Q

secondary osteoporosis

A

corticosteroids, malignancy, infection, arthritides, disuse, RSD

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11
Q

endocrinopathy of osteopenia

A

acromegaly, hyperparathyroidism, hyperthyroidism, Cushing’s disease, pregnancy, heparin, alcoholism

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12
Q

what does a step deformity indicate

A

new compression fracture

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13
Q

on an MRI what is the difference between old and new compression fractures

A

old compression fractures have normal marrow signal intensity, new fractures have abnormal signal intensity

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14
Q

what color would a vertebral body be with a new compression fracture on a T1 weighted MRI

A

black

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15
Q

the gradual loss of skeletal mass that is seen with advancing age

A

senile/postmenopausal osteoporosis

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16
Q

risk factors for osteoporosis

A

female, older than 70, caucasian & asian, early onset of menopause, longer mostmenopausal interval, inactivity, especially lack of weight bearing activity

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17
Q

modifiable risk factors for osteoporosis

A

smoking, alcohol abuse, excessive caffeine consumption, excessive dietary protein consumption, lack of dietary calcium, lack of sunlight exposure (to generate endogenous vit D)

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18
Q

cod fish deformity is indicative of

A

osteoporosis

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19
Q

in cases of severe fractures, a CT is needed is compression exceeds what percentage of the original body height

A

30% (or retropulsion is present or neurologically compromised)

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20
Q

what can be assumed if the interpedicular distance is widened

A

trauma

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21
Q

cases of pathologic compression fracture

A

osteoporosis (MC), lytic mets, multiple myeloma

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22
Q

fractures in what part of the vertebra do not compromise the mechanical stability

A

anterior 1/3 of the vertebral body and everything posterior to the body

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23
Q

fractures in what part of the vertebra do compromise the mechanical stability

A

posterior 2/3 of the vertebral body or any other two regions

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24
Q

what is assumed when the thoracic aorta has more density than the bones surrounding it

A

decreased bone density, not necessarily increased density of the aorta because of calcification

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25
Q

indications of osteoporosis in an extremity

A

thinned cortices, endosteal scalloping, loss of the secondary trabeculae, risks of fractures

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26
Q

different groups of trabeculae

A

greater trochanter group, secondary compressive group, principle tensile group, principle compressive group

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27
Q

wards triangle is formed by

A

trabecular groups

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28
Q

specifically which trabecular groups make up wards triangle

A

laterally - secondary compressive group, medially - principle compressive group, superiorly - principle tensile group

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29
Q

look at trabecular groups on page 240

A

page 240

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30
Q

TRUE or FALSE: osteopososis is qualitatively normal but quantitatively deficient in bone

A

FALSE; it is made visible in patients with osteoporosis

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31
Q

diffuse, significant osteopenia (especially in a patient too young for osteoporosis) could indicate

A

multiple myeloma

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32
Q

rain drop skull is indicative of

A

multiple myeloma

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33
Q

myltiple lytic calvarial lesions and punched out lesions are indicative of

A

multiple myeloma

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34
Q

DEXA scan

A

dual energy x-ray absorptiometry

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35
Q

a bone density measurement will determine the bone mineral density for the area measured and compares that result with the average bone mineral density of the norm. this is the use of which machine

A

DEXA

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36
Q

how does the WHO define osteoporosis

A

T-scores

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37
Q

T-scores

A

(-1) or higher = normal, (-2.5) to (-1) = osteopenia, below (-2.5) = osteoporosis, below (-2.5) with fragility fracture = servere osteoporosis

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38
Q

a person with 90% of normal bone density will tend to have what T-score

A

1 (goes down 1 for every 10% of bone lost)

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39
Q

altered bone quality, lack of calcium salts deposited, and abnormally high ratio of osteoid to mineralized bone (inadequately mineralized bone matrix)

A

osteomalacia

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40
Q

two main causes for osteomalacia

A

vit D metabolism, renal tubular phosphate loss

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41
Q

franconi’s syndrome

A

osteomalacia

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42
Q

looser lines/zones are assocaited with

A

osteomalacia

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43
Q

best diagnostic procedure for osteomalacia

A

bone biopsy

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44
Q

radiographic findings of osteomalacia

A

osteopenia, coarsened trabeculation, looser lines, bone softening deformities, basilar invagination, acetabular protrusion

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45
Q

linear regions of unmineralized osteoid usually bilateral and symmetrical at right angles to the bone. what does it signify

A

looser lines; osteomalacia

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46
Q

radiographic findings for rickets

A

widened, bulky epiphyseal plates and irregularity (fraying), splaying (cupping) of the weakened bone at the junction of the metaphysis and physis

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47
Q

rachitic rosary

A

rickets

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48
Q

paintbrush metaphysis

A

rickets

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49
Q

patient with joint swelling, irritability, pain and tendency to lie supine and motionless with thighs abducted probably has

A

scurvy

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50
Q

manifested by spontaneous hemorrhage due to capillary fragility

A

scurvy

51
Q

white line of frankel

A

scurvy

52
Q

pelken’s spurs

A

scurvy

53
Q

wimberger’s sign

A

scurvy

54
Q

trummerfeld’s zone

A

scurvy

55
Q

dense sclerotic zone of provisional calcification due to delayed conversion to bone

A

white line of frankel

56
Q

beak-like metaphyseal outgrowths

A

pelken’s spurs

57
Q

radiodense sclerosis around epiphysis, radiolucent centrally

A

wimberger’s sign

58
Q

scorbutic zone, a radiolucent band may be visible directly beneath zone of provisional calcification

A

trummerfeld’s zone

59
Q

strong osteoclastic hormone

A

PTH

60
Q

primary hyperparathyroidism

A

parathyroid gland adenoma

61
Q

secondary hyperparathyroidism

A

hemodialysis (endstage renal glomerular disease) aka… renal osteodystrophy

62
Q

renal osteodystrophy (synonym)

A

secondary hyperparathyroidism

63
Q

most common type of hypercalcemia

A

primary HPT

64
Q

elevated PTH levels, hypercalcemia, hypophosphatemia

A

primary HPT

65
Q

loss of calcium and phosphorus and stimulates PTH release

A

secondary HPT

66
Q

maintains the circulating level of calcium ions

A

PTH

67
Q

stimulates osteoclasts

A

PTH

68
Q

calcium loss and abnormal vit D formatino leading to hypocalcemia and the release of PTH

A

secondary HPT

69
Q

radiographic findings for HPT

A

osteopenia, subperiosteal resorption, distal tuft resorption, accentuated trabeculation, brown tumors, loss of cortical definition, soft tissue calcification

70
Q

most definitive radiographic sign of HPT

A

subperiosteal resorption

71
Q

ungal tufts

A

distal tufts; HPT

72
Q

salt and pepper skull

A

HPT

73
Q

rugger jersey spine

A

HPT

74
Q

sub-endplate sclerosis

A

rugger jersey spine

75
Q

geographic lytic lesion containing osteoclasts and mononuclear cells and fibroblasts with focal hemorrhages

A

brown tumor

76
Q

bone disorder occurring when the kidneys fail to maintain proper levels of calcium and phosphorus in the blood

A

renal osteodystrophy

77
Q

symptoms of pituitary tumor

A

HEADACHES!!!, visual disturbances, generalized discomfort in extremities

78
Q

significance of an enlarged sella

A

empty sella, tumor, normal, aneurysm

79
Q

what are the normal measurements of the sella turcica across and deep

A

16mm across and 12 mm deep

80
Q

what causes acromegaly

A

pituitary tumor secreting GH

81
Q

which type of ossification is responsible for the subcutaneous hypertrophy of the bone tissue; most common in the hands and feet

A

intramembranous

82
Q

specifically what causes gigantism in patients with a pituitary tumor

A

a pituitary tumor secreting excessive GH before the growth centers close

83
Q

acromegaly predisposes patients to what disorder

A

DJD

84
Q

TRUE or FALSE: patients with acromegaly have normal life spans

A

FALSE; shortened lifespan

85
Q

tissues affected by acromegaly

A

bone, cartilage, skin, organs

86
Q

TRUE or FALSE: patients with acromegaly have enlarged jaw, hands, feet, and head with no increase in height

A

TRUE

87
Q

macroglossia is associated with

A

acromegaly

88
Q

protruding frontal sinuses, prominent forehead is associated with

A

acromegaly

89
Q

TRUE or FALSE: an enlarged sella turcica could indicate acromegaly

A

TRUE

90
Q

radiographic findings of acromegaly

A

spade like distal tufts, hooking osteophytes, increased joint spaces (initially), widened shaft, increased tissue thickness

91
Q

a heel pad thickness greater than ___ indicates acromegaly

A

23mm

92
Q

what is the indication if the patient has a heel pad is greater than 23mm

A

acromegaly

93
Q

most common form of hypercortisolism

A

exogenous corticosteroid administration

94
Q

types of patients at risk for hypercortisolism

A

patients requiring immunosuppression (autoimmune disorders, organ transplants)

95
Q

endogenous oversecretion of ACTH by the pituitary and adrenal cortex adenoma, or ectopic ACTH secretion

A

hypercortisolism

96
Q

excessive glucocorticoid steroids, released by the adrenal cortex

A

cushing’s syndrome

97
Q

patient is obese, especially in the upper thorax and face (moon face)

A

cushing’s syndrome

98
Q

accelerated hair growth

A

cushing’s syndrome

99
Q

deposition of fat over the upper thoracic spine

A

buffalo hump

100
Q

buffalo hump is indicative of

A

cushing’s syndrome

101
Q

abdominal striae are indicative of

A

cushing’s syndrome

102
Q

radiographic findings for cushing’s syndrome

A

osteopenia, compression fractures, AVN, atherosclerotic plaquing

103
Q

most common congenital dwarfing skeletal dysplasia

A

achondroplasia

104
Q

shortened proximal long bones are indicative of

A

achondroplasia

105
Q

trident hands

A

achondroplasia

106
Q

narrowing of the spinal canal

A

achondroplasia

107
Q

metaphyseal cupping is indicative of

A

achondroplasia

108
Q

champagne glass pelvis

A

achondroplasia

109
Q

exaggerated posterior body convexity (posterior body scalloping)

A

achondroplasia

110
Q

horizontal sarcum

A

achondroplasia

111
Q

what to look for on film of spine when achondroplasia is suspected

A

scalloping of the posterior vertebral bodies, canal stenosis, no spinous/lamina (due to laminectomy), horizontal sacrum, champagne glass pelvis

112
Q

what to look for on film of skull when achondroplasia is suspected

A

macrocephaly, frontal bossing, foramen magnum stenosis (associated with arnold-chiari malformation)

113
Q

cleidocranial dysplasia is defect in which type of ossification

A

intramembranous

114
Q

radiographic features of cleidocranial dysplasia

A

inverted “pare shaped” fontanelle, wormian bones, hypoplasia or aplasia of clavicles, wide pubic symphysis (pubic diastasis)

115
Q

failure of collagen to be produced normally

A

marfan’s syndrome

116
Q

tall stature, arachnodactyly, heart valve defects, aortic aneurysm, lens dislocation

A

marfan’s syndrome

117
Q

inherited disorder marked by abnormal type I collagen formation

A

osteogenesis imperfecta

118
Q

common clinical findings for osteogenesis imprefecta

A

skeletal, blue sclera, abnormal detition, premature otosclerosis

119
Q

brittle bones

A

osteopetrosis

120
Q

bone within a bone

A

endobone

121
Q

endobones or bone within a bone indicate what

A

osteopetrosis

122
Q

sandwich vertebrae are indicative of

A

osteopetrosis

123
Q

erlenmeyer flask deformity is indicative of

A

osteopetrosis

124
Q

difference between rugger jersey spine and osteopetrosis findings on film

A

osteopetrosis has well defined endplates

radiology 1 quizlet (3 decks)

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