Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

INTERP -1 > Roentgen Signs of BONE DISEASE > Flashcards

Roentgen Signs of BONE DISEASE Flashcards

1
Q

Roentgen Signs of Bone Disease

CATEGORIZATION OF,,,,,,,,,,,, LESIONS!!

• By disease category‐ CATBITES X 8

1–C ongenital/dysplasia
2–A rthritis
3–T rauma
4–B lood/vascular
5– I nfection/inflammatory
6–T umor/tumor‐like
7–E ndocrine/metabolic
8–S oft tissue
A

KNOW WHAT CATBITE STANDS FOR!!

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

Roentgen Signs of Bone Disease

PRELIMINARY ANALYSIS: CLINICAL DATA

• Patient age
• Patient sex
• Ethnic/cultural background
• History/chief complaint
******* This information will help rule in or out certain conditions
A

KNOW THESE 4

&

DEVELOP GOOD HABITS: SEARCH
PATTERN
• You need to consistently perform a complete search pattern on every radiographic study that you assess

• Use your ABC’S
– Alignment
– Bone
– Cartilage (joint)
– Soft tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Roentgen Signs of Bone Disease

IS THERE A LESION?? IF YES….

• You must determine if it is ____, joint, or soft
tissue in origin, and it must be described in a
systematic fashion

• This will direct you to a differential and in
some cases, a __________ diagnosis

• You must determine if the lesion appears
benign or _________

• You must indicate, on your report, the NEXT
step in evaluation, treatment, and referral.

A

bone

specific

aggressive

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

Roentgen Signs of Bone Disease

A LIST OF THINGS TO ASSESS X 14
• Once a lesion or lesions involving bone have
been identified, there are many variables that
can be assessed:

  • -Skeletal location
    • Behavior of the lesion
  • -Position within the bone
    • Matrix
  • -Site of origin
    • Periosteal response
  • -Shape
  • -Soft tissue changes
  • -Size
  • -Number of lesions
  • -Margination
    • Symmetry in the body
  • -Cortical integrity
  • -Systems involved
A

KNOW CUZ…HERE THEY COME!!

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

Roentgen Signs of Bone Disease

THE ANALYSIS / DESCRIPTION OF THE LESION

1— Skeletal LOCATION
– in what part of the skeleton is it located
(spine, skull, humerus)

2—Position WITHIN the bone
– is it metaphyseal, diaphyseal, etc.
– is it in the vertebral ____, pedicle, etc.
– is it concentric or eccentric??

A

body

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

Roentgen Signs of Bone Disease

ANALYSIS / DESCRIPTION OF THE LESION

3— _________ of origin
– is it medullary, cortical, periosteal, extraosseous, or a
combination.

4— _______ (morphology)
– is it ROUND, oval, scalloped, pedunculated,
sessile, serpiginous, etc.

A

SITE

SHAPE

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

Roentgen Signs of Bone Disease

ANALYSIS / DESCRIPTION OF THE LESION

5— SIZE
– if possible, __________ the lesion
– some lesions are distinguished primarily by their size

6— MARGINATION
– __________= usually poorly defined
(indistinct, wide zone of transition)

–________ = usually well defined
(sharp, short zone of transition)

A

measure

]

aggressive

benign

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

Roentgen Signs of Bone Disease

ANALYSIS / DESCRIPTION OF THE LESION

7— Cortical integrity

EX• THINNING‐ focal: from a medullary or soft tissue lesion; diffuse: from osteoporosis
EX• THICKENING‐ variety of causes
EX• EXPANSION‐ typically described as
“______ _______”, especially if septated
EX• ______________ ‐ usually a sign of aggression
• CORTICAL interruption= ____________

A

soap bubbly

DESTRUCTION

fracture

*******MUST SEE SLIDE 18!!!

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

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

8— NUMBER of lesions
– multiple lesions most common in ________ conditions, dysplasia, metastasis.
– this finding alone does NOT indicate the nature of the pathology!!

9— SYMMETRY of lesions
– symmetry tends to lead ______ from tumors and trauma, and focus into a systemic or metabolic processes

A

systemic

AWAY

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

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

10— SYSTEMS involved
– is the condition _________ to the bones, or are there findings in the viscera, brain, joints, or other soft tissues?

A

isolated

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

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

11— OsteoLYTIC/LUCENT lesions
– both terms indicate a focal DECREASE in bone density
– osteoLYTIC is usually reserved for _______ lesions,
–lucent for ___________;
but there is no specific rule
– changes due to pressure erosion/osteoclastic activity‐ NOT direct tumor LYSIS

A

aggressive

benign

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

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

12— GEOGRAPHIC lesions
– lucent destruction of bone, usually from a
non‐aggressive lesion
– lesions are usually over 1‐cm in diameter, and have sharp borders
– usually solitary, but can be __________
– may be expansile or ___________

A

multiple

non‐expansile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

13--- Moth‐eaten
– invariably due to an aggressive lesion
– focal, \_\_\_\_\_\_\_\_\_  and ill‐ defined areas of lytic
bone destruction
– lytic foci are of \_\_\_\_\_\_\_\_ size
A

irregular

varying

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

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

14— Permeative
– invariably due to an aggressive lesion, usually a TUMOR
– focal, pin‐point areas of lytic destruction
– can coalesce to form a ______________ pattern

A

moth‐eaten

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

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

15— OsteoBLASTIC/SCLEROTIC lesions
– both terms indicate an ________ in bone density
– osteoBLASTIC is usually reserved for _________ lesions, sclerotic for benign; but there is no specific rule
– due to bone reaction to the _________, or actual
bone production

16— Mixed lesions
– a combination of most any of the above

A

increase

aggressive

tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

17---  MATRIX of the lesion
– The dominate internal \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_ in a lesion
– Often there are radiographic findings that can give a clue to what the matrix is
– 5 basic types of matrices
• Fat
• Cartilage
• Bone
• Fibrous
• Cystic / fluid
A

extracellular substance

17
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

17— Matrix

1– FAT
• fat density lesion if in the _______ _________.
• bone lesions tend to be LUCENT, and like to ossify/Ca++

A

soft tissues

18
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

17—-MATRIX CONT…..

2– CARTILAGE
• typically lucent/lytic
• cartilaginous lesions usually demonstrate some type of
CALCIFICATION
• different TYPES of calcification seen =
– ____________: focal, small spots, relatively uniform
– ____________: larger, variable size and density, confluence of stippled Ca++
– ____________: thin, curvilinear Ca++, typically seen
in aggressive lesions

A

stippled

flocculent

arc & ring (C & O)

MUST SEE SLIDE 36!!!

19
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

17— MATRIX CONT…

3-– OSSEOUS
• can have a lucent, sclerotic, or __________ appearance
• classic lesions are densely radiopaque, rather than the focal patterns seen with cartilage based calcification

A

mixed

20
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

17—MATRIX CONT..

4—– FIBROUS
• see hazy “________ ______”, OR “_____ _____”, OR “smudged” appearance
• can be LUCENT OR LYTIC, similar to cartilage‐ based lesions
• Ca+ uncommon

A

ground glass

frosted mug

21
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

18—MATRIX CONT..

5—– Cystic
• NOT a true tissue‐ based division
• includes most other ______ lesions that are at least mildly expansile and have a fluid component.

A

benign

22
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

19— Periosteal reactions
A– Almost always considered evidence of an _________ process

B– How aggressive depends on the pattern

C– 4 basic patterns
• Solid
• Laminated
• Spiculated
– Sunburst
• \_\_\_\_\_  \_\_\_\_\_\_\_\_\_
A

aggressive

Codman’s triangle

23
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

19—Periosteal reaction CONT.,.

1– Solid
• single layer, typically attached to the _______
• indicates a ________ or SLOW growing lesion

A

cortex

benign

24
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

19—Periosteal reaction CONT.,.

2— – Laminated (_____ _______)
• one or more layers, NOT fully connected to the cortex
• usually indicates a more __________ lesion

A

onion skin

aggressive

25
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

19—Periosteal reaction CONT.,.

3—– Spiculated
• spicules of bone radiating ________ from the cortex
• can be hair‐on‐end (perpendicular to cortex)
• can be sunburst (radiating away from a point source)
• ALWAYS!! indicates an _________ lesion

A

away

aggressive

26
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

19—Periosteal reaction CONT.,.

4—Codman’s TRIANGLE
• periosteum lifted away from ______, with a central disruption
• periosteal remnant and underlying lucent region forms a triangle
• usually due to _________ lesion

5—Complicated periosteal reaction
– Some lesions can demonstrate a mixed bag
– These are usually _________

A

cortex

aggressive

aggressive

27
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

19---Periosteal reaction CONT.,.
6---Soft tissue involvement
– Soft tissue PRIMARY!!
• Larger involvement in the soft tissue
• look for mass‐like region of soft tissue density, fat density, Ca++/ ossification, or air
• look for \_\_\_\_\_\_\_\_\_\_\_  tissue planes

Soft tissue involvement
7– Soft tissue SECONDARY
• More involvement or _________ in the bone
• seen with ________ _________ of joints / bone, or from extension of bone lesions INTO soft tissues
• look for FAT PAD displacement; or blurred or displaced soft tissue planes

A

displaced

destruction

inflammatory processes

28
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

  • Once all possible information has been gathered, then you can begin to determine the_______ OR________ nature of the lesion
  • This will aid in deriving a differential diagnosis, as well as what the next therapeutic or diagnostic step should be
A

aggressive or benign

29
Q

Roentgen Signs of Bone Disease

ANALYSIS / DESCRIPTION OF THE LESION

Characteristics of an ___________ lesion may include but are not limited to:
– LONG ZONE of transition, ill‐defined borders
– PERMeative or MOTH‐eaten pattern of bone destruction
– Cortical destruction
– Solid, laminated or spiculated PERIOSTEAL reaction
– Codman’s triangle
– Soft tissue involvement or mass
– _________ and growing

A

aggressive

Painful

30
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

Characteristics of a ________ lesion may include but are not limited to:
– SHORT zone of transition, WELL‐defined borders, geographic pattern
– Cortical ________
– Cortical ____________ without destruction
– Sclerotic rim or peripheral sclerosis
– Solid periosteal reaction
– Asymptomatic or post‐traumatic pain
– Lesion size stable

A

benign

thinning

expansion

31
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

Characteristics of an indeterminate lesion may include but are not limited to a combination of the aggressive and benign lists.

• The best path to take when a lesion is indeterminate usually involves treating it as an __________ lesion until proven otherwise

A

aggressive

32
Q

Roentgen Signs of Bone Disease
ANALYSIS / DESCRIPTION OF THE LESION

“LEAVE‐ME‐ALONE” LESIONS

  • A specific category of lesion
  • They are NOT normal, but have little or NO clinical or therapeutic significance
  • They are clinically silent, completely ______, found entirely by chance and require NO immediate follow‐up
A

benign

33
Q

CATEGORIZATION OF LESIONS

• By disease category

CATBITES

– Congenital/dysplasia
–Arthritis
–\_\_\_\_\_\_\_\_\_\_
–Blood/vascular
– Infection/inflammatory
–Tumor/tumor‐like
–Endocrine/metabolic
–\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
A

Trauma

Soft tissue

34
Q

CATEGORIZATION OF LESIONS

FOGMACHINES

  • F‐ fibrous dysplasia
  • O‐ osteoblastoma
  • G‐ giant cell tumor
  • M‐ myeloma (plasmacytoma), metastasis
  • A‐ aneurysmal bone cyst
  • C‐ chondroblastoma, chondromyxoid fibroma
  • H‐ histocytosis X, hyperparathyroidism (brown tumor)
  • I‐ infection
  • N‐ non‐ossifying fibroma
  • E‐ enchondroma
  • S‐ simple bone cyst

**By appearance‐ “soap‐bubbly lesions”
– FEGNOMASHIC, FOGMACHINES or
GONE FISH MAC

A

KNOW

INTERP -1 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions