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Bone diseases
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Radiology
ID
Pediatric
100
This condition is characterized by decrease in bone mass which leads to compression fractures of the vertebrates (kyphosis) and shortened statures. Radiographically by diffuse radiolucency of bone. Commonly associated with post-menopausal state, physical inactivity, hyperthyroidism and calcium deficiency. Labs reveal normal serum calcium, normal phosphate, and normal serum alkaline phosphatase. What condition?
Osteoporosis
100
What is forefoot varus and forefoot supinatus? What is the difference?
Forefoot varus - a fixed forefoot varus deformity which causes pronation/eversion of heel Forefoot supinatus - flexible deformity which was caused by heel eversion/pronation like flatfoot deformity
100
Wavy, sclerotic osseous contours extending along the length of a tubular bone simulating wax flowing down the side of a lit candle is characteristic of what condition?
melorheostosis
100
What is the most common organism responsible for pyogenic osteomyelitis in the following groups? Neonates/Newborns/Infants Older children and young adults IV drug user Sickle cell anemia
Staphlyococcus Aureus (the most common) in older children and young adults Hemophilus and Group B Strep in neonates Salmonella in sickle cell anemia Pseudomonas in IV drug user
100
what is the choice of drug of oral antifungal for pediatric?
griseofulvin
200
This condition is caused by vitamin D deficiency in adults. It has defective calcification of osteoid matrix and on x-ray, it shows diffuse radiolucency. Labs shows decreased serum calcium, decreased phosphate, elevated alkaline phosphate and elevated parathyroid hormone. What condition?
Osteomalacia. Vitamin D deficiency in adults. Rickets - vitamin D deficiency in children.
200
A 29-year-old female presents to her psychiatrist with concerns that she may be "OCD." She explains that she has become extremely obsessed with making sure that her fruits and vegetables are completely sanitized by first rinsing with water for exactly 60 seconds and then boiling for exactly 60 minutes. She refuses to eat any fruits or vegetables that did not undergo this process, which she began doing about 3 months ago. Which of the following vitamin deficiencies is she most likely to develop?
Vitamin C deficiency. Scurvy
200
Numerous, small circular islands of increased bone density that are clustered in peri-articular regions is characteristic of what condition? See Figure 5
osteopoikilosis. characterized by a pattern of numerous white densities of similar size spread throughout all the bones. multiple bony islands
200
What is the most adverse effect of linezolid long term-use?
Bone marrow suppression (thrombocytopenia)
200
Barlow's test for which condition?
The Barlow maneuver is a physical examination performed on infants to screen for developmental dysplasia of the hip.
300
A 67-year-old male presents to the emergency department after a motor vehicle collision. The patient is complaining only of left hip pain which has been ongoing for the past 6-8 months. Examination of the left hip reveals mild crepitus, appropriate range of motion, adequate distal sensation, and palpable posterior tibial and dorsalis pedis pulses. A CT scan is ordered as part of the trauma protocol for a high energy motor vehicle collision (Figure 2A). Labs demonstrate alkaline phosphatase of 876 U/L (40-120) and normal vitamin D, calcium, and PTH levels. What is this patient's most likely diagnosis?
Paget's bone disease is a metabolic disorder of abnormal bone remodeling. In Paget's, increased osteoclastic bone resorption and increased osteoblastic bone formation often leading to skull deformities and aching pelvic and joint pain. If one suspects Paget's bone disease as a diagnosis, alkaline phosphatase & calcium levels should be ordered. In this pathology they would be elevated and normal, respectively.
300
What is the deformity called on 3rd, 4th and 5th toe noted in figure 8?
Symphalangism. The middle and far phalanges of the fourth and fifth toes are often fused together
300
an inherited, autosomal dominant (delayed type) condition presenting radiographically with diffuse bone sclerosis (Figure 6). Its characteristic feature has been described as a “bone within a bone” appearance.
Osteopetrosis - marble bone disease. Shows bone within a bone. "Stone bone". Failure of osteoclastic activity.
300
What medications are contraindicated in patients with pseudomembranous colitis besides the underlying medication?
antidiarrheals - toxic megacolon. an acute toxic colitis with dilatation of the colon Narcotics
300
It is the most common skeletal dysplasia. • Major features –Mid-face hypoplasia – Rhizomelic dwarfism – Genu varum (variable) – Three- to three-month delay in motor milestones – Thoracolumbar kyphosis, often resolving with growth – Spinal stenosis. This is greatest in lumbar spine and distally but may affect entire spine, including foramen magnum, and cause severe developmental delay • Height – Final height for males is 46-56 in., and for females, 44-55 in.
achondroplasia
400
What tumor is associated with Paget's disease of bone?
Osteosarcoma. Hearing loss, cardiac failure and bone pains are commonly associated with Paget's disease of bone
400
Radiographic features include diffuse osteopenia (occasionally coarse trabeculae and a honeycomb appearance), diminished bone girth, and flared metaphyses (Figure 4). An obvious complication is fracture. This condition is also known as brittle bone disease, which is due to defect in collagen type 1 production. Blue sclera is noted in some patients.
Osteogenesis Imperfecta
400
Radiographically, linear, regular bands of increased density extend from the metaphysis to the diaphysis, running parallel to the shaft (Figure 7). What condition?
Osteopathia striata.
400
Major organism associated with cat bite?
pasturella moltocida bartonella henselae
400
Name osteochondrosis condition for each following bone: Talar body Phalanges Cuneiforms
Diaz - talar body Thiemann - phalanges Buschke - cuneiforms
500
This condition is caused by primary hyperparathyroidism. On x-ray, shows widespread osteolytic lesions and diffuse radiolucency of bone. Clinically, the patient has "salt and pepper skull". This condition manifests as "brown tumor" of the bone. The lab reveals high serum calcium, low serum phosphorus and high alkaline phosphatase. Figure 1 shows the patient's x-ray of lower extremity. What condition?
Osteitis fibrosa cystica (Von recklinghausen disease of bone). High parathyroid hormone levels stimulates osteoclasts activity and results in bone resorption and releases calcium into the bloodstream. It is a skeletal disorder resulting in a loss of bone mass, a weakening of the bones as their calcified supporting structures are replaced with fibrous tissue (peritrabecular fibrosis), and the formation of cyst-like brown tumors in and around the bone
500
What is the name of the condition for overlapping 5th toe? Treatment of choice?
Digit minimi (quinti) varus Ruiz-Mora - complete excision of proximal phalanx through plantar elliptical skin wedge
500
See Figure 3. What condition and name all radiological signs noted on the x-ray (at least 2 to get credit)
Scurvy. See image 3 Subperiosteal hemorrhage Osteoporosis Wimberger's ring White line of Frankel Pelican spur Trummerfeld zone
500
What are 2 major side effects of Tigecycline?
Nausea and vomiting
500
What are the name of osteochondroses involving tibial sesamoid and fibular sesamoid?
Tibial sesamoid - Renander's Fibular sesamoid - Treves