#first exam Which of the following are an absolute contraindication to adjusting the upper cervical spine? Os odontoideum Os terminale of Bergman Pathologically increased ADI Agenesis of the odontoid C2-3 block vertebra select all that apply

Os odontoideum Pathologically increased ADI Agenesis of the odontoid

#first exam Which of the following is associated with Turner's syndrome? Madelung deformity Omovertebral bone Sprengels deformity brachymetacarpia stylohyoid ligament ossification select all that apply

Madelung deformity brachymetacarpia

#first exam Which of the following is characteristic of, or associated with congenital hip dysplasia? Superolateral dislocation of the femur Shallow acetabulum Os acetabuli Putti's triad Large femoral capital epiphysis select all that apply

Superolateral dislocation of the femur Shallow acetabulum Putti's triad

#first exam Which of the following are best visualized on the lateral projection of each respective body region? Horizontal sternal fracture Horizontal coccyx fracture Horizontal sacral fracture Jones fracture Vertical patellar fracture select all that apply

Horizontal sternal fracture Horizontal coccyx fracture Horizontal sacral fracture

Cumulative Lecture 2 Flashcards by Hannah Brule

first exam

The laminae of L5 are present however do not unite posteriorly.
What is the most appropriate conclusion?

Spina bifida occulta

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first exam

Which of the following are an absolute contraindication to adjusting the upper cervical spine?

Os odontoideum
Os terminale of Bergman
Pathologically increased ADI
Agenesis of the odontoid
C2-3 block vertebra

select all that apply

Os odontoideum
Pathologically increased ADI
Agenesis of the odontoid

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first exam

What is the most common form of hemivertebra?

Lateral

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first exam

What is the most likely conclusion when 1 vertebral segment has 3 pedicles?

Lateral hemivertebra

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first exam

Which of the following is not associated with Klippel-Feil syndrome?

Congenital block vertebra greater than 2 vertebral levels
Omovertebral bone
Plantar calcaneal enthesopathy
Urological abnormalities
Sprengels deformity

Plantar calcaneal enthesopathy

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first exam

Which of the following is often associated with diastomatomyelia?

Butterfly vertebra
Lateral hemivertebra
Ventral hemivertebra
Dorsal hemivertebra
Limbus bone

Butterfly vertebra

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first exam

Which of the following is considered a variant of a Schmorls node?

Butterfly vertebra
Lateral hemivertebra
Ventral hemivertebra
Dorsal hemivertebra
Limbus bone

Limbus bone

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first exam

Which of the following is associated with Turner’s syndrome?

Madelung deformity
Omovertebral bone
Sprengels deformity
brachymetacarpia
stylohyoid ligament ossification

select all that apply

Madelung deformity
brachymetacarpia

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first exam

Bilateral ribs are articulating with a vertebra near the CT junction with transverse processes oriented superiorly.
Which of the following is most appropriate?

Cervical ribs
Thoracic ribs
Normal finding
Lumbar ribs
Pathological finding

select all that apply

Thoracic ribs
Normal finding

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first exam

Eagle’s syndrome is associated with what diagnosis?

Stylohyoid ligament ossification

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A lumbosacral transitional segment is noted with left sided articulation and right sided spatulation without articular nor fusion.
Which Castellvi classification is appropriate?

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A lumbosacral transitional segment is noted with left sided fusion and right sided spatulation without articulation nor fusion.
Which Castellvi classification is appropriate?

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A lumbosacral transitional segment is noted with left sided fusion and right sided spatulation with articulation.
Which Castellvi classifications is appropriate?

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first exam

What is the most common rib anomaly?

Luschka’s bifurcated rib

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first exam

Which of the following is characteristic of, or associated with congenital hip dysplasia?

Superolateral dislocation of the femur
Shallow acetabulum
Os acetabuli
Putti’s triad
Large femoral capital epiphysis

select all that apply

Superolateral dislocation of the femur
Shallow acetabulum
Putti’s triad

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first exam

Which tarsal coalition has been associated with an anteater nose appearance?

Calcaneonavicular

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An osseous fragment is visualized at the superolateral aspect of the patellae bilaterally.
What is the most likely conclusion?

Bipartite patellae

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first exam

A ballet dancer has been experiencing pain at the posterior aspect of the left ankle while practicing.
What is the most likely finding upon conventional radiographic exam of the ankle?

Os trigonium

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first exam

A bony growth is visualized proximal to the elbow upon radiographic examination. The growth is pointing toward the elbow.
___ is the most likely diagnosis and ___ nerve is most commonly affected.

Supracondylar process; median

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first exam

What is the most common carpal coalition?

Lunotriquetral

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first exam

___ ulnar variance predisposes ___.

Negative; lunate to AVN (Keinbock)

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first exam

Which of the following are best visualized on the lateral projection of each respective body region?

Horizontal sternal fracture
Horizontal coccyx fracture
Horizontal sacral fracture
Jones fracture
Vertical patellar fracture

select all that apply

Horizontal sternal fracture
Horizontal coccyx fracture
Horizontal sacral fracture

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first exam

What is the view of the knee in which a lipohemarthrosis can be visualized?

Cross table lateral

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first exam

Which injury is also known as Piedmont’s fracture?

Galeazzi

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#first exam What is the most common carpal bone to fracture?

Scaphoid

#first exam Which carpal bone is most susceptible to injury?

Scaphoid

#first exam What is the most common carpal bone to dislocate?

Lunate

#first exam Which carpal bone fracture is also known as a Fischer fracture?

Triquetrum

#first exam What is the most common fracture of the elbow in adults?

Radial head (fracture)

#first exam What is the most common radiographically occult fracture?

Scaphoid

#first exam What is the most common location for osteochondritis dissecans?

Lateral aspect of the medial femoral condyle

#first exam Which bone is affected by a Kocher's fracture?

Capitellum

#first exam What is the most common elbow fracture in a pediatric patient?

Supracondylar

#first exam Which location of the scaphoid most predisposes it to AVN when fractured?

Proximal pole

#first exam Which of the following is/are eponyms for a radial styloid fracture? * Fischer * Hutchinson * Chauffeur * Barton * Backfire | select all that apply

* Hutchinson * Chauffeur * Backfire

#first exam Which of the following is/are eponyms for a posterior distal radius intra-articular fracture? * Rim * Barton * Backfire * Kocher * Colles | select all that apply

* Rim * Barton

#first exam Which muscle avulses from the AIIS?

Rectus femoris

#first exam What is the most common muscle/group of muscles to develop myositis ossificans?

Quadriceps

#first exam What is the appropriate eponym for a comminuted fracture of the base of the first metacarpal?

Rolando

#first exam Which ligament is most likely disrupted in DISI?

Scapholunate

#first exam What is the eponym for a distal radial fracture with posterior angulation?

Colles

#first exam What is the radiographic sign most specific of an intra-articular fracture?

Posterior fat pad sign of the elbow

#first exam What is the most common location of a shoulder dislocation?

Subcoracoid

#first exam Which of the following is associated with the most common type of shoulder dislocation? * Bankart fracture * Hatchet fracture * Body of the scapula fracture * Clavicle fracture * Flap fracture | select all that apply

* Bankart fracture * Hatchet fracture * Flap fracture

#first exam Which part of the clavicle is most commonly fractured?

Middle

#first exam Which rib is most commonly fractured in benchpressers?

Rib 2

#first exam Which tendon do the sesamoids adjacent to the first metatarsal lie within?

Flexor hallucis brevis

#first exam What is the eponym for a talar (neck) fracture?

Aviator

#first exam A spiral fracture through the diaphysis of the tibia is noted with no evidence of fibular involvement. What is the most likely diagnosis?

Toddler fracture

#first exam Which of the following is also commonly present with a Segond fracture? * ACL tear * PCL tear * Lateral meniscus tear * Medial meniscus tear * MCL tear | select all that apply

* ACL tear * Medial meniscus tear

#first exam Vertical fracture through the superior and inferior pubic rami in addition to contralateral SI joint dislocation. What is the most appropriate diagnosis?

Bucket handle fracture

#first exam What is the most appropriate eponym for an iliac wing fracture?

Duverney fracture

#first exam What is the 2nd most common fracture of the lumbar spine?

Transverse process fracture

#first exam Which diagnosis demonstrates the empty vertebra appearance?

Chance fracture

#first exam Which diagnosis demonstrates the double spinous sign?

Clay shovelers fracture

#first exam What is the most common location for a teardrop fracture?

#first exam What is the most appropriate Salter-Harris classification for a fracture of the epiphysis, physis, and metaphysis?

Type 4

#first exam Which Salter-Harris classification involves a fracture that demonstrates a Thurston Holland fragment?

Type 2

Which of the follow is/are also known as an osteoclastoma? * Brown tumors of HPT * Aneurysmal bone cyst * Giant cell tumor * Chondroblastoma * Simple bone cyst | select all that apply

* Brown tumors of HPT * Giant cell tumor

What diagnosis is also known as Codman's tumor?

Chondroblastoma

What is the most common benign bone tumor of the hands and feet?

Enchondroma

What is the most common benign bone tumor of the vertebral bodies?

Hemangioma

What is the most common benign bone tumor of the sacrum? (also the most common benign bone tumor of the patella)

Giant cell tumor

A 0.8cm nidus is visualized in the diaphysis of the tibia with significant surrounding sclerosis in an 11-year-old male. What is the most likely diagnosis?

Osteoid osteoma

A 1.4cm nidus is visualized in the proximal tibial metaphysis with mild surrounding sclerosis in a 13-year-old female. Pain is **not** relieved by Aspirin. What is the most likely diagnosis?

Osteoblastoma

A geographic lytic lesion is noted in the femoral head in a 15-year-old male. What is the most likely diagnosis?

Chondroblastoma

Which of the following is most common to present in epiphyses and apophyses of long bones? * Enchondroma * Chondrosarcoma * Chondroblastoma * Simple bone cyst * Fibrous dysplasia

Chondroblastoma

Which of the following are findings associated with fibrous dysplasia? * Ground glass matrix * Rind of sclerosis * Shepherd's crook deformity * Long lesion in a long bone * Fallen fragment sign | select all that apply

* Ground glass matrix * Rind of sclerosis * Shepherd's crook deformity * Long lesion in a long bone

What is the most common primary malignant bone tumor of pediatrics?

Osteosarcoma

Which primary malignant bone tumor is associated with cannon ball metastasis to the lungs?

Osteosarcoma

"Blister on bone" is the buzz word most closely associated with which diagnosis?

Non-ossifying fibroma | FCD / NOF / fibrous xanthoma

Which diagnosis is associated with the buzz word "raindrop skull"?

Multiple myeloma

Multiple lytic lesions of varying sizes are noted in the skull. What is the most likely diagnosis?

Osteolytic metastasis

A soap bubbly, lytic, expansile lesion of the posterior elements of the spine is noted at C7. Which of the following is **least** appropriate for your differential? * Osteoblastoma * Enchondroma * Giant cell tumor * Aneurysmal bone cyst * All of the above are appropriate in the differential

Enchondroma

A focal area of stippled calcification is visualized in the proximal humeral metaphysis in a 28-year-old male. What is the most likely diagnosis?

Enchondroma

Fallen fragment sign is seen in 10 percent of which primary benign bone tumor?

Simple bone cyst

Approximately 70% of which soap bubbly, lytic, expansile lesion evolves into multiple myeloma?

Plasmacytoma

Lichtenstein's rule applies to which primary malignancy of bone?

Fibrosarcoma

What is the most common location for a chordoma?

Sacrococcygeal

What is the most common primary benign bone tumor of the clavicle?

Aneurysmal bone cyst

What is the most common primary benign bone tumor of the rib?

Fibrous dysplasia

Which of the following lab findings are associated with multiple myeloma? * M-spike * Reversal of the A:G (ratio) * Bence Jones proteinuria * Normocytic, normochromic anemia * Hypercalcemia | select all that apply

* M-spike * Reversal of the A:G (ratio) * Bence Jones proteinuria * Normocytic, normochromic anemia * Hypercalcemia | all of the above

A sclerotic cumulus cloud appearing lesion is present at the distal femoral metaphysis of a 19-year-old male. What is the most likely diagnosis?

Osteosarcoma

An ivory vertebra is present at L3 with associated anterior vertebral body scalloping. What is the most likely diagnosis?

Hodgkin's lymphoma

What is the most likely diagnosis for an enlarged ivory L3 vertebral body with a picture frame appearance?

Osteitis deformans | Paget disease

What is the most likely diagnosis for an ivory vertebra that is not enlarged and does not demonstrate anterior vertebral body scalloping?

Osteoblastic metastasis

Ollier's disease is the eponym for which condition?

Multiple enchondromas

Hereditary multiple exostosis is the eponym for which condition?

Multiple osteochondromas

A patient with Gardner's syndrome has a high risk for which of the following? * Malignancy of the colonic polyps * Esophageal web * Cushings syndrome * Gastric ulcers * Rheumatoid arthritis

Malignancy of the colonic polyps

What is the most common primary bone tumor?

Osteochondroma

What is the most common benign bone tumor of the nasal sinuses?

Osteoma

A 15-year-old male twisted his ankle during a soccer game. Radiographs were obtained demonstrating a blister of bone appearance in the distal tibial metaphysis, eccentrically located. What is the most appropriate diagnosis?

Non-ossifying fibroma | NOF

A geographic lucent lesion is seen in the calcaneus with a target sequestrum. What is the most likely diagnosis?

Intraosseous lipoma

Approximately 90% of metastatic lesions are ___. * Lytic * Mixed lytic / blastic * Blastic

Lytic

Blow out metastasis would most likely be from which primary locations?

* Kidney * Adrenal glands * Thyroid gland * Skin | RATS

Acral metastasis develops most commonly due to which primary location?

Bronchogenic

A super scan is described in relation to which imaging modality and is due to which pathology?

Bone scan; metastasis

Which of the following is 'cold' on a bone scan? * Enostoma * Metastasis * Multiple myeloma * Osteosarcoma * Osteoid osteoma

Multiple myeloma | no osteoblastic activity

Which diagnosis demonstrates cortical saucerization of a diaphysis of a long bone and a laminated periosteal reaction?

Ewing's sarcoma

Which of the following has been associated with crossing open growth plates of long bones although on a rare occasion? * Giant cell tumor * Enchondroma * Aneurysmal bone cyst * Simple bone cyst * Fibrous dysplasia

Aneurysmal bone cyst

According to Yochum and Rowe, which of the following are characterized as 'the great imitators of bone pathology'? * Paget disease * Fibrous dysplasia * Neurofibromatosis (type 1) * Chordoma * Osteoma | select all that apply

* Paget disease * Fibrous dysplasia * Neurofibromatosis (type 1)

In which diagnosis would a patient present with skin lesions characterized as 'coast of California'?

Von Reckinghausen's disease | NF 1

Which diagnosis may present with twisted ribbon ribs and dumbbell IVFs?

Neurofibromatosis (type 1)

Which of the following has a possible etiology of a viral infection? * Osteoblastoma * Chondroblastoma * Giant cell tumor * Fibrous dysplasia * Paget disease

Paget disease

What diagnosis is characterized by enchondromatosis in addition to soft tissue hemangiomas?

Maffucci's syndrome

Which of the following is considered common sources of fibrosarcoma due to malignant degeneration? * Fibrous dysplasia * Paget disease * Bone infarction * Non-ossifying fibroma * Fibrous cortical defect | select all that apply

* Fibrous dysplasia * Paget disease * Bone infarction

Which of the following is/are also known as ankylosing spondylitis? * Marie Strumpell disease * Bechterews disease * Mazabraud syndrome * Forestier's disease * McCune Albright syndrome | select all that apply

* Marie Strumpell disease * Bechterews disease

What diagnosis is also known as Forestier's disease?

DISH

Which diagnosis is most likely when there is a decrease in medial femorotibial joint space while the lateral femorotibial joint space is maintained?

DJD

What is the most likely diagnosis when trolley track sign is present in a patient with Crohns disease?

Enteropathic arthropathy (arthritis)

Which of the following is the most likely diagnosis in a patient that demonstrates acro-osteolysis and soft tissue retraction of the pads of the fingers as visualized on conventional radiography? * Scleroderma * SLE * RA * Gout * CPPD

Scleroderma

A patient with Haygarth's nodes most likely has which inflammatory condition?

A lateral knee projection that demonstrates intra-articular loose body calcifications that are the same size as each other, suprapatellar in location would warrant which likely diagnosis?

Primary SCM

A left foraminal disc herniation between C6-C7 would affect which nerve root?

Left C7

What is the most likely diagnosis in a patient with chondrocalcinosis of the medial meniscus of the knee?

Pseudogout (CPPD)

Pellegrini Steida can be classified as which of the following? * Myositis ossificans * HADD * CPPD * Gout * SLE | select all that apply

* Myositis ossificans * HADD

Which diagnosis is characterized by alignment abnormalities without evidence of osseous erosions?

SLE

Which diagnosis is often characterized by the presence of corticated overhanging margins?

Gout

A patient presents with calcification of the intervertebral discs and upon urinalysis, it is discovered that their urine turns dark brown / black. What is the most likely diagnosis?

Ochronosis

Which of the following is characteristic of DJD? * Uniform loss of joint space * Heberden's nodes * Haygarth's nodes * Pencil in cup deformity * Ray pattern

Heberden's nodes

Marginal erosions are visualized at the metacarpal heads as well as the ulnar styloid. What is the most likely diagnosis?

Both SI joints demonstrate fusion with long standing history of low back pain and decreased ROM. Which of the following is **least** appropriate for your differential? * AS * Enteropathic arthritis * RA * Psoriatic arthritis * Reactive arthritis

A patient has spondylophytes. What is the most likely diagnosis?

DJD

Which modic change demonstrates the finding of hemispheric spondylosclerosis on conventional radiography?

Modic 3

A left paracentral disc herniation of L5-S1 will most likely affect which nerve root?

Left S1

Synovial cysts are most common to occur at which vertebral level?

L4-L5

Which additional diagnosis commonly presents in patients with DISH?

OPLL

Marginal syndesmophytes are suggestive of which diagnoses?

AS and enteropathic arthritis

Non-marginal syndesmophytes are most suggestive of which diagnoses?

Psoriatic arthritis and reactive arthritis

What is the most likely diagnosis with a finding of gull wing deformity?

Erosive osteoarthritis

DJD of the wrist is most common at which joint?

1st carpal metacarpal joint

DISH is most common at which spinal sections?

TL junction

OPLL is most common at which vertebral segments?

C2-C4

What is the most likely etiology of atrophic neuropathic arthropathy in the shoulder?

Syringomyelia

Which of the following is most likely to cause pencil sharpened spinous process appearance and erosions of the odontoid process? * AS * CPPD * Ochronosis * RA * SLE

Loss of the superior component of the femoroacetabular joint space is most likely due to ___ whereas loss of the axial component of the femoroacetabular joint space is most likely due to ___.

DJD; RA

Bilateral protrusio acetabuli has what eponym?

Otto's pelvis

Still's disease is also known as what?

JCA | aka JIA

What diagnosis is also known as calcific tendonitis?

HADD

Bird-like facies is characteristic of ___ whereas mouse-like facies is characteristic of ___.

JCA (JIA); Scleroderma

There is DIP joint involvement in 80% of patients with psoriatic arthritis when which other finding is also present?

Greater than 20 nail pits

Which of the following is **not** associated with reactive arthritis? * Conjunctivitis * Polyarthritis * Ungual tuft resorption * Urethritis * Bilateral asymmetric sacroiliitis

Ungual tuft resorption

Which of the following is **not** associated with progressive systemic sclerosis? * Calcinosis cutis * Telangectasia * Raynaud's * Esophageal stricture * Reversible subluxations

Reversible subluxations

What is the most likely diagnosis in a patient demonstrating sclerosis of the articular surface of the ilium at the right SI joint without evidence of erosion?

Osteitis condensans ilii (OCI)

What is the most likely diagnosis in a patient excreting homogentisic acid in their urine?

Ochronosis

What is the correct order of the progression of ankylosing spondylitis of a vertebral body?

1. Romanus lesion 2. Squared vertebral body 3. Barrel shaped vertebra 4. Shiny corner sign

What is the most common microorganism to cause acute suppurative osteomyelitis?

Staphylococcus aureus

Which organism has been found to cause septic arthritis more commonly in IV drug abusers than the general population?

Pseudomonas

What is the synonym for septic arthritis in IV drug abusers?

Mainliner's syndrome

Which organism has been found to cause acute suppurative osteomyelitis in patients with sickle cell disease?

Salmonella

Which of the following is **not** one of the five most common locations for septic arthritis in IV drug abusers? * Spine * Sacroiliac joints * Sternoclavicular joint * Subtalar joint * Acromioclavicular joint

Subtalar joint

Which term represents periosteal new bone in acute suppurative osteomyelitis?

Involucrum

How long, approximately, does it typically take for acute suppurative osteomyelitis in extremities to show on conventional radiography?

1 week

How long, approximately, does it typically take for acute suppurative osteomyelitis in the spine to show on conventional radiography?

3 weeks

Which of the following represents a subacute infection of bone? * Sequestrum * Marjolin's ulcer * Osteoblastoma * Osteoid osteoma * Brodie's abscess

Brodie's abscess

What is the most appropriate diagnosis in a patient with night pain that can be relieved by aspirin and upon radiographic examination had a 1.8cm lucent nidus with moderate surrounding sclerosis?

Osteoid osteoma | secondarily Brodie abscess d/t aspirin relief

What organism is most commonly responsible for producing subcutaneous air? | gas gangrene

Clostridium perfringens

Which of the following is **not** known for malignantly transforming to fibrosarcoma? * Pagets * Fibrous dysplasia * Fibrous cortical defect * Chronic osteomyelitis * Bone infarctions

Fibrous cortical defect | FCD / NOF / fibrous xanthoma

Which of the following is **not** true about tuberculosis? * It is the second most common infection in the world * It infects the spine in approximately 50% of cases with skeletal involvement * It is associated with a finding of ranke complex upon chest radiography * It causes a decreased intervertebral disc height faster than with suppurative spinal osteomyelitis * When it affects the bones of the hand it is known as spina ventosa

It causes a decreased intervertebral disc height faster than with suppurative spinal osteomyelitis

Which **two choices** of the following are most closely related to sickle cell disease? * Osteonecroses * Hair on end appearance of the skull * H-shaped vertebrae * Erlenmeyer flask deformity * Paintbrush metaphyses

* Osteonecroses * H-shaped vertebrae

Which of the following measurements of the abdominal aorta is considered dilatation but not aneurysmal? * 5.5.cm * 3.-3.49cm * 3-3.49mm * 7mm * 7cm

3-3.49cm

A finding of generalized osteopenia and Erlenmeyer flask deformity of the distal femurs bilaterally is noted. Which of the following should be included on your differential? * Sickle cell anemia * Hemophilia * Thalassemia * Gaucher's * Osteopetrosis | select all that apply

* Sickle cell anemia * Thalassemia * Gaucher's

What is the most appropriate diagnosis with a finding of widening of the intercondylar notch and ballooning of the epiphysis of the femur and no hand or wrist involvement?

Hemophilia

Radiolucent metaphyseal bands is an associated finding in ___ while radiopaque metaphyseal bands is an associated finding in ___.

Leukemia; lead poisoning

What is the eponym for AVN in the scaphoid?

Preisers

Which fracture predisposes a patient to Diaz disease?

Aviator

Which of the following is **not** associated with causing AVN? * Pancreatitis * Sarcoidosis * Amyloidosis * Caissons * Exogenous steroid use

Sarcoidosis

What is the appropriate eponym for AVN of the humeral head?

Hass

Which of the following eponyms represents a normal developmental finding? * Diaz * Panner * Van neck * Keinbeck * Preiser

Van neck

What is the most common artery to see conduit wall calcification in?

Aorta

Avascular necrosis affects ___ while bone infarction is a term that describes involvement in ___.

Epiphyses; metaphyses

Which of the following are findings associated with hypovitaminosis D? * Ring epiphysis of Wimberger * Pelkin spurs * Subperiosteal hemorrhage * White line of Frankel * Paintbrush metaphyses

Paintbrush metaphyses | osteomalacia

What is the most common etiology of generalized osteopenia?

Senile / post-menopausal

Which T-score is indicative of osteoporosis and which T-score is indicative of a 4x increased risk of sustaining a fracture?

-2.5; -2

Which diagnoses should be included in a differential with a finding of pseudofractures?

* Pagets * Rickets * Osteomalacia * Fibrous dysplasia

Which of the following findings is **not** associated with scurvy? * Scorbutic rosary * Pelkin spurs * White line of Frankel * Cupping of the metaphyses * Trummerfeld zone

Cupping of the metaphyses

Which of the following is **not** associated with hyperparathyroidism? * Ungual tuft resorption * Subperiosteal resorption * Subperiosteal hemorrhage * Tumoral calcinosis * Widening of the SI joints

Subperiosteal hemorrhage

Which of the following is/are associated with hyperparathyroidism? * Histiocytosis x * Pseudotumors * Brown tumors * Renal osteodystrophy * Sandwich vertebrae | select all that apply

* Brown tumors * Renal osteodystrophy

Which of the following is **not** associated with acromegaly? * Prominent superior orbital ridge * Prognathism * Spade like ungual tufts * Posterior vertebral body scalloping * Tumoral calcinosis

Tumoral calcinosis

Which diagnoses should be included in your differential for posterior vertebral body scalloping?

* Marfans * Achondroplasia * Neurofibromatosis 1 * Acromegaly

Which of the following is **not** true of eosinophilic granuloma? * Typically occurs between 5-10yo * It is the most common occurring of the Langerhan's cell hystiocytoses * The skull is involved in 95% of cases * Pancake vertebra may reconstitute the majority of its height * It is associated with a hole within a hole appearance in skull lesions

The skull is involved in 95% of cases

Which of the following should be included on your differential for a finding of posterior vertebral body scalloping? * Marfans * Von Reckinghausens * Achondroplasia * Hodgkins lymphoma * Ehlers-Danlos

* Marfans * Von Reckinghausens (NF 1) * Achondroplasia

Which diagnosis presents with a bone within a bone appearance?

Osteopetrosis | endobone

What is the most likely diagnosis in a patient with otosclerosis, decreased bone density, wormian bones, and poor dentition?

Osteogenesis imperfecta | decreased bone density

What is the most likely diagnosis in a patient with wormian bones, otosclerosis, multiple levels of SBOs, and approximately 45 teeth?

Cleidocranial dysplasia | midline defects

Which **two** diagnoses are most appropriate as a possible diagnosis for a patient with wormian bones and an accessory physis at the proximal 2nd metacarpal base?

* Osteogenesis imperfecta * Cleidocranial dysplasia

Which of the following is the most likely diagnosis for a patient with an excessive amount of dense bone 'flowing' along the peripheral aspect of the left femoral diaphysis? * Melorheostosis * DISH * Myositis ossificans * HADD * Osteopathia striata

Melorheostosis | mesenchymal dysplasia leading to bone thickening

What is the eponym for dysplasia epiphysealis hemimelica?

Trevor disease | distal tibial epiphysis

What is the eponym for osteopetrosis?

Albers schonberg

Which diagnosis is characterized by stippling of the epiphyses of an infant which resolves by the second year of life and the infant will develop identically to an achondroplast?

Chondrodysplasia punctata | aka **Conradi Hunermann disease**

Which diagnosis is characterized by having an osteochondroma of an epiphysis?

Trevor disease | osteochondrosis of distal tibial epiphysis

Which of the following is the **least** appropriate for a differential for a finding of Otto's pelvis? * RA patient on corticosteroids * Pagets * Fibrous dysplasia * Marfans * Melorheostosis

Melorheostosis | mesenchymal dysplasia that thickens cortex

Which of the following is associated with a finding of iliac horns? * Osteogenesis imperfecta * Cleidocranial dysplasia * Downs syndrome * Osteopetrosis * Nail-patella syndrome

Nail-patella syndrome | osteo-onychodysplasia ## Footnote findings of iliac horns, hypoplastic or absent patella, fingernail dysplasia

Which of the following is **not** true of spondylolistheses? * MC at L5 * L4 is the MC level for type III * C6 is the MC cervical spine level * Hangman fracture is classified as a type II * Isthmic is the most common type

Hangman fracture is classified as a type II

What is the most commonly used classification system for grading spondylolisthesis?

Meyerding

Which of the following populations tends to have the highest percentage of spondylolisthesis? * Caucasian * African American * Athletes * Gymnasts * Inuit

Inuit | Canada and Alaska natives

Which of the following is the correct pairing of types of spondylolisthesis? * Type I isthmic * Type III traumatic * Type V dysplastic * Type II pathologic * Type VI iatrogenic

Type VI iatrogenic

Upon radiographic examination, a finding of 35% anterior migration of L4 on L5 with evidence of severe facet arthrosis is noted. What is the most appropriate conclusion? | include spondylolisthesis type and etiology

L4 anterolisthesis grade 2 degenerative

Which scoliosis is most concerning for possible underlying pathology?

Left thoracic

What is the most appropriate diagnosis for a patient with a curvature with thoracic concavity to the left and lumbar concavity to the right?

Right thoracic and left lumbar double major scoliosis | scoliosis is named for convexity

What is the most appropriate diagnosis for a long C curvature and hypertrophy of the gastrocnemius muscles bilaterally in a sedentary person?

Duchenne muscular dystrophy

What is the most common scoliosis?

Right thoracic

What is the most common etiology of scoliosis?

Idiopathic

What is the most likely diagnosis for a patient with a severe kyphoscoliosis and dumbbell IVFS?

Neurofibromatosis (type 1)

Which of the following is the most common idiopathic scoliosis? * Juvenile * Adolescent * Infantile

Adolescent

# second exam What knee view best demonstrates the findings of synoviochondrometaplasia?

Tunnel

# second exam Secondary synoviochondrometaplasia is secondary to what arthritis process?

Degenerative

# second exam Your patient has a subarticular disc protrusion at C5/C6. Which muscle will be weak, and which DTR will be diminished?

Wrist extensors Brachioradialis | C6 nerve root

# second exam A tapered osseous structure is noted posterior to, and not connected with, the spinous processes on the lateral cervical spine radiograph of a patient with DISH. What is the diagnosis?

Nuchal bone

# second exam Bulky bony outgrowths are seen on the lateral lumbar radiograph, bridging the intervertebral discs from T10-L4. The same bony outgrowths are seen on the AP view. The sacroiliac joints are unremarkable. What is the diagnosis?

Diffuse idiopathic skeletal hyperostosis | DISH

# second exam Which soft tissue structure thickens in response to lumbar facet degeneration, contributing to central canal and lateral recess stenosis?

Ligamentum flavum

# second exam Neurologic examination of your patient reveals loss of light touch and pain sensation from the knees to the toes. Physical examination reveals substantial deformity of the ankles and toes. What condition do you suspect?

Neuropathic arthropathy

# second exam Which arthritic condition has a strong association with central spinal stenosis? * DISH * OPLL * CPPD * HADD

OPLL

# second exam On MRI there is a disc lesion which is 10mm wide at the base (15% of the disc circumference) and 4mm deep. What is the diagnosis?

Protusion

# second exam A new patient with known longstanding ankylosing spondylitis presents to your office. As they have not been imaged in several years, you perform thoracic and lumbar radiographs. There is extensive ankylosis. Additionally, in the middle of the L3 vertebral body, there is a radiolucent line extending through all 3 columns of the spine. There are heavily sclerotic cortical margins on either side of the radiolucent line. What does this represent?

Andersson lesion

# second exam Your patient with chronic recurrent low back pain has a history of Crohn's disease. What are you concerned about?

Enteropathic arthritis

# second exam Epiphyseal expansion is a feature of what condition? * Juvenile chronic arthritis * Rheumatoid arthritis * Psoriatic arthritis * Reactive arthritis

Juvenile chronic arthritis | JCA / JIA

# second exam Dense sclerosis with erosive changes are seen in the right sacroiliac joint. Much milder changes are present on the left. What is included in your differential? * Ankylosing spondylitis * Enteropathic arthritis * Psoriatic arthritis * Reactive arthritis * Osteitis condensans ilii | select all that apply

* Psoriatic arthritis * Reactive arthritis

# second exam At the DIP joint, there is a central erosion of the distal articular surface and peripheral erosions of the proximal articular surface. What is being described, and what is the diagnosis?

Mortar in pestle; psoriatis arthritis

# second exam Which are findings of progressive systemic sclerosis? * Bird like facies * Malar rash * Pencil in cup deformity * Rate bite erosions * Blue-brown pigmentation of ears and nose * No correct answer listed | select all that apply

No correct answer listed

# second exam Which of the follow are findings of rheumatoid arthritis in the cervical spine? * Atlanto-axial instability * Multiple spondylolistheses * Marginal syndesmophytes * Tapered spinous processes | select all that apply

* Atlanto-axial instability * Multiple spondylolistheses * Tapered spinous processes

# second exam What joints in the hand are the primary target site for rheumatoid arthritis?

Metacarpophalangeal | MCP

# second exam Which laboratory examination has higher specificity and lower sensitivity for rheumatoid arthritis? * ESR * Anti-CCP * ANA * HLA-B27

Anti-CCP

# second exam A 32yo female presents with bilateral hip pain. She has seen no other providers for this condition. You perform bilateral hip radiographs. Kohler's line is normal. There is sclerosis and flattening of the femoral heads bilaterally. What is the likely underlying condition? * Rheumatoid arthritis * Paget disease * Systemic lupus erythematosus * Pigmented villonodular synovitis

Systemic lupus erythematosus

# second exam Your patient has a known diagnosis of systemic lupus erythematosus. They present complaining of chronic suboccipital headaches. Prior to performing manipulative therapy to the cervical spine, what imaging needs to be done?

Cervcial flexion/extension radiographs

# second exam Wrist radiographs reveal a widened scapholunate space with proximal migration of the capitate. Radiocarpal and intercarpal joint spaces are diminished with extensive sclerosis and subchondral cyst formation. Linear calcification is present distal to the ulna. What is the diagnosis?

Pyrophosphate arthropathy | CPPD

# second exam With the exception of CPPD, what other condition causes chondrocalcinosis?

DJD

# second exam The 1st metatarsophalangeal joint is exquisitely painful, red, swollen, and dry. What is the diagnosis?

Gout

# second exam The patient complains of chronic recurrent right foot pain. On physical examination, you note several regions of soft tissue distension covering white, chalky, subcutaneous deposits. What is your diagnosis?

Gout

# second exam What body region is most commonly involved with hydroxyapatite deposition disease?

Shoulder | HADD

# second exam Globular calcification is noted immediately inferior to the anterior arch of C1 in a patient with acute torticollis. What structure is calcified?

Longus coli | HADD

# second exam Which condition results in extensive intervertebral calcification and disc space loss, with eventual spinal ankylosis?

Ochronosis

# second exam A 29yo male presents with progressive right knee pain and swelling. No other joints are involved. Past medical history is otherwise unremarkable. Bilateral knee radiographs demonstrate uniform joint space loss of all 3 joints of the right knee, and an unremarkable left knee. What is the diagnosis?

Pigmented villonodular synovitis | PVNS

# second exam A 32yo female presents complaining of left hip pain. AP and frogleg radiographs of the hip reveal a normal femoroacetabular articulation, though there is dense sclerosis adjacent to the ipsilateral sacroiliac joint. The sacroiliac joint margin is clean. What is your diagnosis?

Osteitis condensans ilii

# second exam A marathon runner presents with severe pelvic pain. An AP pelvis radiograph reveals erosions of the pubic symphysis with dense pubic body sclerosis. What is the diagnosis?

Osteitis pubis

# second exam A septated geographic lytic severely expansile lesion is seen in the distal radial metaphysis. There is tapered cortical thickening leading up to the edge of the lesion. Advanced imaging reveals fluid/fluid levels. What is the diagnosis?

Aneurysmal bone cyst

# second exam Which lesions are known for being able to cross an open physis? * Codman tumor * Aneurysmal bone cyst * Chordoma * Osteoclastoma | select all that apply

* Codman tumor * Aneurysmal bone cyst

# second exam A geographic lytic lesion with endosteal scalloping is present centrally within the proximal phalanx of the 4th toe. What is the most likely diagnosis?

Enchondroma

# second exam Which description applies to the most common benign tumor of the spine?

Vertical striation | hemangioma

# second exam A 10-year-old patient has an eccentric geographic lytic lesion in the distal femur measuring 7cm longitudinally. There is no periosteal reaction, and a hazy matrix calcification is seen. Radiographs were taken due to positive Ottawa criteria after trauma. What is the diagnosis?

Nonossifying fibroma

# second exam A radiographic skeletal survey demonstrates numerous geographic lytic lesions scattered throughout the skeleton with stippled calcified matrices. No soft tissue calcifications are present. What is the diagnosis?

Enchondromatosis | Ollier disease

# second exam A 17-year-old patient presents with a painful scoliosis. Radiographs reveal enlargement of the pedicle and lamina on the concave side of the scoliosis. Advanced imaging shows a geographic lytic lesion with a nidus of 27mm. What is the diagnosis?

Osteoblastoma

# second exam Which characteristic is the best indicator that a pedunculated osteochondroma has undergone malignant degeneration?

3cm cartilage cap

# second exam Which imaging modality best evaluates focal cortical thickening to determine the presence of a nidus, indicating osteoid osteoma?

# second exam Radiographs of a 19-year-old patient show a central, geographic lytic lesion in the fibular diaphysis. Radiographs taken 10 years ago show the same lesion in the proximal fibular metaphysis. What is the diagnosis?

SBC

# second exam A bone scan demonstrates homogenous uptake of radiotracer through the entire skeleton. No radiotracer is present in the kidneys. What does this represent?

Diffuse metastasis

# second exam Pelvis radiographs of a 52yo male demonstrate a large soft tissue mass with inhomogenous calcifications arising from a destructive lesion in the ilium. Which should be included in the differential diagnosis? * Metastatic disease * Chordoma * Chondrosarcoma * Ewing sarcoma | select all that apply

Chondrosarcoma

# second exam Which tumor is known for directly extending across an articular surface?

Chordoma

# second exam Which primary malignancy of bone most closely mimics infection on clinical evaluation? * Multiple myeloma * Osteosarcoma * Ewing sarcoma * Chondrosarcoma

Ewing sarcoma

# second exam Which tumor has both benign and malignant forms, where the malignant form does not represent malignant degeneration?

Giant cell tumor

# second exam What feature is strongly characteristic of giant cell tumor, and is rarely seen in other neoplasia?

Subarticular extension | sparing

# second exam Which imaging modality is the best to determine whether a lesion is benign or malignant?

MRI with contrast

# second exam You detect an ivory vertebra with accentuated anterior concavity in a 58yo patient. What is the diagnosis?

Hodgkin lymphoma

# second exam Which primary malignancy is associated with metastatic spread into the radius?

Lung / bronchogenic | acral metastasis

# second exam What is the most common primary malignancy of bone in children?

Osteosarcoma

# second exam Which types of periosteal reaction indicate an aggressive condition?

* Laminated * Spiculated * Codman triangle

# second exam A blastic lesion indicates which type of matrix?

Bony | osseous

# second exam What is the most common pathway for malignancies to spread to bone?

Hematogenous

# second exam Radiographs of a 42yo female reveal a geographic lytic lesion of the T6 vertebral body. Which lesions are probably on the differential diagnosis? * Blow out metastasis * Plasmacytoma * Chondroblastoma * Aneurysmal bone cyst * No correct answer listed | select all that apply

Plasmacytoma

# second exam A lytic lesion with a narrow zone of transition is present within the femur, extending from proximal metaphysis to distal metaphysis. There is an indistinct calcific appearance to the matrix. What is the diagnosis?

Fibrous dysplasia | long lesion in long bone

# second exam More than 10 hyperpigmented cutaneous macules with jagged, irregular borders are present. What underlying condition do you suspect?

Polyostotic fibrous dysplasia

# second exam Which condition is associated with tibial pseudo-arthrosis? * Neurofibromatosis type 1 * Hereditary multiple exostosis * Reactive arthritis * Systemic lupus erythematosus

Neurofibromatosis type 1

# second exam What condition is mostly responsible for the second peak in the distribution curve of osteosarcoma?

Paget disease

# second exam A 52yo female has severe anterior bowing of the tibia, confirmed radiographically. The cortical margins and trabecular patterns are coarsened, and there is a questionable matrix calcification pattern. Radiolucent lines extend through the convex surface cortex only. What is the diagnosis?

Paget disease

# second exam What is the first paragraph of the findings section of a radiology report?

Alignment / anatomy

# second exam What is the first sentence of the second paragraph for a patient's radiographs which are completely normal?

Bone density is normal.

# second exam What is the acronym for the universal diagnosis coding system?

ICD | international classification of disease

# second exam What are the three categories of items which belong in the recommendations section of a radiology report?

* Additional imaging * Labs * Referrals

Cumulative Lecture 2 Flashcards

(268 cards)