Flashcards in Radiologic Evaluation, Search Patterns, and Diagnosis Deck (56):
What 3 things does alignment (A) analysis include?
- General Skeletal Architecture
-General Contour of Bone
- Alignment of Bones Relative to Adjacent Bones
When analyzing general skeletal structure, what should you look for?
- Aberrant size of bones
- Supernumerary bones
- Congenital anomalies
- Absence of any bones
- Developmental deformities
Sharp angles in the cortex may be a sign of _____ fractures.
If there is noted trauma at the attachment sites of muscles, tendons, and ligaments it may be a sign of an _____ fracture
What 3 things does bone density (B) analysis include?
- General Bone Density
- Textural Abnormalities
- Local Density Changes
A healthy bone cortex shows up with _____ density than cancellous bone and appears ____.
What bony feature should you asses when looking for textural abnormalities?
What does fluffy trabeculae represent?
random proliferation of both osteoblastic and osteoclastic activity
What types of diseases are fluffy trabechulae present?
In the skulls of patients with Paget’s disease and in hyperparathyroidism
Smudged trabeculae is a characteristic of what disease?
What types of diseases are coarsening trabechulae present?
patients with chronic renal failure and osteoporosis
Why do trabeculae appear coarsened?
The loss of surrounding trabeculae cause remaining trabeculae to appear prominent
Lacy or delicate trabeculae is a characteristic of what disease?
thalassemia (Cooley’s anemia)
Sclerosis is a sign of what?
When does reactive sclerosis occur?
When the body acts to surround and contain a diseased area, such as a tumor or infection
What 3 things does cartilage spaces (C) analysis include?
- Joint Space Width
- Subchondral Bone
- Epiphyseal Plates
How can you tell the difference between degenerative arthritides (OA) and inﬂammatory arthritides (RA or gout) on a plain film?
- In OA subchondral bone becomes increasingly sclerotic as new bone formed to help withstand increased stresses directed at it because of loss of articular cartilage
- In RA or gout there is erosion of the subchondral bone and formation of radiolucent cysts
What are the 4 types of periosteal reactions?
- laminated/onion skin
- Codman’s triangle
What does a solid periosteal reaction indicate?
a benign process
- seen in fracture healing and osteomyelitis
What does a laminated/onion skin periosteal reaction indicate?
- seen in battered child syndrome and sarcomas
What does a spiculated/sunburst periosteal reaction indicate?
malignant bone lesions
- seen in osteogenic sarcomas and in metastatic squamous cell tumor
What does Codman's triangle periosteal reaction indicate?
Present in a variety of conditions, including tumor, subperiosteal hemorrhage, and battered child syndrome
What does gas in soft tissue indicate?
gas gangrene or trauma
What are calcifications within soft tissue the result of?
old trauma whereby bloody hemorrhage has coagulated and calciﬁed
What are the 6 basic categories of pathology in classiﬁcation of skeletal diseases?
What are the 3 types of lesion distributions? Explain each...
- Monostotic or monoarticular: affect only one bone or one joint
- Polyostotic or polyarticular: affect multiple bones or multiple joints
- Diffuse: affect all or nearly all bones or joints
What are the only 2 disease categories that can occur diffusely?
Neoplastic or Metabolic
How many predictor variables may be applied to any bone or joint lesion to assist in making a diagnosis?
What are the 3 descriptors a bone lesion may occur as?
What are the 3 forms in which an osteolytic lesion can take on?
- Geographic destruction
- Permeative destruction
Describe geographic destruction of bone
Large areas of bone are destroyed and appear as radiolucent lesion.
Sharply defined geographic borders are indicative of a _____ lesion
Ragged moth-eaten borders are indicative of a _____ lesion
Describe permative destruction of bone
There is very ﬁne destruction of bone through the haversian system, sometimes requiring magnifying lens to recognize on ﬁlm
Poorly defined permative borders are indicative of a _____ lesion
Where do gout and RA typically manifest?
primarily in small joints of the hands and feet
Where foes typically manifest?
in the knees
Arthritides have characteristic lesion locations on the articular surfaces of bone. However, what is the difference between the 2?
Osteoarthritis affects weight-bearing areas, whereas rheumatoid arthritis affects entire joint surface
In general, margins either sharp and ____ deﬁned or wide and ____ deﬁned.
Sharp, clearly deﬁned, sclerotic borders characteristic of what?
slow-growing or benign lesions
Wide, poorly deﬁned borders with minimal or absent reactive sclerosis are characteristic of what?
fast-growing or malignant lesions
Lesions that are longer than are wider are likely to be _____. Why?
Benign, because the lesion has grown slowly along with bone
Lesions that are wider than they are long are likely to be _____. Why?
Malignant, because they are extending into soft tissue aggressively
Do tumors (benign or malignant) cross joint spaces or epiphyseal growth plates?
What does cross joint spaces?
What are the 3 types of boy reactions?
What is sclerosis?
new bone growth established to fortify an area subjected to increased stress, as in sclerosis of subchondral bone in osteoarthritis
What is buttressing?
formation of bony exostoses or osteophytes at joint margins, which serve to strengthen architecture of joint
A periosteal reaction to a neoplasm is usually characterized as one of what 2 things?
interrupted or uninterrupted
What does an interrupted periosteal response suggest?
Either malignant or non-malignant but highly aggressive lesions
What does an uninterrupted periosteal response suggest?
What do uninterrupted periosteal responses look like?
Solid density, either longitudinal, undulated, or buttressing in pattern
What is matrix?
intercellular tissue produced by some bone tumors
What are the 3 types of tumor matrixes?
- chondroid (cartilaginous)
- osteoid (bony)
- mixed (combination of cartilaginous and bony)
What do chondroid matrixes appear as?
stippled, popcorn-like, or comma-shaped calcifications seen in tumors invading soft tissues