Infections and AVN

Question 1

Infection of the skin.

Answer 1

Cellulitis

Question 2

Infection of bone.

Answer 2

Osteomyelitis

Question 3

Infection of joints.

Answer 3

Septic arthritis

Question 4

Most common areas of infection in drug addicts.

Answer 4

“S” joints: Spine, SI joints, Symphysis pubis, SC joint

Question 5

Most common infection.

Answer 5

Staphylococcus aureus

Question 6

Most common route of administration.

Answer 6

Hematogenous

Question 7

Gender and age bias of suppurative osteomyelitis.

Answer 7

Males aged 2-12

Question 8

Most common locations of hematogenous spread.

Answer 8

Shoulder, hip, ankle, knee and spine

Question 9

Two major categories of infection.

Answer 9

Suppurative (pus/staph) and Non-suppurative (TB)

Question 10

4 radiographic stages.

Answer 10

Latent: 1-10 days
Early: 10-21 days
Middle: Weeks
Late: Months

Question 11

One of the earliest radiographic signs that occurs in the early stage.

Answer 11

Soft tissue swelling

Question 12

In what stage does permeative or moth-eaten destruction occur?

Answer 12

Middle

Question 13

Least aggressive pattern of bone destruction.

Answer 13

Geographic

Question 14

Most aggressive pattern of bone destruction.

Answer 14

Permeative

Question 15

Chalky, white area representing dead bone.

Answer 15

Sequestrum

Question 16

“Bony collar” or chronic periosteal response where pus lifts the periosteum, causing new bone formation.

Answer 16

Involucrum

Question 17

The ulcerative channel with malignant transformation to squamous cell carcinoma within the cloaca.

Answer 17

Marjolin’s ulcer

Question 18

Localized form of suppurative osteomyelitis that resembles an osteoid osteoma.

Answer 18

Brodies Abscess

Question 19

Difference between tumor and infection in respect to growth plates.

Answer 19

Tumor: Respects growth plates, deflects fascial planes
Infection: Ain’t got no respect for GPs or joint spaces

Question 20

Joint effusion, erosion, lytic destruction and juxtaarticular osteoporosis are all descriptors of?

Answer 20

Septic arthritis

Question 21

Teardrop distance

Answer 21

> 11mm

Question 22

Clinical impression of unilateral sacroiliitis? Bilateral?

Answer 22

Unilateral: Infection
Bilateral: AS

Question 23

Most common age range for spinal infections.

Answer 23

> 20 years

Question 24

Most common location of spinal infections.

Answer 24

Lumbar spine

Question 25

Most common location of spinal infection in drug users.

Answer 25

SI joints

Question 26

Sensitivity of plain films for osteomyelitis.

Answer 26

< 5%: Abnormal on presentation < 33%: Positive for findings at 1 week 90% sensitivity at 3-4 weeks

Question 27

Which test often follows MRI to evaluate soft tissue?

Answer 27

Bone scintigraphy

Question 28

Which type of imaging is more sensitive for bone marrow pathologies?

Answer 28

MRI

Question 29

Osteomyelitis findings on MRI.

Answer 29

Decreased signal on T1; Increased signal on T2

Question 30

What is white on T1? T2?

Answer 30

T1: Fat white T2: Water white

Question 31

TB of the spine.

Answer 31

Pott's disease

Question 32

Most common cause of infection-related death worldwide.

Answer 32

TB

Question 33

Most common location of secondary TB.

Answer 33

Spine T/L junction

Question 34

Phemister's Triad.

Answer 34

Juxtarticular osteoporosis, Marginal erosions, Slow joint space loss

Question 35

Most common location for AVN.

Answer 35

Femur and humeral heads

Question 36

4 stages of AVN.

Answer 36

Avascular, Revascularization, Repair, Deformity

Question 37

Radiographic features of AVN.

Answer 37

Collapse of articular cortex, Fragmentation, Mottled trabecular pattern, Sclerosis, Subchondral cysts and Subchondral fx

Question 38

Which signs are present when subchondral fractures are observed?

Answer 38

Rim sign and Crescent sign

Question 39

Gender and age bias of AVN.

Answer 39

Males aged 30-70

Question 40

AVN of the femur head is also known as?

Answer 40

"Chandler's disease"

Question 41

"Bite sign" is associated with?

Answer 41

AVN of the femur head

Question 42

List all signs of AVN.

Answer 42

Snow cap sign, Crescent/Rim sign, Mushroom deformity and Hanging rope sign

Question 43

Which sign of AVN is apparent during the repair phase?

Answer 43

Snow cap sign

Question 44

Which sign of AVN is apparent during the healed phase?

Answer 44

Hanging rope sign

Question 45

Which sign is apparent during the avascular/destructive phase?

Answer 45

Crescent/Rim sign

Question 46

AVN of the femoral capital epiphysis before closure.

Answer 46

Legg-Calve-Perthes disease

Question 47

Treatment for LCP disease.

Answer 47

Self-limiting; resolves in 2-8 years

Question 48

Gender and age bias for Legg-Calve-Perthes disease.

Answer 48

Males 4-8 years old

Question 49

What Roentgenometric finding is most common in LCP?

Answer 49

Increased Teardrop distance

Question 50

Gender and age bias of Osteochondritis Dissecans.

Answer 50

Males age 11-20 years

Question 51

Most common location of osteochondritis dissecans.

Answer 51

Knee (medial femoral condyle)

Question 52

Idiopathic AVN of the knee that is more common in females.

Answer 52

SONK

Question 53

What is an associated injury with SONK?

Answer 53

Medial meniscal lesions

Question 54

Age and gender bias of Osgood-Schlatter's disease.

Answer 54

Males aged 11-15 years

Question 55

Disease that involves the inferior pole of the patella.

Answer 55

Sindig-Larsen-Johanssen disease

Question 56

AVN of the metatarsal heads. Which MT head is most common?

Answer 56

Freiberg's disease; MTP 2 is MC

Question 57

Age and gender bias of Freiberg's disease. Why?

Answer 57

MC in females aged 20-40 due to high heeled shoes

Question 58

AVN of the lunate.

Answer 58

Kienbock's disease

Question 59

Age and gender bias of Keinbock's disease.

Answer 59

Males aged 20-40

Question 60

Possible treatment for Keinbock's.

Answer 60

Silastic implants

Question 61

Vascular insufficiency with localized pain and swelling of the tarsal navicular.

Answer 61

Kohler's disease

Question 62

Scheuermann's disease is also known as:

Answer 62

Juvenile discogenic disease

Question 63

How many contiguous vertebra are needed to diagnose JDD?

Answer 63

3

Question 64

Looks like a crescent sign in the calcaneus.

Answer 64

Sever's disease

Question 65

A calcified medullary infarct is usually associated with what?

Answer 65

Arteriosclerosis