Vascular disorders

Question 1

Atherosclerosis- what is it, mc site

Answer 1

plaque in interior of large vessels causing hardening; conduit wall calcification

mc in abdominal aorta

Question 2

Atherosclerosis- imaging signs and mesurements

Answer 2

look for calcifications on wall of vessel

-aorta should normally measure <3.8cm and be within 5mm of the spine

Question 3

What does it mean if calcifications buldging out/ aorta >5mm from spine

Answer 3

could be indicative of aortic aneurysm, mass etc

-order further cardio exam, lab tests, US, CTA, MRA

Question 4

What is monckebergs medial sclerosis

Answer 4

Calcification in tunica media of small/medium muscular arteries- circular, ring like densities along the entire length of the vessel

Question 5

mc area of monckebergs medial sclerosis

Answer 5

mc in femoral, tibial, radal, ulnar and genital vessels

Question 6

What does monckebergs medial sclerosis relate to

Answer 6

relates w diabetess (should get tested if were not previously)

Question 7

What age is monkebergs medial sclerosis related with

Answer 7

rare before 50

Question 8

Where are aneurysms mc located (and peripheral loc, heart loc)

Answer 8

mc aorta, splenic, renal, vertebral vessels
peripherally in popliteal
left ventricle

Question 9

IF you suspect ant anuerysm what should be the next steps

Answer 9

Advanced imaging- US, CT/MR

cardiovascular exam

Question 10

What type of anurysm can present as back pain in inv

Answer 10

Abdominal aortic anueyrsm (AAA)

Question 11

What are imaging findings of AAA (+ what is a med emergency)

Answer 11

calcifications along wall

-may see blood be extravated out of wall (MED EMERGENCY)

Question 12

Larger than what size AAA requires a vascular surgey/stent

Answer 12

> 5.5cm

Question 13

Venous insufficiency clinical signs

Answer 13

• diminished arterial pulse
• edema
• skin discoloration
• varicosities

Question 14

venous insuffieciency imaging signs (bone + soft tissue_

Answer 14

bone- undulating periostits

soft tissue- Calcifications (phleboliths)

Question 15

Symptoms of sickle cell anemia

Answer 15

Episodic abdominal crisis, jaudice, bone pain and dactylitis

Question 16

What is the key sign of sickle cell anemia in the spine

Answer 16

Vascular compromise results in H vertebra ( due to infarcts etc)

-may also get femoral head ischemic changes

Question 17

What soft tissue sign may you see in Sickle cell anemia

Answer 17

large mass in area of spleen sually

Question 18

What is sickle cell dactylitis- mc age, signs

Answer 18

Painfull swellings of the hands and feet due to either infearction or infection
-common in infancy/young age

Question 19

two mc forms of hemophilia, mc gender, what does it cause

Answer 19

Classical hemophilia (A), Christmas disease (B)
-both sex linked ressesive that only appear in males

-causes skeleteal changes from hemorages within or around joints

Question 20

What is the pathophys of hemophilic arthropathy

Answer 20

Intraarticular hemorage-> permeant changes (degeneration etc)

Question 21

imaging signs of hemophilic arthropathy

Answer 21

• Bone errosion (intracondylar notch, inf pole of patella)

- decreased jt space

Question 22

What is hemophilic pseudotumor and mc locations?

Answer 22

Intraosseous hemorrhage may result in destructive cystic lucent looking expansil lesion

mc in ilium and femur (RARE)

Question 23

Leukemia imaging findings

Answer 23

Demineralization of bones, periostitis, lytic lesions mc in metaphysis/diaphysis

• generalized osteopenia
• radiolucent sub metaphyseal bands
• bone destruction,
• periostitis