metabolic bone disease- radiology

Question 1

types of imaging for bones and differences

Answer 1

X rays, CT, bone densitometry (all look at density) MRI (biochemical composition) , radionuclide bone scans (bone turnover)

Question 2

pathology vs radiological sign

Answer 2

disease causing symptoms, radiological sign is a change in imaging, which MAY cause a pathology

Question 3

how to diagnose osteoporosis

Answer 3

DEXA scan of lumbar spine and hips

Question 4

DIAGRAM radiology of osteoporosis

Answer 4

loss of cortical ie thinning of cortex loss of trabeculae insufficiency fractures

Question 5

whart are insufficiency fractures, common sites

Answer 5

normal stress on abnormal bones vertebral bodies, sacrum, underside of femoral neck, pubic rami

Question 6

DIAGRAM imaging of insufficiency fractures

Answer 6

Xray/CT- normal but may lead to increased sclerosis around fracture MRI- bone oedema (more whiteness in sacrum) bone scan- increased osteoblastic activity (honda sign in sacrum)

Question 7

radiology is osteomalacia vs rickets

Answer 7

depends on age- in malacia there is osteopenia (lack of minerals), looser zones, codfish vertebrae and bending deformities in rickets mainly abnormalities in growth plates

Question 8

DIAGRAM where loosers zones occur and comparison to normal insufficiency fractures

Answer 8

pubic rami, ribs, femur- lot shorter

Question 9

DIAGRAM osteopenia

Answer 9

middle of bone darker compared to normal

Question 10

DIAGRAM codfish verebrae

Answer 10

BICONCAVE deformity of vertebrae in porosis and malacia, seen in 3rd photo- also lot darker 2nd shows porosis ie less of vertebrae

Question 11

DIAGRAM rickets

Answer 11

left normal- shows widening of growth plate, metaphysis CUPPED, and growth plate frayed will also see enlargement of anterior ribs

Question 12

DIAGRAM brown tumour resorption

Answer 12

aka pepper pot, small holes in skull

Question 13

DIAGRAM features of secondary hyperparathyroidism

Answer 13

subperiosteal erosions, and brown tumours

Question 14

DIAGRAM features of secondary hyperparathyroidism

Answer 14

sclerosis (increase bone density) in middle of vertebrae is osteomalacia, but out outside is sclerosis= RUGGED JERSEY SPINE

Question 15

DIAGRAM pagets disease and key thing

Answer 15

cortical thickening, bones looks bigger, course inner trabeculae: osteolysis as well (dark regions, known as osteoporosis circumscripta in skull) pic- cortical bone thickened, bone looks a lot bigger, and increased uptake as well- paget s disease only affects ONE BONE

Question 16

DIAGRAM osteocircumscripta

Answer 16

dark regions due to lytic phase of pagets disease