Ztri 4 - Dxi2 T2 Final Exam

Front 1

With DISH, what spinal structure is most commonly found calcified?

Back 1

Anterior Longitudinal Ligament

Front 2

Which is not another name for DISH?
a. Forestier's Disease
b. spondylosis hyperostotica
c. spondylitis ossificans ligamentosa
d. Japanese Disease
e. all of the above are psuedonyms for DISH

Back 2

d. Japanese Disease (OPLL)

Front 3

How many vertebral segments need to be involved to correctly diagnose DISH on an x-ray?
a. 1
b. 2
c. 4
d. 5
e. 12 or more

Back 3

c. 4

Front 4

What area of the vertebrae is most commonly affected by DISH?
a. cervicals
b. thoracics
c. lumbars
d. sacrum
e. no predilection

Back 4

b. thoracics

Front 5

True/False
DISH will commonly show reduced disc height.

Back 5

False

Front 6

True/False
DISH rarely shows a reduced disc space.

Back 6

True

Front 7

What antigen is found to be positive in 40% of patients with DISH?

Back 7

HLA-B8

Front 8

True/False
Will DISH or AS (ankylosing spondylitis) affect the vertebrae's facet joints?

Back 8

AS does - DISH doesn't -- This is how you differentiate them on films

Front 9

51 year old male with Type 2 diabetes presents with this x-ray. What's the most likely diagnosis?

Back 9

DISH (note the calcification of the ALL) for at least 4 segments, yet no loss of disc space.

Front 10

What vertebral area is most likely to show OPLL?

Back 10

Cervicals

Front 11

49 year old Japanese woman presents with this radiograph. What is the most likely dx?

Back 11

OPLL (aka Japanese Disease)

Front 12

1. Name this syndrome.
2. Name the 2 types of imaging forms this syndrome can present as on plain film.
3. Which is this one presented as?

Back 12

1. Neuropathic Arthritis (aka Charcot Joint)
2. Hypertrophic & Atrophic
3. Atrophic

Front 13

What type of neuropathic arthritis is shown here?

Back 13

Hypertrophic

Front 14

In the USA, what is the most common cause of neuropathic arthopathy?

Back 14

Diabetes Mellitus

Front 15

If neuropathic arthopathy is diagnosed in the shoulder, what is most likely to be the cause?
a. Diabetes
b. Syringomyelia
c. Multiple Sclerosis
d. Alcoholism
e. Spina bifida vera

Back 15

b. syringomyelia (also NA + syringomyelia usually means bilateral involvement!)

Front 16

What is the most common other name of neuropathic arthritis? (hint: named after the physician that first described it

Back 16

Charcot Joint

Front 17

Japanese Disease is another name for ____

Back 17

OPLL (ossification of the PLL)

Front 18

The ___ ____ is the m/c affected area in OPLL

Back 18

cervical spine

Front 19

_% of OPLL is associated with DISH

Back 19

50

Front 20

What are the lab findings for OPLL?

Back 20

They are normal...radiographic Dx is most dependable

Front 21

OPLL is best seen on a ____ radiograph?

Back 21

lateral view

Front 22

T/F Erosive osteoarthritis has a significant inflammatory component

Back 22

FALSE: does NOT have a significant inflammatory component

Front 23

Erosive osteoarthritis has a _____ distribution

Back 23

symmetrical

Front 24

Erosive osteoarthritis m/c affects midle aged ____ (sex) in their _-_ decades of life

Back 24

females; 4-5th decades of life

Front 25

What are the lab findings for erosive osteoarthritis?

Back 25

-normal or slightly increased ESR
-negative for Rf

Front 26

"Gull wing' is a characteristic response to what disease process? What does it look like?

Back 26

Erosive osteoarthritis; erosions are characteristically central in location and on the proximal portion of the joint

Front 27

29 year old male.

Bilateral or unilateral?
Symmetric or asymmetric?
Diagnosis?

Back 27

Bilateral, symmetrical

AS

Front 28

What's the named sign in the skull?
What is the opacity in the center of the lesion called?
Dx?

Back 28

Hole within a hole
Button Sequestrum
EG

Front 29

What are the 3 visible signs here?

What are the 3 Diff Dx's?

If it started in the vertebral body, what would your Dx be?

Back 29

1. Lytic, expansile, spine
2. Osteoblastoma, GCT, ABC
3. GCT

Front 30

Name this disease.

Name the 4 stages this disease goes through.

Back 30

1. Paget's
2. Lytic, Mixed, Blastic, Malignant degeneration

Front 31

What is the radiographic sign in the skull for Paget's disease, in stage 1?

Back 31

Osteoporosis circumscripta

Front 32

What is the radiographic sign in the long bones for Paget's disease in stage 1?

Back 32

Candle flame or blade of grass

Front 33

What is the radiographic sign in the vertebrae for Paget's disease in stage 2?

Back 33

Picture frame

Front 34

What is the radiographic sign in the skull for stage 2 Paget's disease?

Back 34

Cottonwool

Front 35

What is the radiographic sign in the vertebrae for stage 3 Paget's disease?

Back 35

ivory vertebrae

Front 36

Is this (bilateral/unilateral) and (symmetric/asymmetric)?

What is the name of the disease pattern?

Back 36

Psoriatic arthritis

Front 37

Name this disease.

Back 37

Rheumatoid Arthritis

Front 38

What is the name of this disease?

What is the specific name of this stage of disease?

Back 38

Pagets

Stage 1 - Ostetitis Circumscripta

Front 39

What is the diagnosis here?

What sign is evident on the right image?

Is this active or latent?

Back 39

1. Simple bone cyst

2. Fallen fragment sign

3. latent (not touching the growth plate)

Front 40

1. If this is a juvenile, what are some specific names for the affected segment?

2. What is the name of this lesion?

3. How can we differentiate this from Rickets?

Back 40

1. Vertebra plana, silver dollar vertebrae, coin-on-edge

2. Eosinophilic Granuloma

3. EG affects one segment, rickets affects multiple segments

Front 41

What is the named sign if EG is found in the mandible?

Back 41

"Floating tooth sign"

Front 42

1. What is this lesion most likely to be?

2. What is the most severe complication of this lesion?

Back 42

1. Enchondroma
2. Metastatic degeneration

Front 43

1. Describe the calcification pattern

2. What is this lesion most likely to be in this image?

Back 43

1. Stippled, flocculent pattern

2. Enchondroma

Front 44

1. What is this most likely to be?

2. What stages are possible?

Back 44

Paget's

2 or 3

Front 45

1. What bone(s) are involved in this lesion?

2. What is this lesion most likely to be?

3. What imaging modality is this (be specific)?

Back 45

1. Sacrum
2. ABC
3. T2 MRI

Front 46

1. What is this likely to be?
2. What feature is missing that eliminates Paget's Disease?

Back 46

1. Hemangioma
2. No picture frame vertebrae, no enlargement of VB

Front 47

1. What is the name for the calcification in the center of the lesion?
2. What is this most likely to be?

Back 47

1. Target Sign
2. Lipoma

Front 48

1. What is this lesion?
2. What is the space anterior to the sacrum that's important to measure with this lesion?

Back 48

1. Chordoma
2. Retrorectal or presacral space (>2 cm is concerning)

Front 49

1. Most likely diagnosis?

Back 49

Enchondroma

Front 50

Patient is a 19 year old female
1. 3 differentials?

Back 50

1. Ewing's, Osteosarcoma, osteomyelitis

Front 51

1. What segment is affected?
2. What are two names for the likely Dx?

Back 51

1. 1st MTP
2. Gout, Podagra

Front 52

1. What disease is this likely to be?
2. What stage and sign is visible?

Back 52

1. Paget's
2. Picture frame vertebrae, stage 2

Front 53

1. What is the name of the sign the arrows are pointing to?
2. What is the diagnosis?

Back 53

1. Star sign
2. Anklyosing spondylitis

Front 54

1. The middle arrow is pointing to what sign?
2. The outside arrows are pointing to what sign?
3. Diagnosis?

Back 54

1. Dagger sign
2. Trolley Track sign
3. Ankylosing spondylitis

Front 55

Most likely Diagnosis?

Back 55

OPLL

Front 56

1. What are two possible diagnoses?
2. If negative Rf is found, what is the likely dx?

Back 56

Rheumatoid Arthritis, Psoriatic arthritis

Psoriatic