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Differential diagnosis > Musculoskeletal > Flashcards

Flashcards in Musculoskeletal Deck (26):
1

Multiple lytic foci in adult and in a child

Adult:
1. Metastatic disease
2. Multiple myeloma
3. Lymphoma

In a child:
1. Langerhans cell histiocytosis (if patient <30)
2. Fibrous dysplasia
3. Multifocal osteomyelitis

2

A sequestrum

1. Osteomyelitis
2. Langerhans cell histiocytosis
3. Osteoid osteoma
Additional diagnostic considerations:
1. Lymphoma
2. Fibrosarcoma

3

A newborn periosteal reaction

1. Physiologic periosteal reaction
2. Trauma
3. Infection (osteomyelitis, TORCH, TB and syphilis)
Additional diagnostic considerations:
1. Prostaglandin therapy
2. Caffey disease (infantile cortical hyperostosis)

4

Rugger jersey spine

1. Renal osteodystrophy
2. Osteopetrosis
3. Paget disease
Additional diagnostic considerations:
1. Metastatic disease
2. Myelofibrosis

5

Symmetric sacroiliitis

1. Ankylosing spondylitis
2. Inflammatory bowel disease
3. Rheumatoid arthritis
Additional diagnostic considerations:

6

Asymmetric sacroiliitis

1. Psoriatic or reactive arthropathy
2. Osteoarthritis
3. Septic arthritis
Additional diagnostic considerations:

7

Proximal arthritis

1. Rheumatoid arthritis
2. Crystalline arthropathy (CPPD and gout)
3. Collagen vascular disease (SLE)
Additional diagnostic considerations:
1. Haemochromatosis
2. Infection

8

Distal arthritis

1. Osteoarthritis
2. Erosive osteoarthritis
3. Psoriatic arthritis
Additional diagnostic considerations:
1. Reactive arthritis
2. Rheumatoid arthritis

9

Erosive arthropathy involving the foot

1. Rheumatoid arthritis
2. Gout
3. Reactive arthritis
Additional diagnostic considerations:
1. Infection (septic joint)
2. Psoriatic arthritis

10

Chondrocalcinosis

1. CPPD arthropathy
2. Hyperparathyroidism
3. Hemochromatosis
Additional diagnostic considerations:
1. Wilson disease

11

Vertebra plana in a child

1. Langerhans cell histiocytosis
2. Leukaemia/lymphoma
3. Osteomyelitis
Additional diagnostic considerations:
1. Metastatic disease

12

Wormian bones

1. Idiopathic Wormian bones
2. Osteogenesis imperfecta
3. Cleidocranial dysostosis
Additional diagnostic considerations:
1. Down syndrome
2. Metabolic disease (rickets and hypothyroidism)

13

Madelung deformity

1. Idiopathic Madelung deformity
2. Turner syndrome
3. Skeletal dysplasia (multiple epiphyseal dysplasia and dyschondrosteosis)
Additional diagnostic considerations:
1. Trauma
2. Infection/septic arthritis

14

Lucent metaphyseal bands

1. Leukaemia
2. Rickets
3. Osteomyelitis
Additional diagnostic considerations:
1. Neuroblastoma metastatic disease
2. Scurvy
3. Syphilis

15

A medullary/chondroid lesion

1. Enchondroma
2. Bone infarct
3. Chondrosarcoma
Additional diagnostic considerations:
1. Chronic osteomyelitis

16

Acro-osteolysis

1. Hyperparathyroidism
2. Scleroderma
3. Trauma (thermal or cold injury)
Additional diagnostic considerations:
1. Psoriasis
2. Hajdu-Cheney syndrome

17

A dense effusion

1. Haemarthrosis (haemophilia and post-traumatic)
2. Juvenile chronic arthritis
3. Pigmented villonodular synovitis
Additional diagnostic considerations:
1. Septc arthritis
2. Crystalline arthropathy (gout and CPPD)

18

Loose bodies with erosions

1. Synovial (osteo)chondromatosis
2. Pigmented villonodular synovitis
3. Rheumatoid arthritis
Additional diagnostic considerations:

19

An expansile rib lesion in a child

1. Fibrous dysplasia
2. Bone cyst
3. Enchondroma
Additional diagnostic considerations:
1. Langerhans cell histiocytosis
2. Ewing sarcoma
3. Metastatic disease

20

A posterior element lytic lesion

1. Aneurysmal bone cyst
2. Osteoblastoma
3. Infection (tuberculosis)
Additional diagnostic considerations:
1. Metastatic disease
2. Langerhans cell histiocytosis

21

A carpal dislocation

1. Perilunate dislocation
2. Lunate dislocation
3. Midcarpal fracture-dislocation
Additional diagnostic considerations:

22

Periarticular soft tissue calcifications

1. Haemangioma
2. Myosistis ossificans
3. Scleroderma
Additional diagnostic considerations:
1. Arthropathy with calcified soft tissue nodule
2. Soft tissue sarcoma
3. Tumoral calcinosis

23

A benign expansile lytic lesion

1. Fibrous dysplasia
2. Unicameral bone cyst
3. Aneurysmal bone cyst
Additional diagnostic considerations:
1. Giant cell tumour
2. Eosinophilic granuloma

24

Sclerotic lesions in the pelvis

1. Bone island/osteopoikilosis
2. Metastatic disease (breast and prostate)
3. Paget disease
Mneumonic for tumours that go to bone - lead kettle (PB-KTL):
Prostate = sclerotic/blastic (induces bone growth):
Breast = mixed pattern
Kidney, Thyroid and Lung = lytic (induces bone destruction)

25

A vertebral body wedge fracture

1. Traumatic fracture
2. Insufficiency fracture
3. Pathologic fracture
Additional diagnostic considerations:

26

An epiphyseal equivalent lesion

1. Chondroblastoma
2. Giant cell tumour
3. Langerhans cell histiocytosis
Additional diagnostic considerations:
1. Introsseous ganglion cyst