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141 Cards in this Set
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Osteopetrosis (marble bones/chalk bones/osteosclerosis Congential Abnormal symmetrical increase in bone density obliteration of marrow spaces Club shaped ends of the bones in some cases ADDITIVE
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Osteopetrosis (marble bones/chalk bones/osteosclerosis Congential Abnormal symmetrical increase in bone density obliteration of marrow spaces Club shaped ends of the bones in some cases ADDITIVE |
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Osteopetrosis Definition |
Congenital Bone Dysplasia Abnormal increase in bone density associated with recurring fracutres & anemia
Additive |
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Osteopetrosis Causes |
Failure of bone resorption (leads to abnormal increase in bone density |
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Osteogenesis Imperfecta Congenital disorder of connective tissue Multiple fractures - various stages of healing Excessive Callous Formation - leads to deformity Very thin cortical bone (very fragile) Wide Skull Sutures DESTRUCTIVE
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Osteogenesis Imperfecta Congenital disorder of connective tissue Multiple fractures - various stages of healing Excessive Callous Formation - leads to deformity Very thin cortical bone (very fragile) Wide Skull Sutures DESTRUCTIVE |
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Osteogenesis Imperfecta Congenital disorder of connective tissue Multiple fractures - various stages of healing Excessive Callous Formation - leads to deformity Very thin cortical bone (very fragile) Wide Skull Sutures DESTRUCTIVE |
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Osteogenesis Imperfecta Definition |
Congenital disorder of connective tissue Extremely fragile/Thin Cortical bone Fractures extremely common with slight trauma |
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Types of Osteogenesis Imperfecta |
Congenital Osteogenesis Imperfecta -Present at birth -Fatal within weeks
Osteogenesis Imperfecta Tarda -infant appears normal at birth -Bluish sclera of eye -Recurring FX in first year of life |
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Osteogenesis Imperfecta treatment |
No Cure Avoid Injury Surgical rods if possible Medications to regulate osteoclast formation and reduce bone resorption |
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Rheumatoid Arthritis (Mid Stage) Inflammatory Disorder Inflammation of synovial membrane Destructive lesions (lucency) where cartilage has worn away with poorly defined margins Joint space narrowing symmetrically Periarticular Osteoporosis DESTRUCTIVE |
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Rheumatoid Arthritis (Late Stage) Inflammatory Inflammation of synovial membrane Osteoporosis (widespread) Joint Fusion (ankyloses) Ligaments contracting --> deforming joint Ulnar Deviation of wrist DESTRUCTIVE |
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Rheumatoid Arthritis (Late Stage) Inflammatory Inflammation of synovial membrane Osteoporosis (widespread) Joint Fusion (ankyloses) Ligaments contracting --> deforming joint Ulnar Deviation of wrist DESTRUCTIVE |
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Rhemuatoid Arthritis definition |
Chronic Systemic disease of unknown origin Begins at hands and feet - can later involve all joints
3x more common in women
DESTRUCTIVE |
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Rheumatoid Arthritis Process |
1. inflammation of synovial membrane and production of lytic enzymes 2. underlying cartilage and bone erodes 3. ligaments become lax 4. fibrous scarrying and fusion (ankyloses develops) 5. Deformity results |
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Anklyosing Spondylitis Inflammatory Patchy Sclerosis (density) Blurring of Articular margins Joint space narrowing (especially SI joints) Ankyloses Bamboo Spine Common in Males |
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Anklyosing Spondylitis Inflammatory Patchy Sclerosis (density) Blurring of Articular margins Joint space narrowing (especially SI joints) Ankyloses Bamboo Spine Common in males
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Osteoarthritis (Degenerative Joint Disease) Asymmetrical, Irregular joint space narrowing Osteophytes (BONY SPURS) Increased bone density at articular ends Cyst-like lesions (lucent) of articular cortex Sclerotic areas (Dense) of articular cortex Ossified bodies in joint capules |
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Osteoarthritis Definition |
Inflammatory Loss of joint cartilage with reactive new bone formation Part of wear and tear of aging Mostly weight bearing bones May be secondary to repeated trauma, deformity |
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Bacterial Osteomyelitis (EARLY) Inflammatory Inflammation of bone and marrow by infection (usually hematogenous spread to marrow then to medullary canal, then to cortex) Soft Tissue Swelling Bone Abscess
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Bacterial Osteomyelitis (LATE) Inflammation of bone and marrow by infection (usually hematogenous spread to marrow then to medullary canal, then to cortex) Ragged "moth eaten" appearance Bone necrosis Irregular thickening of cortex Involucrum (bony sleeve) surrounds sequestra (dead original cortical bone) |
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Bacterial Osteomyelitis (EARLY) Inflammatory Inflammation of bone and marrow by infection (usually hematogenous spread to marrow then to medullary canal, then to cortex) Softened cortical outline with irregular borders -demineralization and reactive sclerosis Narrow disk space Paravertebral Abscess |
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Bacterial Osteomyelitis (EARLY) Inflammatory Inflammation of bone and marrow by infection (usually hematogenous spread to marrow then to medullary canal, then to cortex) Softened cortical outline with irregular borders -demineralization and reactive sclerosis Narrow disk space Paravertebral Abscess |
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Bacterial Osteomyelitis |
Inflammation of bone and marrow by infection Usually hemagenous spread Bone abscess -> pus in medullary canal -> outward to cortex Common in diabetics and IV drug users |
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Bacterial Osteomyelitis tests |
Bone Scan - Best, detects within hours of onset
X-rays - take 10 days after onset |
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2 Stages of Bacterial Osteomyelitis |
Active -Destructive
Healed -Bone callus when healed, bone is thickened -Additive |
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Osteoporosis Definition |
Reduction of calcified bone mass per unit volume skeletal tissue Results in brittle bones Most common cause of T/L compression FX and inter-trochanteric FX of hip |
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Osteoporosis causes |
Accelerated bone resorption (most common)
Decreased new bone formation
Aging & Menopause
Steroid use
Disuse of casted extremity |
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Osteoporosis Test |
DEXA - Bone densitrometry (best choice) Pelvic and spine x-rays (need 50-70% bone loss 1st) |
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Osteoporosis findings |
Thin cortical bone with irregularities Picture frame appearance Anterior wedging and compression fractures Often discovered following pathological FX |
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Osteoporosis Considerations |
Very Destructive Need Short Scale image |
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Osteomalacia Metabolic Bowing of weight bearing bones Callous (hardening) from healing of pathological FX Thinning of cortical bone Loss of bone density DESTRUCTIVE |
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Osteomalacia Metabolic Bowing of weight bearing bones Callous (hardening) from healing of pathological FX Thinning of cortical bone Loss of bone density DESTRUCTIVE |
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Osteomalacia definition |
Insufficient bone mineralization in the adult skeleton (soft bones) |
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Osteomalacia causes |
Inadequate intake or absorption of calcium, phosphorous, or vitamin D
Renal diseases where calcium is lost in urine |
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Rickets Metabolic Osteomalacia but in children Defective calcification of growing bones Increased distance between epiphysis and shaft Bowing of wt bearing bones Softening of bones DESTRUCTIVE |
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Rickets Definition |
Equivalent of osteomalacia but occurs in children
Defective Calcification of growing bones |
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Rickets causes |
Vitamin D deficiency
Lack of UV light
Most common in infants 6m - 1y |
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Gout Metabolic - increase in blood levels of uric acid Deposit of uric acid crystals in joints, cartilage, kidneys "Rat Bite" lesions Large Lumpy tissue swelling (TOPHI) Joint space narrowing Bone destruction around joint DESTRUCTIVE |
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Gout Metabolic - increase in blood levels of uric acid Deposit of uric acid crystals in joints, cartilage, kidneys "Rat Bite" lesions Large Lumpy tissue swelling (TOPHI) Joint space narrowing Bone destruction around joint DESTRUCTIVE |
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Gout Description |
metabolic disorder causing increase in blood levels or uric acid --> leads to deposits of uric acid crystals in joints, cartilage, kidneys |
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Gout causes |
Primary Gout -inherited enzyme defect
Secondary Gout -Certain Cancers -Chemotherapy & Hypertension meds -Kidney Failure
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Gout Considerations |
Destructive |
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Pagets Disease (metabolic) Disruption of normal bone remodeling Weakened,thick,irregular bone
Bone scan nuke med - method of choice |
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Pagets Disease (metabolic) STAGE 1 DESTRUCTION!!!!!!! Disruption of normal bone remodeling Weakened,thick,irregular bone Excessive Bone resorption Softened and Bowing of bones Sharp lucent areas of bone Destructive
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Pagets Disease (metabolic) STAGE 1 DESTRUCTION!!!!!!! Disruption of normal bone remodeling Weakened,thick,irregular bone Excessive Bone resorption Softened and Bowing of bones Sharp lucent areas of bone Destructive |
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Pagets Disease (metabolic) STAGE 1 DESTRUCTION!!!!!!! Disruption of normal bone remodeling Weakened,thick,irregular bone Excessive Bone resorption Softened and Bowing of bones Sharp lucent areas of bone Destructive (Bone Window) |
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Pagets Disease (metabolic) STAGE 1 DESTRUCTION!!!!!!! Disruption of normal bone remodeling Weakened,thick,irregular bone Excessive Bone resorption Softened and Bowing of bones Sharp lucent areas of bone Destructive (Bone Window) |
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Pagets Disease (metabolic) STAGE 2 REPAIR!!!!! Defective bone remineralization Mottled bone Patchy "cotton-wool" appearance "Ivory" vertebrae "Picture frame" thickened cortex Increased trabeculation Additive |
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Pagets Disease (metabolic) STAGE 2 REPAIR!!!!! Defective bone remineralization Mottled bone Enlarged bone Thickened cortex Course trabecula Additive |
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Osteochrondroma (Benign Neoplasm) Benign bony projection w/ cartilage cap running parallel to long bone away from nearest joint
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Osteochondroma definition |
Congenital defect or trauma to PERICHONDRIUM) resulting in herniation of growth plate through periosteum causing it to grow rapidly
Most common skeletal neoplasm, in children + teens (especially long bones/knee)
Additive |
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Osteochondroma causes |
Congenital defect or trauma to the perichondrium resulting in herniation of growth plate through periosteum
Childhood radiation therapy |
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Enchondroma (Benign neoplasm) Cartilaginous tumor of medullary canal In hands and feet Lucent lesion speckled with CHONDROID calcification Lesion thins cortical bone -> leads to FX
DESTRUCTIVE |
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Osteoma (Benign Neoplasm) Bony Growth - in skull, sniuses, mandible Well defined round, very dense lesion less than 2cm in diamter
ADDITIVE |
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Simple Bone Cyst (Benign neoplasm) Fluid filled cyst with fibrous tissue walls in humerus or femur Lucent well defined lesion Oval, parallel to bone Cortical thinning Sclerotic rim around lesion DESTRUCTIVE |
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Osteogenic Sarcoma (Malignant neoplasm) Osteoblasts produce osteoid and spicules of calcified bone Lytic and Sclerotic lesions Sunburst pattern spicules of calcified bone radiating outwards Codemans Triangle elevated periosteium and new bone growth around lesion |
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Osteogenic Sarcoma (Malignant neoplasm) Osteoblasts produce osteoid and spicules of calcified bone Lytic and Sclerotic lesions Sunburst pattern spicules of calcified bone radiating outwards Codemans Triangle elevated periosteium and new bone growth around lesion |
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Osteogenic Sarcoma (Malignant neoplasm) Osteoblasts produce osteoid and spicules of calcified bone Lytic and Sclerotic lesions Sunburst pattern spicules of calcified bone radiating outwards Codemans Triangle elevated periosteium and new bone growth around lesion |
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Osteogenic Sarcoma |
Malignant tumor consisting of osteoblasts which produce osteoid and spicules of calcified bone
Spicules = needle-like
Osteoid = unmineralized bone |
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Multiple Myeloma (Malignant) Widespread malignancy of plasma cells within the intramedullary canal "Punched out" areas of osteolytic lesions multiple areas of lucency Bonedestruction, marrow failure, renal failure, infections CONTRAINDICATION FOR IV CONTRAST DESTRUCTIVE
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Multiple myeloma tests |
MRI - best Lateral Skull - best if doing x-rays Bone scan = normal |
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Bone Metastases (malignant) Hemogenous spread usually Increased Osteoblastic activity Bone lysis seen as lucent areas with irregular borders, may completely erode bone small illdefined sclerosis/densities "Ivory Vertebrae"
Nuke med - best |
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Bone Metastases (malignant) Hemogenous spread usually Increased Osteoblastic activity Bone lysis seen as lucent areas with irregular borders, may completely erode bone small illdefined sclerosis/densities "Ivory Vertebrae" |
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Bone Metastases (malignant) Hemogenous spread usually Increased Osteoblastic activity Bone lysis seen as lucent areas with irregular borders, may completely erode bone small illdefined sclerosis/densities "Ivory Vertebrae" |
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Bone Metastases |
Most common malignant tumors spread hematogenously Increased osteoblastic activity
Lysis and Sclerosis |
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Bone Metastases findings |
Lysis - destruction - lucent areas
Sclerosis - increased anatomical densities (bone building)
Ivory vertebrae |
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Bone Metastases considerations
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Additive - when Sclerotic
Destructive - when lytic |
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Fracture definition |
Disruption of bone by mechanical forces applied directly to bone or through shaft of bone |
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4 major classifications of FX |
Complete
Incomplete partial discontinuity or a portion of cortex intact
Closed
Open (Compound) |
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First 5 FX types |
Transverse Oblique Spiral Avulsion Comminuted |
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Second 5 FX types |
Butterfly Segmental Compression Depression Stress |
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Third 5 FX types |
Green Stick Torus Bowing Undisplaced Dislocation |
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Last 2 FX Types |
Subluxation Pathological FX |
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Depression FX |
A comminuted FX but fragments are forced in |
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Transverse FX caused by |
Direct Blow |
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Oblique FX caused by |
angled and compression forces |
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Spiral FX caused by |
Torsional forces (Twisting)
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Avulsion FX caused by |
Indirect forces applied to site of attachment
small fragment torn off bony prominence usually where ligament or tendon attaches |
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Butterfly FX |
Elongated, triangular piece of cortical bone detached from two larger segments |
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Segmental FX |
elongated triangular piece of cortical bone detached from two larger segments |
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Stress FX |
Osteoclasts resorb bone and then a callous forms around it in an attemp to strengthen the bone
caused by repeated stress on bones, like marching |
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Best Modality for stress FX |
Bone Scan |
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Green Stick FX |
Incomplete break at site of force
opposite cortex remains intact |
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Torus FX |
One side of cortex intact
Other side buckled or impacted |
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Oblique FX complete closed displaced |
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transverse complete closed displaced |
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spiral closed complete undisplaced |
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torus (side of cortex is intact, other is buckled closed incomplete |
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avulsion small piece broken off prominence closed complete indirect forces |
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Dislocation complete displacement of a bone so it is not in contact with its articular surface |
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subluxation
partial displacement of bone over its articular surface |
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subluxation
partial displacement of bone over its articular surface |
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Pathogenic FX
Also...
Osteogenic Sarcoma |
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FX Considerations |
Positioning modifications
2 views 90* apart
Both Joints |
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avulsion (indirect forces) complete closed |
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COLLES FX Transverse subluxation closed incomplete displaced |
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Navicular FX Transverse closed undisplaced Callous? due to healing |
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Navicular FX Transverse closed undisplaced
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Boxers FX (of 5th metalcarpal) Transverse Complete Closed Palmar angulation of distal fragment |
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Fat Pad Sign Effusion Posterior pad lifted from olecranon fossa Anterior more anterior to distal humerus REMEMBER TO GET SOFT TISSUE INDICATES FX IN ELBOW |
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Potts FX Medial malleolus - Complete Avulsion Lateral malleolus - Spiral Dislocation of joint complete closed |
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Potts FX Medial malleolus - Complete Avulsion Lateral malleolus - Spiral (oblique here) Dislocation of joint complete closed |
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Bimalleolar FX Oblique transverse complete spiral? displaced dislocated closed |
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Bimalleolar FX Oblique transverse complete spiral? displaced dislocated closed |
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Trimalleolar FX both malleoli and posterior lip of tibia closed, complete, displaced, avulsion |
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Trimalleolar avulsion complete transverse dislocation displacement closed |
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Trimalleolar avulsion complete transverse dislocation displacement closed |
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Jones FX Transverse FX in base of 5th metatarsal closed displaced complete? |
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Orbital "Blow Out" FX Blunt trauma to the face FX of the zygoma Bone Window Displacement closed |
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Orbital "Blow Out" FX Blunt trauma to the face FX of the zygoma Soft Tissue Window displacement closed |
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Shoulder dislocation
ANTERIOR
humeral head displaces medially |
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Shoulder dislocation
POSTERIOR
increased distance between glenoid and humeral head |
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Hip Dislocation
Posterior & Anterior
Patient's Left = Anterior (displaced inferior and medial)
Patient's Right = Posterior (displaced superior and lateral)
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Hip Dislocation
Posterior
Displaced superior and lateral |
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Hip Dislocation
Anterior
Displaced inferior and medial |
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Battered Child Syndrome definition |
Multiple, repeated injuries to child by parent or guardian |
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Battered Child Syndrome findings |
Many FX in various stages of healing Often in corners metaphysis FX in unusual sites: ribs/sternum/scapula Widened Skull sutures |
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Jefferson FX Comminuted FX of ring of atlas with fragment displacement
displacement of lateral masses of C1 unequal spaces on either side of odontoid process |
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Jefferson FX Comminuted FX of ring of atlas with fragment displacement
displacement of lateral masses of C1 unequal spaces on either side of odontoid process |
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Jefferson FX Comminuted FX of ring of atlas with fragment displacement
displacement of lateral masses of C1 unequal spaces on either side of odontoid process |
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Jefferson FX Comminuted FX of ring of atlas with fragment displacement
displacement of lateral masses of C1 unequal spaces on either side of odontoid process |
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Jefferson FX Comminuted FX of ring of atlas with fragment displacement
displacement of lateral masses of C1 unequal spaces on either side of odontoid process |
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Jefferson FX Comminuted FX of ring of atlas with fragment displacement
displacement of lateral masses of C1 unequal spaces on either side of odontoid process |
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Odontoid FX Transverse fx across dens complete |
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Odontoid FX Transverse incomplete |
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Hangmans FX Bone window FX neural arch of C2 Subluxation C2 over C3
acute hyper extension of head on neck
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Hangmans FX FX neural arch of C2 Subluxation C2 over C3 |
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Clay Shovelers FX Avulsion of spinous process Closed Complete Avulsion caused by stress indirect forces Bone Window |
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Clay Shovelers FX Avulsion of spinous process Closed Complete indirect forces caused by stress Avulsion |
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Herniated Disk Nucleus pulposis, fibrous disk Stenosis Neural Impingment Degenerative disk disease spurs MRI |
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Spondylosis disk space narrowing Facet Atrophy Bony spurs leads to anklyosing Compression FX formations
Degenerative disease of spinal column |
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Spondylosis disk space narrowing Facet Atrophy Bony spurs leads to anklyosing Compression FX formations
Degenerative disease of spinal column |
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Spondylolysis Congenital defect Cleft/Lucency in pars interarticularis NO DISPLACEMENT Oblique L-Spine for scotty dogs
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Spondylolysis Congenital defect Cleft/Lucency in pars interarticularis NO DISPLACEMENT Oblique L-Spine for scotty dogs |
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Spondylitis inflammation of vertebra Anklyosing (fusion of bone, stiffening) Bamboo spine Compression FX Decreased disk spaces |
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Spondylitis inflammation of vertebra Anklyosing (fusion of bone, stiffening) Bamboo spine Compression FX Decreased disk spaces Bone Window |
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Spondylitis inflammation of vertebra Anklyosing (fusion of bone, stiffening) Bamboo spine Compression FX Decreased disk spaces |
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Spondylolithesis anterior subluxation of vertebral body over another
forward displacement of defective vertebra common in L5, so do a spot for detail |
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Spondylolithesis anterior subluxation of vertebral body over another
forward displacement of defective vertebra common in L5, so do a spot for detail |
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Spondylolithesis anterior subluxation of vertebral body over another
forward displacement of defective vertebra common in L5, so do a spot for detail |
