Meeting 2 Learning objectives Flashcards
(47 cards)
What is osteoperosis?
Metabolic disorder due to endocrine and nutritional disorders.
How much bone needs to be removed before osteoperosis can be seen on radiographs?
30-50% of all bone calcium must be lost.
When is regional osteoperosis seen?
Seen with immobilization from 6-8 weeks.
What is osteomalacia?
Excessive ammount of uncalcified osteoid in the adult.
Due to vitamin D deficiency and hypophosphatemia seen in kidney disease.
What is seen in patients with osteomalacia?
Bowing deformities
Transversely oriented incomplete radiolucencies known as pseudo fractures or looser’s zones.
What are loosers lines?
Seen in osteomalacia running perpendicular to the cortex occuring most commonly on the inner border of bone.
How do loosers lines look in osteomalacia vs hypophosphatemia?
Hypophosphatasia looks very similar however the transverse radiolucency will be on the outer corticy of the bone.
Osteomalacia is on the inner corticy.
Osteopenia Radiographic signs
Radiolucency of bones thinning of cortexes, intracortical tunneling, and prominence of primary trabeculation occurring most commonly in the cortical bone.
what is the pathomnemonic for osteopenia?
Increased bone resorption and decreased bone production.
Leaves the primary trabeculations viewable in the bone as the horizontal are loss!!
What serum phosphate concentration is considered hypophosphatasia?
<2.5 mg/dL
What are the acute causes of hypophosphatasia?
Alcoholism, burns, starvation
What are the chronic etiologies of hypophosphatemia?
Hyperparathyroidism
Chronic diahrrea
Long term diuretic use
What is primary hyperparathyroidism?
Tumor/growth to the thyroid
What is secondary hyperparathyroidism?
Seen in renal disease.
Low Vit D levels lead to low calcium output leading to bone resorption.
what is tertiary hyperparathyroidism?
Parathyroid is enlarged and does not respond to vit D.`
What X-ray signs will be seen in hyperparathyroidism?
Subperiosteal bone resiprtion primarily as brown tumors (round lytic lesions)
Will also have acral osteolysis of the distal aspects of the phalanges.
What is renal osteodystrophy?
Very similar to hypoparathyroidism seen in patients with renal failure in which hyperphosphatemia results in excessive bone resorption to release calcium.
Will have calcified soft tissue and vessels in addition to what is commonly seen in osteoperosis, hyperparathyroidism and osteomalacia.
When given a childs X-ray physis which two conditions should immediately come to mind?
Scurvey and Rickets
What is the cause of rickets?
Hpyophosphatemia and vitamin D deficiency seen in children.
What are the X-ray signs of rickets?
Occur at the growth plate with widening of the physis, decreased density at the zone of provisional calcification leading to fraying/paint brush appearance.
Widening/cupping of the metaphysis.
What are the etiologies of scurvy?
Deficiency in vitamin C intake decreasing collagen in periosteal blood vessels resulting in perostitis.
How will scurvy present at the metaphysis?
Line if increased density (white line of scurvy)
with a line of decreased density (scurvy line) and a small beaklike outgrowth of bone along the margins of the metaphysis.
Extensive periostitis entire length of bone.
Epiphysis appears as an outer shell of increased density surrounding a central lucency (Wimbergers sign)
What are the radiographic signs of acromegaly?
Heel pad thickness greater than 25 mm
Widened joint spaces
Thickened met shafts
Proximal phalangeal shafts are thinned
What is the etiology of osteogenesis imperfecta?
Insuficient osteoid production
