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Elevated alkaline phospahte
Refferal to PCP or endocrinologist (Pagets?)
63 year old male. What is the most likely lab finding and what is the next step in Managment

Osteoma
The most Ikely diagnosis for the finding in the froetal sinus is

All of the provided options are possible
Sinus infections
Asymptomatic
Headaches
The most likely symptom/finding for the patient above is?

Fibrous dysplasia
37 year old male with hip pain.
The most Bely dagnosis is

Cafe au lait - coast of maine
Rind of sclerosis
37 year old male with hip pain
Based on the above findings, please pick one possible physical exam finding and an associated radiog aphic name sign that may not necessarly be seen here but could be seen in a patient with this condition
Pick two of these
- Cafe au lait » coant of Maine
• Fibroma moluscum
• hortased hat size
• Petic brim sign
• ribbon rib appearance
•rind of sclerosis

Osteosarcoma
13 year old male with shoulder pain.
Most likely diagnosis:

Ill defined
Cortical destruction
Colman's triangle
Aggressive appearing
13 year old male with shoulder pain.
Please describe the lesion above with appropriate answer options.
Select 4 correct answers

Osteomyelitis
10 month old infant with 1 week history of knee pain and swelling.
The most likely diagnosis is:

Urgent referral to emergency department
Elevated WBC
10 month old infant with 1 week history of knee pain and swelling
Please choose the best management and most likely lab finding.
Select 2 correct answers

Cotton wool skull
76 year old male.
The name sign seen above is:

Pagets
Basilar invagination
76 year old male
Please choose the diagnosis and most clinically significant finding.

Neurofibromatosis
Adult patient with known chronic condition. The patient also demonstrates multiple smooth margin, non-elevated darkly pigmented skin lesions on their thorax.
Most likely diagnosis?

Kyphoscoliosis
Adult patient with known chronic condition. The patient also demonstrates multiple smooth margin, non-elevated darkly pigmented skin lesions on their thorax.
The most common radiographic finding for this patient's diagnosis is:
• Cortical khickening
• Ground glass appearance
• Kyphoscoliosis
• Subligamentous vertebral destruction

Avascular necrosis
54 year old male with chronic bilateral hip pain. History reveals the patient suffers from alcoholism.
Best diagnosis:
• Septic arthritis
• Paget disease
• Osteomalacia
• Avascular necrosis

Corticosteroid use
54 year old male with chronic bilateral hip pain. History reveals the patient suffers from alcoholism.
The most common cause for the above diagnosis is:
Vitamin D deficiency
Staphylococcus aureus
Paramyxovirus
Corticosteroid use

avascular necrosis
54 year old male with chronic bilateral hip pain. History reveals the patient suffers from alcoholism.
Best diagnosis:
• Septic arthritis
• Paget disease
• Osteomalacia
• Avascular necrosis

Infectious discitis
Diabetic patient with low back pain of 3 weeks that is getting progressively worse.
Most likely diagnosis:
Chordoma
Metastasis
Kummel's disease
Infectious discitis

Urgent referral to emergency department
Diabetic patient with low back pain of 3 weeks that is getting progressively worse.
Best management:
Urgent referral to emergency department
No referral necessary; begin chiropractic care
Refer for bone scan to find other areas of involvement
Refer to oncologist

Neurofibromatosis
The patient above demonstrates dilation of the thecal sac along with numerous nerve sheath tumors.
Most likely diagnosis:
Chordoma
Tubercular meningitis
Fibrous dysplasia
Neurofibromatosis

All of the above
The patient above demonstrates dilation of the thecal sac along with numerous nerve sheath tumors.
Which of the following conditions could also cause the vertebral body changes?
Choose all that apply.
Acromegaly
Marfan syndrome
Achondroplasia
Spinal tumor

Corduroy cloth
Name sign seen above:
Vertebra plana
Rugger jersey spine
Corduroy cloth
Picture frame vertebra

Hemangioma
The most likely diagnosis for the above finding is:
Lytic metastasis
Hyperparathyroldism
Hemangioma
Paget disease-

Elevated parathyroid hormone??
Based on the findings seen above, the most likely lab finding is:
Vitamin D deficiency
Elevated alkaline phosphatase
Elevated parathyroid hormone
Elevated growth hormone

Hyperparathyroidism??
The most likely diagnosis is:
• Acromegaly
• Osteomalacia
• Hyperparathyroidism
• Paget disease

Tuberculous spondylitis
54 year old homeless man with chronic severe mid back pain and also complains of having a long standing cough.
The above changes are consistent with:
Neurofibromatosis
Transient regional osteoporosis
Dialysis related spondyloarthropathy
Tuberculous spondylitis

Phemister's
54 year old homeless man with chronic severe mid back pain and also complains of having a long standing cough.
Which triad may be seen with involvement of the above condition in the extremities.
• Gardners
• McCune's
• Puttis
• Phemister's

Multiple myeloma
54 year old male with severe fatigue.
Based on the x-ray findings seen above, what is the most likely diagnosis:
Multiple myeloma
Paget disease
Blastic metastasis
Fibrous dysplasia

Raindrop skull
54 year old male with severe fatigue.
The most likely SKULL radiographic name sign seen with this condition is:
Asterion defect
Cotton wool skull
Pepper pot sign
Raindrop skull

Crescent sign
Snowcap sign
Please choose two name signs seen above.
Select 2 correct answeria
Rind of sclerosis sign
Coxga manga sign
Crescent sign
Snowcap sign
Sagging rope sign

Legg Calve Perthes
6 year old male with right hip pain.
The most likely diagnosis is:
Septic arthritis
Legg Calve Perthes
Slipped capital femoral epiphysis
Acetabular dysplasia

Paintbrush metaphysis
18 month old female with joint pain and irritability.
Which radiographic finding is seen above?
Dense ring epiphysis
Subperiosteal hemorrhage
Narrowed growth plate cartilage
Paintbrush metaphysis
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Nut Pro

Rickets
18 month old female with joint pain and irritability.
Most likely diagnosis:
McCune albright
Scurvy
Rickets
Neurofibromatosis

Freiberg
The condition seen above is known as:
Haas
Freiberg
Kohler
The Panner

High heeled shoes
Elongated second digit
Please choose two possible causes for the condition seen above.
Select 2 correct answers:
High heeled shoes
Septic arthritis
Metatarsal crush injury
Elongated second digit

Ivory vertebrae
Name sign seen above?
Sandwich vertebra
Jail bar vertebra
Picture frame vertebra
Ivory vertebra

Multiple myeloma
All of the following may cause the above findings EXCEPT:
Blastic metastasis
Paget disease
Lymphoma
Multiple myeloma

Osteomalacia??
Secondary hyperparathyroidism??
Please choose two possible diagnoses:
Select 2 correct answers:
• Fibrous dysplasia
• Osteomalacia
• Secondary hyperparathyroldism
• Paget disease

Elevated parathormone??
Low serum calcium??
Please choose two likely lab findings.
Select 2 correct answer
Low alkaline phosphatase
Elevated parathormone
Elevated phosphorus
Low serum calcium

Aneurysmal bone cyst
13 year old male with right ankle pain and swelling of approximately 3 months duration.
Best diagnosis:
• Aneurysmal bone cyst
• Osteochondroma
• Plasmacytoma
• Ewing sarcoma

Fluid fluid sign
13 year old male with right ankle pain and swelling of approximately 3 months duration.
Which name sign may be associated with the above condition?
• Fluid fluid sign
• Cumulus sign
• Double line sign
• Rim sign
