Rad 1 Review Concepts

1. Differentiate cellulitis, osteomyelitis and septic arthritis.

2. Find an example for each type of dissemination of osteomyelitis: hematogenous, direct extension, direct implantation.

3. Differentiate the term suppurative from non-suppurative.

4. What are the earliest radiographic features of an infection? What is the latency period for these features to be seen?

5. As this process develops, what middle stage radiographic features become apparent?

6. Do infections cross anatomical barriers such as growth plates or joint surfaces? Why and why not?

7. During chronic osteomyelitis, the inner most layer of bone becomes necrotic as it becomes surrounded by granulation tissue. What radiographic process is associated with this process?

8. As the infection subsides, it may persist in the chronic form. Describe the basic process of reactive sclerosis, especially, is reactive sclerosis a specific finding for infection?

9. What is inside a Brodie’s abscess?

10. Differentiate a Brodie’s abscess from a subchondral cyst based on location?

11. Describe the process responsible for forming a periosteal reaction?

12. What group of arthritides looks radiographically similar to septic arthritis? What are the main differentiating factors?

13. What are the two earliest radiographic indicators of effusion associated with hip infection?

14. What advanced imaging modality best demonstrates the presence of infection when the above radiographic features are seen?

15. What are two types of disease that commonly lead to joint ankylosis?

16. What radiographic feature distinguishes infections from degenerative disc disease?

17. Do tumors and metastatic disease cross joint spaces? How is this relevant?

18. Is tuberculosis a suppurative or non-suppurative process?

19. Is it likely that someone with respiratory TB will develop skeletal involvement?

20. Can you adjust someone with respiratory TB?

21. Non-suppurative infection look like suppurative osteomyelitis but have a slower progression and associated calcific abscess. True or false.

22. Acromegaly is caused by an increase in __________.

23. What is the maximum acceptable limit for the sella turcica size?

24. What disease process may lead to enlarged frontal sinuses and protruding mandible?

25. Where can excess cortisol possibly coming from in patients with Cushing’s disease?

26. What types of patients are likely taking high levels of corticosteroids?

27. What does parathyroid hormone attempt to do to blood calcium levels?

28. Where does the body take calcium from to alter blood levels?

29. What is the pathognomonic radiographic feature of hyperparathyroidism cased by osteoclastic activity immediately beneath the periosteum in long bones?

30. How about in the spine?

31. Osteoporosis is a decrease in______________.

32. What happens to the thickness of the cortical and trabecular bone in osteoporotic patients?

33. What are the complicating issues that must be addressed if a compression fracture is found in the spine?

34. What other aggressive process can cause pathological compression fractures?

35. Osteomalacia/rickets is a deficiency in __________.

36. The lack of vitamin D manifests in what way on radiographs?

37. Rickets leads to hyperlucent physis, indistinct metaphyseal borders and is associated with pseudofractures and bowing deformities. True or false.

38. Differentiate between fractures and pseudo fractures.

39. Vitamin D is required for proper _______ metabolism and comes from ________.

40. Differentiate between osteonecrosis, bone infarct and avascular necrosis.

41. What are features of avascular necrosis in the femoral head?

42. What clinical symptoms are seen in patients with osteochondritis dissecans?

43. What are the MRI findings for avascular necrosis of the hip?

44. What are factors that increase the risk for avascular necrosis?

45. What are the main features of sickle cell anemia? Thalassemia?

46. Compare acromegaly and hemochromatosis?

47. What are risk factors for idiopathic/involutional/postmenopausal osteoporosis?

48. Define renal osteodystrophy.

Name as many differential diagnoses you can for:

· Osteopenia

· Osteosclerosis

· Regional osteopenia

· Hook osteophytes

· Periosteal reactions

· Subperiosteal resorption

· Acro-osteolysis

· Sacroilitis

· Undertubulation of bone

· Multiple compression fractures