MSK

Question 1

Answer 1

Erlenmeyer Flask

Thalaseamia: coarsened trabeculation producing a ‘cobweb’ appearance.

Osteopetrosis

Pyle disease/ Pick disease

D

OI

Gaucher: osteopenia and pencil thin cortices. Hepatosplenomegaly

Question 2

Erlenmeyer flask deformity, ‘sandwich vertebrae’ and
‘bone within bone’ appearance

Answer 2

osteopetrosis.

Question 3

Soft tissue calcification

Answer 3

1. Tumoral calcinosis
2. Haematoma
3. Myositis ossificans
4. Crystal arthropathy
5. Scleroderma
6. Dermatomyositis: Sheets of Ca.
7. Synovial osteochondromatosis
8. Synovial sarcoma

Question 4

Expansile lytic bone lesion, B9

Answer 4

1. Fibrous dysplasia: GG +/- Ca++
2. ABC:
   
   • Posterior elements of the spine.
   • soap bubble.
   • Fluid fluid level
3. Unicameral bone cyst
   
   • central location and expansion.
   • Thin sclerotic rim
4. GCT
   
   • epiphyseal extension
   • septation
   • eccenteric location
5. EG:
   
   • well-defined areas of cortical or medullary rarefaction;
   • in the later stages, there may be a sclerotic margin, periosteal reaction, and bone expansion.

Question 5

A 71-year-old man with shoulder pain and swelling

Answer 5

1. Synovial osteochondromatosis
   
   • multiple, round, similar-sized calcified bodies.
   • Treatment is resec- tion of the bodies along with synovectomy. Recurrences after surgical debridement can occur.
2. PVNS:
   
   • MRI: Joint effusion and focal or diffuse synovial thickening that is low signal on T1 and T2 because of hemosiderin deposition.
   • The hemosiderin causes susceptibility artifact and blooming on gradient-echo sequences.
   • Treatment is synovectomy; incomplete resection is associated with high recurrence rates.
3. Rice bodies:
   
   1. RA
   2. resembles rice grains
   3. low T2, joint effusion, synovial hypertrophy and synovial enhancement.

Question 6

A 49-year-old woman with chronic bilateral hand pain and

ulcerations

Answer 6

Acro-osteolysis:

1. Hyper - PTH:
   
   • Subperiosteal resorption of bone, especially along the radial aspect of the second and third middle phalanges of the hands, is virtually diagnostic
   • resorption of the distal clavicles,
   • “rugger-jersey” spine,
   • brown tumors, and
   • resorption of the terminal phalanges.
2. Scleroderma: soft-tissue resorption and calcifications with distal phalangeal acro-osteolysis. CREST syndrome.
3. Trauma: Frost-bite, burn injury.
4. Psoriasis:
   
   • DIP
   • soft tissue swelling. peri-articular erosion, fluffy periostitis
   • sausage digit
   • pencil in cup deformity
5. Hajdu-Cheney Syndrome- AD
   
   • enlarged sella
   • wormian bones
   • basilar invagination
   • hearing and speach impairment