Week 4

Question 1

Name 3 primary bone cancers

Answer 1

osteosarcoma, Ewing’s sarcoma, Chondrosarcoma,

Question 2

commonest sites for chondrosarcoma

Answer 2

pelvis, proximal and distal femur

Question 3

CT can show soft tissue and bones, true or false

Answer 3

true

Question 4

xrays can show soft tissue, true or false

Answer 4

false

Question 5

C3-C7, T1-T12, L1-L5 vertebrae components

Answer 5

a vertebral body
2 pedicles
2 laminae
1 spinous process
2 transverse processes

Question 6

does C1 (atlas) have a vertebral body

Answer 6

no

Question 7

which vertebrae has an odontoid process aka dens

Answer 7

C2

Question 8

which imaging is more sensitive for spine - xray or CT?

Answer 8

CT. but usually we see most fractures on xray. if we need more detail we go CT.

Question 9

what does normal vertebral alignment on imaging imply?

Answer 9

intact intervertebral ligaments and a stable spine

Question 10

what does abnormal vertebral alignment on imaging imply

Answer 10

intervertebral ligament damage and an unstable spine

Question 11

which type of imaging allows ligaments to be seen

Answer 11

MRI

Question 12

what colour are normal ligaments on MRI

Answer 12

black

Question 13

what colour are damaged ligaments on MRI

Answer 13

light

Question 14

give examples of soft tissue abnormalities that may be seen on MRI (that are not picked up on xray and ct) - spine stuff

Answer 14

acute prolapsed intervertebral disc
epidural haematoma
spinal cord damage

Question 15

what symptoms would acute prolapsed intervertebral disc show

Answer 15

lower back pain
numbness or tingling in shoulders, back, arms, hands, legs or feet
neck pain
problems bending/straightening back
muscle weakness
sciatic

Question 16

MRI findings in vertebral tumours

Answer 16

early - bone marrow infiltration
late - extradural mass and spinal cord compression

Question 17

function of intervertebral discs

Answer 17

cushion the vertebrae from stress/absorb shock

Question 18

do healthy intervertebral discs contain water?

Answer 18

yes

Question 19

can you see intervertebral discs on xray?

Answer 19

no, because they are soft tissue

Question 20

can CT show lower lumbar disc prolapse

Answer 20

yes

Question 21

which type of imaging can show all types of disc prolapse

Answer 21

MRI

Question 22

can MRI see dehydration of intervertebral discs

Answer 22

yes

Question 23

what may follow intervertebral disc dehydration?

Answer 23

disc prolapse

Question 24

can you see the spinal cord on xrays

Answer 24

no

Question 25

how well can you see the spinal cord on CT

Answer 25

poorly

Question 26

which imaging adequately shows the spinal cord

Answer 26

MRI

Question 27

causes of spinal cord disease

Answer 27

trauma tumour demyelination ischaemia

Question 28

if soft tissue disorder of the spine suspected, what imaging should we do?

Answer 28

MRI

Question 29

classification of bone tumour

Answer 29

bone-forming cartilage-forming others

Question 30

what is the commonest primary tumour of the bone

Answer 30

multiple myeloma

Question 31

risk factors for primary bone tumours

Answer 31

previous radiotherapy predisposing conditions e.g. pagets genetic - e.g. Li Fraumeni (p53)

Question 32

what is the most common primary sarcoma of bone?

Answer 32

osteosarcoma

Question 33

what ages does osteosarcoma present?

Answer 33

children/young adults elderly (pagets)

Question 34

osteosarcoma treatment

Answer 34

chemo and limb salvage

Question 35

what age group does Ewing's Sarcoma affect?

Answer 35

5-25yrs (young people)

Question 36

what age group does chondrosarcoma affect

Answer 36

older (45-70yrs)

Question 37

what is chondrosarcoma

Answer 37

malignancy of chondrocytes (cartilage cells)

Question 38

is osteoid osteoma benign or malignant

Answer 38

benign

Question 39

what age group get osteoid osteoma?

Answer 39

young people (5-25yrs)

Question 40

can osteoid osteomas resolve spontaneously

Answer 40

yes. can treat with radiofrequency ablation though

Question 41

what can enchondroma and chondrosarcomas look like on xray

Answer 41

popcorn

Question 42

another name for diaphysis of the bone

Answer 42

shaft

Question 43

if periosteum is involved on xray, what does that suggest about rate of bone tumour growth?

Answer 43

fast growing. sunburst appearance

Question 44

red flags for bone pain

Answer 44

increasing persistent worse at night atraumatic

Question 45

where is a primary bone tumour most likely to metastasise to

Answer 45

lungs

Question 46

reasons for hip replacement

Answer 46

pain pain pain!

Question 47

some risks of hip replacement

Answer 47

infection blood loss thrombosis nerve damage dislocation limp

Question 48

if a young patient is getting a hip replacement, what materials may be used so that it lasts longer?

Answer 48

ceramic on ceramic

Question 49

who may get resurfacing instead of hip replacement?

Answer 49

Andy Murray (males under 40s, especially if they have high functional demands)

Question 50

what condition might carpet fitters get because of all the kneeling?

Answer 50

bursitis

Question 51

what imaging can be useful if suspecting meniscal tear?

Answer 51

MRI

Question 52

what age group does Osgood-Schlatter's affect

Answer 52

teenagers