Clinical Indications for Lower Limb Imaging (Chapter 6)
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1
Arthrography images large diarthrodial joints, such as the knee, by injecting a ______ into the joint capsule.
contrast medium
2
What 3 things does computed tomography (CT) evaluate in the lower limb?
Soft tissue involvement; Extent of fractures; Bone mineralization
3
The ______ is the portion of the lower limb most often evaluated with magnetic resonance imaging (MRI).
knee
4
What does magnetic resonance imaging (MRI) detect that makes it invaluable for the knee?
Ligament damage and meniscal tears
5
Bone densitometry evaluates bone loss in ______ patients or those with a lytic (bone-destroying) disease.
geriatric
6
Nuclear medicine uses radioisotopes injected into the bloodstream and is particularly useful for showing osteomyelitis and ______ bone lesions.
metastatic
7
A bone cyst is a benign, neoplastic bone lesion filled with ______ that most often occurs near the knee in children and adolescents.
clear fluid
8
What is the radiographic appearance of a bone cyst?
A lucent area with a thin cortex and sharp boundaries
9
Chondromalacia patellae, a softening of the cartilage under the patella, is commonly known as ______.
runner's knee
10
Chondrosarcomas are malignant tumors of ______ that usually occur in the pelvis and long bones of men older than 45.
cartilage
11
What is the difference between an enchondroma and a chondrosarcoma?
An enchondroma is a slow-growing benign cartilaginous tumor of small bones of the hands and feet, whereas a chondrosarcoma is a malignant cartilage tumor of the pelvis and long bones of men older than 45.
12
An enchondroma often leads to a ______ fracture with only minimal trauma.
pathologic
13
Ewing sarcoma is a primary malignant bone tumor that arises from bone ______ in children and young adults.
marrow
14
Layers of new bone formation in Ewing sarcoma give an ______ look on radiographs.
onion peel
15
True or False: Ewing sarcoma generally occurs in the diaphysis of long bones.
True
16
An exostosis (osteochondroma) grows parallel to the bone and ______ the adjacent joint.
away from
17
Gout is a form of arthritis in which ______ acid is deposited in the joints.
uric
18
Common initial gout attacks occur in the first ______ joint of the foot.
metatarsophalangeal (MTP)
19
A ______ is accumulated fluid in the joint cavity that signals an underlying condition such as fracture or dislocation.
joint effusion
20
What does the Lisfranc ligament span?
The articulation of the medial cuneiform and the first and second metatarsal bases
21
Why is the Lisfranc region prone to stress injury?
No transverse ligament exists between the first and second metatarsal bases
22
A moderate sprain of the Lisfranc ligament shows an abnormal ______ between the first and second metatarsals.
separation
23
Which projections prevent a Lisfranc injury from being missed?
Weight-bearing AP and lateral foot projections
24
Multiple myeloma is the most common type of primary ______ bone tumor.
cancerous
25
True or False: Multiple myeloma generally affects persons 20 to 40 years old.
False. Multiple myeloma generally affects persons 40 to 70 years old.
26
What is the radiographic appearance of multiple myeloma?
Multiple "punched-out" osteolytic lesions
27
Osgood-Schlatter disease involves inflammation of the anterior proximal tibia and is most common in boys aged ______.
10 to 15 years
28
What causes Osgood-Schlatter disease?
The large patellar tendon detaches part of the tibial tuberosity
29
Osteoarthritis is also called ______ joint disease (DJD).
degenerative
30
What 3 radiographic findings are seen in osteoarthritis?
Narrowed, irregular joint spaces; Sclerotic articular surfaces; Spurs
31
Where do osteoclastomas (giant cell tumors) typically occur?
In the long bones of young adults, in the proximal tibia or distal femur
32
Osteoclastomas appear on radiographs as large ______ separated by thin strips of bone.
"bubbles"
33
Which bone tumor shows a classic sunburst pattern on radiographs?
- Osteogenic sarcoma
- Ewing sarcoma
- Osteoclastoma
- Multiple myeloma
34
True or False: The peak age of osteogenic sarcoma is 40 years.
False. The peak age of osteogenic sarcoma is 20 years.
35
What is the difference between osteoid osteoma and osteogenic sarcoma?
Osteoid osteoma is a benign bone lesion of teenagers and young adults, whereas osteogenic sarcoma is a highly malignant primary bone tumor with gross bone destruction.
36
The pain of osteoid osteoma typically worsens at ______ and is relieved by over-the-counter medication.
night
37
Osteomalacia (rickets) is caused by a lack of calcium, phosphorus or ______ D.
vitamin
38
What bone deformity commonly results from rickets in children?
Bowing of the tibia
39
How is exposure adjusted for osteomalacia?
Decrease (-) because of loss of bone matrix
40
Which disease has a radiographic appearance described as cotton wool?
- Paget disease
- Osteomalacia
- Gout
- Reiter syndrome
41
What is the most common initial site of Paget disease?
The pelvis
42
How is exposure adjusted for Paget disease with extensive sclerotic areas?
Increase (+)
43
What 3 conditions are characteristic of Reiter syndrome?
Arthritis; Urethritis; Conjunctivitis
44
Reiter syndrome erodes bone at the Achilles tendon insertion on the ______ margin of the calcaneus.
posterosuperior
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