Tramline appearance (X-ray)
Ankylosing spondylitis
The tramline appearance is of a ‘bamboo spine’ due to syndesmophyte growth between the margins of the vertebrae as well as calcification and ossification of the interspinous ligaments. X-ray of the pelvis will show fusion of the sacroiliac Joints.
Extensive osteophyte formation
Osteoarthritis
Rugger-jersey spine
Renal osteodystrophy
The rugger-jersey spine sign is said to be almost diagnostic of the osteosclerosis associated with secondary hyperparathyroidism of chronic kidney disease.
Kayser-Fleischer ring
Wilson’s disease
Kayser-Fleischer rings are brown-/green-coloured depositions of copper within Descemet’s membrane in the cornea, and may be identified via slit lamp examination. These are found in > 90% of people with Wilson’s disease who have neurological involvement; given that this man has cerebellar ataxia, this makes the absence of a Kayser-Fleischer ring incorrect here. The liver manifestations of Wilson’s disease are very widely variable, ranging from asymptomatic abnormalities in liver enzmyes, to more severe manifestations including acute liver failure or advanced cirrhosis.
Nesbit operation
Surgery for Peyronie’s disease
In which plication with or without excision of the tunica albuginea on the opposite side to the plaque is performed; this procedure is inevitably associated with penile shortening.
Pappenheimer bodies
Numerous conditions including: myelodysplastic syndrome (MDS), sideroblastic anemia, hemolytic anemia, lead poisoning and sickle cell disease.
Sézary cells
cancerous T lymphocytes (a type of white blood cell) found in patients with Sézary syndrome, a form of cutaneous T-cell lymphoma
These cells are characterized by an abnormally shaped, cerebriform nucleus and are present in the blood, skin, and lymph nodes of affected individuals.
Darier’s Sign
Pathognomonic for cutaneous mastocytosis
Rubbing a lesion causes urtication (wheal formation) due to mast cell degranulation
“cherry-red spot” in the eye
Tay Sachs disease
Koplik spots
Small white spots on buccal mucosa; early sign of measles
Koplik spots are pathognomonic for measles, appearing inside the mouth 1-2 days before rash onset.
Schaumann bodies
Sarcoidosis
Schaumann bodies are laminated, calcified structures also found in multinucleated giant cells in sarcoid granulomas. Like asteroid bodies, they are not specific but are supportive.
‘Mulberry’ molars
Congenital syphilis
The term refers to the characteristic appearance of the first permanent molars, which develop abnormally due to enamel hypoplasia caused by the infection affecting tooth development in utero.
The occlusal surface of the molars shows multiple rounded enamel nodules resembling a mulberry fruit, instead of the normal cusps and fissures.
Syphilitic infection disrupts ameloblast function during tooth formation, leading to defective enamel mineralisation and abnormal morphology.
Shuffner’s dots
blood film analysis of P. vivax and P. ovale
NOTE: in falciparum malaria you would see Maurer’s clefts on blood film
Winterbottom’s sign
Trypanosoma brucei
Sleeping sickness (african) - enlarged cervical LNs (Winterbottom’s sign), recurring fever, somnolence, coma
T. brucei gambiense = gradual infection (mo-yrs for Sx to occur), West + Central Africa, >95% of cases
T. brucei rhodesiense = rapid, South + East Africa
Thayer-Martin culture plate
Used for determining Abx sensitivities (Gonorrhoea)
Condylomata lata
Secondary syphilis
● Specific feature - Condylomata lata - not to be confused with condylomata acuminata (warts) - Broad-based, wart-like papular erosions - anogenital region, intertriginous folds, oral mucosa
Gummatous lesions
Tertiary syphilis
granulomatous, locally destructive lesions typically affecting the skin and bone
Hutchinson teeth (notched, widely spaced teeth) and mulberry molars (poorly developed first molars)
Late congenital syphilis (onset after 2 years of age)
Skeletal: “saber shins” (anterior bowing of the tibia), painless arthritis in knees and other joints (clutton’s joints - swelling symmetrically)
Late congenital syphilis (onset after 2 years of age
