Metabolic Bone Disease – Radiology Flashcards Preview

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Flashcards in Metabolic Bone Disease – Radiology Deck (16)
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1

What are the two main radiographic signs?

Osteopenia
Osteosclerosis

2

What is the lucency of the following scans proportional to:
a. X rays
b. Densitmetry
c. CT scans
d. MRI scans
e. Radionucline bone scans

a. X rays
Density
b. Densitometry
Density and attenuation
c. CT scans
Density and attenuation
d. MRI scans
Chemical and water content
e. Radionuclide bone scans
Bone turnover

3

What is the main difference between osteoporosis and osteomalacia?

Osteoporosis – decreased bone mass
Osteomalacia – decreased bone mineralisation

4

Describe the microstructure in osteoporosis.

Normal
Though there is an overall decreased quantity of bone

5

What are the features of osteomalacia?

Too little mineral – osteopenic and soft bone bends and deforms
Too much osteoid – Looser’s zones
If calcium remains low --> secondary hyperparathyroidism

6

What are Looser’s zones? Where are they found?

Narrow lucency, perpendicular to the bone cortex
Found in the pubic rami, proximal femur, scapular and lower ribs

7

What is a distinctive feature of osteomalacia that can be seen in an X-ray of the vertebrae?

Codfish vertebrae – biconcave loss of height

8

What radiographic feature is common to both osteomalacia andosteoporosis?

Osteopenia

9

What is the key difference between osteomalacia and rickets?

Rickets occurs before the growth plates have fused
As the metaphysis grows most rapidly, it shows the most obvious changes

10

What are the radiographic features of rickets that are linked to the metaphysis?

Indistinct frayed metaphyseal margin
Widened growth plate (no calcification taking place)
Bowing of weight bearing bones

11

What is Rickety Rosary?

Enlargement of the anterior ribs

12

Describe how PTH, calcium and phosphate change in:
a. Primary HPT
b. Secondary HPT
c. Tertiary HPT

a. Primary HPT
PTH – high
Calcium – high
Phosphate – low
b. Secondary HPT
PTH – high
Calcium – low
Phosphate – normal or low
c. Tertiary HPT
PTH – high
Calcium –high
Phosphate – low

13

What are the main consequences of secondary HPT to bone?

Resorption and increased density

14

List 4 types of bone resorption.

Subperiosteal
Subchondral
Intracortical
Brown tumours

15

What are the differences between slow and fast bone loss?

Slow – Involutional Osteoporosis
 Bone has time to remodel
 Bone loss occurs according to mechanical needs
Fast – hyperparathyroidism/disuse osteoporosis
 Bone loss is too rapid
 Loss does not cater to mechanical needs

16

Describe the radiological features of renal osteodystrophy.

 Subperiosteal bone erosions
 Brown tumours
 Sclerosis – axial skeleton/vertebral end plates (rugby jersey spine)
 Soft tissue calcification (arteries/cartilage)