Flashcards in Bone Path II Quiz 1 Deck (263)
What are the categories of bone disease?
Congenital, Arthritis, Tumor, Blood, Infection, Trauma, Endocrine, Soft Tissues (CATBITES)
What are some clues to have a preliminary analysis of bone disease? (7)
1) Age 2) Sex 3) Race 4) History 5) Number of lesions 6) Symmetry of lesions 7) Systems involved
what are the 4 different types of imaging modalities?
1) Plain film 2) Computed tomography (CT) 3) MRI 4) Bone scan
what type of imaging is the 1st choice for osseous lesions/
How much bone loss is required to be seen on the film?
Are CT often used for tumor, infection and arthritis?
What is the difference between CT and plain film?
Same basic imaging as plain film, more detail
What does CT detect? (3)
1) Detects more subtle osseous changes (lytic destruction, cortical integrity) 2) Detects subtle periosteal response 3) Detects subtle calcification
Which typ of imaging provides excellent evaluation of marrow?
Does MRI provide good evaluations of cortex and trabeculae?
No, poor eval of cortex and trabeculae
What are some properties of MRI? (5)
1) Better evaluation of extent of lesion 2) more information regarding matrix 3) Visualize soft tissue mass 4) Evaluate larger areas 5) Evaluate impact on surrounding structures
What is another name for a bone scan?
Radionuclide imaging; scintigraphy
What are "hot spots" on a bone scan?
areas of increased uptake (black) where areas of increased metabolic activity are found
are bone scans specific or sensitive?
very sensitive (3-5% bone loss) but not specific
Do bone scans provide good anatomic detail?
No, poor anatomic detail
what are the aspects of a bone to evaluate? (5)
1) Shape 2) Size 3) Cortex 4) Trabeculae 5) Overall radiographic density
What are the aspects of osseous anatomy to evaluate? (11)
1) cortex 2) periosteum 3) endosteum 4) cancellous bone 5) trabeculae 6) cellular marrow 7) fat and hematopoietic tissue 8) Epiphysis 9) Metaphysis 10) Diaphysis 11) Physis
what are the 6 types of tumor types?
1) Metatstatic 2) Primary 3) benign 4) malignant 5) Quasimalignant 6) Tumor-like processes
what is a malignant tumor?
A tumor that may metastasize
What is a quasimalignant tumor?
Giant cell, some are benign, some are malignant
Which types of tumors would you refer to an internist?
Metastasis and multiple myeloma (may go to oncologist/ rheumatologist)
Which types of tumors or conditions would you refer to an orthopedic surgeon?
Primary malignancies, painful benign lesions, lesions with significant risk of complications (pathologic fractures, effect on growth, malignant trasformation) and infection
Which types of tumors would you document and not refer?
Asymptomatic, benign lesions without significant risk of complications
what are the 12 aspects to analyze a lesion?
1) Skeletal location
2) Position within the bone
3) Site of origin
4) Joint changes
8) Cortical integrity
9) Behavior of the lesion
11) Periosteal response
12) Soft tissue changes
when do most mets occur?
In patients >40
when are most primary benign cancers found in patients?
In patients < 30
Are tumors more common in males or females?
Is race usually a helpful differentiation for neoplasms? What is the exception?
No, race is not often helpful with neoplasm, Ewing's sarcoma is exception since it is less common in blacks
What are some red flags for cancers? (5)
1) weight loss 2)fatigue 3) malaise 4) recurrent infection 5) pain pattern