Radiology case 328-4963

Images and description of Scheuermann's Kyphosis

sclerotic bone metastases. Notes, links and Images

scoliosis notes, links & illustrations

Definition Septic arthritis is a common destructive arthropathy that requires prompt diagnosis and treatment to avoid the significant morbidity that results from the loss of a joint. Therefore, it should be strongly considered in the differential diagnosis of monoarticular disease. Diagnosis Traditionally, the diagnosis of septic arthritis was based on clinical assessment and prompt arthrocentesis. However, the clinical picture may be obscured by multiple confounding factors and a paucity of specific findings especially for the deep joints, ie. the hip or shoulder. Imaging can be used to confirm the diagnosis of septic arthritis and more importantly, imaging findings suggestive of septic arthritis can direct the clinician to a diagnosis that may not have been considered. Radiologic Findings Plain film findings of septic arthritis include: joint effusion, soft tissue swelling, periarticular osteoporosis, loss of joint space, marginal and central erosions and bone ankylosis. CT is more sensitive than plain films for the detection of early bone destruction and effusion. The role of MRI in the diagnosis of septic arthritis has been increasing in recent years in an effort to detect this entity earlier. Findings are usually evident within 24 hours following the onset of infection and include: synovial enhancement, perisynovial edema and joint effusion. Signal abnormalities in the bone marrow can indicate a concomittant osteomyelitis. The sensitivity and specificity of MRI for the detection of septic arthritis has been reported to be 100% and 77% respectively. Diagnostic Radiology/Musculoskeletal Imaging/Joint Disorders/Septic Arthritis From Wikibooks, the open-content textbooks collection

Sever disease
osteochondrosis of the apophysis of the os calcis apopohysis becomes dense and sclerotic and undergoes fragmentation difficult to differentiate from normal finding on plain films apophysis normally varies greatly and may ossify from several centers

Showing AVN of humeral heads and vertebral changes

Radiology case 338-776

Radiology case 338-4232

spontaneous osteolysis several syndromes of "vanishing bones": (Cf: rapid demineralization) idiopathic hereditary osteolysis autosomal dominant, manifest in early childhood carpals + tarsals involved first autosomal-recessive carpal and tarsal osteolysis idiopathic osteolysis with nephropathy carpals, tarsals, adjacent tubular bones involved azotemia --> death in early adulthood massive osteolysis of Gorham angiomatous destruction

Stress ("march") Fracture, 3rd Metatarsal The only radiographic abnormality detected is subtle periosteal reaction in the diaphysis of the 3rd left metatarsal. No bone destruction is evident. No fracture is seen. Radiographic findings in a patient with clinical history of "being on his feet a lot" suggest stress fracture of the 3rd metatarsal. -------------------------------------------------------------------------------- You may wish to review some facts regarding this entity: Typical patient is one with new, increased and/or unusual stress. The result of normal bone subjected to repetitive stress. Most, but not all, stress fractures involve the lower extremity. Jumping, ballet, sports, marching, etc. common precipitating events. Common sites: calcaneus -- jumping tibia/fibula -- running patella -- hurdling pelvis, obturator ring -- gymnastics ribs -- heavy lifting, coughing vertebrae, pars interarticularis -- lifting clavicle -- post-op radical neck dissection scapula, coracoid -- trap shooting humerus. ulna -- throwing baseball, pitching hamate -- golf, baseball

A multi-organ disease (chest, bone, GI, etc.) of unknown etiology, affecting F> M. Immune? Abnormal collagen metabolism? Vascular abnormality? Clinically, Skin thickening (edema ->fibrosis) Muscle weakness Raynaud's phenomenon -- paroxysmal occlusion of digital arteries. Can be seen as isolated disease of associated with other entities including SLE, RA, dermatomyositis, mixed connective tissue disorder (MCTD). Dysphagia In the hands, Atrophy of soft tissue in finger tips Soft tissue calcification. Acro-osteolysis but DDx is extensive. Scleroderma HPTH Frostbite Leprosy Psoriasis Epidermolysis bullosa Polyvinyl chloride Multicentric reticulohistiocytosis Erosive osteoarthritis Lesch-Nyhan Syndrome Progeria In joints, Extensive involvement of 1st MCP with erosion, Ca, subluxation is characteristic. Erosions DIP, PIP must be distinguished from: RA PA Erosive osteoarthritis Elsewhere, metastatic calcification is seen, but must be differentiated from: Hypervitaminosis D Renal Osteodystrophy Milk alkali syndrome Other hypercalcemic states Dystrophic calcification

Radiology case 462-23 Clinical presentation: Swelling and discomfort in the left ankle in an adult male from India.

Radiology case 338-231