RAD III Lab - Final Exam Review (video)

Paget's Disease

1. Mosaic pattern = Haphazard distribution of trabeculae

2. Pelvic brim/ rim sign = Thickening of iliopectineal line

3. Shepherd's crook

4. Lab findings = Increased Alkaline phosphatase

What is this?

Ex. Elderly man with b/l hip pain

Picture Frame VB (Paget's Disease)

1. Cortical thickening

2. Trabecular accentuation w/ bony enlargement

What is this?

Osteoporosis Circumscripta (Paget's Disease)

1. Lytic phase of Paget's Disease

2. Ovoid lesion

What is this?

Cotton-wool Skull (Paget's Disease)

1. Thickening of cortex

2. Patches of sclerosis

What is this?

Blade of Grass (Paget's Disease)

1. AKA Inverted V sign/ Candle Flame

What is this?

Ivory VB (Blastic Mets)

1. Blastic Mets

2. Hodkings = Malignant lymph node puts pressure on anterior body = anterior scalloping

3. Paget's = Not Paget's b/c no change in size/ shape + overall whitening

What is this?

Fibrous Dysplasia

1. Prox femoral neck lytic lesion

2. Rind of sclerosis = sclerotic rim

3. Ground glass appearance

What is this?

Ex. Pt is asymptomatic, lesion found incidentally

McCune Albright Syndrome (Fibrous Dysplasia)

1. Open growth plates = Young pt

2. Shepherd crook deformity

What is this?

Ex. Young female pt with Cafe Au Lait spots + Coast of Maine

Neurofibromatosis Type I

1. Dumbbell IVF + Dural ectasia

2. Neurofibromas

3. Posterior body scalloping

What is this?

Ex. Pt has Fibroma Molluscum, Cafe Au Lait spots + Coast of California, Kyphoscoliosis

Kyphoscoliosis (Neurofibromatosis)

1. Enlargment of IVF

2. Post body scalloping

3. Acute angular kyphoscoliosis

What is this?

Ex. Pt has Fibroma Molluscum, Cafe Au Lait spots + Coast of California, Kyphoscoliosis

Pseudoarthrosis of Tibia

1. Bowing of long bones

What is this?

Ex. Pt has Fibroma Molluscum, Cafe Au Lait spots + Coast of California, Kyphoscoliosis

Neurofibromatosis

1. Open growth plate

2. B/l non-ossifying fibromas

3. Soap-bubbly lesions

What is this?

Sequestrum

- Necrotic cortical or medullary bone

What is this?

Involucrum

- Cortical collar of new bone

What is this? (White arrow)

Cloaca

- Draining sinus

What is this? (Red arrow)

Acute Suppurative Osteomyelitis

1. Open growth plate = Child

2. Swelling around area

3. ill-defined margins on the medial aspect of distal radius

4. DDx = Ewing's Sarcoma

What is this?

Acute Suppurative Osteomyelitis

1. Ill-defined lucency throughout humerus

2. Multiple layers of periosteal reaction

What is this?

Septic Arthritis

1. Single joint

2. Swollen

3. Decreased uniform joint space + Subchondral bone

4. Indistinct articular cortex

5. Increased ESR + WBC count

What is this?

- Staph Aureus Infection in joint space

Infectious Discitis

1. Decreased subchondral bone on both sides of joint space

What is this?

- Infection in disc

Brodie's Abscess

1. Local form of osteomyelitis

2. Typically larger than 1cm

3. Penumbra Sign = rim of vascularized granulation tissue surrounding an intraosseous abscess cavity, Used to DDx Brodie's VS Osteoid Osteoma

What is this?

Ex. Local limb pain, relieved with aspirin

Pott's Disease (Non-suppurative Osteomyelitis)

1. Spondylitis of L1-L2

2. Cold Abscess + Snowflake Sign

What is this?

Ex. Calcification of Psoas + TB infection

Pott’s Disease (Non-suppurative Osteomyelitis)

1. Extensive gibbus deformity = Long vertebra

2. Anterior "Gouge" Defect

What is this?

Ex. TB infection at L1

Scurvy

1. Ring Epiphysis

2. Pelken Spur

3. Scorbutic Zone

4. White line of Frankel

5. Subperiosteal Hemorrage

What is this?

Ex. 8-14 mo pt with Vit C deficiency

Ricket's

1. Widened growth plate

2. Paint brush metaphysis

3. Swelling

What is this?

Ex. 6 mo-1 yo pt with Vit D Deficiency

Ricket's

1. Paint brush metaphysis

2. Rachitic Rosary

What is this?

Osteomalacia

- Adult form of Rickets

1. Decreased bone density

2. Coarsening of remaining trabeculae

3. Thinning of cortex

What is this?

Acromegaly

1. Enlarged pituitary fossa

2. Enlarged frontal sinuses

3. Thickened skull vault

4. Prognathic mandible (AKA Lantern Jaw)

What is this?

Spade-like Tufts (Acromegaly)

What is this?

Thickened Heel-pad (Acromegaly)

1. Wider than 19mm

What is this?

Salt & Pepper Skull (Hyperparathyroidism)

What is this?

B/l distal clavicular resorption (Hyperparathyroidism)

What is this?

Generalized Osteoporosis

1. Accentuation of trabeculae

2. Thin cortices

3. Subperiosteal resorption

What is this?

Rugger Jersey Spine (Hyperparathyroidism)

1. Look at VB

2. Arterial calcification

What is this?

Osteoporosis

1. Biconcave/ Fish VB

2. Decreased bone density

3. Accentuation of trabeculae

What is this?

Ex. Pt has hyperparathyroidsm

Kienbock

1. AVN of Lunate = More sclerotic

What is this?

Chandler

1. AVN of femoral head in Adult (Closed growth plate)

What is this?

Legg-Calve-Perthes

1. AVN of femoral head in Adult (Open growth plate)

2. Small femoral epiphysis

What is this?

Ex. Pt is 3-12 yo Male with (+) Trendelenburg

Snowcap sign (Legg-Calve-Perthes)

1. Short, wide femoral neck

2. Increased cortical density

3. Increased density from osteoid repair

What is this?

Kohler

1. AVN of Navicular

What is this?

Freiberg

1. AVN of metatarsal head

What is this?

Scheuermann's Disease

1. Hyperkyphosis

2. Irregular endplate

3. Wedge deformity

What is this?

Osteochondritis Dessicans

1. Ischemia to lateral aspect of medial femoral condyle

What is this?

Osgood's Schlatter's

1. Thick patellar tendon

2. Fragments

What is this?