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Skeletal Radiology 1 CUKC > Sickle Cell > Flashcards

Sickle Cell Flashcards

1
Q

What inherited disorder is nearly exclusive to Blacks?

A

Sickle cell anemia

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2
Q

Fragile sickled RBC’s lead to what?

A

increased blood viscosity, stasis,
clots and
lowered pH

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3
Q

Clinical and radiographic features of sickle cell relate to what kind of occlusion?

A

vascular occlusion
tissue infarction
marrow hyperplasia

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4
Q

Hand-foot syndrome is caused by vascular occlusive leads to what?

A

ischemia

infarction of distal parts of extremities

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5
Q

Sickle cell crisis in the abdomen are due to which of the following symptoms?

A

mesenteric vascular thrombosis

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6
Q

Name clinical symptoms observed sickle cell anemia?

A 
Congestive heart failure
Dactylics aka welling in fingers/toes 1st yr of life
crisis 
jaundice
cholelithiasis
bone pain
anemia
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7
Q

Sickle cell manifesting as a vaso-occlusive crises resulting in what 2 things?

A

bone infarcts and subperiosteal hemorrhages

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8
Q

What is the presentation of osteomyelitis in sickle cell anemia?

A

local pain and systemic features of infection

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9
Q

What are the radiographic features of SCA in long bones?

A

osteopenia coarsened trabeculae, widened metaphysis, thin cortices, bone infarcts

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10
Q

What are the radiographic features of SCA in spine bones?

A

osteopenia, endplate infarction (H-shaped vertebra), collapse, widened vascular notch, extra-medullary hematopoiesis

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11
Q

Radiographic features from marrow hyperplasia, ischemia, necrosis and osteomyelitis in sickle cell anemia are mc in what location?

A

long bones

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12
Q

Sickle infections are a result of what bacteria?

A

Salmonella

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13
Q

Radiographic features of infarction in short tubular bone with sickle cell anemia are as follows

A

ST welling
diaphyseal linenear periostitis
cortical spitting (bone in bone)

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14
Q

Name the MC location within short tubular bones for manifestation of an infarction?

A

metaphysical and diaphyseal medullary infarcts

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15
Q

What is the MC location of epiphyseal necrosis in sickle cell anemia short tubular bones?

A

Femoral

Note: features are growth disturbances, patch areas of lucency/sclerosis, bone fragmentation

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16
Q

What is the mc location of acute osteomyelitis?

Where w/in bone does this condition begin?

A

Femur, large tubular bone

metaphysis

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17
Q

a. What pediatric symptom is expected in acute osteomyelitis?
b. ID the specific symptom/sign observed in acute osteomyelitis to distinguish adults from pediatric.

A

a. Acute Hight fever

b. Insidious onset

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18
Q

Name the pathologic feature associated with acute osteomyelitis.

A

early detection on MRI

Irreversible cartilage damage w/in 48 hrs

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19
Q

What is an the early radiologic feature seen in acute osteomyelitis?

A

ST edema

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20
Q

Name radiologic feature expected in septic arthritis.

A

periarticular swelling
early widened joint space
late narrowed joint space

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21
Q

Destruction in septic arthritis is seen in what part of the bone?

A

Metaphyseal or Epiphyseal in infants and adults d/t blood supply in both areas

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22
Q

Prognosis of acute osteomyelitis is dependent upon what?

A

stage, location and pt immune status

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23
Q

What is the MC location of low grade/chronic osteomyelitis?

A

Tibia

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24
Q

An ill defined lucency, sclerosis, cortical thickening, No periosteal reaction or ST well, and presence of cloaca radiologic features are observed in what condition?

A

low grade/chronic osteomyelitis

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25
What is PLASTIC RAGS and what condition is this nemonic associated with?
``` Pancreatitis Lupus Alcoholism, Atherosclerosis Steroid Therapy Trauma Idiopathic Caisson’s Disease Radiation, RA (steroids) Amyloid Gaucher’s Dz Sickle Cell Dz ``` associated w/ostenecrosis
26
What is the time frame of ischemia for marrow elements, bone cells and marrow fat?
6-12 hrs 12-24 hrs 2-5 days
27
A decrease of blood flow lead to what just before bone infarction?
bone ischemia
28
Provide at least 2 patho-mechanic mechanisms of infarction.
intra-luminal obstruction arterial wall dz vascular compression physical disruption of vessel
29
True or False | Osteonecrosis is not visible on radiograph until the removal, remodeling and deposition stage.
True
30
Which of the following is the result of an articular surface collapse?
step defect
31
Define subchondral collapse
frx of trabecular cancellous bone just below the subchondral bone plate w/out articular surface disruption.
32
What is the aka for subchondral collapse?
crescent sign
33
what is the pathognomonic of late osteonecrosis?
Subchondral collapse
34
What's the order of late osteonecrosis? In other words which is worst Crescent sign or step defect?
Step defect
35
What is the MC hematologic condition of bone?
osteonecrosis
36
Osteochondritis dissecans has what kind of necrosis occurring in pads?
focal
37
Avascular necrosis involvement is what type of necrosis?
junta-articular | usually in epiphysis
38
Early osteonecrosis will have what radiographic findings?
joint effusion patchy density changes (lucency, sclerosis) Bite sign
39
Reactive interface line, double line sign and rim sign are MRI T2 weighed findings associated with what condition?
Osteonecrosis in femoral head
40
What is the MC location of osteonecrosis?
femoral head | males 40-60 yrs old
41
Osteonecrosis in the femur head Signs/symptoms are asymptomatic seen early.. True or False
True | Note: pain in hip, butt, groin later in dz.
42
ID sign/symptoms of femoral head osteonecrosis?
Hip, butt, groin pain Reduced motion m. atrophy
43
Radiographic features seen in early osteonecrosis of the femur are what?
joint effusion patchy density changes bite sign
44
Radiographic features seen in late osteonecrosis of the femur are what?
``` subchondral collapse (crescent sign), articular collapse (step defect) deformity ```
45
What is the exact location for the development of knee osteonecrosis?
medial condyle of distal femur pt over 60 yrs old
46
What S/S of knee osteonecrosis?
sudden onset of knee pain
47
What are the radiographic features of osteonecrosis in the knee
articular cortex flattening/collapse altered subchondral bone density loose bodies articular degeneration
48
What radiographic features are observed during the avascular stage of leg-calve-perthes?
joint effusion medial space widening aka waldenstom's sign sign of joint effusion small epiphysis
49
What does BME stand for?
Bone Marrow Edema
50
What MRI finding is associated w/pain?
Bone Marrow Edema
51
MR is most sensitive and demonstrates changes earlier than XR. What findings are noted on MRI?
reactive interface line double line sign rim sign
52
What is the alternating signal intensity on T2 weighted MRI and is diagnostic?
double line sign
53
True or False | Infarcts imply bone death but are Not at risk of bone fracture or joint frx because it stays in medullary cavity.
True
54
What are the radiographic signs of medullary infarct?
sclerotic lesion in metaphysis of long bone that have snakes like outlines (aka serpentine)
55
Osteonecrosis in the knee has what appearance?
Flattening of convex articular surface altered subchondral bone density subchondral frx step defect (articular surface frx)
56
Osteonecrosis in head of the second metatarsal
Freiburg infraction
57
Osteonecrosis in humeral head
Hass dz
58
Kienbock dz is Osteonecrosis activity in what bony structure?
lunate
59
What bone structure is effected in Kohler dz?
navicular in children
60
Kummell dz is ostenecrotic active in what structure?
vertebral body
61
Osteonecrosis to the scaphoid is called?
preiser dz
62
Necrotic activity to the capitellum of the humerus is called?
Panner dz
63
Calcaneal epiphysis is damage known as?
Sever dz
64
What locations are location specific sub-articles for ANV?
Hip avascular necrosis | Scaphoid avascular necrosis
65
Name the MC sites of osteonecrosis
femoral head femoral condyle humeral head scaphoid
66
What conditions are self limiting?
Legg-Calve-Perthes | Osgood-Schlatter's
67
What self limiting conditions is caused by osteonecrosis?
Legg-Calve-Perthes
68
What are 3 correlations of deformity in legg-calve-perthes?
``` coxa vara Lg femoral head aka coxa magna fattened head aka mushroom deformity Lg greater trochanter Sagging rope ```

Skeletal Radiology 1 CUKC (15 decks)

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