T/F? Sexual precocity is rare in females
False 30% of females with FD suffer from Albrights syndrome. Sexual precocity is rare in males
T/F? Expanding focal rib lesions are characteristic of FD
True. FD is the commonest cause of such lesions.
T/F? Re enchondroma of bone: Typically calcifies.
True
Re enchondroma of bone: Are found in Maffucci syndrome
True Maffucci syndrome is enchondroma with soft tissue haemangioma
Fluid fluid level on CT
GCT ABC and solitary bone cyst and telangiectatic osteosarcoma.
Lytic lesion in distall femur, does not reach the articular surface and has a fluid fluid level
ABC GCT abuts the articular surface
? Diagnosis Multiple NOF, cafe au lait spots , mental retardation, hypogonadism and cardiac malformation
Jaffe Campanacci Syndrome
Location of baker's cyst
between semimembraneous and MEDIAL head of gastric
Discoid meniscus is a normal varian of the ...... meniscus
lateral meniscus and is prone to tear.
Double PCL sign and intact ACL
Bucket handle tear
? diagnosis T2/STIR: celery stalk appearance T1: Drumstick
ACL mucoid degeneration Predisposes to ACL ganglion cyst
5 distinct manifestations of Psoriatic arthropathy:
1. Oligoarthritis 2. Polyarthritis (usually DIP) 3. Symmetric type 4. Arthritis mutilans 5. Spondyloarthropathy
Pencil in cup deformity and telescoping of the joints
Psoriatic arthropathy that
Diagnosis? Wide bones with thick trabecula
Pagets
The typical radiographic appearance of this lesion is circumferential calcification with a lucent centre and a radiolucent cleft (string sign) that separates the lesion from the cortex of the adjacent bone.
Usually post traumatic
myositis ossificans
fluid fluid level due to previous haemorrhage.
Exess and deficiency of Vit D causes?
hypervitaminosis D is rare and leads to hypercalcaemia:
- Facilitating calcium deposition in soft tissues, such as the arteries and kidneys.
hypovitaminosis D:
- paediatric: rickets
- adult: osteomalacia
This has a typical appearance on plain radiographs with amorphous and multilobulated ("cloud-like") calcification located in a periarticular distribution.
Tumoral calcinosis
Juxta-articular cystic lesions filled with calcium fluid
Defect in Phosphate met - Ca is normal
There is focal areas of symptomatic perineural fibrosis around a plantar digital nerve of the foot. The condition is thought to be due to chronic entrapment of the nerve by the intermetatarsal ligament.
Morton Neuroma
The 3rd web-space (between 3rd and 4th metatarsal heads) is the most commonly affected site.
10% bilateral
MRI findings of morton neuroma
sign associated with this condition
Dumbbell/ovoid-shaped lesion at a similar position to that described on ultrasound:
- T1: typically low-to-iso signal
- T2: typically low signal but can sometimes be intermediate in signal
- T1 C+ (Gd): tends to show intense enhancement
A sonographic Mulder sign may be elicited with the probe.
T1 +Gd FS
Diagnosis?
- bone within a bone appearance
- Erlenmeyer flask type deformity of the tubular bones
- sandwich vertebrae: diffuse end plate sclerosis (peripheral bony sclerosis) and lucency of the centre of vertebral body
- alternating radiolucent metaphyseal bands
Osteopetrosis
Diagnosis? What are the typical findings?
Osteopetrosis
- bone within a bone appearance
- Erlenmeyer flask type deformity of the tubular bones
- sandwich vertebrae: diffuse end plate sclerosis (peripheral bony sclerosis) and lucency of the centre of vertebral body
- alternating radiolucent metaphyseal bands
PVNS findings
- Joint effusion
- Ca is rare- Ca excludes PVNS
- Low signal on all MR seq and BLOOMING
The usual mechanism of this injury is falling onto outstretched hand in ulnar deviation
Or...
Direct blow to dorsum of the hand
Triquetrel fracture.
Scaphoid Fracture is more common in FOOSH and radial deviation
35F. Pain in the hands and wrists. History of Rheumatic fever and SLE
Jaccoud arthropathy
- non-erosive arthropathy
- ulnar deviation of the 2-5th fingers with metacarpophalangeal (MCP) joint subluxation.
- post-rheumatic fever.
- in association with
- systemic lupus erythematosus (SLE)
- psoriatic arthritis,
- inflammatory bowel disease and
- malignancy.
It is thought to be related to ligamentous laxity.
What features would be suggestive of Fe deficiency anaemia
- Narrowing of deploe
- Hair on end skull
- osteopenia of zygoma
- osteosclerosis of sphenoid
- biconcave vertebra
Hair on end skull
widening of diploe
OP in long bones
45F foot pain and difficulty walking and swelling along the medial malleolus and arch of foot.
What tendon is most likely to have been injured?
Tibialis posterior
Assualt to face: unable to open his mouth. Severe bruising and flattening of the contour of his cheek. Diagnosis?
- Zygomatic arch fracture
- Le Fort I
- Le Fort III
- Coronoid process
- Orbital blowout fracture
Zygomatic arch fracture
X ray shows loss of lamina dura of majority of teeth. What is the possible cause?
- osteopetrois
- hypoPTH
- Scleroderma
- Sickle cell
- Myeloma
Scleroderma
Other causes include:
- Cushing
- pagets
- hyperPTH
- OP
- osteomalacia
- leukaemia
- mets
- LCH
Which of the following lesions would appear as HOT on bone scan?
- Osteopoikilosis
- FCD
- Acute fracture
- FD
- Haemangioma
Fibrous dysplasia
Other causes:
- Pagets
- Brown tumour
- ABC
- Chondroblastoma
- Ostoid osteoma