Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Diagnostic Imaging > Slide Exam Prep > Flashcards

Slide Exam Prep Flashcards

1
Q

DISH main radiographic features

A

At least 4 contiguous vert. bodies with marginal syndesmophytes
Normal: disc height, subchondral bone, facets

NO HVLA. Refer for medical management (medication?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ankylosing Spondylitis main radiographic features

A

Romanus lesions (corner erosion)
Shiny corner sign
B/L symmetrical sacroilitis (bead sign, sclerosis (+/- star sign), ghost sign (complete fusion))
BL symmetrical marginal syndesmophytes (fine, multilevel, bamboo spine, osteoporosis, carrot stick fracture
Dagger sign, trolley track sign

NO HVLA. Refer to GP for medical management,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Psoriatic Arthritis

A

Non-marginal asymmetrical syndesmophytes:
Increased ADI
U/L or B/L Asymmetrical sacroilitis
** Same radiographic findings as Reactive Arthritis in the spine **

NO SMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Reactive Arthritis

A

** Same radiographic findings as Psoriatic Arthritis in spine **

+finger signs for next slide exam

NO SMT (double check?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Osteitis Condensans Ilii

A

Isolated to SIJ, B/L triangle sclerosis in ilium subchondral bone (only ilium side)
NO erosions or joint space change

CAN HVLA but not likely to be useful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Osteitis Pubis

A
  • erosions, motheaten, wider pubic symphysis
  • local osteoporosis

** Can’t tell appart from Infection off radiograph only **

No SMT?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CPPD

A

Small linear horizontal calcification in disc at multiple levels

*meniscus calcification

Can SMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

HADD

A

Small calcification anterior to C2

Calcification of longus colli muscle

Can SMT?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypertrophic Osteoarthropathy

A

B/L symmetrical long bone periostitis

Presents as: digital clubbing, often secondary to cardiopulmonary, GIT, endocrine, hematologic, and inflammatory conditions

No HVLA until primary condition not determined. Refer to GP for blood tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Differentials for B/L symmetrical sacroiliitis

A

AS
Enteropathic Arthritis
Osteitis Condensans Ilii

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Differential for U/L sacroiliitis

A

Rheumatoid A.
Infection
DJD

Also Reactive / PA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Differential for B/L asymmetrical sacroiliitis

A

PA / Reactive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Differential for non-marginal syndesmophytes

A
  • DJD
  • DISH
  • PA / Reactive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Differential for Marginal syndesmophytes

A

-Ankylosing spondylitis

More?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Paget’s

A 
Cortical thickening
Expansion
Coarsened trabeculae
Sclerosis / Ivory
Pahological fractures

Spine:
-picture frame vertebra

Pelvis:

  • lost kohlers teardrop
  • thick pubis
  • brim sign
  • acetabulae protrusio

Skull:
…

Long bones:

  • bade of grass defect-pseudofractures
  • more..

NO SMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Differential for Ivory vertebra

A

Pagets (+ expansion)
Bastic mets
Hodgkins (+ anterior erosio / scallop)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fibrous Dyslasia

A

Large geographic lucency with separations, haziness

NO HVLA because weakened bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Neurofibromatosis

A

Nerve sheath overgrowth (neoplasm)

-cortex intact

  • posterior scalloping
  • short angular scoliosis
  • kyphosis
  • IVF very large (means its in the IVF)
  • scalloped ribs

-asymmetrically elongated phalanges

No SMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Differential for posterior scalloping

A 
Neurofibromatosis
Marfans
Ehlers Danlos
Achondroplasia
Osteogenesis imperfecta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Differential for lucent benign lesions

A 
Haemangiona
Non-ossifying fibroma, Fibrocortical defect
SBC, ABC, GCT
Osteobastoma, Chondroblastoma
Enchondroma, Ollier’s disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Differential for sclerotic malignant lesion

A

Osteosarcoma
-Parosteal osteosarcoma

Metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Differential for mixed sclerotic and lucent malignant lesion

A

Osteosarcoma

Mets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Differential for lucent malignant lesion

A 
Plasmacytoma
Chordoma
Ewing’s sarcoma
Malignant GCT
Chondrosarcoma
Fibrosarcoma
Non-Hodgkins Lymphoma
Hodgkins Lymphoma
Multiple Myeloma
Mets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Gardner’s Syndrome

A

Multiple osteomas (skull + hands and feet)

Can HVLA. Refer to investigate for systemic signs (epidermal cysts, colonic polyps)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Hereditary Multiple Exostoses

A

Multiple osteochondromas (bony growths off the cortex of long bones)

Could HVLA but with caution as they can fracture.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Osteoblastoma

A

Sclerotic periosteal rim around lucent nidus >25mm diameter, expansive, thins cortex
-posterior elements of spine, C1 SP

DDx: Osteoid osteoma (smaller), ABC (more expansion + no sclerotic rim)

NO HVLA because weakened bone fracture risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Ollier’s Disease

A

Multiple enchondromas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Marfucci’s Syndrome

A

Very rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Chondroblastoma

A

One of the few tumours that are in the epiphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Parosteal Osteosarcoma

A

Lobulated juxtacortical sessile mass, lytic portions

DDx: osteoma (much smoother and less messy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Plasmacytoma

A 
Geographic lucent soap bubbly, expansive
Fades away bone areas (erased)
Targets: mandible, ilium, vertebra, ribs, prox femur, scapula, sacrum
DDx: Chordoma, Malignant GCT
REFER because malignant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Chordoma

A

Invades surrounding STs, large, crosses disc space
85% sacrococcygeal or spheno-occipital
Malignant

DDx: Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Hodgkins Lymphoma

A

-vertebral body

  • anterior scalloping of vert body
  • ivory vertebra

DDx:

  • Multiple myeloma
  • Pagets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Jefferson’s fracture

A

APOM: lateral masses shift past articular processes C2

-say transverse ligament rupture if masses displaced >7mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Hangman’s fracture

A
  • B/L pedicle fracture
  • Lateral view

-hyperextension injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Differential for increased ADI

A
  • agenesis dens
  • agenesis posterior arch
  • RA
  • PA
  • trauma
  • Downs
  • Marfans
  • Ehllers Danlos
  • Morquio’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

C1 posterior arch fracture

A

(study some images)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Pillar fracture

A

Wider, altered shape

study some images

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Posterior ponticle

A

Bridging C1 poaterior arch and occiput

Can SMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Uncinate fracture

A
  • tiny triangle on AP view

- rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Differential for blurry C1 SP

A

Malignant:

  • chordoma
  • plasmacytoma
  • lytic mets

Benign

  • osteoblastoma
  • ABC
  • GCT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Differential for missing pedicle on AP view

A

Lytic mets

Osteobastoma
Chordoma

*multiple myeloma spares the pedicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Differential for vertebral body destruction

Disc space intact

A

Lytic mets
Chordoma
Plasmacytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Differential for posterior elements destruction

A

Infection

Lytic mets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Differential for triangular ossific density anterior to the disc space

A
  • Limbic bone (smaller than defect)
  • Intercalary bone (in front and no defect)
  • Teardrop fracture (exact missing piece)
  • Ring epiphysis (widespread)
  • Compression fracture (ish)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Differential for bony fragment posterior to C7

A
  • clay shovelers fracture perfect match and displaced a bit)
  • persistent apophysis (smaller)
  • nuchal bone (vertical)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Agensis dens

A
  • can’t see odontoid

- triangular anterior arch + bigger + more sclerotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

TVP fracture

A

C7 TVP

Lumbar TVP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Sacral fractures

A
  • usually also pelvic fractures

- not on SLIDE exam 1?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Differential for single non-marginal syndesmophyte

A

Highly likely Psoriatic arthritis

DJD
DISH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Picture frame vertebra

A

Pagets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Sandwich vertebrae

A

Bone-in bone look

Osteopetrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Rugger Jersey spine

A

Hyperparathyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What are the elements in the description of a scoliosis?

A
  1. Convex side
  2. Start and end
  3. Cobb angle
  4. Apex
  5. Rotation: grade, side, span
  6. Skeletal maturity: Risser’s or epyphysis visible
  7. Obvious cause
  8. Secondary consequences (DJD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Grade rotation of a scoliosis

A

1+ pedicle bit to midline (other overlaps with edge of vert)

2+ pedicle 2/3 midline (other barely visible)

3+ pedible midline (other not visible)

4+ pedicle past midline (other not visible)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Risser Sign grading

A
  1. 25% grown
  2. 50%
  3. 75%
  4. 100% visible
  5. Fused to ilium (closed)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Where is most degenerative spondylolysthesis? And Isthmic ? Dysplastic?

A

DJD spondy : L4

Pars fracture: L5

Congenital: L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

C1 posterior arch agenesis

A

C2 megaspinous, C1 anterior arch hypertrophy
DDx: occipitalisation

NO HVLA until proven stable. Refer for flexion extension views

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Agenesis pedicle

A
  • winking owl
  • sclerotic C/L pedicle

DDx:

  • Lytic mets
  • rotation

Yes SMT. Stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Agenesis articular process

A

Check images

Yes SMT. Stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Hemivertebra

A

Check images

-short angular scoliosis

NO SMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Caudal Regression Syndrome

A
  • sacral agenesis

- 2 lia articulate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Os odontoideum

A
  • lucent gap
  • failure of fusion of dens to body
  • instable

DDx:

  • mach effect
  • fracture

NO SMT. Unstable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Ossiculum Terminale

A

-lucent gap at tip of dens

Yes SMT. Insignificant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Spondyloschisis

A

SBO at C1
APOM: follow cortical lines of lamina
Lateral: no spinolamina junction line
DDx bifid vertebra

No HVLA because instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Clasp Knife deformity

A
  • SBO at S1

- long L5 SP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Butterfly Vertebra

A
  • AP
  • triangular endplate lines

Yes SMT. Insignificant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Occipital vertebrae

A

Epitransverse
Paracondylar
Paramastoid

*check images

NO SMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Occipitalisation

A
  • C1 fused to occiput
  • atlantoaxial instability

NO SMT

70
Q

Congenital block vertebrae

A
  • wasp waist
  • posterior elements maybe fused too

Can maybe SMT

71
Q

Acquired block vertebrae

A

Barrel shape

DDx: infection, DJD, malignancy, surgical

72
Q

Lumbosacral transational segment

A

Can SMT but different mechanics

73
Q

Basilar impression

A

-dens passes McGregors line >45mm

DDx:

  • occipitalisation
  • spondyloschisis
  • abnormal dens or atlas
  • klippel-fail
  • osetomalacia, tumour…

NO SMT

74
Q

Eagles syndrome

A
  • stylohyoid ligaments calcified
  • looks like phalanx bones

NO SMT

75
Q

Facet Tropism

A

Asymmetrical facet orientation

DDx: rotation

Can SMT. Changes biomechanics

76
Q

Schmorl’s Nodes

A

-clear corticated circular depression

DDx:

  • compression fracture
  • nuchal impression

Can SMT. Insignificant

77
Q

Nuclear Impressions

A
  • smooth indentation in endplate
  • AP: cupids bow

DDs: lateral flexion

Can SMT. Insignificant

78
Q

Venous Channel of Hahn

A

-horizontal sclerosis in anterior middle of vertebra

Can SMT. Insignificant

79
Q

Omovertebral Bone

A

Bone from cervical spine to scapula

SMT??

80
Q

Klippel-Feil Syndrome

A
  1. Block vertebrae
  2. Basilar impression
  3. Scoliosis
  4. Sprengel’s deformity

Presents as: short neck, limited neck mobility

NO Cervical HVLA due to possible instability

81
Q

Achondropplasia

A
  • bullet-nose vertebrae
  • posterior scalloping
  • short pedicle (stenosis)
  • large spinal curves
  • basilar impression
  • ping pong paddle ilium

NO SMT

82
Q

Cleidocranial Dysplasia

A
  • small or no clavicle
  • small scap
  • biconvex vertebrae
  • SBO
  • hemivertebrae
  • large curves
  • small pelvis
  • small dens

NO SMT

83
Q

Spondyloepiphyseal Dysplasia

A

Widespread platyspondyly, bulbous vertebrae, large spinal curves, short ilium, widespread skeletal changes

NO cervical HVLA because of atlanto-axial instability. Can treat else wear. Refer to examine for associated systemic dysfunctions.

84
Q

Holr-Oram Syndrome

A
  • heart hand syndrome
  • sprengles deformity

+ more

No SMT?

85
Q

Fibrodysplasia Ossificans Progressiva

A
  • striate muscle calcification
  • torticolis
  • osteomalacia
  • pathological fractures

NO manual therapy at all

86
Q

Marfan’s Syndrome

A
  • tall vertebra
  • posterior scalloping
  • thin cortex
  • scoliosis

NO SMT because lax dense?

87
Q

Metaphyseal Dysplasia

A
  • widespread platyspondyly
  • erlenmeyer flask deformity

No SMT?

88
Q

Nai-Patella syndrome

A

Not realy spine

89
Q

Ehlers Danlos Syndrome

A
  • widespread platyspondyly
  • posterior scalloping
  • large spinal curves
  • early DJD

NO SMT. Weak bones

90
Q

Hurler’s Syndrome

A
  • short vertebrae
  • round vertebrae
  • small dens
  • paddle ribs
  • flair ilia
  • osteoporosis

NO SMT

91
Q

Morquio’s Syndrome

A
  • widespread platyspondyly
  • centrall beaking vertebral bodies
  • large curves

-small dens

NO SMT

92
Q

Osteogenesis Imperfecta

A 
Biconcave vertebrae
Platyspondyly
Osteoporosis
Multiple fractures
Large spinal curves

Presents with: blue sclerae, multiple frequent fractures with little trauma, bone deformities

NO HVLA

93
Q

Melorheostosis

A
  • hyperostosis under periosteum along side of long bones
  • candle wax dripping

Can SMT. Insignificant unless huge

94
Q

Osteopathia Striata

A
  • B/L
  • vertical linear opacities from metaphysis to diaphysis

Cinicaly insignificant

95
Q

Osteopoikilosis

A
  • widespread small round opacities
  • B/L, symmetrical, uniform

DDx:
-mets

Clinicaly insignificant

96
Q

Osteopetrosis

A

-dense brittle bones

  • generalised sclerosis
  • bone within bone / sandwich vertebrae

-erlenmeyer flask deformity

NO SMT

97
Q

Differential of widespread platyspondyly

A

Multiple myeloma
Osteoporosis

Spondyloepiphyseal dysplasia
Meta[hyseal dysplasia
Ehlers Danlos
Morquio’s

98
Q

Differential for posterior scalloping

A

Single:
Neurofibromatosis

\+??
Widespread:
Achondroplasia
Ehers Danlos
Marfans
99
Q

Differential for widespread bullet nose vertebrae

A

Achondroplasia
Spondyloepiphyseal dysplasia
Hurlers disease

100
Q

What are the elements of a radiographic description of a fracture?

A
  1. Location (in body)
  2. Orientation (horz, vert obli)
  3. List cortices broken
  4. Alignment (distal frag to prox)
  5. Apposition (good, partial, none)
  6. Rotation
  7. Joint space and ST involvement
101
Q

Compression fracture

A
  • step defect
  • wedge deformity
  • linear zone of condensation
  • lucent line
  • paraspinal swelling
  • compression or pathalogical
  • new or old
102
Q

Burst fracture

A

Like compression fracture but more central and increase AP diameter

103
Q

Odontoid fracture

A

Type 1:

  • oblique tip
  • stable

Type 2:
-dense base

Type 3:
-odontoid onto body

2 and 3 not stable

104
Q

Chance fracture

A
  • horizontal splitting of spine and neural arch

- L1 to 3

105
Q

Degenerative Joint Disease

A

Osteophytes, subchondral sclerosis and cysts
Facets: Bubble like (AP view), IVF narrowing (Oblique view)
IVD: decreased height, vacuum phenomenon, intercalary bone
Uncinate: cat ears, pseudofractures (Lateral view)

Can HVLA (unless suspect instability), no referral needed (unless suspect instability)

106
Q

Rheumatoid arthritis

A
  • dens erosion
  • > ADI
  • stepladder spondylolysthesis

NO SMT

107
Q

Differential of irregular endplates

A

-compression fracture

  • nuclear impressions
  • schmorls nodes
  • lateral flexion

-butterfly vertebrae

+more?

108
Q

Spondylitis

A
  • starts anterior superior corner of vertebra
  • moves up disc into next endplate
  • decrease disc space
  • ST density in disc space
  • ST involvement around
  • ankylosis

-can be posterior elements

  • paraspinal abscess
  • psoas abscess
  • paraspinal swelling on AP

Suppurative: less severe

Nonsuppurative:

  • TB
  • gibbus deformity

NO SMT if active.
Can SMT if old??

109
Q

Osteomalacia

A

Lucencies between trabeculae / checkerboard
Double cortex (thin too)
Concave endplates / bowing
Pseudofractures (ribs, pubic and ischial rami, scapula)
Protusio acetabuli (PORT)

NO SMT, refer to GP for blood tests and medical management

110
Q

Osteoporosis

A

Pencilled cortices, generalised decrease density, vertical trabecular
Empty box, wedging, vertebra plana, biconcave, hyperkyphosis

DDx:
Multiple myeloma
Post-scheurmans

NO SMT, refer to GP for DEXA and medical management

111
Q

Hyperparathyroidism

A 
Rugger jersey spine, concave endplates
Subperiosteal resorption of outer cortex (frayed look)
Blurred cortices **Hallmark**
Accentuated trabeculae
Salt and pepper / granular skull
ST calcifications
Clavicle resorption (MSHIRT)
Brown tumours: jaw, femur. Pelvis

NO HVLA, refer to GP for medical management

112
Q

Rickets

A

-osteomalacia in child

Radiographic features like adult + growth impairment

NO SMT

113
Q

Features of a benign tumour

A

Cortex:

  • thinning, scalloping, expansion
  • thickening
  • clear margins
  • solid periosteal reaction

GEOGRAPHIC

114
Q

Features of a malignant bone tumour

A
  • motheaten
  • permeative
  • cortical destruction
  • wide transition zone

-laminated or spiculated periosteal reaction

115
Q

Osteoma

A

-skull

116
Q

Osteoid osteoma

A

Sclerotic pedicle with acute angle scoliosis around it
Might see the small lucent nidus
Cortical thickening

Presents as: pain relieved by aspirin

DDx: Brodies abscess, stress fracture with healing response

117
Q

Osteosarcoma

A

Wide tranzition, fracture, cortex destruction
Sclerotix or mixed
Periosteal reaction, ST involvement

DDx: Ewings sarcoma (kids), Non-Hodgkins (elderly)

118
Q

Metastasis

A
  • diffuse opacities or densities or both
  • assymmetrical, non-uniform
  • NO expansion, cortex destruction, periosteal reaction
  • accross multiple bones
119
Q

Enchondroma

A
  • geographic
  • bit expansive
  • metaphyseal
  • endosteal scaloping

-matrix calcification

120
Q

Haemangioma

A

-vertical trabeculations

DDx:
-osteoporosis

121
Q

Nonossifying fibroma

A
  • diametaphyseal
  • cortical, eccentric
  • oval
  • thin cortex
  • hazy / smoky

-2-7cm

DDx:

  • fibrous dysplasia (bigger)
  • osteomyelitis
  • brodies abscess
122
Q

Fibrocortical defect

A
  • diametaphyseal
  • cortical /eccentric
  • thin cortex
  • hazy /smoky

<2cm

123
Q

Simple Bone Cyst

A

-fragment sign *Hallmark**

  • truncated, central
  • septations
  • mild expansion
  • endosteal scalloping

DDx:

  • ABC
  • ++??
124
Q

Aneurysmal Bone Cyst

A
  • extreme expansion
  • eggshell cortex
  • buttressing
  • septation

DDx:
-SBC

125
Q

Giant Cell Tumour

A
  • up to joint lint *Hallmark**
  • epiphysis

DDx:
-Malignant GCT

126
Q

Malignant GCT

A

-expansive distal radius

GCT became expansive now

-other place too

127
Q

Ewings Sarcoma

A

-kids

  • cortical saucer
  • diaphyseal

really looks like Osteosarcoma

DDx:

  • Osteomyelitis
  • Osteosarcoma (ST mass)
  • Non-Hodgkins Lymphoma (ST mass)
128
Q

Non-Hodgkins Lymphoma

A

-elderly

  • permeative / motheaten
  • medullary
  • patchy
  • ST mass

DDx:

  • Osteosarcoma
  • Ewings (kids)
129
Q

Chondrosarcoma

A
  • calcific densities
  • expansion
  • meta/diaphysis
  • scalloping
  • septations

-ST mass

130
Q

Fibrosarcoma

A

-huge ST mass

131
Q

Multiple Myeloma

A
  • circumscribed
  • uniform size multiple circular lytic lesions
  • endosteal scalloping
  • decerae density
  • vertebra plana

DDx:

  • Osteoporosis (looks same)
  • Lytic Mets
132
Q

What tumours mostly go to the spine?

A

Hemangioma
Mets
Multiple Myeloma
Osteoid Osteoma

Sacrum:

  • Plasmacytoma
  • Chordoma

+more?

133
Q

Scheurmann’s Disease

A

At least 3 consecutive vertebra with at least 2 of:

  • schmorls nodes
  • anterior wedging
  • increased AP diameter
  • increased kyphosis
  • decreased disc height

*must be in a child or teen

Post scheurmans DDx:
-osteoporosis

134
Q

Differential for hyperlucency in a chest x-ray

A
  • Pneumothorax
  • COPD
  • Bulla

-mastectomy

135
Q

Pneumothorax:

A
  • mediastinal shift
  • absent lung markings
  • shriveled up lung
136
Q

COPD

A
  • B/L generalised hyperlucent lungs
  • big lung size: flat diaphragm, heart lifted off it
  • Ephysema
137
Q

Bulla

A
  • still lung markings
  • thin wall of density around
  • circular

-can be with emphysema

138
Q

Differential for hyperdense area on chest x-ray

A
  • Pleural effusion (bottom)
  • Atelectasis (uniform, pulls mediastinum)
  • Pneumonia (lobe shape, NO mediastinum shift)
  • Coin lesion (pulls mediastinum)
  • Interstitial fibrosis
  • Miiary shadows (TB, Mets, sarcoidosis)
  • Pleural plaques
  • Mesothelioma
139
Q

Pleural effusion

A
  • lung base
  • meniscus sign
  • blunt costophrenic angle
140
Q

Atelectasis

A

Uniform:

  • lobe shape
  • pulls mediastinum
  • no lung markings left

Linear:

  • 1-3cm above diaphragm
  • horizontal
141
Q

Pneumonia

A
  • lobe shape
  • blurry borders
  • NO mediastinum shift
  • air bronchogram sign: fluid black white circles
142
Q

DDx for Coin lesions on chest Xray

A

Mets (spiculated, lobulated, multiple)
Bronchial carcinoma (one mass)
Pleural plaques

143
Q

DDx for Interstitial fibrosis on a chest xray

A

Pneumoconiosis
TB
Sarcoidosis, RA, SLE

*Mediastinal shift toward lesion (if U/L)

144
Q

DDx for Miliary shadows on a chest xray

A

TB (apical lobe)
Sarcoidosis (middle lobe)
Mets (lower lobe)

(Spotty, similar densities)

No HVLA if Mets (weakened bone=fracture risk), refer to GP for blood tests and medical management

145
Q

Pleural Plaques

A

Thickness around lung periphery
Crosses structures (not defined by lobes)
Often B/L

Refer to GP for blood tests and management

146
Q

Mesothelioma

A

Lobulated triangular opacity from border of the thoracic cage, pointing towards the lungs
Decreased lung size because it buldges onto lung field

*Refer to GP for CT to accurately stage disease and begin management

147
Q

Differential for unilateral hilar enlargement

A
  • tumour

- infection

148
Q

Differential for bilateral hilar enlargement

A

Sarcoidosis
Mets
Infection

149
Q

Signs of cardiomegaly on chest Xray

A

Cardio-thoracic ratio > 1/3
Heart border close to spine on lateral thoracic view
Double contour to the right heart border and splaying of the carina

150
Q

Abdomina perforation

A

Air under diaphragm

151
Q

Inguinal Hernia

A

Air under inguinal ligament

152
Q

Hepatomegaly

A

Liver shadow over ilium and or midline

153
Q

Bowel obstruction

A

Air fluid levels
Small intestine visible
Stripes over bowels

154
Q

Retroperitoneal fluid

A

-blurred psoas lines

155
Q

Kidney stones

A

Stag horn

DDx gallstones

156
Q

Pancreatic calcification

A
  • spotty pancreas shape

- L and R oblique shape

157
Q

Gall stones

A
  • sclerotic rim
  • grapes
  • on the R
158
Q

Ureteric calculi

A

larger than phleboliths or uterus fibroids

159
Q

Splenic artery aneurysm

A

The only time u see the spnelic artery

Looks like single gallstone (but on the L)

160
Q

Thoracic/Lumbar trauma indicators that justify an xray

A

Multiple of the following: female >65, make >75, osteoporosis Hx, chronic corticosteroid use, severe trauma, contusion

161
Q

Knee trauma indicators that justify an xray

A 
>55
Tender fib head or patella
Can't flex to 90 degrees
Can't walk at least 4 steps
Pain > 7 days
162
Q

Ankle trauma indicators that justify an xray

A

Tender distal 6cm of fib or tib, or malleoli
Can’t weight bear
Elderly + malleoli pain
Elderly + swelling

163
Q

Midfoot trauma indicators that justify an xray

A 
Tender base of 5th metatarsal
Tender navicular
Can't weight bear
Pain >10 days
Toe trauma
164
Q

Hip indicators that justify an xray (non traumatic)

A 
> 4 weeks failed conservative care
Hx uninvestigated trauma
Lost mobility
Acute onset locking
Palpable enlarging mass
165
Q

Shoulder trauma indicators that justify an xray

A 
Serious trauma
Shape, mass, deformity
Severe mobility loss
Epileptic seizure or electric shock
First time dislocation
166
Q

Wrist/hand trauma indicators that justify an xray

A 
Deformity
Painful active or passive ROM
Tender + oedema
Painful grip or supination
Pain at snuffbox or on longitudinal thumb compression
167
Q

Elbow trauma indicators that justify an xray

A

Inability to fully extend
Forearm pain
Instability
Localised elbow pain

168
Q

Features that justify a Cervical xray because you suspect spondyloarthropathy

A

Chronic pain (>3months) + risk factors:

  • insidious onset <40yrs
  • improves with exercise, NSAIDS
  • night pain
  • family Hx
  • extremity articular symptoms
  • systemic symptoms (psoriasis, IBD, uveitis)
169
Q

Features that justify a Thoracic xray because you suspect a scoliosis

A

Child or adolescent with:

  • positive Adams test
  • rib humping

Adult with acute onset or sudden progression of a scoliosis curve

170
Q

Non-traumatic features that justify a Hip, Knee, Ankle, Foot, Shoulder or Elbow xray

A 
Non change with conservative care >4 weeks
Red flags (unrelenting, night pain, not related to movement, fever, unexplained weight loss)
Significant activity limitation
Swelling, mass, deformity
171
Q

Differential diagnosis of Acro-osteolysis

A 
Psoriatic arthritis
Scleroderma, sarcoidosis
Hyperparathyroidism
Injury
Raynaud's disease
Thermal (extreme cold/ heat)
(PSHIRT)

Diagnostic Imaging (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions