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Diagnostic imaging exam 3 extra stuff > systemic bone diseases > Flashcards

systemic bone diseases Flashcards

1
Q

What does CATBITES stand for?

A 
Congenital
Arthritis
Trauma
Blood
Infection
Tumor
Endocrine, nutritional, metabolic
Soft tissue
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2
Q

what are the 2 hormones that inhibit bone production?

A

PTH

cortisol

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3
Q

what hormones and nutrients stimulate bone production?

A 
GH
T3, T4
Calcitonin
D 
C
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4
Q

what is an all encompassing definition for increased radiolucency or decreased bone density?

A

osteopenia

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5
Q

what is the MC osteopenia?

A

osteoporosis

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6
Q

what are some other causes of osteopenia?

A 
osteomalacia
hyperparathyroidism
rickets/osteomalacia
scurvy
neoplasm
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7
Q

which osteopenia has linear radiolucencies/ looser lines on imaging?

A

osteomalacia

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8
Q

which osteopenia produces subchondral and subperiosteal resorption?

A

HPT

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9
Q

which osteopenia produces focal lesions?

A

neoplasms- plasma cell myeloma

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10
Q

what percent of bone mass loss is needed to be seen on film?

A

30-50%

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11
Q

which condition has qualitatively normal but quantitatively deficient bone?

A

osteoporosis

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12
Q

which type of fracture in women doubles every 5 years after 60?

A

hip fracture

vertebral fractures are also high at 64%

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13
Q

senile, postmenopausal and transient or regional are all what classification of osteoporosis?

A

primary

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14
Q

what are some causes of secondary osteoporosis?

A 
corticosteroids
malignancy
infection
arthritides
disuse 
RSD
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15
Q

osteoporosis radiographic features seen in the spine

A

cortical thinning- pencil thin
resorption of non-stress bearing trabeculae
accentuated vertical struts
altered vertebral shape- wedge shaped, compressed, fish vertebra, codfish deformity
schmorl’s nodes
end plate infarctions

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16
Q

with severe fractures, if the compression exceeds 30% of original body height or retropulsion is present or if neurologically compromised, what additional imaging is needed?

A

CT- evaluation of canal, bone marrow and hemorrhage in canal

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17
Q

what are some radiographic signs for osteoporosis in an extremity?

A

pencil thin cortices
endosteal scalloping
loss of secondary trabeculae
fracture risk

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18
Q

what are the trabecular patterns of the hip?

A

1 primary compressive- medial
2 secondary compressive- lateral
3 primary tensile

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19
Q

confluence of the 3 trabecular groups forms a triangle of radiolucency known as?

A

Ward’s triangle

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20
Q

in osteoporosis, which trabecular pattern is last to be involved?

A

primary compressive

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21
Q

radiolucency of ward’s triangle is more prominent in?

A

osteoporosis

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22
Q

with increasing severity, tensile group compression regresses ___ to _______ opening Ward’s triangle laterally

A

medial to lateral

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23
Q

with significant osteopenia how do you differentiate osteoporosis from MM?

A

with MM patient is too young for osteoporosis and will have multiple punched out lesions

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24
Q

what are T-scores used to measure?

A

fracture risk associated with osteoporosis

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25
Q

What are the WHO t-scores?

A

T-1 or higher= normal
T -2.5 to -1= osteopenia
T below -2.5= osteoporosis
T below -2.5 + fragility fracture= severe osteoporosis

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26
Q

disuse inhibits ______ activity

A

osteoblastic

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27
Q

what is a regional osteoporosis following a trivial trauma with acute pain in those under 50 and especially affects the hands?

A

reflex sympathetic dystrophy

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28
Q

what are some clinical signs of RSD?

A

reflex hyperactivity of SNS

pain, swelling, vasomotor disturbances, trophic skin changes (skin atrophy, pigmentation abnormal)

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29
Q

who is most affected by transient osteoporosis of the hip?

A

30-50 year olds
3:1 males
3rd tri pregnancy females- usually left hip
bilateral in men

onset of sudden pain, antalgia and limp, self limiting over 3-12 months

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30
Q

which condition has an abnormally high osteoid to mineralized bone ratio- inadequately mineralized bone matrix?

A

osteomalacia

31
Q

what are the 2 main causes of osteomalacia?

A

Vit D metabolism

renal tubular phosphate loss

32
Q

what is fanconi’s syndrome?

A

renal tubular phosphate loss, associated with osteomalacia

33
Q

what are linear regions of unmineralized osteoid usually bilateral and symmetrical at right angles to the bone?

A

looser lines

34
Q

what condition do you see looser lines/ pseudofractures?

A

osteomalacia

35
Q

what condition presents with muscle tetany, irritability, weakness, delayed development, small stature, bone deformities and pain

A

rickets- also soft tissue swelling around growth plates due to hypertrophied cartilage

36
Q

what is elevated in rickets?

A

alkaline phosphatase

37
Q

where are the most prominent radiographic features of rickets usually seen?

A

costochondral jx of middle ribs
distal femur, proximal humerus
both ends of tibia
distal ulna and radius

38
Q

what is fraying and what condition do you see it in?

A

widened, bulky growth plates and irregularity- rickets

39
Q

splaying, fraying, bowing deformities and rachitic rosary of the chest are all seen in?

A

rickets

40
Q

what is the term for expansion of the anterior rib ends at the costochondral junctions?

A

rachitic rosary

41
Q

splaying of weakened bone at jx of metaphysis and physis predisposes to?

A

slipped epiphysis- epiphysiolysis

42
Q

paintbrush metaphysis is seen in?

A

rickets

43
Q

what is Barlow’s disease?

A

scurvy

44
Q

what are some clinical findings of scurvy?

A 
osteopenic bone
spontaneous hemorrhage
cutaneous petechiae, bleeding gums, hematuria 
joint swelling
irritability 
frog-leg position 
malaise and lethargy
45
Q

what is a dense sclerotic zone of provisional calcification due to delayed conversion of bone?

A

white line of Frankel

46
Q

what are beak like metaphyseal outgrowths extended at right angles to shaft?

A

Pelken’s spurs

47
Q

what sign shows radiodense sclerosis around epiphysis and radiolucency centrally?

A

wimberger’s sign

48
Q

what is corner sign?

A

irregularity of metaphyseal margins

49
Q

what is it called when there is a radiolucent band visible directly beneath zone of provisional calcification?

A

Trummerfeld’s zone/ scorbutic zone

50
Q

subperiosteal hemorrhage, Trummerfeld’s zone, white line of frankel, wimberger’s ring and pelken’s spurs are all radiographic features seen in?

A

scurvy

51
Q

primary HPT is the MC and 90% caused by?

A

parathyroid gland adenoma

52
Q

what is the MC cause of hypercalcemia?

A

primary HPT

53
Q

what are 3 causes of secondary HPT?

A

chronic renal disease
hemodialysis
renal osteodystrophy

54
Q

what type of HPT is seen in dialysis patients, parathyroid gland acts independent of serum calcium?

A

tertiary HPT

55
Q

renal stones, peptic ulcers, pancreatitis, confusion, lethargy, weakness, bone pain, polyuria and polydypsia are all signs of?

A

HPT

56
Q

what are brown tumors?

A

cystic accumulations of fibrous tissue

57
Q

what are some radiographic signs seen in HPT?

A 
osteopenia
subperiosteal resorption
distal tuft resorption 
brown tumors 
soft tissue calcification
cortical definition loss
58
Q

what is the most radiographic definitive sign of HPT?

A

subperiosteal resorption- esp at radial margins of middle and proximal phalanges of 2-3 digits

59
Q

widened joint spaces and osteolysis is seen MC where in HPT?

A

AC and SI joints

60
Q

what happens to the teeth with HPT?

A

loss of lamina dura of teeth

61
Q

rugger jersey sign and salt and pepper skull are classic signs of?

A

HPT

62
Q

what are lytic lesions containing osteoclasts and mononuclear cell and fibroblasts with focal hemorrhages?

A

brown tumors

63
Q

what produces the brown color in a brown tumor?

A

hemosiderin from hemorrhage

64
Q

brown tumor aka

A

osteoclastoma

65
Q

what accounts for 10% of all neoplasms within the cranium?

A

pituitary tumors

66
Q

headaches, visual disturbances and generalized discomfort in the extremities are all signs of?

A

pituitary tumor

67
Q

what is a classic radiographic sign seen in pituitary tumors?

A

enlarged sella turcica

68
Q

an oversecretion of GH from pituitary adenoma occuring AFTER open growth plate closure resulting in excessive growth and proliferation of CT?

A

acromegaly

69
Q

excessive GH before growth plates close

A

gigantism

70
Q

“spade like” distal tufts and hooking osteophytes with widened shaft and increased joint spaces of extremities is seen with?

A

acromegaly

71
Q

frontal bossing is seen with?

A

acromegaly and gigantism

72
Q

macroglossia and heel pad thickening are seen with?

A

acromegaly

73
Q

what is cushings aka

A

hypercortisolism

74
Q

what are radiographic features seen in cushings?

A 
generalized osteopenia
compression fractures
avascular necrosis- high 
atherosclerotic plaquing 
healing with excessive callus

Diagnostic imaging exam 3 extra stuff (5 decks)

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