Lecture 1 Flashcards
(25 cards)
What are the two classifications of Abnormalities in Ossification?
1: Calcification / ossification of soft tissue.
- Most common in the skull and spine
2: Incomplete mineralisation of bone
- Calcification of falx cerebri, choroid plexus, pineal gland etc.
- Patent metopic suture (10% pop.)
- Bipartate / tripartate patella
What are some common artefacts seen in radiographs of the skull?
Metal- Hairpins, false teeth, dental fillings, Eyeglasses, earrings
Water/Air- Wigs, hair styles
What are some common artefacts seen in radiographs of the Cx spine?
Metal- False teeth, dental fillings, earrings, necklaces
What are some common artefacts seen in radiographs of the Upper Limb?
Water/air- Clothing
Metal- Watches, rings, bracelets
What are some common artefacts seen in radiographs of the Abdomen?
water/air- Clothing
Metal- Objects in pockets, body piercing
What are some common artefacts seen in radiographs of the Pelvis?
Objects in pockets, orthopaedic supports, piercing
What are some common artefacts seen in radiographs of the Lower Limb?
Shoes, socks
What are some common variants seen in radiographs of the skull?
- Choroid plexus- Common calcifies with no clinical significance
- Metopic Suture- Incomplete ossification of frontal bones
- Wormian bones- Isolated intra-sutural bones occurring along the course of cranial sutures.
- Calcification of flax Cerebri
What are some common variants seen in radiographs of the Cx Spine?
- Enlarged Occipital Protuberance
- Pons Posticus- Calcification of occipito-atlanto ligament creating the arcuate foramen
- Pseudo Jefferson #
In adult this would suggest a Jefferson #, however in children represents differential ossification rate between C1 and 2. - Ankylosis of normal C2/3 zygopophyseal joints.
Rarely seen clearly due to oblique anatomic orientation. (if it was AS would see more hallmarks like disc degeneration) - Enlarged T.P C5/6- Enlargement of tubercles
- Cervical rib
What are some common variants seen in radiographs of the Chest/Tx Spine?
- Hiatal hernia:
Air/fluid levels represent gas in the fundus of the stomach after herniation through the diaphragm - Lines of Hahn’s: Horizontal venous channels seen in central portion of Tx. V.B. Common in lower Tx. spine. It is calcification of either side of the venous supply to the VB
- Limbus bones: migration and herniation of nuclear material through the ossifying VB resulting in non-union
- Schmorls Node: disc growing into the VB
- Costochondral calcification of the 1st rib
What are some common variants seen in radiographs of the Lx Spine, Abdo, Pelvis and hip?
- Tropism: Rotation in normal vertical facet joint line
- Trapezoidal Lx Vertebrae: V.B can appear trapezoid (cons. with # shape but not appearance) however normal development variant.
- Os acetabulum: Small ossicle of bone formed from improper ossification.
- Femoral hernia: Radiolucency present within femoral neck show herniation pits
What are some common variants seen in radiographs of the Lower Extremity?
- Fabella: Normal sesamoid bone within the lateral gastroc tendon.
- Bipartate or tripartite Patella: Ossifies in 2 or 3 parts, cartilaginous junctions.
What are some common variants seen in radiographs of the Foot?
- Talar Break: Developmental variance that should not be confused with spurring
- Os-trigonum: An accessory ossicle and should not be confused with # of the post. process of the talus
- Additional sesamoid: Usually at 1st MTP.
What are some common variants seen in radiographs of the Shoulder and Upper Ex?
- Scapula Nonunion: Failure of union at ossification site
2. Wrist Nonunion: Failure of union at ossification site
How can you tell a bone is immature?
If the ossification centres haven’t merged, ie Epiphysis and Metaphisis
What is an Apophysis?
Apophysis- A common attachment site ie greater trochanter of the femur
Pons Posticus (posterior ponticle)
Calcification of occipito-atlanto ligament, turning it radio-opaque. Which makes an arcuate Formen which is susceptible to a VBI on end-range rotation
What can happen with excessive rotation of a Pons Posticus (posterior ponticle) patient?
Occlusion of the VBA supply on excessive rotation
How to differentiate AS with tropism in Cx spine?
The discs should also be ossified/ loss of disc space in an AS patient
How to distinguish a limbic bone vs fracture of VB?
Ask the patient if they’ve had trauma to the area and/or severe pain. Also keep in mind, how can you fracture a chip off the posterior VB without other structures around being damaged.
What is a limbic bone?
IVD discal extrusion causing a # appearance
What is a hallmark of Spina Bifida on a Bone-window CT?
Incomplete ossification of the lamina of a vertebra
If a lesion is expansile what type of pathology could it be?
Aneurysmal bone cyst
If there is multiple sharply demarcated osteolytic lesions present throughout the diaphysis, what is a DD?
Multiple Myeloma
