1
Q
flat nasal bridge
broad mandible
decreased AP distance
short anteriorly flared concave ribs
anterior beak in lumbar spine
decreased vertebral body height
scoliosis
‘tombstone’ iliac bones from squaring
champagne glass’ pelvic inlet
‘trident’ hand
short femoral necks
short interpedicular distance
small foramen magnum
rhizomelia
horizontal acetabular roof
can get spinal cord compression due to spinal stenosis
A
achondroplasia
2
Q
Legg Calve-Perthe disease
(coxa plana)
A
idiopathic femoral head avascular necrosis (males more commonly, peak at 4-8 years).
3
Q
Kohlers
A
AVN of navicular (muller weiss in adults)
males 4-6
4
Q
Keinbock
A
AVN of lunate, due to negative ulnar variance
5
Q
Freiberg
A
AVN of metatarsal heads, 10-18 female
early - cysts
later - sclerosis and flattening and bone thickening
6
Q
CPPD
A
arthritis with calcium deposits in the articular cartilage
acute CPPD = pseudo gout
causes
hypothyroid
hyperparathyroid
haemachromatosis
low magnesium
7
Q
hypotelorism - narrow PD
atlantoaxial subluxation
flattening of acetabular roof
metaphyseal flaring
anterior VB scalloping
A
downs
8
Q
shin splint uptake
A
posterior cortex
MRI more sensitive than bone scintigraphy
9
Q
most common spinal change in NF1
A
1) kyphoscoliosis
2) vertebral scalloping: can be associated with dural ectasia or neurofibromas
10
Q
SHAD
scoliosis
hallux valgus
arachnodactyly (long fingers)
dolichocephaly/scaphocephaly
A
Marfans
11
Q
nail patella syndrome
A
age 20-30
absence of nails
absent patellae
bilateral posterior iliac horns
12
Q
Non ossifying fibroma
A
benign
self limiting
metaphases
multiloculated, lucent lesion
eccentrically located in the metaphysis near the physis
long axis parallel to the axis of the bone
thin sclerotic rim
13
Q
pagets disease
A
excessive bone remodelling
phases: lytic - mixed - sclerotic
osseous expansion
thickening of the cortex
coarsened trabecular patterns
they get basilar impression - hydrocephalus
transforms to osteosarcoma
osteoporosis circumscripta
cotton wool skull
14
Q
failure of osteoclasts
dense bones
weak and brittle
sandwich vertebra (well defined)
A
osteopetrosis
rugger jersey spine - more ill defined (rough rugby players) - hyperparathyroidism
15
Q
PVNS
A
no joint space narrowing
16
Q
Caplan syndrome
A
rheumatoid arthritis and pneumoconiosis.
hyperimmune reactivity to silica inhalation with rapidly developing pulmonary nodules - upper and peripheral
17
Q
felty syndrome
A
RA
splenomegaly
osteopenia
18
Q
panners disease
A
osteonecrosis of the capitellum
low t1 high t2
no loose bodies
It heals spontaneously with little if any residual deformity
19
Q
affect of sarcoidosis on bones
A
small bones of hands and feet
destruction of the terminal phalanges
lace-like reticular pattern of bone destruction of the metaphysis
cystic bone lesions with well-defined margins
lytic bone lesions with periosteal reaction
osteopenia/osteoporosis
20
Q
scleroderma
A
calcinosis
sclerosis
soft tissue swelling
carpal bone erosions
21
Q
features of psoriatic arthritis
A
periosteal reaction
pencil in cup’ deformity
ivory phalanx
squaring of vertebra
atlantoaxial subluxation
22
Q
abnormal x-ray
normal bone scan
A
metabolically inactive benign conditions (bone cysts/ bone island/exostoses)
recent fractures (less than 48 hours)
multiple myeloma
osteoporosis
metastases if there is no osteoblastic activity.
23
Q
normal x-ray
abnormal bone scan
A
PLOP
Pagets
lymphoma
osteomyelitis
primary hyperparathyroidism
24
Q
knee locking
A
intra-articular loose body
25
Maisonneuve fracture
medial malleolus avulsion
proximal fibula
26
pilon fracture
talus into the tibial plafond
27
forced plantar flexion
lisfranc injury
can be missed in 20% of initial X-rays
lisfranc ligament is between 2nd metatarsal and medial cuneiform
28
most common site of mandible fracture
condyle
29
sub capital neck of femur fracture
this is intracapsular
young patient - cannulated screws
older patient - hemi arthroplasty
30
falling on outstretched hand in ulnar deviation or direct blow to back of hand
triquetral fracture
31
skiers thumb/gamekeeper thumb
forceful abduction of the thumb
ulnar collateral ligament
32
trabeculated bone lesion
GCT
33
lymphoma of the bone
diaphysial
destructive
34
fibrous dysplasia
monostotic is most common
increased uptake Tc99m
35
pagets
polystotic is most common
early lytic later sclerotic
well defined lytic skull lesions
platybasia/flattening of the skull base
36
giant cell tumour
skeletally mature
no surrounding sclerosis
can have soap bubble
mononuclear cells
37
osteosarcoma
10-20
non expansile destructive
metadiaphyseal
distal femur/proximal tibia
foci of high T1 due to haemorrhage
hair on end periosteal reaction
very poor prognosis if mets present
38
chondromyxoid fibroma
well defined lucent lesion with sclerotic rim
metaphyseal
age 30-40
internal calcification uncommon
39
chondrosarcoma
elderly
ring and arc
40
popcorn calc
fibrous dysplasia
cartilage producing nodules
41
cause of OM in sickle cell
staph aureus
42
Ewing sarcoma
onion periosteal reaction
most commonly in sacrum if spinal
43
increased uptake in blood pool phase
ABC
high vascular tumours
44
causes of ivory vertebra
MPHIL
mets (osteoblastic)
Pagets
Haemangioblastoma
Infection - TB
Lymphoma
45
CMF
Geographic bone destruction with a prominent sclerotic rim
metaphyseal
distal femur proximal tibia
age 20-30
expansile, sclerotic rim, internal calcification
46
chondroblastoma
10-20
chondroid matrix
florid marrow odema
sclerotic rim
47
enchondroma most likely to present as
pathologic fracture
small lobule like lytic lesion
doesn't always calcify
no soft tissue mass
metaphyseal location as they arise from the growth plate
48
ewings
2x more common in females
49
brown tumours
well defined cortical lesions
50
causes of fibular pseudoarthrosis
fracture non union
NF1
51
Cleidocranial dysostosis
AD
52
acromegaly
pituitary adenoma
prolonged overproduction of GH
causes acromegaly
bitemporal hemianopia
increased heel pad thickness
53
carpal tunnel
volar bowing of the flexor retinaculum
nerve can enhance if oedematous
or non enhance if ischaemic
54
Ehlers danlos
fragile blood vessels
no aortography
55
thickening of the cortex and increased uptake
pagets disease
56
cystic tumour attached to and moves with tendons
ganglion
low t1 high t2
periosteal new bone formation
spontaneous resolution
57
septic arthritis
caused by staph aureus
58
jacqoud arthropathy
non-erosive
no joint narrowing
ulnar deviation of all 4 fingers
MCP joints with subluxation
associated with rheumatic fever and SLE
59
h shaped vertebra
osteoporosis
osteomalacia
renal osteodystrophy
osteogenesis imperfecta
gaucher
sickle cell
60
features of rheumatoid arthritis
subchondral sclerosis
osteoporosis
loss of joint space
erosions
scalloped erosion on undersurface of clavicle
tapered margin of
distal clavicle.
61
features of turners syndrome
madelung deformity
coarctation
aortic stenosis
horseshoe kidneys
a shield-shaped chest
squared lumbar vertebrae
thinned ribs
62
no uptake on bone scan
myeloma
haemangioma
radiotherapy field
63
uptake on bone scan
mets
fractures
pagets
dental disease (infection)
64
popliteus muscle
controls lateral mensical displacement
initiates knee flexion
65
Person with RA or inflammatory artropathy
suddenly unable to plantar flex or invert
swelling of medial malleolus
spontaneous tibialis posterior rupture
66
most sensitive sign for mesenteric injury
intraperitoneal free fluid
67
stable c spine fracture
clay shoveller
tip of spinous process
doesn't need to stay in
68
chance fractures
involve all 3 columns
69
valgus trauma to knee (out to in) with no rotation
tears the MCL
70
horse riding injury
forceful adduction of the thigh
during an abductional movement
causes strain and injury of adductor longs
71
direct blow to face
best seen on submentovertex view
flattening of the cheek
zygomatic arch fracture
72
bone lesion where the cortex is not intact
sign of aggressive lesion
ewings
osteosarcoma
chondrosarcoma
73
ABC
female under 20
74
Ewing sarcoma
diaphysial location
contain blue cells
75
approach for a distal femur lesion
medial
avoids the supra patellar pouch
76
prostate cancer
sclerotic mets
77
lytic mets
kidney thyroid
78
Monostotic fibrous dysplasia commonly affects
diaphysis
79
treatment of osteosarcoma
wide resection and chemo
80
any sarcoma, what staging investigation first?
CXR - mets
81
lytic lesion with an associated soft tissue mass
osteoblastoma
found in posterior elements of the spine
it does have a sclerotic rim
82
3 features of mccune Albright syndrome
cafe au lait spots
fibrous dysplasia
endocrine dysfunction
83
HSC triad
diabetes
lytic skull lesions
exophthalmos
84
high ALP suggests
osteosarcoma
85
MIBG scans are positive in
neuroblastoma
phaeochromocytoma
paraganglioma
lung carcinoid
GI NET
medullary thyroid cancer
86
Olliers
one sided ollie
multiple enchondromas
(cartilaginous rests)
one sided
limb length discrepancy
chondrosarcoma risk
associated with
juvenile granulosa tumour of the ovary
pancreas ca
gliomas
87
maffucis
Maffucci phleb and Haem
MEHL
PHLEBOLITHS and HAEMANGIOMAS (soft tissue calc)
multiple enchondromas and haemangiomas and lymphangiomas
associated with juvenile granulosa tumour of the ovary and colorectal haemangioma
88
multiple myeloma
plasma cells proliferation
produce monoclonal IG
lytic bone lesions
red jelly like material
raised serum globulin
bone pain
anaemia
renal failure
raised calcium
raindrop skull
endosteal scalloping
89
bone tumour dark on T1 and T2
GCT
due to haemosiderin
90
hemangiopericytoma
develops from the cells that surround a vessel - thigh pain
91
LCH/eosinophilic granuloma
young kids
92
vertebral haemangiomas
T1 variable
bright if lipid rich
dark if lipid poor
T2 bright
93
TB spondylitis
Lumbar
94
Holt Oram syndrome
radial limb anomalies
congiential cardiac disease
95
AVN - which study
MRI best
shows loss of fat
bone scan - early photopenia, late donut sign
96
DISH features
ossification of patellar ligament
heel spurs
whiskering of the iliac crest
flowing ossification of at least four contiguous vertebral bodies
No SI joint involvement
97
gout
high uric acid in blood
plain film findings after 6-12 years
joint space preserved
no osteopenia due to short attacks
chondrocalcinosis in 5%
98
features of haemachromatosis
Skeletal features include: generalised osteoporosis, small subchondral cyst-like lesions in the metacarpal heads, uniform joint space narrowing, enlargement of metacarpal heads, osteophyte formation and chondrocalcinosis in 60%.
99
Melorheostosis
flowing ossification
dermatomal distribution
overlying fibrosis
100
Charcot joint
Dense subchondral bone (sclerosis)
Degeneration
Destruction of articular cortex
Deformity ('pencil points' of metatarsal heads),
Debris
Dislocation
101
still disease/JIA
rectangular phalanges
ribbon ribs
gracile bones
pleural and pericardial effusion
HS megaly
widened metaphyses
102
causes of looser lines
POOF
pagets
osteogenesis imperfecta
osteomalacia
fibrous dysplasia
103
Tuberous sclerosis
seizures
mental retardation
adenoma sebaceum
sclerotic bone lesions
bone cysts
thickening of diploe
expansion and sclerosis of ribs
periosteal thickening of long bones
104
direction of slip in SUFE
posteromedial
105
talocalcaneal coalition
bony union across the middle facet
106
ochronosis/alkaptonuria
bamboo spine
disc calcification
narrow discs
skin pigmentation
black pigment deposition in cartilage and sclera
disc narrowing
disc calc
syndesmophytes
OA
chondrocalcinosis
aortic stenosis
107
causes of T2 bright bone marrow
VB collapse (odema)
haemangioma
Modic 1 and 2
lytic mets
RADIOTHERAPY (cell damage - more water)
108
fall on outstretched arm
fracture surgical neck of humerus
109
chance fracture
deceleration injury
L1/thoracolumbar junction
110
segond fracture
bony fragment
lateral aspect of proximal tibia plateua
ACL rupture
111
causes of paraneoplastic hyperglycaemia
chondrosarcoma (ribs)
osteosarcoma
112
giant cell
involve articular surface
eccentric
epiphyseal
adults with closed growth plates
113
bone lesion from excess PTH
osteitis fibrosa cystica
raised calcium
low phosphate
114
most common location of an osteoid osteoma
femoral neck
has double density sign on a bone scan
115
soft tissue mass and lytic bone lesions
mazabraud syndrome -
fibrous dysplasia and soft tissue myxomas
soft tissue mass low t1. high t2
116
ages of bone lesions
chondrosarcoma - 45
GCT - 30
osteosarcoma 10-30
117
ewings
most commonly in femur
small round blue cell
age 10-20
located in metadiaphysis
118
osteosarcoma
in adolescents
second peak after 60 from pagers
119
epiphyseal lesion with surrounding odema and sclerotic rim
chondroblastoma
120
newborn sacral lesion
sacrocoyccygeal teratoma
raised AFP
hydronephrosis
imperforate anus
121
lytic mets
thyroid and renal
lung breast melanoma
expansile
122
sclerotic mets
prostate breast colon melanoma
123
spinal cord astrocytoma
thoracic
124
adamantinoma
tibial diaphysis
125
curved PCL =
ACL tear
126
osteoid osteoma
age 10-30
127
stress fracture
triple phase bone scan
128
erosion of the pubic symphysis
Ank spond
Hyper PTH
psoriatic
childbirth
infection
129
premature ageing (progeria)
progeria
distal clavicle erosion
early coronary artery calc and MI
narrow chest
thin ribs
Autosomal recessive
AR PR(ogeria)
130
causes of Erlenmeyer flask deformity
lead gnome
Lead: lead poisoning
G: Gaucher disease
N: Niemann-Pick disease
O: osteopetrosis, osteochondromatosis
M: metaphyseal dysplasia
E: 'ematological, e.g. thalassaemia
thallasema is first 2 years of life
131
ACL rupture is associated with
deepening of the lateral femoral condyle
132
BL pars fracture
hyperextension with traction
hangman
133
fat embolism vs PE
fat embolism - 36 hours, long bones
PE - 7-10 days, post op
134
shoulder buford complex
normal variant
absent anterior labrum with a
thickened cord-like middle glenohumoral ligament
135
causes of bone mets
breast
bung
byroid
benal
prostate
136
lytic and expansile mets
renal
137
hallmark finding of psoriatic arthritis
new bone formation
138
hallmark finding of RA
periarticular osteoporosis
139
RA features
marginal or central erosions
loss of joint space
140
cause of painful TMJ clicking
anteriorly displaced intra-articular disc
141
radiation necrosis
can have a long latent period of many years
dose dependent
142
osteochondroma cartilage cap size
>1.5cm is malignant
143
mri l spine
recurrent disc vs fibrosis
disc and fibrosis both t1 and t2 dark
fibrosis enhances on t1 + c
144
Boutonnière deformity
flexed proximal IP joint (central slip of the extensor tendon)
extended distal IP joint
feature of RA
145
Maisonneuve fracture
medial ankle mortise and
proximal 1/3 of fibula
146
O’Donoghue’s unhappy triad
ACL
MCL
medial meniscus
147
Which type of acetabular fracture is most
commonly associated with significant neurological injury
posterior wall
sciatic nerve injury
148
which osteosarcoma has best survival
paraosteal osteosarcoma has
the most favourable 5-year survival rate of 80%.
149
BPOP
WIDE base
150
protrusio acetabuli
feature of RA
151
post traumatic osteolysis
distal clavicle
152
locations of DAI
corticomedullary junction, centrum semiovale, corpus callosum and
cerebellum.
153
sinus tarsi syndrome
low t1
low t2
enhancement
154
ulnar nerve compression
hook of hamate fracture
155
Sappho syndrome
arthropathy of the sternoclavicular joint
156
central cord syndrome
from hyperextension and stretching of cord
upper limb motor loss
157
anterior cord syndrome
loss of motor, pain and temp below lesion
vibration and proprioception is preserved
worst outcome
158
brown sequard
ipsilateral motor, vibration and proprioception
contralateral pain and temp a few levels down
159
causes of red marrow reconversion
when there is an increased physiological need
reconversion begins centrally and works outwards
long distance running
smoking
anaemia - sickle cell
chemo
160
US for tears
anisotropy gives false positive
poor mobility gives false negative
161
wrist arthography
contrast seen in mid carpal row
what ligaments disrupted
SLT
scapholunate
lunotriquetral
162
contrast in the distal radioulnar joint
TFCC tear
163
double PCL sign
bucket handle tear
medial meniscus lies anterior and parallel to the PCL
164
intramedullary chondrosacoma
deep endosteal scalloping
165
volar tilt of lunate
pie shaped on AP
lunate dislocation
166
atlantoaxial instability
downs and morquios
167
middle beaking
odontoid hypoplasia
atlantoaxial subluxation
platyspondyly (flat VBs)
os odontoid
morquio
168
mental retardation
hurlers
169
inferior vertebral body beaking
downs
hurlers
achondroplasia
170
parasyndesmophytes
psoriatic and reactive arthritis
171
4 signs femoral head at risk of AVN
wedge-shaped lysis of the femoral head
calcification lateral to the epiphysis
lateral subluxation of the epiphysis
horizontal orientation of the growth plate
172
Barton’s fracture
intra-articular fracture of the dorsal margin of the distal radius
dorsal dislocation of the radiocarpal joint
173
features of scurvy
Ground-glass osteoporosis
sclerotic line in the metaphyseal zone
a radiolucent zone immediately to the diaphyseal side of the white line
corner fractures
sclerotic ring around the epiphysis
bleeding diathesis is seen in scurvy; therefore, subperiosteal haematoma and haemarthrosis are also features.
174
milwaukee
Milwaukee shoulder refers to a destructive arthropathy associated with advanced rotator cuff tears and deposition of basic calcium phosphate crystals including hydroxyapatite crystals.
175
adhesive capsulitis
small axillary recess
small subscapularis bursa
thickening of the coracohumeral ligament
thickened joint capsule
obliteration of fat triangle between CHL and CP
lymphatic filling still present
176
ulnar impaction syndrome
positive ulnar variance
pronation
TFCC tear
177
le fort
1 - inferior medial and lateral maxillary buttress
2 - inferior lateral and superior medial
3 - superior medial and lateral maxillary buttress
178
causes of super scan
most common - prostate or breast mets
myelofibrosis
mastocytosis
renal osteodystrophy
pagets
widespread pagets (hyperphosphate)
lymphoma
multiple myeloma
179
alkaptonuria
AR
Vertebral:
severe osteoporosis
multilevel intervertebral disc calcification: tends to be widespread (and involves nucleus pulposus)
multilevel vacuum phenomenon
syndesmophyte formation
multilevel disc space narrowing
180
causes of increased Atlanto dens interval
Trauma
Downs
RA
Ank spond
181
half moon sign
intra-articular osteoid osteoma (can cause limb length discrepancy)
treat with laser ablation if they have a pacemaker
stress fracture
182
maffuci
phleboliths
183
chondroblastoma vs chondrosarcoma
Both - sclerotic rim
Sarcoma - have matrix calcification
Blastoma - HAS periosteal reaction and bone marrow odema (NOT in the sarcoma)
184
CMF vs NOF
NOF small eccentric
CMF bubbly large expansile with bone destruction
185
hyperparathyroidism
Skeletal Features
Osteopenia
Subperiosteal bone resorption
"Salt-and-pepper" skull
Brown tumors
Acro-osteolysis
Subchondral and subligamentous resorption
Loss of the lamina dura
Rugger jersey spine
Soft Tissue and Other Findings
Nephrocalcinosis and nephrolithiasis
Chondrocalcinosis
Vascular calcification
186
osteochondritis dissecans
CT scan - fragments, loose bodies - tells about stability
atraumatic elbow pain
repeated overhead activities
187
IP/OP ratio
out phase / in phase ratio
<0.8 benign
>0.8 malignant
188
Mx of psoriatic arthritis
1) Methotrexate
2) TNF a inhibitor
189
tx of amyloid involving joints
systemic treatment with chemo - bortezomib
190
ABER MRI
used for subtle labral pathologies
replicates throwing injuries
191
SI joint erosions
Ank spond and IBD bilateral - erosion, sclerosis, fusion
reactive and psoriatic - can be uni or bilateral
RA does not cause SI joint erosion
192
calcified thigh mass
Lucent centre
myositis ossificans
has benign periosteal reaction
has a cleft sign
central calcification seen in malignant lesions (bad at their core)
parosteal sarcome has central calc
arises from periosteum
broad base attachment to cortex
193
Lucent bone lesions, Cortex not involved
kids - Ewings, eosinophilic granuloma, infection
adults - MM, lymphoma, mets
194
Lucent bone lesions involving the cortex
aggressive osteoporosis
haemangioma
radiation induced change
195
causes of secondary OA (basically not just due to age related wear and tear)
Previous fracture involving joint surface
Ligamentous injury
Meniscectomy (knee)
DDH
SUFE
Perthes
Septic arthritis
RA gout CPPD
Haemochromatosis
Wilson’s disease
Acromegaly
Avascular necrosis (AVN), e.g. post-steroid, alcohol, sickle cell
Neuropathic (Charcot) arthropathy → diabetes
Paget’s disease of bone
196
VISI DISI
1st step is the CL angle - if increased then it's VISI or DISI
Then look at SL angle
D SL up
V LT down
If SL distance >3mm - SL dissociation
DISI = Dorsal tilt, Scapholunate ligament torn, angle ↑
VISI = Volar tilt, Lunotriquetral ligament torn, angle ↓
normal SL 30-60
capitolunate angle is >30 in both
relative to position of the lunate
197
tibialis posterior tendon rupture associated with
spring ligament tear
abnormal sinus tarsi
all in the medial ankle
198
radiolucency of the anterior inferior calcaneus
poorly defined
pseudolucency of the calcaneum
199
positive response to chemo on a bone scan
flare response
the lesions become hotter
no new lesions
stable in size
osteoblasts activity increases
bone scan represents bone repair
a very aggressive cancer can have a cold spot because repair is diminished
200
osteoblastoma
can have a soap bubble appearance
calc
not improved with NSAIDs
can have sclerotic rim
posterior elements of VB's
201
giant cell tumour
lytic
subarticular
eccentric
non-sclerotic margin
202
adult causes of vertebra plana
mets
myeloma
lch
trauma
scheurmanns
plasmocytoma is a precursor to MM and can also cause VB collapse (soft tissue growth which collapses)
thallasemia causes picture frame/VB expansions/
203
non aggressive periosteal reaction
septated
204
causes of bilateral symmetric periosteal reaction
HPOA
thyroid acropachy
pachydermoperiostosis
forestiers
osteomyelitis is unilateral
205
causes of distal clavicle erosion
mets
MM
CCD
trauma
RA
hyperPTH
pyknodysostosis
206
causes of block vertebra (fused VB's)
TB (paraspinal calc) - VB collapse, gibbous deformity (acute kyphosis)
klippel feil
RA
Ank spond
Trauma
207
bony features of hyperparathyroidism
subperiosteal erosions, radial side
aero-osteolysis
distal clavicle erosion
SI J
brown tumours
chondrocalcinonsis
osteosclerosis
osteoporosis
208
hypoparathyroidism
skull vault thickening
basal ganglia calcification
209
dorsal defect of the patella
superolateral quadrant of the patella
low t1 high t2
sclerotic rim
normal variant
210
hurlers
coarse facies, hepatosplenomegaly, developmental delay, cardiomyopathy,
posterior VB scalloping from dural/epidural GAG accumulation
J shaped sella
short clavicles
paddle shaped ribs
anterior beak VB
211
radiographic stages of AVN
1 normal
2 osteopenia/sclerosis
3 subchondral collapse
4 articular collapse
5 degenerative joint
212
fragmentation of the tibial tubercle
osgood schlatters
thickening of the patellar tendon
SLJ involves inferior pole of the patella
213
RA features
symmetrical sacroiliitis
starts on the iliac side - erosion, sclerosis, proliferation
erosion of VB corners
squaring of VBs
bamboo spine
interspinous ligaments calc
shiny corner - Romans
trolley track sign - calc of the interspinous ligaments
214
causes of dense metaphyseal bands
leukaemia post chemo
rickets
heavy metal poisoning
lead poisoning
scurvy
vit D hypervitaminoses
hypothyroid
hypoparathyroid
osteopetrosis
congenital syphylis
215
discoid meniscus
lateral knee affected
lateral knee pain, locking, snapping
loss of triangle, rectangle or bow tie appearance on 4 consecutive sequences
more prone to tears
216
psoriatic arthritis
joint swelling before bone change
marginal osteophytes
sausage finger
ivory phalanx
enthesitis
217
ivory vertebra causes
hodgkin lymphoma
breast and prostate mets
carcinoid
pagets
218
causes of neuropathic arthropathy
DM - foot
Syringomyelia - UL
Syphylis - knee
6 D's
dense bones
degeneration
debris
dislocation
deformity
destruction
219
acromegaly
excess growth hormone
pit hyperplasia/adenoma
enlarged sella, eroded posterior wall
thickened vault
enlarged frontal sinuses
enlarged terminal phalangeal tufts
heel pad thickness
spine:
DISH
posterior VB scalloping
tall, long, wide VB's
220
gout
sodium urate crystal deposition
joint effusion and joint space initially preserved
periarticular soft tissue swelling
no periarticular osteopenia
the typical appearance is the presence of well-defined “punched-out” erosions with sclerotic margins in a marginal and juxta-articular distribution, with overhanging edges, also known as rat bite erosions
Gouty tophi
T1 iso
T2 hypo
Enhancing
221
hyperparathyroidism features
bone resorption (SI, mid phalanx, distal clavicle, terminal tuft)
osteopenia
brown tumours
terminal tuft erosions
osteosclerosis
soft tissue calcification
222
tumoral calcinosis
calcium deposits around the joints
periarticular deposition of massive calcium phosphate in soft tissues.
223
CPPD
fine linear calcification within the cartilage itself
(gout is around the cartilage)
224
ankle inversion injuries
inversion - peroneus longus tendon (longus lateral)
deltoid ligament is medial - eversion injuries
longus lateral deltoid medial
225
kids with bone mets
LONE
leukaemia
osteosarcoma
Neuroblastoma
Ewings
Wilms met's to lung
226
osteogenesis imperfecta
brittle bone disease
📸 Radiological Features
Generalised osteopenia
Multiple fractures at different stages of healing
Wormian bones in skull sutures
Gracile (“pencil-thin”) ribs and long bones
Vertebral compression fractures → scoliosis
Long bone deformities (bowing, angulation)
🩺 Clinical Features
Bone fragility → recurrent fractures
Blue sclerae (classic, esp. in Type I)
Dentinogenesis imperfecta → opalescent teeth
Hearing loss (otosclerosis)
Joint laxity and ligamentous hyperlaxity
Short stature, skeletal deformity in severe types
227
cupping and splaying of metaphyses
hypervitaminosis A
228
causes of Charcot
Diabetes
alcohol
syphylis
spina bifida
229
lytic mets
RCC
230
sclerotic mets
neuroblastoma
colon
carcinoid (calcium CC)
prostate
231
bone scan with VB uptake involving posterior elements
pages
mets only occupy the body usually
232
mazabraud syndrome
fibrous dysplasia of bone (expansile lytic lesions, GG)
soft tissue myxomas (thigh buttocks)
233
mccune Albright
Fibrous dysplasia + endocrine abnormalities + café-au-lait spots
234
erlenmeyer flask deformity
Lead: lead poisoning
G: Gaucher disease
N: Niemann-Pick disease
O: osteopetrosis, osteochondromatosis
M: metaphyseal dysplasia (Pyle disease) and fibrous dysplasia
E: 'ematological, e.g. thalassaemia
235
tennis elbow
common extensor origin
236
features of TB spondylitis
no disc involvement
thin smooth wall of abscess
subligamentus spread
multiple/entire VB involvement
237
differential for fluid fluid levels
ABC
giant cell tumour
telangiectatic osteosarcoma
238
avulsions pelvis
ASIS sartorius TFL
AIIS rectus femoris
STR
239
features of klippel feil
web neck
sprengel shoulder
fused facets
femi vertebrae
240
tensile side fracture of the femur
pagets
241
scheurmanns
vertebral wedging, endplate irregularity and narrowing
of the intervertebral disc spaces
thoracolumbar spine
242
homocystinuria
osteoporosis
lens down and in (homos go down)
243
supraspinatous free edge
adduction
internal rotation
hand in back pocket
244
MFH/pleomorphic undifferentiated sarcoma
pleomorphic spindle cells
50-70
thighs
pleomorphic spindle cells
painless
erodes bone
RF's: pages and radiotherapy
245
hot on MDP bone scan but benign
Paget’s disease
fibrous dysplasia
brown tumours (bone resorption)
ABC (vascular)
OO (resorption)
chondroblastoma (vascular)
246
shepherds crook deformity
Shepherds FOP
varus proximal femur
fibrous dysplasia
pagets
OI
247
caffey disease
infantile cortical hyperostosis
periostitis
periosteal reaction
hyperostosis
soft tissue swellings
bone expansion
mandible clavicle ribs
self limiting , NSAIDS
248
rolando fracture
comminuted intra-articular fracture-dislocation of the base of the thumb
249
Desmoid tumour
aggressive fibromatosis
locally invasive
recur post resection
no mets
T1 iso
T2 hetero
variable enhx
infiltrative margins
NSAIDs and anti-oestrogens can be used to reduce the rate of recurrence
associated with Gardner syndrome (FAP)
found in anterior abdominal wall
250
Target sign = peripheral high T2 with central low → Neurogenic tumours
neurofibroma or schwannoma (eccentric and homogeneous with peripheral enhx)
251
Triple signal intensity =
Synovial sarcoma
"triple sign" which is due to areas of necrosis and cystic degeneration with very high signal, relatively high signal soft tissue components and areas of low signal intensity due to dystrophic calcifications and fibrotic bands
252
soft tissue chondrome
no bone connection
Isointense to muscle on T1, high T2 (unless calcified).
253
Synovial Chondromatosis
Multiple cartilaginous nodules in joint/tendon sheath/bursa.
Men, large joints (esp. knee).
70% show calcification/ossification.
Classic: multiple similar-sized calcified intra-articular bodies.
May cause extrinsic bone erosion. Rare malignant transformation.
254
Amorphous mineralisation + rim-enhancement
Extraskeletal osteosarcoma
255
Ring-and-arc calcification
Mesenchymal chondrosarcoma
can be in the orbits
256
Synovial chondromatosis (benign)
nodules are high T2 if non-calcified
257
metaphyseal bone lesion
under 20
fluid fluid levels
thin wall
ABC
doesn't extend to epiphysis
an intraosseous AVM
pre-op embolisation followed by curettage and bone graft - resected completely
258
treatment of a giant cell tumour
curettage and filling with polymethylmethacrylate
259
DDH
normal = > 60 <77
dysplastic hips = <60 >77
alpha off (<60) - deficient bony acetabulum
beta off (>77) - subluxed hip
260
pain in knee sprinting or jumping
osgood schlatter
tibial tubercle avulsion
261
Umair's 2A
flashcards
Decks in class (9)
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