Term
|
Definition
|
|
Term
| asses spinal maturation by the closure of the iliac crest |
|
Definition
|
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Term
|
Definition
the end of growing bone
produce and support articular cartilage |
|
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Term
|
Definition
longitudinal growth
periosteum for bone width
ab[N] length is Dwarfism or Giantism |
|
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Term
|
Definition
most active part of bone
most prone to tumors and infections |
|
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Term
|
Definition
longest part of bone aka= shaft
thickened cortex
decreased medullary space
main function is mechanical strength and contains bone marrow |
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Term
|
Definition
Multiple Myeloma
Ewing's sarcoma
Non-Hodgkin's lymphoma
infection |
|
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Term
|
Definition
densest and strongest of all bone
thickness and integrity is a strong indicator of bone tumors, infection etc |
|
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Term
|
Definition
internal cavity of bone
contains bone marrow |
|
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Term
|
Definition
not normally seen on xray
around diaphysis and metaphysis
none around epiphysis |
|
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Term
|
Definition
outer layer = attachments
inner layer = metabolically active = osteoblastic and osteoclastic potential |
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Term
|
Definition
| covers inner cortical margins |
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|
Term
| Vertebral body development: Age 0-1 |
|
Definition
| vertebral body is ovoid/egg-shaped with slightly rounded anterior margins. The body = disc height |
|
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Term
| Vertebral body development: Age 2-5 |
|
Definition
| vertebral body assumes more of a rectangular shape |
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|
Term
| Vertebral body development: Age 6-8 |
|
Definition
| steplike recesses are seen in the vertebral bodies above and below |
|
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Term
|
Definition
localized and generalized skeletal anomalies
ex spinal block vertebrae |
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Term
|
Definition
injuries
e.g. fractures, subluxation, dislocations and soft tissue ab[N] such as myosistis ossificans |
|
|
Term
|
Definition
joint problems
alternations in alignment, articular contour and joint space are identifiable |
|
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Term
|
Definition
neoplastic conditions
B9 or malignant
recognized by productive and destructive features |
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Term
|
Definition
infective disorders of bone (osteomyelitis)
infective disorders of joints (septic arthritis)
difficult to differentiate from tumors |
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|
Term
|
Definition
characterized by origin in bone marrow
e.g. hemolytic anemias and absence of blood supply as in epiphyseal avascular necrosis |
|
|
Term
| nutritional, metabolic, endocrine |
|
Definition
broad category
nutritional osteopenias - scurvy rickets
parathyroid diseases (metabolic) |
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Term
|
Definition
| increases serum calcium by promoting bone, kidney and gut resorption of calcium |
|
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Term
|
Definition
| antagonistic to PTH and actively decreases serum calcium |
|
|
Term
|
Definition
stimulates bone production
closely controls longitudinal growth and maturity |
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Term
|
Definition
male counterpart of estrogen
controls longitudinal growth and maturity |
|
|
Term
|
Definition
absence during growth (child) = dwarfism
excess during growth (child) = giantism
excess in adult - acromegaly |
|
|
Term
|
Definition
| most important one effecting bone = hydrocortisone |
|
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Term
|
Definition
| skin penetrated over fracture site |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
2 fragments
fracture completely through bone
eg Jefferson's Fx |
|
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Term
|
Definition
| portion of bone torn away by muscular or ligamentous pulling |
|
|
Term
| impaction fracture or compression fraction |
|
Definition
| portion of bone driven into adjacent segment |
|
|
Term
| pseudo fracture aka Loser's Lines |
|
Definition
imcomplete fracture
often multiple
associated with Paget's, Rickets, Osteomalacia of Fig Dysp |
|
|
Term
|
Definition
infancts, children < 10
bone bends: increased pressure to convex side we produces transverse fx with concave side intacts
heals w/o complications |
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Term
|
Definition
| due to compressive force the cortex bulge outward |
|
|
Term
|
Definition
|
|
Term
|
Definition
fx that gives clinical signs a/o radialogic evidence
7-10 days later resorption of bone mated at fx site |
|
|
Term
|
Definition
only visible w/ MRI in traumatic injuries
respresents hemorrhage of edema associated with trabecular micro fx |
|
|
Term
| Type I classification of epiphipeal fxs |
|
Definition
isolated fx thru growth plate
x-rays appears [N] |
|
|
Term
| Type II classification of epiphipeal fxs |
|
Definition
fx through a displaced growth plate, carries a corner of the metaphysis
Most common |
|
|
Term
| Type III classification of epiphipeal fx |
|
Definition
fx along growth plate toward epiphysis
most freq site = disal tibial |
|
|
Term
| Type IV classification of epiphipeal fx |
|
Definition
compressive deformity of growth plate
least common of all salter harris fx |
|
|
Term
| Radiological feature of healing fractures within the first 5 days |
|
Definition
resportion of fracture line
result --> increase in width of actural fx line |
|
|
Term
| radiological features of healing fractures in 10-15 days |
|
Definition
| "veil" of new bone formed adjacent to fx site |
|
|
Term
| how long does the healing process take? |
|
Definition
4-6 weeks in young patient
6-12 weeks in geriatric patients
there is a complete absence of fx line |
|
|
Term
|
Definition
arterial injury
fat embolism syndrom
thromboembolism |
|
|
Term
|
Definition
bruise appears behind mastoid
battle sign
associated with clear nasal discharge |
|
|
Term
|
Definition
aka bursting fracture
fxs through anterior and posterior arches
lateral mass spread apart
associated with ruptured transverse ligament |
|
|
Term
|
Definition
most commone injury of cervical spine
bipedicular fx of C2
associated with anterior displacement of C2 on C3 |
|
|
Term
| Mechanism of Hangman's Fx |
|
Definition
| usually a MVA with abrupt deceleration; fracture occurs during hyperextension/rotary force |
|
|
Term
|
Definition
|
|
Term
|
Definition
**most unstable
fx at junction of base and body
most common type and most frequent not to heal |
|
|
Term
|
Definition
odontoid base w/ extension into body
most readily to heal |
|
|
Term
| Vertebral Body compression fx |
|
Definition
sharp, triangular, anterior wedging of superior end plate
ant body height 3mm < post. body height
most common fracture of lumbar spine |
|
|
Term
|
Definition
aka coal-miner's fx
SP avulsion fx
usually at C7; then C6
A-P view shows a double spinous sign |
|
|
Term
|
Definition
soft tissue injury
alordosis
arcual kyphosis
segmental flex/ext |
|
|
Term
| bilateral interfacetal dislocation |
|
Definition
highly unstable
body of segment is displaced anteriorly
superior facets are post to inf facets of vertebra above
post zyg ant to pre-zyg of vertebra below |
|
|
Term
| chance fx aka Lap Seatbelt Fx |
|
Definition
transverse fracture through pedicles, pars, lamina, and SP
usually by way of a MVA |
|
|
Term
|
Definition
2nd most common fx of lumbar spine
assoc with hyperextension w/ lateral flexion - avulsion of paraspinal mm |
|
|
Term
|
Definition
fx of distal radius with posterior angulation of distal fragment
assoc with fall on an outstreched, extended hand |
|
|
Term
|
Definition
fx of distal radius with anterior angulation of distal fragment
associated with direct blow with wrist in hyperflexion |
|
|
Term
|
Definition
aka piedmont or reversed monteggia
fx of distal radial shaft at junction of middle and distal thirds with dislocation of distal radio ulnar joint |
|
|
Term
| post traumatic myositis ossificans |
|
Definition
heterotrophic bone formation in soft tissue
most often in muscle, but can be in fascia, tendons, joint capsules and ligaments |
|
|
Term
| What is the anatomical/ radiological correlation of the arthritides? |
|
Definition
A = alignment
B = bone
C = cartilage (soft tissue) |
|
|
Term
|
Definition
| anatomical term for transition zone between bone and ligament and tendon |
|
|
Term
|
Definition
| inflammatory cellular infiltrate at the bone/ligament or bone/tendon junction. Seen in inflammatory arthritides, esp, AS as cortical erosion and periostitis |
|
|
Term
|
Definition
| loss of bone due to pressure atrophy or active breakdown of bone tissue |
|
|
Term
|
Definition
|
|
Term
|
Definition
| 2 - 4 joints are involved in the disease processs |
|
|
Term
|
Definition
|
|
Term
|
Definition
| degenerative bony outgrowth continuous with underlying cortex, covered with cartilagenous cap, occuring at insertion of capsular ligament |
|
|
Term
|
Definition
| inflammatory arthropathies simulate RA clincally w/o RA factor show different pathological and radiographic features |
|
|
Term
|
Definition
| inflammatory ossificans w/i spinal ligament |
|
|
Term
|
Definition
| localized periosteal new bone; seen in inflammatroy arthritides |
|
|
Term
|
Definition
| usually between ALL or PLL; usually in DISH |
|
|
Term
| what must be present in order for something to be diagnosed as osteoarthritis? |
|
Definition
L - non uniform loss of joint space
O- osteophytes
E - eburnation |
|
|
Term
| What are the radiological features of DDD/DJD/ OA |
|
Definition
Must have LEO
loose bodies
subchondral cysts
Vacuum sign
Gull Sign |
|
|
Term
|
Definition
seen in OA/DDD/DJD
linear radiolucency in the disc space; represents collection of nitrogen gas in nuclear and annular fissures |
|
|
Term
|
Definition
| biconcave articular contour at distal and proximal interphalangeal joints (DIP & PIP) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Diffuse Idiopathic Skeletal Hyperostosis (DISH) |
|
Definition
| ligamentous ossification; esp ALL interupted by discal extensions |
|
|
Term
| What are the radiological features of DISH? |
|
Definition
flowing ossification of at least 4 contiguous segments
[N] disc height
hyperostosis; usually anterior
"flame configuration"
50% ossification of PLL |
|
|
Term
|
Definition
muscle soreness
morning stiffness
systemic connective tissue disease wc targets synovial tissue; early = symmetrical peripheral joint pain and swelling esp in hands
later = deformities such as ulnar deviation, swan neck and boutonniere |
|
|
Term
|
Definition
Ext of DIP
Flex of PIP
seen in RA |
|
|
Term
|
Definition
Flex of DIP
Ext of PIP
seen in RA |
|
|
Term
| what lab findings is present in RA |
|
Definition
RA factor is present
elevated ESR |
|
|
Term
| What are radiological features of RA? |
|
Definition
bilateral and symmetrical
periarticular soft tissue swelling (pannus)
juxt-articular osteoporosis
uniform loss of joint space
Rat bite erosions |
|
|
Term
| What should you always check for in a patients hand when suspecting RA? |
|
Definition
Styloid Process
carpel bones MCP's and PIP's |
|
|
Term
| What are the most common affected areas of RA in the cervical spine? |
|
Definition
increased ADI space
Decreased IVD space
generalized osteoporosis |
|
|
Term
|
Definition
| Bilateral acetabular protrusion due to RA |
|
|
Term
|
Definition
aka Still's Disease
present before the age of 16
present with fever, a characteristic rash, lymphadenopathy
**Lacks a positive RA factor |
|
|
Term
| Radiological features of Juvenile RA |
|
Definition
soft tissue swelling
osteoporosis
periostitis
ankylosis
loss of joint space
erosions
subluxations |
|
|
Term
| Where are the target sites for Juvenile RA? |
|
Definition
Cervical spine
hands
feet
knees |
|
|
Term
| What happens in the cervical spine during Still's Disease? |
|
Definition
| posterior motor unit fusion between C2-C3-C4-C5 |
|
|
Term
|
Definition
tenderness over boney protuberances
bilateral sciatica
onset between 15-35 males
pain |
|
|
Term
|
Definition
|
|
Term
| Radiological features of AS. |
|
Definition
Bilateral and Symmetrical Ankylosis of the SI Joint
Syndesmophyte formation (marginal)
bony ankylosis
erosions with surrounding sclerosis
Bamboo Spine/ Poker Spine
Trolley track sign
Carrot stick fracture |
|
|
Term
|
Definition
associated with psoriasis
between 20-50
usually in the DIP joints |
|
|
Term
| Describe the lesions present with Psoriatic Arthritis. |
|
Definition
| well defined, dry, raised red and silvery, scaly patches |
|
|
Term
| What is the lab finding for Psoriatic Arthritis? |
|
Definition
|
|
Term
| Radiological features of psoriatic arthritis. |
|
Definition
soft tissue swelling
bone reapsortion (bone disappears)
pencil in cup deformity
most common at DIP shows the Ray Pattern
mouse ears sign
NO ULNAR DEVIATION
increased ADI |
|
|
Term
|
Definition
bilateral, symmetrical SI disorder
multiparous females
usally affect women 20-40
self-limiting
no lab findings
asymptomatic |
|
|
Term
| Radiological features of Osteitis Condensans |
|
Definition
bilateral dense, triangular shaped iliac subchondral sclerosis
lower 1/2 of joint
joint space and margins [N] |
|
|
Term
|
Definition
inflammation usually following pelvic surgery or childbirth
pain restricted movements |
|
|
Term
| Radiological features of osteitis pubis |
|
Definition
joint surface erosion
subchondral sclerosis
motheaten localized osteoporosis
widened joint space
looks identical to infection |
|
|
Term
|
Definition
ab[N] purine metabolism
sodium monourate crystals in cartilage usually lower extremities
in males usually 40's and 50's |
|
|
Term
|
Definition
increased ESR
leukocytosis
hyperuricemia |
|
|
Term
|
Definition
classic "over-handing margin sign"
marginal bone erosions |
|
|
Term
|
Definition
1st metatarsophalangeal joint
hands
wrists |
|
|
Term
| Hydroxyaoatite Deposition Disease (HADD) |
|
Definition
calcification within tendon, bursa, other periarticular soft tissue
AKAs calcifying tendinitis
peritendinitis calcarea |
|
|
Term
| Where is HADD most commonly seen? |
|
Definition
shoulder
hip cervical spine |
|
|
Term
| radiological features of HADD |
|
Definition
shoulder: supraspinatous tendon
hip: gluteus maximus tendon is most common
Nucleus pulposus calcification
annulus fibrosis calcification
may also see calcified thyroid cartilage, stylohyoideous, and iliolumbar lig |
|
|
Term
|
Definition
aka Charcot's Joint
lack of objective and subjective pain despite joint swelling, instability, and crepitation
destructive articular disease which occurs secondary to a loss or impairment in joint proprioception |
|
|
Term
| Neurological signs of Neurotrophic Arthropathy |
|
Definition
altered gait patterns; loss of deep reflex; pain insensitivity
2 basic types: hypertrophic and atrophic |
|
|
Term
|
Definition
Distension
Density
Debris
Dislocation
Disorganization
Destruction |
|
|
Term
| Where does hypertrophic normally exist? |
|
Definition
|
|
Term
|
Definition
More common in shoulder hip, foot
articular ends appear surgically amputated or tapered
licked candy stick
absence of 6 D's |
|
|
Term
| Characteristics of Neurotrophic Arthopathy in the lumbar spine |
|
Definition
| large osteophytes, prominent sclerosis, advanced discopathy, severe subluxations and body fragmentation |
|
|
Term
| Lab findings for Neurotrophic Arthopathy |
|
Definition
(-) for joint disease
(+) for causitive disease eg syphillis, diabetes |
|
|
Term
|
Definition
aka Alkaptonuria
ab[N] tyrosine metabolism - urine turns black upon standing
arthritis - insidious onset of back pain and joint stiffness |
|
|
Term
|
Definition
premature DDD
chondrocalcinosis
ligament calcification |
|
|
Term
| Radiological features in the spine |
|
Definition
universal discal calcification
decreased disc space - waffer thin disk
calcification of interspinous ligament
begins in lumbarsl ascends spine |
|
|
Term
|
Definition
rare spinal involvement
formation of noncaseating granulomas |
|
|
Term
|
Definition
most common - hand, wrist, feet
coarsened trabecular with numerous areas of decreased density (lace- like)
2nd most common area is chest |
|
|
Term
| Lab findings of Sarcoidosis |
|
Definition
increased ESR
reversed A-G ratio
hypercalcemia
(+) Kviem test |
|
|
Term
Calcium Pyrophosphate Dihydrate Crystal Deposition
(CPPD) |
|
Definition
| inflammatory joint ds caused by deposition of CPPD into synovial fluid, linings and articular cartilage |
|
|
Term
| What are the clinical features of CPPD |
|
Definition
acute - stimulates Gout or RA
Chronic - stimulates DJD
Asymptomatic - the only sign is chondrocalcinosis |
|
|
Term
|
Definition
soft tissue calcification
cartilage calcification - most common in knees |
|
|
Term
|
Definition
present in the wrist a step ladder appearance
the scaphoid moves proximally and the lunate moves more distally |
|
|
Term
| Where are the crystal deposition in Gout and CPPD |
|
Definition
in gout the crystals are around the joint
CPPD the crystals are within the joint |
|
|
Term
| Synoviochondrometaplasia (SCM) |
|
Definition
B9 arthropathy
synovial tissue undergoes metaplasic transformation -- forms cartilage
calcifies -- ossifies -- loose bodies
joint mice |
|
|
Term
| The most comone site for SCM |
|
Definition
| ** knee, hip, ankle, elbow, wrist |
|
|
Term
| radiological features of SCM |
|
Definition
each loose body in the joint is round, oviod, smooth, faceted, laminated and strippled
may have internal trabeculae |
|
|
Term
| What are the congenital fusions? |
|
Definition
Occipitalization
basilar impression
block vertebra |
|
|
Term
|
Definition
fusion of C1 to base of occiput
lack of segmentation and separation of most caudal occipital sclerotome |
|
|
Term
|
Definition
| decrease space of non-existent space between C1 and occiput |
|
|
Term
|
Definition
| inferior portion of cerebellar hemispheres and medulla protrude thru FM into spinal canal; usually accompanied by spina bifida and meningomyelocele |
|
|
Term
|
Definition
2 adjacent vertebra osseously fused from birth
failure of [N] segmentation
causes stress above and below block results in premature degeneration |
|
|
Term
| Where are the most common occurence of blocked vertebra? |
|
Definition
|
|
Term
| Radiological features of blocked vertebra |
|
Definition
anterior concavity forming a "C" shape
wasp waist |
|
|
Term
| What are the pathological fusions? |
|
Definition
Klippel Feil Syndrome
Sprengel's Deformity
Acquired Block Vertebra |
|
|
Term
|
Definition
classic triad
short webbed neck
low hairline |
|
|
Term
| Radiological features of Klippel Feil Syndrome |
|
Definition
| 2 or more blocked vertebrae in cervical or upper thoracic region |
|
|
Term
|
Definition
patient will have decreased abduction of arm, and torticollis
associated with omovertebral bone (30-40%) |
|
|
Term
|
Definition
| anytime an atypical bone forms a joint space with normal anatomy |
|
|
Term
|
Definition
Lack of anterior concavity
aka ankylosis |
|
|
Term
| Radiological features of acquired block vertebra |
|
Definition
no neural arch fusion
considered an E shape
osteophytes generally present |
|
|
Term
|
Definition
interruption of pars interarticularis
ant displacement of vert body with vertebrae below |
|
|
Term
| Radiological Feautures of Bowline of Brailsford |
|
Definition
| inverted Napolean's Hat Sign |
|
|
Term
|
Definition
| an interruptions of the pars interarticularis; this may be wither unilateral or bilateral |
|
|
Term
|
Definition
| Dysplastic congenital ab[N] |
|
|
Term
| Type II spondylolisthesis |
|
Definition
| Isthmic - lytic or stress fracture of pars; elongated but intact, acute fx of pars |
|
|
Term
| Type III spondylolisthesis |
|
Definition
| Degenerative - 2 degrees to long standing degenerative arthrosis of zyg joints without pars separation |
|
|
Term
|
Definition
| Traumatic - 2 degrees to a fx to the neural arch |
|
|
Term
|
Definition
| Pathological - in conjunction with bone disease (Pagets, mets) |
|
|
