Diagnostic Imaging Pt.2

Brodie’s Abscess

radiolucent nidus surrounded by reactive sclerosis, night pain relieved by aspirin, fever and increased WBC

Osteoporosis

>70 , normal labs (primary)

RA (juxta-articular)

drugs (steroids)

diseases (cushing’s)

Post trauma (RSDS)

Osteogenesis imperfecta

connective tissue disorder causing brittle bones, multiple fractures

blue sclera and osteoporosis

Osteopetrosis

build up of cartilage within bone causing “os in os” (sandwich vertebra) appearance in spine

stone/marble bones

anemia and elevated alkaline phosphatase

Secondary HPT

Aka renal osteodystrophy

hypercalcemia (vascular calcification), radial finger erosions (pathognomonic)

rugger jersey spine

salt and pepper skull

distal tuft erosions (acro-osteolysis) → kidney failure

Bennet’s fracture

Thumb (1st metacarpal)

Boxer’s fracture

2nd and 3rd metacarpals

barroom

4th and 5th metacarpals

game keepers thumb

avulsion of thumb

Colles fracture

distal radius (posterior displacement)

Smith’s fracture

distal radius (anterior displacement)

Monteggeia’s

ULNA broken, radius dislocated

Galeazzi’s fracture

RADIUS is broke, ulna is dislocated

Transverse fracture

pathological disease (pagets)

Growth plate fracture

salter harris

greenstick fracture

children

fatigue fracture

repetitive physical stress

Comminuted fracture

more than 2 pieces (3 or more)

impaction fracture

one part driven into another

Compound fracture

part protruding through the skin

C1 Arch fracture

Jefferson’s fracture aka burst fracture of C1

compression force

C2 Arch fracture

hangman’s

bipedicular

C2 dens

Type 1, Type 2 (unstable and Type 3

Whiplash

teardrop fracture (unstable)

Compression fracture: anterior only

benign

Compression fracture anterior and posterior

malignant

horizontal fracture

chance fracture, seat belt, fulcrum

unstable spine fractures

ADI, dens Type 2, flexion teardrop

Potts

distal fibula fracture

Jones fracture

base of 5th metatarsal

March’s fracture

stress 2-4 metatarsals

Calcaneal fractures

stress fracture

Hyperkyphotic spine compression fx

T4-T8

SLAP tear

injury to glenoid labrum

Hil-sachs deformity (hatchet)

cortical depression of posterolateral head of humerus

Dislocations

Talus: lateral

Hip: posterior

Lunate: anterior

Patella: superior and lateral

Shoulder: Anterior inferior

Unillateral facet: flex and rotate

Pelvic fractures:

Pubic rami most common fracture

malgaigne’s fracture

ipsilateral sprung SI and pubic rami fracture (inferior and superior rami)

Bucket handle fracture

contralateral sprung SI and pubic rami fracture (superior and inferior)

Sraddle fracture

bilateral pubic rami fractures

Sprung pelvis

bilateral SI sprain and pubic diastasis

Duveryney’s fracture

iliac wing fracture

ASIS avulsion fx

sartorius

AIIS avulsion fracture

Rectus Femoris

Ischial tuberosity avulsion fx

hamstring

Lesser trochanter avulsion fx

Iliopsoas

Osteoarthritis (DJD)

instability causes osteophytes, sclerosis and disc thinning

Finger nodules: DIP (heberden’s), PIP (bouchard’s) and MCP (hargarths)

RA

Synovium, soft tissue swelling

juxta-articular osteoporosis, rat bites, ADI space instability

migration and fusion

Hip joint OA

narrow superior margin

Medial migration of hip joint

acetabular protrusio

RA

Widening of hip joint

infection

AS

targets SI in young males, starts in SI joints and move up the spine into costo-vertebral joints (dyspnea)

causes thin, fragile, bilateral, marginal syndesmophytes

also fuses posterior joints and nuchal ligaments

DISH (aka forestier’s)

anterior vertebral bone exostosis, ALL calcification

dysphagia

preserved discs, no posterior joint fusion

related to Diabetes mellitus

Reiter’s (reactive arthritis)

can’t see, can’t pee, can’t dance with me

due to chlamydia

Psoriatic arthritis

80% have pitted nails, 15% have arthritis, ray pattern, pencil in cup, mouse ear periostitis

Gout

purine metabolism (red wine, meat and cheese)

dysfunction, monosodium urate crystals, hyperuricemia

overhang or edge sign

CPPD / pseudogout

chondrocalcinosis, likes the knee

HADD

non-traumatic, calcified tendon near joint

shoulder

SLE

reversible ulnar deviation, ADI instability

systemic malar rash

scleroderma (PSS)

soft tissue calcinosis, tight, shiny skin, dysphagia, acro-osteolysis

Neuropathic (neurogenic or charcot’s joints)

“bag of bones”, density, debris, dislocated, disorganized, destruction, diffuse

Synoviochondrometaplasia (osteochondromatosis)

multiple joint mice, crepitus, joint locking

Arthrosis

posterior joint DJD

Spondylosis

anterior joint DDD

SPondylolysis

broken pars

Anterolisthesis

anterior slippage

Spondylolisthesis

anterior slippage (broken pars)

increased sacral base angle, sagittal facets, trapezoid shaped body

Spondylolytic spondylo

slipped and broken

Spondyloptosis

tilted downward, contra to adjustment

invertednapolean hat aka brailsford bow

Spondyloschisis

spina bifida (L5)

Seronegative HLA-B12

Ulcerative colitis

Reiters

AS

Psoriatic

Enteropathic

MRI

Soft tissue, best for nerve, healing (joints)

T1= fat (bright)

T2 = H20 (CSF bright)

GAdolinium on T1 makes cord bright

CAT scan (reformatting)

Hard tissue, hounsfield units, lung, bleeding

SPECT

CT with better resolution to inspect the bone

Bone scan (Scintigraphy)

Metabolic activity, technetium-99 (TC99)

Myelography

contrast dye, space and spine

Angiography

brain and vessels

Doppler ultrasound

belly and vessels

Dynamic xray

motion, stress studies

Fluoroscopy

Radiograph in motion (TMJ)

DEXA (absorptiometry)

bone density

IVP

kidney stones

syringomyelia

MRI

arnold chiari skin malformation

CT

MS neurological lesions

MRI

Subdural hemorrhage

CT

ADI

X-ray

Joint healing

MRI

Bone mets

bone scan (scintigraphy)

Severe tearing abdominal pain

CT

Kidney stones

IVP

DVT

ultrasound

Pneumothorax

X-ray

Asymmetrical facets

tropism

Wasp waist

blocked vertebra

multiple blocked vertebra

klippel feil

molding

os odontoideum

champaign pelvis

achondroplasia

shallow acetabulum

congential hip dysplasia

herniated nucleus pulposus

schmorl’s nodes