Musculoskeletal Imaging Introduction and General Bone (done except ask about those 2 flashcards that say to)

What is Wolff’s Law and Utah Paradigm?

A bone grows and remodels as a response to force or demands placed on it

What should you interpretation paradigm be?

1. Soft tissue changes

2. Osseous changes (periosteum, cortex, medulla, zone and rate)

3. Classify as benign or aggressive

4. Differentials

Why should you radiograph the opposite limb?

For comparison to the other limb

How do you assess the soft tissue?

Are the changes focal, regional, or diffuse

Is there an increase or decrease in volume

Is there an increase or decrease in density

Right, less soft tissue opacity

What is a fascial plane?

A potential space around muscles

Fascial plane. Cranial is infrapatellar fat pad. Caudal fascial plane

Fascial planes

Which is abnormal and why?

Right because infrapatellar fat pad is indented and caudal fascial plane is obstructed

What is a term for gas within the soft tissue?

Emphysema

What can cause soft tissue emphysea?

Penetrating trauma wounds

Iatrogenic from an injection

Gas producing bacteria

What are the types of mineralization?

Dystrophic

Metastatic

What causes increased soft tissue opacity?

Mineralization

What is dystrophic mineralization?

A tissue is injured and metaplasias into mineral

Soft tissue mineralization of the triceps at its insertion on the tuber olecrani

dystrophic

Soft tissue mineralization caudal to the ulna

Dystrophic

Soft tissue mineralization at the area of the gastrocnemius

Could be healing from a wound, or a lymph node. Maybe dystrophic?

metal opacity from a ballistic

What are causes of metal opacity in soft tissue?

Ballistics

Implants

Microchip

How can lesions in a bone be distributed?

Monostotic

Polyostotic

Focal

Generalized

Symmetrical

Asymmetrical

What does monostotic mean?

Only effects one bone

What does polyostotic mean?

Effects multiple bones

What are predilection sites?

IDK i couldnt understand her

How can bone respond to disease?

Take away bone

Add more bone

T/F bone can be taken away and added at the same time?

True

What is osteosclerosis?

Radiographic term for increased bone opacity/density

What is osteopenia?

Radiographic term for decreased bone opacity/density

What are the 2 types of osteopenia?

Osteoporosis

Osteomalacia

What is osteoporosis?

Quantity of bone is decreased but existent bone is of normal composition

What is osteomalacia?

Quality of bone is decreased. Increased % of non-calcified osteoid or insufficient mineralization of osteoid matrix

What are the causes of generalized osteopenia?

Metabolic

Nutritional

ASK WHAAT OTHER 2 ARE

Osteopenia (decreased overall density, more trabeculae)

What is a pathological fractures?

No trauma but getting a fracture

How long does it take for lytic changes to appear radiographically?

5-7 days

How long does it take for productive/blastic changes to appear radiographically?

10-14 days

What causes osteoblastic change?

Periosteal reactions

Callus (fracture)

Osteophytes and enthesophytes (joint)

What are the patterns of osteolytic change?

Geographic lysis

Moth eaten lysis

Permeative lysis

What is the periosoteum?

Outer layer of the bone

What is the structure of the periosteum?

Inner cambium layer

Outer fibrous layer

Attached to bone by Sharpey’s fibers

T/F the periosteum is invisible until pathology arises?

True

What is a periosteal reaction?

Caused by when periosteum is damaged or elevated from underlying bone. It heals by new bone being laid down from the inner cambium layer

What can you use to determine between non-aggressive and aggressive bone lesions?

Location and number

Pattern of lysis

Pattern of new bone production

Cortical changes

Transition zone to normal bone

Change in lesion over time

T/F the radiographic appearance of an aggressive lesion will change rapidly compared to non-aggressive lesions?

True

Which is more aggressive?

Right

What are the types of continuous periosteal reactions?

Solid

Lamellar

Lamellated

What are the types of periosteal reactions?

Continuous and interrupted

What type periosteal reaction?

Solid

Describe a solid periosteal reaction?

bone completely fills the area under the reaction

More chronic, the more solid/mineralized

Surface can be smooth or undulating

Non-aggressive

Callus

What type of periosteal reaction?

Lamellated periosteal reaction

Describe a lamellated periosteal reaction

Layered or onion skin appearance

Indicates a cyclic or intermittent process

More aggressive than solid, smooth bone usually associated with a benign process

What type of periosteal reaction

Amorphous periosteal reaciton

What is the most aggressive periosteal reaction?

Amorphous

What are the patterns of bone lysis in order of aggressiveness?

Geographic

Moth-eaten

Permeative

Geographic bone lysis

Moth-eaten bone lysis

Permeative bone lysis

Geographic bone lysis

Geographic bone lysis (multiple myeloma identified by the “punch” wound in the bone)

Geographic bone lysis

Moth eaten lysis

Moth eaten lysis

Moth eaten lysis

Permeative lysis

Permeative lysis and a fracture

How should you characterize a lesion?

Based on the most aggressive feature

T/F skeletal changes fall along a continuum?

True

What can cause a solid periosteal reaction?

Callus, benign

What can cause a lamellated periosteal reaction?

Low grade osteomyelitis

Chornic/repeated

What can cause a columnar (palisading periosteal reaction)?

Hypertrophic osteopathy

Bacterial osteomyelitis

What can cause a spiculated periosteal reaciton?

Neoplasia or osteomyelitis

What can cause an amorphous periosteal reaction?

Amorphous

Rank the periosteal reactions from least to most aggressive

Solid, smooth bone

Lamellated

Columnar

Spiculated

Amorphous

What are the interrupted periosteal reactions?

Thick brush-like

Thin brush-like

Sunburst

Amorphous bone production

What is a spiculated periosteal reaction?

Periosteal reaction perpendicular to the cortex along the Sharpey’s fibers

What does spiculated periosteal reaction appear as?

Columns of bone or radiating like a sun burst

When is columnar spiculated periosteal reaction seean?

Diseases like hypertrophic osteopathy

What periosteal reaction

Palisading periosteal reaction

What periosteal reaction?

Sun burst