MUSCULOSKELETAL RADIOLOGY

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Author:
crapeanglr
ID:
14490
Filename:
MUSCULOSKELETAL RADIOLOGY
Updated:
2010-04-15 08:47:54
Tags:
MSK musculoskeletal radiology bone imaging orthopedic ortho
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Description:
Musculoskeletal radiology differentials and pearls for the oral boards
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  1. multiple lytic lesions in the pelvis with widening of the pubic symphysis
    brown tumors of hyperparathyroidism

    widened ps = subperiosteal bone resorption
  2. Must be mentioned in every diff dx for lytic bone lesion if patient is under 30
    • E.G.
    • Infection
  3. Must be mentioned in every differential diagnosis in a lytic lesion with a patient >40 years of age
    • Infection
    • Mets
  4. Looks like fibrous dysplasia, but in the tibia
    Adimantinoma
  5. benign sclerotic lesion in the femoral neck
    fibrous dysplasia
  6. Descriminators to tell enchodroma from chondrosarcoma
    • Chondrosarcoma has -
    • pain
    • mri soft tissue
    • mri scalloping

    • Don't ever give differential of enchondroma vs chondrosarcoma,
    • don't want to biopsy an enchondroma because it looks like chondrosarcoma
  7. multiple enchondromas only
    Ollier's disease (no risk of malig degen)
  8. Multiple enchondroma's + hemangioma's
    Mafucci's (inc. risk of malig. degen)
  9. Giant cell discriminators
    • epiphysis must be closed
    • must abut articular surface
    • eccentric
    • well defined, but nonsclerotic margin
  10. Don't touch lesions
    • Enchondroma
    • Non-ossifying fibroma
  11. patient under 30, cortically based lytic lesion, sclerotic margin, no pain
    NOF
  12. DDx: Expansile lytic bone lesion with patient under age of 30
    • ABC
    • UBC
    • Osteoblastoma
  13. Bone lesions where patients have to be under 30
    • •EOSINOPHILIC GRANULOMA
    • •ABC
    • •NON-OSSIFYING FIBROMA
    • •CHONDROBLASTOMA
    • •SOLITARY BONE CYST
  14. Bone lesions with no pain or periostitis
    • •+/-FIBROUS DYSPLASIA
    • •ENCHONDROMA
    • •NON-OSSIFYING FIBROMA
    • •SOLITARY BONE CYST
  15. Epiphyseal lesions
    • •CHONDROBLASTOMA
    • •INFECTION
    • •GIANT CELL TUMOR
    • •GEODE (SUBCHONDRAL CYST)
  16. Multiple lytic lesions
    "FEE HIM"

    • FIBROUS DYSPLASIA
    • ENCHONDROMA
    • EOSINOPHILIC GRANULOMA
    • HYPERPARATHYROIDISM
    • INFECTION
    • METS & MYELOMA
  17. Partial articular surface tear of the supraspinatus near its humeral head insertion
    • rim rent tear
    • occurs in the "critical zone"
  18. DDx: Cortical holes "pseudopermeative appearance"
    • –Aggressive osteoporosis
    • –Hemangioma
    • –Radiation changes

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