What does CATBITES stand for?
-Categories of bone disease Congenital Arthritis Trauma Blood Infection Tumor Endocrine, Nutritional, Metabolic Soft Tissue
What are some clinical data to consider during your preliminary analysis of a film?
Age Sex Race History Symmetry of lesions Systems Involved
An osteolytic lesion will appear more __ on the film
black
What are the 3 types of Osteolytic lesions?
Geographic
Moth-eaten
Permeative
A Geographic lesion has ___ borders and is the ___ aggressive. It is ___ growing and >__mm in diameter
sharp
least
slow
5
Geographic lesions have a __ zone of transition
narrow
T/F Geographic lesions are benign
T
Moth-eaten lesions have ___ borders and may be ___. These are from __-__mm in diameter
jagged
malignant
2-5
Permeaive (pinhole) lesions have a __ zone of transition and implies aggressive ___. These lesions are <__mm in diameter.
wide
malignancy
1
Motheaten lesions predispose patients to a high risk of pathological ___
fracture
Osteoblastic lesion AKA
Osteogenic
Osteoblastic lesions appear ___ on film
white
2 pathologies that may cause an osteoblastic lesion
Paget’s
Osteosarcoma
Mixed lesions are __ and __, and are fairly uncommon
blastic
lucent
What are 7 things to consider when analyzing a lesion?
Skeletal Location Metaphysis Site of origin Shape Size Length Margination
A sharp or short zone of transition means that the lesion is ___
benign
Poorly-defined or long zone of transition means __ or __
infection
malignancy
Sclerotic margin is typical of ___
infection
A destroyed cortex indicates __ or ___ ___
infection
malignant tumor
e lesion with an expanded cortex may be __ or __
benign
malignant
5 categories of the matrix of a lesion
Fat Cartilage Osseous Hematogenous Fibrous
What are the 3 types of Cartilage appearances in the matrix of a lesion?
Stippled
Flocculent (cloud-like)
Arc/Ring
The periosteum is the __ covering the bone and shares __ supply with the bone
membrane
blood
What 4 things may stimulate the psriosteal response?
Inflammation Break tear stretching .... of the periosteum
With slow-growing processes, there is an ___ pattern of the periosteal new bone along the __ of affected bone.
uninterrupted
cortex
AKA for slow growing processes
Solid Periosteal reaction
With rapidly-growing processes, the perisoteum cannot produce new bone as fast as the lesion is growing. What appearances of lesion are associated with rapid growing processes?
Lamellated
Spiculated
If a lesion grows unevenly, (stops and stops) the periosteum may lay down a thin shell of calcified new bone, leading to a ___ appearance that creates ___.
lamellated/ Onion Skin/ Laminated
If a lesion grows fast and evenly, Periosteum will not have enough time to lay down even a thin shell of bone. __ fibers become stretched out ___ to the bone and ossified fibers produced a ___ pattern periosteal reaction. This is the ___ aggressive of the 3 (solid, onion, sunburst)
Sharpey’s
perpendicular
Sunburst/ Spiculated
Most
Codman’s triangle appears on a process growing too fast for the periosteum to respond with even thin shells of new bone. Only the __ of the __ periosteum will ossify. It forms a small ___ with the surface of the bone, but not a complete triangle.
edges
raised
triangle
What are 3 causes of solid periosteal reaction?
Infecton
Benign neoplasm
Osteoid Osteoma
What are some possible causes of aggressive periosteal reactions?
Osteomyelitis
Malignant Neoplasm
Lymphoma
Leukemia
What is used to quantitatively evaluate bone density?
Dexa Scan
How many bones are in the body?
How many are Appendicular?
Axial?
206
126
80
4 Functions of bone
Support mechanical loads
Protect vital organs
Contributes to mineral homeostasis
Serves as a site for hematopoiesis
First bone (and last) to ossify?
Clavicle
From which germ layer is bone formed?
Mesodermal tissue (Mesenchymal cells)
Long bone begins as __ cartilage in fetus
hyaline
Primary center ossification
Diaphysis
Secondary center of ossification
Epiphysis
Intramembranous ossification is the __ stage of the ossification process. In this process, embryonic __ transforms into bone. This increases the __ of the bone
first
CT
diameter
Endochondral ossification is the __ stage of ossification process. Primary endochondral ossification is when ___ tissue from ___ cells transforms into bones. This __ the bone.
2nd
cartilaginous
mesenchymal
lengthens
Seocondary endochondral ossification occurs within the __ and __. Associated with which bones?
Epiphysis Apophyses Tubular bones Vertebrae Ethmoids Inf. Conchae
Zone of proliferation is the most ___ zone
active
ZOne of hypertrophy is where ___ fractures may occur
salter-harris
Bone is __% mineral and __% collagen
70
30
Compact bone makes up __% of total bone
80
Flat Flat bones have an inner and outer layer of ___ tissue and there is __ between the 2 layers of cancellous bone
dense bony tissue
red marrow
Bone marrow lies in spaces between the ___ of the __ bone
trabeculae
cancellous
Calcium to phosphorus ratio
2:1
What is the main calcium-phosphorus complex?
Crystalline Hydroxyapatite
Ca10(PO4)6(OH)2
Phosphorus levels are __ related to calcium. Phosphorus allows __ of calcium at the bone crystal surface
inversely
Precipitation
Gigantism is increased somatropin ___ physeal closure
before
Acromegaly is increased somatropin ___ physeal closure
after
Parathyroid Hormone is an important regulator of skeletal ___. What are it’s 2 main functions?
Metabolism
- Stimulate and control rate of bone remodeling
- Influence mechanisms governing control of the plasma level of calcium
PTH direct effect is in the __ and it stimulates __ absorption from __ fluid
Kidney
Ca++
Glomerular
PTH indirect effect is in the ___ and it promotes osteoclastic ___.
bone
resorption
Vitamin D regulates intestinal __ absorption. Also maintains ___ growth and mineralization
mineral
skeletal
What produces estrogen?
Ovarian Follicle
Estrogen ___ bone production by inducing ___ anabolic activity
stimulates
protein
Androgen is produced in ___ and ___
testicles
adrenal cortex
Growth Hormone comes from ___ cells of ___ ___
acidophilic
anterior pituitary
Growth hormone controls ___ proliferation and __ at the growth plate
chondrocyte
proliferation
What is the most common glucocorticoid to affect bone?
hydrocortisone
Glucocorticoids induce protein ___ and ___ excretion , therefore encourages ___
catabolism
phosphorus
osteoclasts
A person with acromegalywill have an enlarged __ __ after growth plate closes
sella turcica
Is dexa scan quantitative or qualitative?
Quantitative
What is the most metabolically active part of the long bone?
Metaphysis
What is the most active layer of the physeal plate?
Proliferative zone
Do newborns have more red or yellow marrow?
red