Questions and Answers
What does the acronym ABCS stand for in relation to the search pattern?
Alignment, Bone, Cartilage, Soft Tissue
What does the acronym CATBITES represent in the categorical approach to bone disease processes?
Congenital, arthritides, trauma, blood, infection, tumor, endocrine, soft tissue
What lesion is described as a well-defined, lucent, expansile lesion in the central diaphysis of the 2nd proximal phalanx with no periosteal reaction?
Enchondroma
What diagnosis is associated with a well-defined, lucent, expansile lesion in the distal metadiaphyseal of the tibia often described as a soap bubble lyric lesion?
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What diagnosis is indicated by anterior inferior shoulder dislocation from trauma with an opacity and sclerotic osseous depression on the superior portion of the humeral head?
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What diagnosis is characterized by sclerosis around the articular surface of SI joints, a decrease in joint space, and multiple jagged erosions?
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In reference to lesions, what diagnosis is indicated by a lucent line going through the mid-diaphysis of the 2nd metatarsal with a periosteal reaction?
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What periosteal reaction is most likely benign and slow, such as in a stress fracture or osteoid osteoma?
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What periosteal reaction is also known as 'onion skin' and is associated with aggressive lesions, such as Ewing's sarcoma?
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What periosteal reaction has sharpie's fibers, causes cortical disruption, and is aggressive, also called 'sunburst'?
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What diagnosis is characterized by a very aggressive lesion with lots of cortical disruption?
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What diagnosis is indicated by a well-defined, radiopaque/sclerotic appearance with a brush-border appearance on the proximal humerus?
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What diagnosis involves triangle-shaped sclerosis at the SI joints, has smooth margins, and is common with childbirth?
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What condition is characterized by decreased uniform density at the metacarpal/phalanx joint and juxta articular osteopenia?
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What lesion is described as well-defined, radiolucent, located in the mid portion of the calcaneus, with a thin sclerotic border?
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Name four findings associated with degenerative joint disease (DJD) found on x-ray.
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What is the term for posterior deviation of the sternum, which may have clinical implications such as heart problems?
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What diagnosis is characterized by increased density at C2 and C6 vertebral bodies, with ill-defined, radiopaque/blastic lesions in the hemipelvis?
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What condition is described as a pencil eraser-shaped indent affecting the endplate with a sclerotic border, commonly related to disc herniation?
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What lesion is described as being in the distal metaphysis of the tibia, eccentric, well-defined, lucent with a sclerotic border, and benign?
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What diagnosis is indicated by a solid periosteal reaction in the diaphysis of the fibula?
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What lesion is described as distal femur, ill-defined, moth-eaten, with sunburst/spiculated cortical destruction and high suspicion for soft tissue involvement?
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What diagnosis is characterized by pain and a bump on the anterior portion of the knee in children, resulting from a fragmented ossification center?
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What diagnosis involves multiple small bone islands in a well-defined supraacetabular region?
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Name three findings associated with Scheurmann's Disease.
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How can you determine if block vertebrae are congenital?
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What lesion is characterized by a geographic, radiolucent, sclerotic margin in the diaphysis?
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What diagnosis is described as congenital block vertebra, undescended scapula, or occipitalization?
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Which of the following would be descriptive of benign pathology? (Select one)
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What is a distinguishing characteristic and association regarding the difference between CT and MRI?
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Classic degenerative joint disease radiographic findings will not include which of the following? (Select one)
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Solid periosteal reaction is not typically associated with which of the following etiologies? (Select one)
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A geographic radiolucent lesion with a poorly-defined margin and no marginal osteosclerosis would have a Lodwick classification of?
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What are signs associated with rheumatoid arthritis?
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Radiographic findings include all of the following with the exception of: (Select one)
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What is the likeliest diagnosis for a patient with chronic restricted range of shoulder motion and intra-articular pathology?
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What is the best radiographic diagnosis for a patient presenting with chronic bilateral hand pain, swelling, and joint stiffness? (Select one)
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Study Notes
Search Patterns and Disease Processes
- Search Pattern (ABCS): Focus on Alignment, Bone, Cartilage, Soft Tissue.
- Categorical Approach to Bone Disease Processes (CATBITES): Includes Congenital, Arthritides, Trauma, Blood disorders, Infection, Tumor types, Endocrine issues, and Soft Tissue concerns.
Lesion Diagnoses
- Enchondroma: Well-defined, lucent, expansile lesion in central diaphysis of the 2nd proximal phalanx; common benign tumor in hands/feet.
- Aneurysmal Bone Cyst: Soap bubble-like lesion; well-defined, lucent, expansile in the distal metadiaphysis of the tibia, painful.
- Hill-Sachs Deformity: Anterior inferior shoulder dislocation leading to sclerotic osseous depression on the humeral head.
- Sacroilitis: Characterized by joint space decrease, sclerosis, and bilateral, symmetric jagged erosions around the SI joints.
- Stress Fracture: Lucent line through mid-diaphysis of the 2nd metatarsal; benign with periosteal reaction presenting as solid.
- Bone Island (Enostoses): Well-defined, radiopaque appearance on proximal humerus with a brush-border look.
Periosteal Reactions
- Solid: Slow and benign; seen in stress fractures or tumors like Osteoid Osteoma.
- Lamellated/Laminated: Aggressive "onion skin" pattern; typically associated with Ewing's sarcoma.
- Speculated: Sharpie's fibers indicating cortical disruption; aggressive, also known as "sunburst."
- Codman Triangle: Very aggressive with significant cortical disruption.
Specific Conditions
- Osteitis Condensans Ilii: Triangular-shaped sclerosis at SI joints with smooth margins, associated with childbirth.
- Rheumatoid Arthritis: Decreased uniform density at metacarpal/phalanx joints with osteopenia in adjacent carpal bones.
- Non-Ossifying Fibroma: Well-defined, eccentric, lucent lesion at the distal metaphysis of the tibia with a soap-bubbly appearance.
Key Findings in Conditions
- DJD Findings (Degenerative Joint Disease): Joint space loss, sclerosis, large osteophytes, subchondral cyst formation.
- Scheuermann's Disease: Irregular endplates, Schmorl nodes, anterior vertebral body wedging.
- Klippel-Feil Syndrome: Congenital block vertebra with undescended scapula and decreased neck ROM, occurring during the 3rd-8th week of gestation.
Radiographic Features
- Geographic lesions: Characteristically indicative of benign pathology.
- Well-defined, radiolucent lesions with sclerotic margins signify benign conditions like Fibrous Dysplasia.
- Signs of Rheumatoid Arthritis: Para-articular bony erosion, soft tissue swelling, and joint space narrowing.
Key Diagnoses
- Osgood-Schlatter's Disease: Inflammation and ossification at the anterior knee; results from repetitive stress.
- Osteosarcoma: Malignant, aggressive lesions presenting as moth-eaten, ill-defined lesions with significant cortical destruction.
- Blastic Metastasis: Increased density in specific vertebrae with aggressive characteristics indicating malignancy.
Diagnostic Considerations
- Codman Triangle: Indicates highly aggressive lesions with cortical disruption.
- The distinction between CT and MRI: CT presents cortical structures as white and involves radiation exposure.
- Articular margin erosion is not typical for degenerative joint disease findings.
Exam Review
- Recognize that solid periosteal reactions are usually benign and not associated with malignant conditions.
- Lodwick classification aids in defining geographic radiolucent lesions; poorly-defined margins suggest more aggressive behavior.
- Familiarize with best diagnoses for symptom presentations like chronic bilateral hand pain, which leans towards Rheumatoid Arthritis.
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Description
Prepare for your Skel Rad Lab midterm with these flashcards. Review critical terms and definitions focused on bone disease processes, alignment patterns, and lesion identification. Perfect for enhancing your understanding of skeletal radiology.
