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1.
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What is the most common hematological condition of the skeleton?
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Osteonecrosis (Avascular Necrosis)
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2.
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What is the best type of imaging to view bone necrosis?
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MRI
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3.
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What is the term used to describe the area around the joint that is affected by Avascular Necrosis?
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Juxtaarticular Involvement
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4.
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What are the 4 mechanisms that are responsible for AVN?
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(1) Intraluminal Occlusion of vessel(2) Arterial Wall Disease(3) Extrinsic Compression on vessels(4) Disruption of vessel
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5.
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What are 4 disposing causes of AVN?
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(1) Alcoholism(2) SLE(3) Fatty Embolism(4) Scaphoid fracture
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6.
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What is an example of an Endocrine disorder/disease that may lead to AVN?
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Cushing's disease
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7.
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What is an example of a Congenital disease that may lead to AVN?
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Gaucher's Disease
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8.
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What is an example of an Inflammatory disease that may lead to AVN?
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Gout (& Pancreastitis)
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9.
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Medullary Bone Infarcts affect what area of the bone?
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Metaphysis & Diaphysis
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10.
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What are the most common areas of the bone to be affected by osteonecrosis of the Metaphysis & Diaphysis?
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Distal and proximal femur, proximal humerus and proximal tibia
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11.
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What type of imaging is ideal to view Medullary Bone Infarcts?
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MRI
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12.
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Where is the infarction most commonly seen in Medullary Bone Infarcts?
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Medullary Cavity
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13.
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Where does Epiphyseal Necrosis most commonly take place?
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Femoral Head (also in distal femur)
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14.
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What are the four pathological stages of AVN?
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(1) Avascular stage(2) Revascularization(3) Repair/Deposition(4) Deformity
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15.
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What is the earliest manifestation of AVN on plain film? What does this indicate?
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Rim Sign (indicates Subchondral fx.)
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16.
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What is the most important factor for determining residual deformation?
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Compressive forces during the Revascularization stage of AVN
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17.
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Sclerosis is most commonly found during what stage of AVN?
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Revascularization stage
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18.
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The separation of cortex from cancellous bone is the definition of what radiographic sign?
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Rim sign
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19.
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What is the most common area to view Subchondral cysts in the bone?
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Femoral capital epiphysis
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20.
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Spontaneous Osteonecrosis is most common at what location?
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Femoral head (hip)
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21.
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Spontaneous AVN of an adult's femoral head is indicative of what disease?
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Chandler's Disease
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22.
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What age range is most susceptible to develop Chandler's Disease?
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30-70 yrs old
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23.
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True/False:Females are 4 times more commonly affected by Chandler's disease than men.
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False; men 4x's more than women
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24.
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What area of the femoral head is typically necrotic with Chandler's Disease?
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Central Apex (anterior superior weight bearing region)
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25.
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What radiographic sign is observed with Chandler's Disease that indicates femoral head necrosis?
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Bite sign
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26.
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What radiographic sign is observed with Chandler's Disease that indicates sclerosis?
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"Snow cap" sign
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27.
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What radiographic sign indicates a Subchondral fx. associated with Chandler's Disease?
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Rim sign or Crescent sign
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28.
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What radiographic observation is present which indicates a Cortical collapse associated with Chandler's Disease?
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Step Defect
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29.
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What demographic is most susceptible to Spontaneous Osteonecrosis of the Knee (SONK)?
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Females over 60yrs old
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30.
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What area of the knee is the most common site for SONK?
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Inferior aspect of the medial condyle
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31.
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True/False:SONK almost always occurs on the side of the knee that is CONCAVE.
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False; CONVEX
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32.
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What is the most common symptom associated with SONK?
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Progressive knee pain/sudden onset of medial knee pain
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33.
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True/False:Radiographic manifestations of SONK may be seen in the acute phase of the condition?
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False; 5 weeks to months into the course of the condition
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34.
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AVN of the humeral head is indicative of what disease?
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HASS disease
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35.
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Which artery is occluded with HASS disease?
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Arcuate artery
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36.
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What demographic is most likely to develop Osgood-Schlatters Disease
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11-15 yr old males
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37.
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What are 3 soft tissue changes that can be seen radiographically that are associated with Osgood-Schlatters Disease?
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(1) Displacement of overlying skin line(2) Thickening of patellar tendon(3) Blurring of infrapatellar fat (Hoffa's fat)
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38.
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What are the AKA's for Scheurman's disease (4)?
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(1) Vertebral Epiphysis(2) Juvenile Kyphosis(3) Juvenile Chondrosis(4) Osteochondrosis Juvenile Dorsi
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39.
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Scheurman's disease is caused by the traumatic disruption of what?
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Ring Epiphysis
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40.
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True/False:Osteochondrosis Juvenile Dorsi is most common in males from the age of 13-15 yrs. old
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True
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41.
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Scheurman's disease is most commonly found in what area of the spine?
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Mid-Thoracics (75%) & TL junction (25%)
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42.
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What are the 3 criteria seen on radiographs that indicate Scheurman's disease?
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(1) At least 3 occurances of anterior wedging of VB(2) Ant. endplate abnormalities (Schmorl's node)(3) IVD space thinning
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43.
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Osteochondritis Dissecans is AKA what?
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Konig's disease
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44.
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Necrotic bone fragment which becomes displaced is known as....
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Osteochondritis Dissecans
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45.
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What demographic is most likely to develop Konig's disease?
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Males age 11-20
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46.
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Which are of the knee is most likely to develop Konig's disease?
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Lateral aspect of Medial Epicondyle (L.A.M.E.)
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47.
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Which area in the ankle is most likely to develop Konig's disease?
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Medial portion of the dome of the talus
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48.
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What is the radiolucent area called seen on plain film of bone tissue affected by Konig's disease?
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"Halo"
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49.
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True/False:Sever's Phenomenon is a secondary center of ossification on the calcaneous that is not AVN.
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True
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50.
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What is the most symptomatic type of Sickle Cell Anemia?
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Homozygous Hb SS
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51.
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Spontaneous, episodic, acute abdominal pain caused by infarcts of the Mesenteric arteries is known as what?
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Sickle Cell Crisis
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52.
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"H" vertebra and "Reynolds Phenomenon" as well as "Fish" vertebra are all terms used to describe the bone changes associated with what condition?
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Sickle Cell Anemia
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53.
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Osteomyelitis may be caused by infection with what?
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Salmonella
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54.
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Tibiotalar slant deformity may result from what?
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Hyperemia
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55.
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Thalassemia syndromes are most common in what ethnic background?
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Mediterranean
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56.
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True/False:Major Thalassemia is a heterozygous condition?
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False; homozygous
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57.
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What are 2 major signs/symptoms associated with Sickle Cell Anemia?
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(1) Mongoloid facies ("Rodent" facies)(2) Maxillary overgrowth
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58.
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Marrow hyperplasia results is responsible for what radiographic sign associated with what condition?
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Major Thalassemia (Coolie's Anemia)
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59.
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True/False:Paravertebral Extramedullary Hematopoesis is a radiographic sign of Minor Thalassemia.
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False; Major Thalassemia (Coolie's Anemia)
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60.
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True/False:Erlenmeyer Flask Deformity is associated with Coolie's Anemia.
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True
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61.
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True/False:Minor Thalassemia is a heterozygous condition.
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True
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62.
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True/False:Minor Thalassemia is the most severe.
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False; it is benign
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63.
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Hemophilia A8 or Classic Hemophilia is known to be deficient in what clotting factor?
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Factor 8 (Antihemophilic factor)
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64.
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A deficiency of clotting factor 9 (Serum Protease Activating factor) is indicative of what condition?
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Hemophilia B9 or Christmas disease
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65.
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What is the most common joint to develop Hemophilia?
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Knee (any weight bearing joints)
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66.
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An aggressively growing fibrous layer of cells found in Synovium is known as....
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Pannus
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67.
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'Squaring of the patella' is indicative of what condition?
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Hemophilia
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68.
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What is the best type of imaging to observe Hemophilia? why?
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MRI/ because of the Hemosiderin deposition
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