Term 3 pathology Flashcards
(28 cards)
The lateral x ray of her thoracic spine indicates a possible pathology at the 7th
thoracic vertebra which has resulted in a loss of her overall stature (she has got
shorter and lightly more hunched).
Name the type of pathology you suspect.
Compression fracture
Describe the radiographic pattern of a compression fracture at the 7th thoracic vertebra
Buckled anterior cortex.
Loss of height of anterior vertebral body.
The radiographic appearance of the spine indicates uniform radiolucency.
Given the women’s age of 55 and presenting symptoms, you suspect an underlying
metabolic condition which may be affecting her skeletal system.
Name and define the condition you suspect?
Osteoporosis
A bone disorder in which the rate of bone resorption is greater than the rate of
bone formation
Osteoporosis: This condition can be grouped into two types depending on age and hormonal status.
Name and describe the features of the type you suspect a woman of 55 years has.
TYPE 1: POST MENOPAUSAL OSTEOPOROSIS
Due to oestrogen deficiency
Loss of trabecular bone
50 – 70 years
Fractures of vertebrae
and distal radius
Osteoporosis: List six modifiable risk factors that may affect this condition.
Immobilisation (sedentary = inactive / sitting all day) Calcium deficiency (diet) High protein diet Alcoholism Caffeine intake Smoking High dietary phosphates
Describe the pathology regarding peak bone mass (PBM) of Osteoporosis
Peak bone mass (PBM) is achieved around the age of 30 – 35
PBM is greater in men and blacks
PBM can be affected by the modifiable risk factors
Bone mass begins to decrease 0.5% per year after this age
Bone mass decrease more rapidly for 3 – 7 years following menopause at 1.0%
per year
Eventually enough bone mass is loss to reach a fracture threshold level
The greater the PBM the less likely the bone loss will reach the fracture
threshold level
You suspect a sero-negative inflammatory arthritic condition which may
present in young males.
Name the condition you suspect
Ankylosing Spondylitis
State the distinguishing pathological features of Ankylosing Spondylitis
Bilateral sacroilitis Ascending spinal involvement Thoraco-lumbar region Lumbo-sacral region Costo-vertebral joints Large synovial joints maybe involved
Describe the radiographic findings you might expect to see in the sacro iliac joints
and spine if Ankylosing Spondylitis is present
SACROILIAC JOINT Bilateral and Symmetrical Lower 2/3 of joint involved Reactive sclerosis mainly on the ilium side of the joint
SPINE Discovertebral junction “Squared” vertebra on lateral film “Barrel shaped” vertebra on lateral film “Bamboo spine” on AP film
Differentiate Ankylosing Spondylitis from a degenerative condition by describing the radiographic
features of osteoarthritis in the vertebral bodies and articular facet joints of the spine.
IVD/Vertebral body ü Asymmetrical distribution ü loss of height ü Osteophytes ü Subchondral sclerosis ü Canal stenosis Articular facet joint ü Deformity/osteophytes ü Subluxation ü IVF encroachment ü Sclerosis
Describe the aetiological pathology of a prolapsed disc
Degenerative changes, trauma, or increased pressure may rupture the annulus
fibrosus - usually at its weakest spot - the posterior aspect where it is the
thinnest and where the posterior longitudinal ligament is the weakest
(3.5 marks for the concept of stress exceeding anatomy)
With increased pressure transmitted through the spine the nucleus pulposus
will then herniate postero-lateral or posteriorly
(1.5 mark for the concept of NP herniation)
Compressing on the roots of the spinal nerves or directly on the spinal cord
What clinical indications of a perforated bowel would you expect to see on an x-ray image?
There is air under the right hemidiaphragm
What are the clinical indications of gall stones on an x-ray image?
These are demonstrated as opacities
in the gallbladder.
Name the radiographic features of small bowel obstruction.
Dilated loops of small bowel proximal to the obstruction
Predominantly central dilated loops
Name some request indications that may indicate small bowel obstruction.
Symptoms may include abdominal (stomach) cramps and pain, bloating, vomiting, nausea, and severe constipation
Name the radiographic features of large bowel obstruction.
The large bowel can distend up to approximately 6 cm in diameter
Sigmoid volvulus will be seen as a distended loop of bowel rising out of the pelvis and may have a coffee-bean configuration
There will often be proximal dilatation of the large bowel
Name some clinical indications on a request that may indicate large bowel obstruction
Symptoms may include cramp-like abdominal pain and distension, constipation,nausea and vomiting. Dehydration and electrolyte imbalance may occur
What is Sigmoid Volvulus?
Is a cause oflarge bowel obstructionand occurs when thesigmoid colontwists on its mesentery, thesigmoid mesocolon
What are the radiographic features of Sigmoid volvus?
Sigmoid volvulus is differentiated from acaecal volvulusby its ahaustral wall and the lower end pointing to thepelvis
Will show a large, dilated loop of the colon, often with a fewgas-fluid levels.
Specific signs include a coffee bean (or kidney bean) sign, absent rectal gas, or a liver overlap sign (wherein the sigmoid loop is seen ascending to the right upper quadrant projecting over liver)
What is Inflammatory bowel disease?
Is a medical term describing conditions in which the intestine becomes inflamed (red and swollen)
What are the two main types of inflammatory bowel disease and how are they classified?
- Crohn disease 2. Ulcerative colitis
Both autoimmune diseases whereby the body attacks the digestive system.
What are the radiographic features for Crohn’s disease
The presence of skip lesions and discrete ulcers
Thickened folds due to edema
What are the radiographic features for Ulcerative colitis
Involvement of the rectum is almost always present
May show evidence of mural thickening withthumbprinting, as seen in more severe cases
What are kidney stones?
Hard deposits made of minerals and salts that form inside the kidneys and can affect any part of the urinary tract
