Msk -- Metabolic

Front 1

1. What are the imaging manifestations of rickets?
2. What are some causes of vitamin D deficiency?

Back 1

1. Widened physis, cupping, fraying and irregularity of the distal metaphysis, osteopenia, anterior rib splaying (rachitic rosary).
2. Nutritional vitamin D deficiency, lack of sunlight, neonatal hepatitis, anticonvulsant medications, sprue, defect in D synthesis, inherited renal tubular acidosis, familial vitamin D resistance
In young children, the distal ulna is the most sensitive bone, whereas in older children, the knee is the most sensitive.

Front 2

1. What is the role of vitamin C?
2. What are the imaging manifestations?

Back 2

1. VitamIn C is involved in collagen synthesis. Vitamin C deficiency affects wound healing, vessel integrity, and osteoid matrix formation.
2. Osteopenia, cortical thinning, periosteal new bone formation (2/2 vessel wall fragility that leads to sub periosteal hemorrhage). Additional findings include the Frankel line which is a dense zone of calcification at the edge of the metaphysis, just beneath the physis.
The Trummerfield zone is the lucent band in the metaphysis beneath the white line of Frankel.

Front 3

1. What are the imaging findings in hyperparathyroidism?
2. What are Brown tumors?
3. How does renal disease lead to low Ca?

Back 3

1. Resorption of subperiosteal bone, decreased mineralization, coarsened trabeculae, widening of growth plates, and erosive changes at the insertion of muscles.
2. Aggregates of osteoclasts, debris, and hemorrhage forming solitary expansile lucent lesions.
3. Nonfxning kidneys are unable to activate vitamin D.

Front 4

1. What is osteopetrosis?
2. What are the imaging features of osteopetrosis?
3. What are the findings in the mandible and maxilla?

Back 4

1. Diffuse osteosclerosis secondary to dysfunctional osteoclasts lacking the ability to resorb bone which leads to obliteration of the medullary cavity resulting in anemia, leukopenia, and thrombocytopenia.
2.
- Increase in bone density with loss of distinction between the cortical and the medullary bones.
- Failure of tubulation results in an "Erlenmeyer flask" deformity.
- "Bone-in-bone" appearance may be evident in the long bones and spine.
- Diffuse vertebral body sclerosis or increased density only at the end plates (sandwich vertebrae sign).
- Obliteration of the diploic space.
3. Poor dentition may lead to osteomyelitis of the maxilla and mandible.