Dx Imag 4 Remediation Flashcards by Danton Dye

What is this?

Type of calcification? (physiologic, Dystrophic/post traumatic, or metastatic)

What group is this in?

Can Chiros treat this?

Myositis Ossificans

dystrophic/post traumatic

Hadd Group

Chiros can treat

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Differential DX?

Is this reversible or not?

SLE or Jaccouds

it is reversible

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Which of the following would you expect to see together?

a. bamboo spine
b. ghost joint
c. disuse osteoporosis
d. Romanus lesion

a,b,c are all toghether in the END STAGES

romanus lesion is in the early stage

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Diff Dx?

What if there is elevated HLA-B27? which one would you then rule out?

DISH, reactive, psoriatic

Rule out DISH with HLA-B27

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Any abnormal lab findings?

Is this multiparity?

What is this?

yes

osteitis condensans ilii

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ADI goes with which category?

Inflammatory

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What is this?

What type of B/L digits?

EOA

B/L sausage digits

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List and describe all Modic types

Type 1 - Edema (t1 down, t2 is up)

Fibrovascular changes

Type 2- Fatty change (T1 and T2 both UP/bright)

Fatty yellow marrow

Type 3 - sclerosis (T1 and T2 are down

Sclerosing of bone

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Image with a hip replacement (both not so good hips but showing only one has been replaced)

Large obturator foramen

underdeveloped rami

premature maturation which disallowed the acetabuli to finish growing

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destruction, soft tissue swelling, obliteration of joint space

What category does this sound like????????

Septic

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Image with a lot of fusion, there is an odd shaped mandible, but IVF’s are still clearly seen

Premature maturation

sero positive

flexion extension views

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What is demonstrated on the image?

Ray pattern of psoriasis

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DJD

a. MMP TIMP imbalance or balance
b. bone softening? is acetabular depth normal
c. can it produce ankylosis?
d. ADI instability?

a. imbalance
b. no bone softening, depth is normal
c. not producible
d. not producible

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What type of osteoporosis is seen with Ank Spond?

Disuse

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Bag of bones foot

What is the root cause?

What is this patient more susceptible too?

Cause is vascular insuffieciency

patient is more susceptible to infection and developing neurotrophic joint disease

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After a prolapsed disc releases some of the nucleus into the central canal. we get local ______ and then the procoss of _______ begins in order to resect the nucleus from the canal.

local inflammation

phagocytosis

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Activated Chondrocytes degrad integrity by what type of mediators??

Pro inflammatory

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Best explanation for the earliest radiographic change in discogenic spondylosis??

Dehydration of the Nucleus propulsus

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DJD of Synovial versus Cartilagenous joints. these two are very similar but what is the one difference?

Synovial cyst/ subchondral cyst

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When RA also presents with Rheumatoid nodules its going to be a MORE __________disease.

severe

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Cacific tendonitis requires adequate treatment to prevent a most serious complication of

spontaneous rupture

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Which joint when affected by secondary DJD demonstrates increase joint space

AC JOINT

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Which arthride is associated with overhang sign

Gout

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put these in order Ank spond progression

Disuse osteoporosis
Romanus lesion / local lucency
Syndesmophytes

4Bamboo spine

5.Shiny corner

2,5,3,4,1

Romanus lesion / local lucency

Shiny corner

Syndesmophytes

Bamboo spine

Disuse osteoporosis

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Secondary DJD is associated with what?

Congenital block vertebra

What are the phases of DJD?

Phase 1: Edema and Microcracks Histologic signs of microcracks and chondrocyte proliferation, edema of extacellur matrix, Phase 2: fissuring and pitting clusters of chondrocytes appear at edges of clefts in cartilage, surface defect deepen in line with applied forces Phase 3: erosion Loose body formation, cartilage detachment causes local inflammation

Example of a seronegative inflammatory arthritis commonly affecting SI joints?

Ank Spond

Anklyosis occurs in a higher percentage of patients with _____ than other choices.

Psoriasis

What are the 3 types of Soft tissue calcification?

Physiologic, Metastatic, and dystrophic/post-traumatic

What are some examples of physologic calcification? Are calcium levels normal? Are the tissues normal?

calcium and tissues are normal examples are posticus ponticus, arcuate foramen, vertebro-basilar artery insuffiency THINK THYROID (CARTILAGE, LIGAMENTS)

Explain Dystrophic calcification. are the calcium levels normal? are tissues normal or damaged? What are some common examples?

Post-traumatic calcification, calcium is normal, tissues are damaged. Ex. calcific bursitis, myositis ossificans, calcific tendonitis, tophacious gout

Explain metastatic calcification. Calcium levels normal? Tissue normal? Examples?

calcium is high, tissues are normal, ex. HPT, lytic mets, mutiple myeloma

Which category of arthritis demonstrates joint preservation until the late stages of the disease???

Metabolic

Ochronosis has 2 distinctive radiographic features. what are they? What is the missing enzyme called?

1. Disc calcification 2. abnormal bone density enzyme = homogentisic acid oxidase remember homogentisic acid turns urine black, pt will have black on cheek and ears

What is this?? Pt has what common signs and symptoms? What are the phases?

Complex regional pain syndrome Pt has cold foot, hairless foot and ankle, tactile sensitivity phase 1- early- severe burning without radiographic changes phase 2- dystrophic- edema, cold bone scan and reduciton in bone density phase 3- atrophic- atrophy of the skin, muscle, and persistant pain

Matching a. abnormally high or frequent stresses? b. normal stresses are applied and they fracture c. trivial stresses are applied to osseous fractures and they fail 1. insufficiency 2. stress 3. pathologic

If there is an image that ask which vertebra has REDUCED bone density......

look for darker image

Path in upper lung field, destruction of GH joint, cystic changes around the knee,

Tuberculosis

Diabetes, Infection, Atrophic form of neurotrophic joint disease (candy lick appearance)

Fat toe with local lucency... what category??

infection

Pt had polymyalgia rheumatica and were being treated with a biologic Small white area of ¼ of vertebra and a week later its taken up ½ of vertebra

Edema = Infection

What is this? Does it have malignant potential? M/C what of spine? Is it prone to path fracture? Why are there lines on it?

Hemangioma aka root beer shaped vertebra No malignant potential M/C benign tumor of spine is NOT PRONE TO PATH FRACTURE EXTREMLEY VASCULAR thats why it has all of those lines

Ivory white vertebra diff dx

Hodgkins lymphoma (20-40) Blastic Mets (45+) Paget's disease (55+)

Image with periosteal reaction in the METAPHYSIS OF A KID

Osteosarcoma

What is this sign? What is it indicitive of?

Raindrop skull multiple myeloma

What is this??

Skull Mets

What is this??? What causes this? is this a sign of premature maturation? What else would you see

Saber shin Syphyllis would also see clutton joints, hutchinsons teeth and wimberger sign of syphyllis NOT a sign of premature maturation

What are the spects in the spleen indicitive of???

Histoplasmosis

What is this sign Indicitive of what?? failure to thrive?

hypovitaminosis D aka Ricketts failure to thrive cupped and frayed metaphysis

What sign is this?? What is it associated with?

Silver dollar sign Eosinophilic granuloma

Bony prominences with infection

coccidiomycosis

From the list below select all of the choices associated with the most common cause of non-suppurative a. gibbus b. potts c. time test? d. cold abcess

all of them

Most likely to present with spine pain and segmental neuropathy?

Neurofibromatosis

which of the following presents as bubbly expansile progressive?

Kidney or thyroid

Which organism typically does not have a pneumonitis phase?

Maduramycosis

Who can appear to respect boundaries

TB because it moves so slowly

Which of the following can increase alkaline phosphatase levels? ## Footnote Blastic mets Pagets Bone repair

all of the above

Which of the following is a rare consistant feature of a benign bone tumor osteoid osteoma

Lucent nidus outside of bone under periosteum Does not increase risk of fracture it actually reduces it

Most common primary bone tumor to metastasize to another bone

EWINGS

Most common primary benign of the spine

Hemangioma

Most common primary aggressive

Female patients w/ osteoporosis have fracture concentrations in the

Wrist Femur Spine

Acromegaly look at sella turcica for what sign

Double floor sign Or enlarged sella turcica

CRPS stages

Early Dystrophic Atrophic

Which of the following types of cancer has the ability to mets to the cortex of bone

lung can also go beyond knee and elbow

Hands that are deformed but no erosion

SLE and Jaccouds

Dx Imag 4 Remediation Flashcards

(66 cards)