Bone Abnormalities

8/13/2019 Bone Abnormalities

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Radiographic Image I nterpretation " Level F ive" -Radiology

Prepared By: Dr .Rana Abd Almugeeth

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Bone AbnormalitiesMethods of examination:

1-Plain x-ray

2- Computerized tomography (CT)

3- Magnetic resonance imaging (MRI)

4-Angiography

5- Radio-isotope scanning

Signs of bone diseases are:

1- Decrease in bone density which may be focal or generalized

- Focal reduction in density is called osteolytic area.

- Generalized reduction in density is called osteopenia.

2- Increase in bone density (sclerosis) which may be focal or diffuse

3- Periosteal reaction which refers to excess bone produced by periosteum in response to

trauma, inflammation or tumor.

4- Cortical thickening.5- Alternation in trabecular pattern.

6- Alternation in the shape of bone. Lateral Calcaneum with spur

7- Alternation in bone age.Calcaneal Spur:

There is stress at the plantar(bottomof the foot) aspect of the

calcaneus(heel bone) at the

attachment of the plantar

aponeurosis. This stress is caused by

excessive running, standing, or walking, especially when the individual is unaccustomed

to the activity.


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Cervical Rib (Thoracic outlet syndrome):

A supernumerary rib articulating with a cervical vertebra, usually the seventh, but not

reaching the sternum anteriorly.

RadiographicAppearance

AP radiograph of the cervical spine:

Elongated transversal process of the

7th cervical vertebra either unilateral

or bilateral.

Coxa Vara:

Coxa vara, coxa adducta, coxa flexa,

Alteration of the angle made by the axis of the femoral neck to the axis of the femoral

shaft so that the angle is less than 135; the neck becomes more horizontal.


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OsteomyelitisDefinition:It is a suppurative inflammation of the bone and the underlying bone marrow

which mainly affects the metaphysis of long bone in children.Radiological diagnosis:1- Acute osteomyelitis

a) Early, soft tissue swelling and blurred facial planes.

b) Later on, enlarging ill-defined radiolucencies in the infected bone with periosteal new

bone formation.

2- Chronic osteomyelitis

a) A sequestrum which is a fragment of necrotic bone that is separate from the living

parent bone.

b) An involcrum which is a layer of bone that is formed around dead bone.

c) A cloaca which is an opening in the involcrum through which sequestra may bedischarged.

a) initial film reveals normal tibia

(b) A film taken 3 months later shows some destruction and extensive periosteal

reaction

(c) Late acute osteomyelitis in upper humerus showing sequestrum formation

(d) Chronic osteomyelitis in lower tibia.


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(Pott's disease). tuberculous osteomyelitis

Broadies Abscess

Rickets

Rickets is a disease caused by deficiency of Vitamin D leading to

bony deformities and hypocalcemia.

Achondroplasia:Definition

achondroplasty; osteosclerosis congenita; Parrot's disease (2); a type of chondrodystrophy

characterized by an abnormality of conversion of cartilage into bone, predominantly

affecting the epiphyses of long bones in which epiphysial growth is retarded and ceases

early, resulting in dwarfism apparent at birth, with short extremities, but normal trunk; the


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head is frequently enlarged, with flattened nose,

due to midfacial hypoplasia; autosomal dominant

inheritance.

Radiographic Appearance - Radiology:

Skeletal X-Ray

*Short bowed wide bones with expanded ends

*Increased bone density

*Characteristic cupping of metaphases

*Incomplete glenoid fossa and acetabulum.

*Wide joint spaces

Ankylosing Spondylitis:Marie-Strmpell

disease; rheumatoid spondylitis; arthritis of the

spine, resembling rheumatoid arthritis, that may

progress to bony ankylosis with lipping of

vertebral margins; the disease is more common in

the male often with the rheumatoid factor absent

and the HLA antigen present.

Radiographic Appearance

Anteroposterior Pelvis X-Ray

Usually sufficient as only X-Ray

confirmation

Reveals Bilateral and symmetric

sacroiliitis

Spine X-Ray other findings

Bony sclerosis appears as squaring of

vertebrae and Syndesmophytes between

vertebrae (Classic "Bamboo" spine (


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Arthrogryposis

DefinitionArthrogryposis translated from the Greek literally means "curved or hooked

joints." Hence, this term is used to describe multiple joint contractures present at birth.

Radiographic Appearance

shoulder -- internal rotation deformity

elbow -- extension and pronation deformity

wrist -- volar and ulnar deformity Foot deformity(clubfoot)

hand -- fingers in fixed flexion, and thumb-in-palm

deformity

hip -- flexed, abducted and externally rotated, often

dislocated

knee -- flexion deformity

foot -- clubfoot deformity

Hand Deformity

Rheumatoid arthr i t is:

It is a multisystem collagen disorder in which

synovial joints are affect with erosive changes in

the subchondral bone.

Radiological diagnosis:- Symmetric erosivechanges of the metacarpophalangeal and

proximal interphalangeal joints of both hands


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Aneurysmal Bone Cyst

The Aneurysmal Bone Cyst (ABC) is a type of bone tumor bone cyst can cause

destruction of bone and isolated symptoms at the site of the lesion. The most

common problem that a bone cyst will cause is weakening of the bone. This

may lead to increased susceptibility to fracture at that location..

Epiphyseal Dysplasia:

Dysplasia Epiphysealis Multiplex (DEM) (earlier synonyms: Fairbank's

Disease, Ribbing's disease, Epiphyseal dysostosis, Hereditary enchondral

dysostosis) presents in childhood with bilaterally symmetrical short limb

dwarfism with conspicuous absence of other systemic anomalies.

Bone Abnormalities

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