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145 Cards in this Set
- Front
- Back
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What is the point of radiology?
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identify lesions
make diagnosis |
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ABC's viewing pattern means....
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evaluate alignment
bone opacity congruity - joint space soft tissue |
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Bone reacts in what ways
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increased production
increased resorption/lysis |
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How much bone mass must be lost before bone lose is visible
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30 - 50 %
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Orthopedic rads should have what settings
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low kVP
High mAs |
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What are the possible explanations for any finding
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Normal
projection artifact Normal variant abnormality |
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What 9 things should be described in the findings
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Name of bone involved
fracture type, class, direction location within bone displacement/angulation of distal segment overriding/distraction open/closed soft tissue changes joint involvement pathologic or not |
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a fracture at 90 degrees to long axis
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transverse fracture
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if a fracture has more than 2 pieces it is
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a comminuted fracture
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if a fracture is only through part of the bone cortex it is
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an incomplete fracture
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Incomplete frax with bending of opposite cortex is a
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green stick fracture
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demineralized bone is at risk of what type of fracture
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incomplete folding fracture
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What disease process can cause incomplete folding fractures
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hyperparathyroidism,
nutritional hyperparathyroidism |
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What are the bone characteristics of hyperparathyroidism
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thin cortex with decreased bone opacity
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Chip fractures can be mistaken for
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sesmoid bones
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Salter fractures can only occur with
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open physes
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Salter fracture type 1
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fracture through open physis
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Salter fracture type 2
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fracture almost through whole physis but goes into metaphysis
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Salter fracture type 3
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partially through physis into joint
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Salter fracture type 4
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across physis into metaphysis
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Salter Fracture type 5
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crushed physis
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Salter fracture type 6
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assymetic fracture through physis
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What salter fracture type have articular involvement
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Types 2 ? 3, and 4
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Fracture that is not through all cortices
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Incomplete fissure fracture
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How do you know if fracture is open radiographically?
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there is gas in the soft tissue
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Fracture displacement is described by
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naming the movement of the distal segment relative to the proximal segment
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carpal/tarsal displacement is described by
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using dorsal plantar/palmar
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when the proximal displacement of a fracture causes the bone column length to be shortened is called
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overriding
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Monteggia's Fracture is
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fractured proximal ulna with luxated radius - common jumping out of back of pick up truck
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Descriptors of fractures
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Transverse/oblique/spiral
Simple/comminuted Complete/incomplete Closed/open overriding/distracted |
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fracture of one joint surface to another
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slab fracture
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fracture at the attachment site of tendon/ligament
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Avulsion
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Fracture that shortens the length of a vertebra
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Compression
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Fracture with more than 2 fragments, but lines don't intersect, more than 1 cortex to cortex fracture
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Segmental
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Fracture with loss of bone, glancing or friction
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Shearing
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Primary bone healing characteristics
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Direct extension fo bone without intermediate tissue or callus
only occurs with rigid fixation - no gap |
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If a fracture disappears without callous formation it has healed by
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primary bone healing
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Secondary bone healing characteristics
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Hematoma, then fibrous callus, then bony callus
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Radiographic signs of secondary bone healing
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5 - 10 days: round margins, widened fracture
10 - 20 days: begin callus, narrowing fracture 30 + days: fracture line gradulaly disapperas, callus thickens 3 months + reestablish cortex/medullary trabeculation, remodel callus |
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When a fracture has stabilized with a callus that resulted in a non-anatomic alignment or configuration
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Malunion
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Occurs when fracture end are rounded and sclerotic
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Nonunion
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A nonunion is characterized by
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cortical bone surrounding all fractured ends - no further attempts to heal will be made
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Characteristics of hypertrophic non-union
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Fracture ends are proliferative
Ends are rounded and sclerotic |
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Atrophic Nonunion characteristics
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Fracture ends are atrophying - there is a decrease in the diameter of the bone
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Sequestrum
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Fragment with loss of blood supply, may be sterile or infected, highly opaque fragment surrounded by zone of lysis and involucrum
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Premature physeal closure can cause
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gap in joint. IE closure of distal radius can cause gap in elbow
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A false joint is called
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Pseudo-arthrosis
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Osteochondrosis Osteochondritis Dissecans characteristics
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Develops at 6 - 9 mo of age
Failure of endochondral ossification Large breed, rapidly growing dogs typical locations Often bilateral disease |
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OC/OCD results in
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epiphyseal cartilage necrosis, fissures and fragmentation
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Radiographic signs of OC
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Flattening or concave defect of articular bone surface, surrounding sclerosis
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Radiographic signs of OCD
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Adjacent mineral body (osteochondral fragment in joint)
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Elbow displasia characteristics
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Developmental conditon
results from joint incongruity results in early OA/DJD |
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Typical lesions of elbow dysplasia
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ununited anconeal process
fragmented medial coronoid process OCD of medial aspect of humeral condyle |
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The anconeal process physis should be closed by
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6 months of age
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The medial coronoid process has what purpose
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main weight bearing surface for humerus
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What view makes a fmcp visible
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dorso lateral medial caudal
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A normal medial coronoid process has the shape of a
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nose
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What lesions occur in adolescent toy and small breed dogs
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Avascular necrosis
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Avascular necrosis is caused by
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damaged blood supply to fermoral head causing bone necrosis
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The revascularization of necrotic bone in avascular necoris causes
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permanent malformation of the femoral head
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Avascular necrosis radiological changes include
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proliferative changes
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Canine panosteitis occurs in
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large breed dogs - many G Shepard and bassets
Usually 5 mo to 2 years but up to 7 years |
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Panosteitis clinical signs
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shifting limb lameness, recurrent bouts
no trauma Self limiting |
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Canine Panosteitis radiologic signs
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Circumscribed nodular areas of increased opacity in diaphyseal medullary cavity
central diaphysis |
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As panosteitis becomes chronic what changes occur
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medulla becomes more opaque
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Hypertrophic Ostodystrophy is a
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systemic disease
occurs around 4 mo of age self limiting, but sometimes sever |
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Hypertrophic osteodystrophy radiographic characteristics
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transverse radiolucent lines in meatphysis - double physis sign
irregular new bone |
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Hypertrophic osteodystrophy may also have
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soft tissue swelling too.
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Hypertrophic osteodystrophy may also have what periosteal changes
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a lifted periosteum with infection underneath
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Craniomandibular osteopathy occurs in what breeds
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Mainly terrier breeds,
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Craniomandibular Ostopathy general characteristics
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Heritable component
self-limiting 3 - 8 mo old Progression ends at maturity |
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CMO radiographic changes
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irregular osseous proliferation on mandible, TMJ, bullae, and occassionally calvarium
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Hyperparathyroidism - primary
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functiona hyperplasia, adenoma, or adenocaricinoma of parathyroid gland, or a neoplasia producing PTH like protein
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Hyperparathyroidism -Secondary
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Nutritional - diet deficient in Ca or has Ca:P imbalance
Renal: chronic renal disease |
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Radiographic signs of Hyperparathyroidism
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generalized decrease in bone opacity
Thin bone cortices Loss of lamina dura around tooth roots folding fractures spinal deformities |
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In the muzzle of HPT what happens
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Osteoclasts remove bone and it is replaced by fibrous tissue creating a thick muzzle
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With HPT the bone cortices are
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thin
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Multiple Cartilaginous Exostosis
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Benign prolferative disease of bone and cartilage
Cartialge islands grow in long bones and vertebrae cease growth at skeletal maturity |
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Multiple Cartilaginous Exostosis may cause
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space-occupying problems
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MCE occassionaly undergoes
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malignant transformation
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Hepatozoonosis
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seen on CT - proliferative changes of the scapula
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Aggressive bone lesions may indicate what diseases
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cancer and infection
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Aggressive periosteal reaction
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Amorphous
Spiculated, Sunburst |
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Non-aggressive periosteal reaction
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smooth, continuous, laminated
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Sunburst periosteal reaction
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Very aggressive with soft tissue swelling
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Spiculated periosteal reaction
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aggressive and chronic
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Palisading periosteal reaction
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aggressive from bacterial osteomyelitis and can be active hypertrophic osteopathy
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Smooth periosteal reaction
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non-aggressive
inactive |
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Aggressive Bone destruction characteristics
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Permative, moth-eaten, corical destrcution
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Non-aggressive bone destruction
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Geographic with intact cortex
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Permeative lysis is what type of bone destruction
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very aggressive
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Geographic lysis is
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either benign or aggressive and has sharp margins
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Zone of Transition
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The zone between normal and diseased bone
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Aggressive bone lesion Z of T
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long, but can be short
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Non-aggressive Z of T
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Short
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Long Z of T
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irregular
hazy expansile chronic active |
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Does non-aggressive bone lesions have cortical disruption?
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NO
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What are the 4 characteristics used to separate aggressive from non-aggressive lesions
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Periosteal reaction
Cortical disruption Zone of transition Rate of change |
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DDX for aggressive bone lesions
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neoplasia
osteomyelitis |
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If noeplasia is the DDX for an aggressive bone lesion you have to determine if
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it is a primary bone tumor
metastatic neoplasia |
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Osteomyelitis DDX
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fungal
bacterial |
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A monostotic bone lesion is more likely to be ____
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bacterial
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A polyostotic lesion is more likely to be ____
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fungal or neoplastic
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Concurrent clinical signs of osteomyelitis
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Septic- bacterial
Febrile/lymphadenopathy - fungal |
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A solitary metaphyseal aggressive bone lesion in dogs or cats should be considered to be a
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primary bone tumor until proven otherwise
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The most common primary bone tumor in dogs and cats
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Osteosarcoma
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Osteosarcoma occurs in
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any bone
common locations begins in metaphysis |
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Osteosarcoma radiographi lesions include
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mixed lytic and proliferative changes
Soft tissue swellings |
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Chondrosarcoma radiologic findings
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amorphous reaction
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Mycotic ostemyelits can look identical to
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primary bone tumor
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If a dog has mycotic osteomyelitis it may also be
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systemically ill
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Coccidiomycosis
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# 1 bone lesion causing fungus
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Bacterial osteomyelitis is usually
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secondary to surgery, surgical implant, trauma and wound
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A bacterial osteomyelitis will have
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sharply margined bone fragment rimmed by lucent halo, surrounded by sclerotic bone
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A cat radiograph can be distinguished because they have
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a clavicle
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Polyostotic leision differentials
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Metastatic neoplasia - carcinomas, osteosarcome etc
mycotic osteomyelitis |
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The usual metastatic neoplasias causing polyostotic lesions are
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bladder and mammary tumors
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Hypertrophic osteopathy
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occurs secondary to mass in the thoracic cavity
or secondary to abdominal or urinary bladder mass |
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HO will resolve after
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mass removal
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Radiographic findings of HO
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proliferation of periosteum
plaisading/spiculated appearance begins distally and proceeds proximally also has soft tissue swelling |
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Hypertrophic Osteopathy usually begins on the
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abaxial side of 2nd and 5th metacarpals
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Hepatozoonosis
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systemic infection from protozoa - hepatozoon
neutrocytosis, |
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Hepatozoonosis is a
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systemic infection from ticks - gulf coast tick
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Hepatozoonosis radiographic findings
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sysmmetric bilateral periosteal proliferation on bones
usually smooth lamellar in the femur or humerus, but irregular on the vertebrae |
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Osteoarthritis types
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Primary - djd of older animals
Secondary - Joint instability, injury, infection, OC, OCD |
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The hallmark radiographic features of OA
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Osteophyte production
joint narrowing subchondral bone sclerosis intra articular joint effusion Subchondral cyst formation |
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Osteophyte
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noe bone formed at margins of joint surface
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Enthesophyte
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New bone formed at attachment sites of tendons, ligaments, and joint capsule
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Bone sclerosis looks
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more opaque
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Chronic degenerative disease
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Osteoarthritis
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Septic arthritis
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aggressive infectious disease
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Immune mediated arthritis
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active inflammatory disease
rhumatoid arthritis - erosive lupus - non-erosive |
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Hip Dysplasia general characteristics
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occurs in large breed fast growing dogs
genetic component multiple factors developmental disorder, NOT CONGENITAL - not born with, it develops |
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Hip Joint laxity causes
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joint subluxation - instability
Joint malformation |
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Radiographic signs of Hip dysplasia
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shallow acetabulum
blunt/malformed femoral head progressive DJD |
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Mild CHD
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Joint incongruity
Poor coverage of the head by the acetabulum - 30 % coverage |
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Early signs of Cranial cruciate ligament injury
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Early - joint effusion
possible avulsion fragment from insertion site on tibial plateau |
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Chronic signs of CCL
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Osteoarthritis
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A normal stife, on radiographs, has what features
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smooth articular margins, and uniform subchondral bone
small area of synovium and large normal infrapatellar fat pad and caudal edge of joint capsule |
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Patellar luxation often occurs
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in small breeds
in conjunction with angular limb deformity predisposes to OA/DJD development |
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2 categories of immune mediated arthropathies
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erosive
non-erosive |
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Erosive arthropathies
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rheumatoid arthritis
feline PP form |
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Non-erosive arthropathies
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SLE
feline idiopathic |
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Most common type of joint tumor
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synovial sarcoma
in stifle and elbow soft tissue mass, may look like effusion eventual lysis of adjacent bone on both sides of joint |
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Synovial sarcomas are treated how
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cured with amputation
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