Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NYCC Bone & Joint > (3) Osteoporosis > Flashcards

(3) Osteoporosis Flashcards

(60 cards)

Start Studying
1
Q

What is the radiographic finding of osteoporosis?

A

osteopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

With osteoporosis, bone has ____ quality, and ____ quantity.

A
  • normal quality
  • reduced quantity (^porous trabecular bone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

With osteomalacia, bone has ____ quality, and ____ quantity.

A
  • reduced quality
  • normal/reduced quantity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 3 categories of osteoporosis?

A
  • generalized
  • regional
  • localized
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What category of osteoporosis involves the majority of the skeleton?

A

generalized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What category of osteoporosis involves most of a limb?

A

regional
(region or segment of body affected)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What category of osteoporosis is periarticular osteoporosis?

A

localized
(focal area of bone loss)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What category of osteoporosis is permeative/motheaten osteolysis?

A

localized
(focal area of bone loss)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common cause of generalized osteoporosis?

A

post-menopausal/senile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What patient are we most concerned about never hitting peak bone density?

A

female athlete triad
(amenorrhea –> less hormones, less protective)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is another name for post-menopausal/senile osteoporosis?

A

senescent osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What demographic is affected by post-menopausal/senile osteoporosis?

A
  • F>M (4:1 in 5th & 6th decades)
  • males catch-up to bone loss in 7th & 8th decades
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does bone density change after 35 years of age?

A

1% cortical and 2% medullary bone loss per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the rate of bone loss per year at menopause?

A

3-6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the clinical and lab findings of post-menopausal/senile osteoporosis?

A
  • painless until Fx or deformity
  • normal labs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the most common skeletal location of post-menopausal/senile osteoporosis?

A

axial skeleton –> extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What locations of traumatic/pathologic fractures are considered life-threatening in patients with post-menopausal/senile osteoporosis?

A
  • thoracolumbar spine
  • hip
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What postural finding is associated with post-menopausal/senile osteoporosis?

A

Dowager’s hump
(microFx’s create hyperkyphosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the common locations of traumatic/pathologic fractures in patients with post-menopausal/senile osteoporosis?

A
  • T/L spine
  • hip
  • distal radius
  • proximal humerus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the common location of insufficiency fractures in patients with post-menopausal/senile osteoporosis?

A
  • T/L spine
  • sacrum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the imaging modality of choice for evaluating bone density?

A

densitometry (DEXA)
(radiographs are insensitive to early density changes; no zone of impaction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the radiographic findings of osteopenia?

A
  • cortical thinning (pencil-thin)
  • altered trabecular pattern (body of vertebra same shade as ST; pseudo-hemangiomatous appearance)
  • fractures (fish/biconcave vertebrae, Schmorl nodes)
  • deformities (^kyphosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How would you differentiate osteopenia in the spine versus a hemangioma?

A

osteopenia is seen affecting multiple levels as opposed to just 1 segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the changes in trabecular pattern that occur with osteopenia

A
  • early resorption of non-weight bearing trabeculae (horizontal; ^Ward’s triangle)
  • late resorption of weight bearing trabeculae (vertical)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How is Dual Energy X-ray Absorptiometry used?
uses low dose x-rays to quantify bone mass (severity of osteoporosis or osteopenia)
26
What are the 2 types of DEXA scans and what body regions are they used for?
- central: spine, hips - peripheral: radius, calcaneus, finger
27
What 2 readings are obtained from a DEXA scan?
- T-score - Z-score
28
What is the T-score on a DEXA scan?
bone density compared to 18-25y/o of same race & gender; gives risk of Fx
29
What is the Z-score on a DEXA scan?
bone density compared to other pts of same age, race, gender
30
What population is the Z-score useful for?
pre-menopausal female athlete triad
31
What T-score readings are considered normal?
+1 to -1
32
What T-score readings are considered osteopenia?
-1 to -2.5
33
What T-score readings are considered osteoporosis?
-2.5 or less
34
What T-score readings are considered severe osteoporosis?
-2.5 or less with a Hx of fragility Fx
35
What does T-score of -2 indicate about fracture risk?
4x more likely to Fx (2^2)
36
What does T-score of -3 indicate about fracture risk?
8x more likely to Fx (2^3)
37
What does T-score of -4 indicate about fracture risk?
16x more likely to Fx (2^4)
38
What are 3 causes of regional osteoporosis?
- disuse osteoporosis - complex regional pain syndrome (CRPS) - transient regional osteoporosis (of the hip)
39
When determining differentials for regional osteoporosis, what is the first question to ask yourself?
is it in the hip?
40
If regional osteoporosis is affecting the hip, what is the likely diagnosis?
transient regional osteoporosis of the hip (TROH)
41
If regional osteoporosis is *not* affecting the hip, what is the next question to ask yourself?
is there an old Fx?
42
If regional osteoporosis is *not* affecting the hip, and there is evidence of an old fracture, what is the next question to ask?
is their pain increasing or decreasing?
43
If regional osteoporosis is *not* affecting the hip, there is evidence of an old fracture, and no pain, what is the likely diagnosis?
disuse osteoporosis
44
If regional osteoporosis is *not* affecting the hip, there is evidence of an old fracture, and increasing pain, what is the likely diagnosis?
CRPS OR Disuse
45
If regional osteoporosis is *not* affecting the hip, and there is *no* evidence of an old fracture, what is the likely diagnosis?
CRPS
46
What are the 3 patterns of regional osteoporosis on imaging?
- mottled (irregular) radiolucency (simulates permeative/motheaten destruction) - band-like metaphyseal or epiphyseal radiolucency - generalized osteoporosis
47
What is the most common cause of regional osteoporosis?
disuse osteoporosis
48
What can cause disuse osteoporosis?
immobilization: - Fx in cast - wheelchair bound - paralysis
49
What are the radiographic findings of disuse osteoporosis?
- can appear like permeative lytic - appears 7-10 days after immobilization(disuse occurs in extremities) - peak density loss by 2-3 months (8-12wks)
50
What percent of bone density loss must occur after immobilization to be visible radiographically?
30%
51
What are other names for complex regional pain syndrome?
- reflex sympathetic dystrophy syndrome - post-traumatic osteoporosis - sudeck's atrophy - causalgia - shoulder-hand syndrome
52
What is the definitive diagnostic test for regional osteoporosis due to complex regional pain syndrome?
3 phase bone scan
53
If you determine your patient has CRPS, what is your next step?
refer to neurology
54
What is the clinical presentation of CRPS?
- unexplained severe neurologic pain - surface changes (hair loss on forearms, sweating/anhidrosis)
55
What is the most common location of transient regional osteoporosis?
hip (femoral head/neck)
56
What is another name for transient regional osteoporosis of the hip?
transient bone marrow edema of the hip
57
What demographic is primarily affected by transient regional osteoporosis of the hip?
- M>F - 20-40yrs
58
What is the clinical presentation of transient regional osteoporosis of the hip?
- sudden onset - pain (not reproduceable) - antalgia & limp - self-limiting (full recover in 3-12mo)
59
What are the **early** imaging features of transient regional osteoporosis of the hip?
- X-ray = normal - MRI = marrow edema
60
What are the **late** imaging features of transient regional osteoporosis of the hip?
- X-ray = regional osteopenia - MRI = marrow edema

NYCC Bone & Joint (71 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions