Search Pattern

Question 1

What are the 2 errors of observation?

Answer 1

• Missing a significant finding (false negative)

- Identifying a normal variant as abnormal (false +)

Question 2

What is an error of interpretation?

Answer 2

• Failure to link radiologic findings to clinical data

Question 3

What are the ABCs of search patterns?

Answer 3

• Alignment
• Bone density
• Cartilage
• Soft tissues

Question 4

What are the 3 categories of alignment?

Answer 4

• Skeletal architecture
• Contour of bone
• Alignment of adjacent bones

Question 5

What are 4 types of skeletal architecture abnormalities?

Answer 5

• Aberrant size
• Extra (supernumerary) bones
• Absent bones
• Developmental deformities

Question 6

What are 3 contour of bone abnormalities?

Answer 6

• Interal/ external irregularities
• Smooth/ cortical outline
• Spurs

Question 7

What are 3 alignment of adjacent bone abnormalities?

Answer 7

• Fractures
• Dislocations
• Subluxations

Question 8

What does aberrant size mean?

Answer 8

A structure is either too large or too small.

Question 9

What can cause a false abberant size?

Answer 9

• Distortion caused by unequal distance from the image receptor

Question 10

What is acromegaly?

Answer 10

• Increased size of structures due to extra production of GH.

Question 11

What type of aberrant size does Paget’s disease cause?

Answer 11

• Increased trabeculae and cortical thickening

Question 12

What is a fabella?

Answer 12

Pattela like bone on posterior knee.

Question 13

What are 6 examples of supernumerary bones?

Answer 13

• Extra rays
• Extra distal phalanx
• Surgical rib
• Sesamoid bones within tendons (calcificaiton)
• Extra toes
• Extra phalanges in thumb

Question 14

How is TO related to supernumerary bones?

Answer 14

• Surgical rib compresses brachial plexus, and vasculature.

Question 15

What are two causes of absent bones?

Answer 15

• Congenital

- Post surgical

Question 16

What are 2 examples of developmental deformities affecting alignment?

Answer 16

• Scoliosis

- Genu varum

Question 17

What are 4 types of internal/ external irregularities related to alignment?

Answer 17

• Pathologic changes
• Traumatic injuries
• Developmental
• Congenital

Question 18

What do breaks in the cortical outline indicate?

Answer 18

• Fracture

Question 19

What are exostoses and spurs?

Answer 19

Spurs: osteophytes
Exotoses: calcification after a bleed

Question 20

What is a Salter-Harris injury?

Answer 20

• Fracture that disrupts joint alignment

Question 21

What are the differences between dislocations and subluxations?

Answer 21

Dislocation: No joint congruence
Subluxation: Partially congruent

Question 22

What differentiates bone from soft tissue in a radograph?

Answer 22

Bone density.

Question 23

What else does bone density help to differentiate?

Answer 23

• Cortical from trabecular bone.

Question 24

How is the texture of trabeculae described?

Answer 24

• Descriptive term that lacks precise definition:

Ex)

• fluffy
• smudged
• coarsening
• lacy

Question 25

What is sclerosis in relation to bone?

Answer 25

- Localized increase in bone density

Question 26

What are 2 examples of excessive sclerosis?

Answer 26

- Normal fracture healing callus | - Abnormal calcification (OA)

Question 27

What is reactive sclerosis?

Answer 27

- Body acts to surround and encapsulate an infection or tumor

Question 28

What is the term for reactive sclerosis due to an infection?

Answer 28

Osteomyelitis.

Question 29

What is a bony tumor called?

Answer 29

Osteosarcoma.

Question 30

What is a sign that bone is growing too fast?

Answer 30

- The bone does not have a cortex.

Question 31

What explains normal sclerotic processes?

Answer 31

Wolff's law.

Question 32

What are 3 elements of cartilage space?

Answer 32

- Joint space width - Subchondral bone - Epiphyseal plates

Question 33

What is meant by the width of the joint space?

Answer 33

Width of the cartilage

Question 34

When might there be an actual joint space?

Answer 34

During traction.

Question 35

Which compartment of the knee has thicker cartilage?

Answer 35

The medial compartment.

Question 36

What are 3 effects of increased sclerosis in subchondral bone?

Answer 36

- Loss of cartilage; linked with increased force through the joint (cause of, or caused by) - Wears out bone - Bony loss wears on cartilage

Question 37

What are bony cysts?

Answer 37

- Erosion of bone - Due to inflammatory arthritices - Areas of round bony loss

Question 38

What 3 characteristics of epiphyseal plates are evaluated in plain film?

Answer 38

- Position of primary and secondary growth centers - Width of the plate - Smoothness of the borders

Question 39

What is difficult to evaluate in epiphyseal plates?

Answer 39

Fractures.

Question 40

What alterations need to be made to evaluate soft tissue in plain film?

Answer 40

- Density | - Contrast

Question 41

What are 6 soft tissue structures that may be examined on plain film?

Answer 41

- Muscles - Fast pads/ fat lines - Joint capsules - Periosteum - Gas - Calcifications in soft tissue (myositis ossificans)

Question 42

What causes myositis ossificans?

Answer 42

Bone formed in soft tissue due to deep bleeds/ bruises/ tears.

Question 43

When may soft tissues become visible in plain film?

Answer 43

- When distended by intra-articular swelling

Question 44

What are 4 types of periosteal changes that can be seen on plain film?

Answer 44

- Solid (due to fracture healing) - Laminated (onion formation) due to repetitive injury - Spiculated (malignant lesion) - Codman's Triangle (aggressive bone tumor)

Question 45

What is codman's triangle?

Answer 45

- Bony tumor

Question 46

What are 7 categories of skeletal pathology?

Answer 46

- Congenital - Inflammatory - Metabolic - Neoplastic - Traumatic - Vascular - Other

Question 47

What is an example of congenital skeletal pathology?

Answer 47

- Polydactylli (extra fingers) - Club - Coxa valga

Question 48

WHat is an example of inflammatory skeletal pathology?

Answer 48

- RA | - Gout

Question 49

What is an example of metabolic skeletal pathology?

Answer 49

- Osteoporosis

Question 50

What is an example of neoplastic skeletal pathology?

Answer 50

- Osteosarcomas | - Osteophytes

Question 51

What is an example of traumatic skeletal pathology?

Answer 51

- Bone fracture

Question 52

What is an example of vascular skeletal pathology?

Answer 52

- Avascular necrosis (femoral head, scaphoid)

Question 53

What are 11 variables that help diagnosis a skeletal lesion?

Answer 53

- Behavior (building, destroying) - Bone or joint involved - Locus within a bone - Age, gender, and race of a patient - Margin of the lesion (defined = better = slow growing) - Shape of lesion - Joint space crossed? (tumors don't cross. Infections do) - Bony reaction - Matrix production (some tumors produce intracellular matrix) - Soft tissue changes - History of trauma or surgery

Question 54

What can a margin of a bony lesion tell us?

Answer 54

If it is well defined, the lesion is slow growing.

Question 55

Why might matrix production indicate the type of skeletal lesion?

Answer 55

Tumors can produce matrix.

Question 56

What non bony changes can diagnose a skeletal lesion?

Answer 56

Soft tissue.

Question 57

If a lesion crosses a joint space, is it a tumor or an infection?

Answer 57

An infection.

Question 58

What census type data can help define a skeletal lesion?

Answer 58

Age, gender, and race.

Question 59

What is meant by a skeletal lesion's behavior?

Answer 59

- Building. | - Destroying

Question 60

What features of the bone its self can help diagnose a skeletal lesion?

Answer 60

- The bone's reaction to the lesion - The location, and joint's involved - Where is lesion is focused/ spread through the bone (locus)

Question 61

What can help diagnose a skeletal lesion during the patient interview?

Answer 61

- History of fractures | - Recent surgeries