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Tumor like diseases
Tumor like diseases
74
Anatomy
Professional
12/11/2012

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Term
Known as the great imitator of bone diseases
Definition
Fibrous Dysplasia
Term
Clinically: age 8-14; pathological fractures are most commonly the symptom; bowing deformites; cafe au lait spots
Definition
fibrous dysplasia
Term
chestnut pigmented non elevated macules
Definition
cafe au lait spots
Term
coast of main appearance is the same as
Definition
cafe au lait spots
Term
Most common type of fibrous dysplasia
Definition
monostotic
Term
Most common site of monostotic fibrous dysplasias
Definition
femur, diaphyseal
Term
Polystotic fibrous dysplasia affects
Definition
multiple bones
Term
Fibrous displasia location is
Definition
geographic
Term
Fibrous dysplasia when viewed radiographically is seen as
Definition
radiolucent, lobulated, trabeculated ground glass, smokey appearance
Term
Fibrous dysplasia viewed as very thick is known as
Definition
Rind of sclerosis
Term
Expecially in polystotic fibrous dysplasia there is
Definition
bone expansion, endosteal thinning (inside out)
Term
Fibrous dysplasia in the hip joint will have ___ deformity
Definition
shepherds hook
Term
Fibrous dysplasia in the ribs will have___ sign
Definition
extrapleural sign-expansile rib lesions
Term
Fibrous dysplasia is known as pseudo___
Definition
arthrosis
Term
In fibrous dysplasia the lesion grows with __
Definition
the bone (long lesion=long bone)
Term
"great imitator of bone disease" of unknown etiology with a higher incidence in countries of UK, Austrailia, and New Zealand
Definition
Pagets disease
Term
Countries of low incidence of paget's
Definition
asia, africa, scandinavia
Term
Clinically male 2:1 predominance, over the age 55, 90% are asymptomatic except pain associated with deformities, fractures
Definition
Paget's disease
Term
Labs with Paget's disease will shwo
Definition
increase in alkaline phosphatase
Hypercalcemia
Term
Four stages of Paget's
Definition
Osteolytic (destructive or monophasic)
Combined (mixed biphasic)
Sclerotic (ivory vertebra reabsorbtion/laying down new)
Malignant degeneration (hair on end appearance)
Term
Radiographic features of Paget's
Definition
thickened cortex
coarsened trabeculae
bone expansion
increased or decreased density
subarticular extension
long lesions
deformity
Term
What are two radiological features that causes pagets to differ from fibrous dysplasia
Definition
subarticular extension
long lesions
Term
Pagets of the skull is known as
Definition
Osteoporosis Circumscripta
Term
Appearance of bone in the skull with Pagets
Definition
cotton wool appearance
Term
Appearance of bone in the spine with Pagets
Definition
picture frame appearance
Ivory vertebra
Term
Pagets of the pelvis appearance
Definition
brim sign or rim sign (thickened)
Term
Appearance of the femur and tibia with pagets
Definition
blade of grass appearance (osteoclastic activity)
Term
Pagets of long bone(femur/tibia) lesions will have a
Definition
V lesion
Flame appearance
Term
Bowing of the leg bones with Pagets is known as
Definition
Sabre Shin
Term
Pagets may cause 6 deformites of bone
Definition
Shepherds crook deformity
Sabre shin
Protrusio acetabuli
Leontiasis Ossea
Basiler Invagination
Frontal and parietal bossing
Term
If pagets causes basiler invagination what line is going to be used to measure it
Definition
mcgregors
Term
McGregors line the tip of the odontoid should not exceed
Definition
8mm in males
10mm in females
Term
Complications of pagets may include
Definition
pathological fracture
pseudo fracture
spinal stenosis
anemia
malignant degeneration
Term
If there is suspected spinal stenosis you measure using
Definition
Eisnesteins line (<15mm is stenosis)
Term
Pagets may affect any bone including
Definition
small bones of the ear causing hearing loss
Term
Poverty of bone; demineralization
Definition
Osteopenia
Term
3 ways to visualize Osteopenia
Definition
Generalized
Regional
Localized (ex RA)
Term
Radiographic features of osteopenia
Definition
more radiolucent
pencil thin cortices
altered trabecular patterns throughout the spine
fracture deformity
Term
Altered trabecular patterns in one spinal segment only is
Definition
hemangioma
Term
2 forms of generalized osteopenia
Definition
multiple myeloma
osteoporosis
Term
4 Osteoporosis spinal manifestations
Definition
decreased bone density
trabecular changes (pseudohemangiomatous appearance)
cortical thinning
changes in vertebral shape
Term
What are the changes in vertebral shape of osteoporosis
Definition
wedge vertebra (hyperkyphotic)
vertebral plana
Term
5 things can cause a pathological compression fx
Definition
metastasis (osteolytic)
multiple myeloma
infection
osteoporosis
eosinophilic granulomas (children)
Term
Adult rickets that alters the quality of bone to make "soft bones"
Definition
Osteomalacia
Term
Causes of osteomalacia
Definition
interference with the metabolism of
calcium
phosphorus
vitamin D
Term
Radiographic features of osteomalacia
Definition
decrease in bone density
coarse trabecular pattern
Loss of cortical definition
Pseudo FX
Deformities
Term
Childhood deficiency in Vitamin D, Calcium, or phosphate
Definition
Rickets
Term
Clinical: tetany, pain, weakness, delayed maturity, deformities, and growth plate swelling
Definition
Rickets
Term
Radiological features of rickets will show a ___ metaphysis
Definition
frayed and cupped paintbrush metaphysis
Term
The cortical margin of growth plate in rickets will show
Definition
absent zone of provisional calcification
Term
Radiological features of rickets are
Definition
generalized osteopenia
coarse trabeculation
widened growth plates
decreased bony length
scoliosis
pseudo fractures
bowing deformity
Term
Patient presents with fever and cough for 3 weeks, swelling and tenderness, irritability
Definition
scurvy
Term
Hypovitaminosis C (infant fed solely on pasteurized milk), spontaneous hemorrhages, swelling, irritability, pain, lying motionless (frog legged), coastal rosary
Definition
scurvy
Term
Compared to scurvy, rickets has ___ physis
Definition
wide
Term
Compared to scurvy, rickets has ___ metaphysis
Definition
frayed
Term
Compared to rickets, scurvy has ___ cortices of metaphysic at the ___
Definition
thick white, physics
Term
"Stones, bones, abdominal moans, and psychiatric overtones"
Definition
Hyperparathyroidism
Term
"Stones, bones, abdominal moans, and psychiatric overtones" refers to
Definition
renal calculi, bone pain, peptic ulcers, pancreatitis, and CNS problems (confusion, lethargy, weakness)
Term
3 presentations of hyperparathyroidism
Definition
Primary, secondary, tertiary
Term
Primary hyperparathyroidism is due to
Definition
due to adenomas, carcinoma
Term
Secondary hyperparathyroidism is due to
Definition
renal glomerular disease
Term
Tertiary hyperparathyroidism is due to
Definition
dialysis
Term
Clinical presenatation of hyperparathyroidism
Definition
weakness, lethargy, polydipsia, polyuria, hypotonic muscles that feel weak, nephrolithiasis
Term
Labs of primary hyperthyroidism
Definition
hypercalcemia
Term
Labs of secondary hyperthyroidism
Definition
normal to low serum
Term
Labs of Primary and secondary hyperthyroidism will have
Definition
increased alkaline phosphatase
Term
Radiographic features of hyperparathyroidism
Definition
osteopenia
accentuated trabeculae
subperiosteal resorption
loss of cortical definition
brown tumors
Salt and pepper appearance
Term
Subperiosteal resorption in HPT is seen
Definition
phalanges
Term
Browns tumors in HPT is seen in
Definition
radiolucency of the hands
Term
Reabsorption of lamina dura seen in HPT is viewed as
Definition
salt and pepper appearance in the skull
Term
HPT of the spine will mimic
Definition
infection
Term
HPT of the spine is viewed as
Definition
loss of endplates, body destruction, loss of disc height
Term
HPT in the soft tissue will be viewed as
Definition
nephrocalcinosis
renal calculi
chondrocalcinosis
Term
Thick radio-opaque cortical end plates seen in HPT is known as
Definition
rugger jersey spine
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