DDX Bones Flashcards

femoral head
Terms Definitions
Bubbly Lesions of the BonesFEGNOMASHIC
Fibrous DyspasliaFibrous Cortical DefectEG, EndchondromaGCTNOFOsteoblastomaMets, MyelomaABC (always eccentric)Simple bone cyst (always central)Hyperparathyroidism, HemophiliaInfectionChondroblastoma
Malignant Bone Tumors by AgeUp to Age 10
EwingsOSALeukemia , lymphoma
Malignant Bone Tumors by Age10-20
OSAEwingsLymphoma, Leukemia
Malignant Bone Tumors by Age20-30
OSA LymphomaEwingsMFH
Malignant Bone Tumors by AgeOver 30
MyelomaMetsLymphomaChondrosarcomaMFH,FibrosarcomaOSA
Lytic Epiphyseal Lesions
TUMORGCTEGChondroblastomaMets (rare)INFECTIONOsteomyelitis, TBSUBCHONDRAL CYSTArthropathy (CPPD, OA, RA, hemophilia)Intraosseous ganglion
Sclerotic METS
ProstateBreastHodgkinsOther PrimariesCarcinoidMedulloblastomaBladderLung
Permeative Lesions in Children
Round CellsInfectionEG
Permeative Lesions in Adults
MetsMyelomaLymphoma, Leukemia
Boney Sequestrum(Calcified nidus in Bone Lesion)
OsteomyelitisEG (button sequestrum)Osteoid Osteoma
Malignant Transformation of Bone LesionsFibrous DysplasiaPagetsOsteomyelitis with draining sinusRadiationBone InfarctOlliers DiseaseMaffici's SyndromeHereditary Osteochondromatosis
Fibrosarcoma, OSA, MFHOSA>> chondrosarcoma, fibrosarcomaSquamous cell carcinomaOSA, Condrosarchoma, MFHChondrosarcomaChondrosarcomaChondrosarcoma
OsteonecrosisASEPTIC
AnemiasSteoidsEthanolPancreatitis, pregnancyTraumaIdiopathicCaisson disease, collagen vascular disease
Jaccouds ArthropathyUlnar and Volar Subluxation of the Metacarpals
SLERAScleroderma
Periarticular Osteopenia
RASclerodermaHempohiliaOsteomyelitis
New Bone Formation in Arthritis
Periostial New Bone Formation Psoriasis, Reiter'sOsteophytes OA, CPPD
AcroosteolysisPINCHFO
PsoriasisInjuryNeuropathy DM, LeprosyCollagen Vascular Dx scleroderma, Raynauds dxHyperparathyroidismFamilial Hadju-CheneyOther PVC, snake and scorpion venom
Periostial New Bone Formation in Arthritis
Periostial New Bone Formation Psoriasis, Reiter'sOsteophytes OA, CPPD
Calcifications and Arthropathy
Periarticular sclerodermaArticular CPPD, ChondrocalcinosisJoint Space related Neuropathic, Osteochondritis dissecans
ChondrocalcinosisHOGWASH
HyperparathyroidismOchronosis (Alkaptonuria)GoutWilsons DiseaseArthritides (any)(P)seudogot CPPDHemochromatosis
Differential diagnosis of Athritides By Distribution
DISTAL OA, Psoriasis, Reiter's SyndromePROXIMAL (MCP, Carpus) RA, CPPD, Hemochromatosis, Wilson'sULNAR STYLOID RA
Monoarticular ArthritisCHRIST
Crystal ArthropathiesHemophiliaRA (atypical)Infection (excluding Lyme's Dx and gonorrhea)Synvial PVNS, synovial osteochondromatosisTrauma
Neuropathic Joint
COMMON DM, Spinal Cord Injury, Myelomeningocele, Syringiomyelia, Alcohol AbuseUNCOMMON Syphilis (tabes dorsalis) Congenital iddiference to pain Neuropathies Amyloidosis
Phemister's Triad
(TB Arthritis)OsteoporosisMarginal ErosionsSlow Cartilage Destruction
Still's Disease
JRAhepatosplenomegalylymphadenopathy
Felty's Syndrome
RASplenomegalyneutropenia
Diffuse Osteosclerosis (Dense Bones)3Ms Proof
MetsMyelofibrosisMastocytosisSickle cell anemiaPyknodysosis, Paget'sRenal OsteodystrophyOsteoporosisOther (hypothyroidismFluorosis
CREST Syndrome
calcinosisRaynaudsesophageal dymotilitysclerodactylytelangiectasia
Atlantoaxial Subluxation
JRA, RASeronegative SpondylarthropathiesSLEDownsMoriquio'sTrauma
OSTEOPENIALOCALIZED OSTEOPENIA
Dissuse osteopenia-pain, immobiliztionArthritisSudek's Atrophy Reflex Sympathetic DystrophyPaget's Dx (lytic phase)Transient osteoporosis (hip)Regional Migratory Osteoporosis
OSTEOPENIADIFFUSE OSTEOPENIA
Primary OsteoporosisSecondary Osteoporosis Endocrine Deficiencies Nutritional Deficiencies MedicationsOsteomalaciaVit D deficiency, GI absorbtion, Renal DxHYPERPARATHYROIDISMMarrow ReplacementMalignacy (Myeloma)Marrow Hyperplasia (hemaglobinopathy)Lysosomal storage dx Gaucher's
PeriostiumAsymmetric Periostial Reaction
TumorInfection (osteo, congenital, soft tissue)Inflammation (psoriatic, reiter's, JRA)Trauma (fractures)Vascular (subperiostial hemorrhage)
PeriostiumSymmetric Periostial Reaction in Adults
Vascular Insufficiency (venous > arterial)Hypertrophic Pulmonary Osteoarthropathy (HPOA)PachydermoperiostitisFluorosisThyroid Acropachy
Hypertrophic Pulmonary Osteoarthropathy (HPOA)
Intrathoracic Tumor Bronchogenic Ca Benign fibrous tumor of the pleura Mets MesotheliomaChronic Pulmonary Infection bronchiectasis, abcessOther but more associated with clubbingIBD, Cirrhosis, Cyanotic Heart Disease
SKULLSolitary Lytic Lesion
TUMORMetsMultiple MyelomaEGEpidermoid HemangiomaInfection, inflammtionOsteomyelitisSarcoidosisMetabolicPaget's HPTTraumaleptomeningeal cyst
SKULLDiffuse skull lesions
Sickle cell anemia, thalasaemia (hair on end)HPT (salt and pepper skull)Paget's (cotton wool)Fibrous Dysplasia (outer table)Tuberous sclerosis (increased density both sides)
SKULLMultiple Lytic LesionsPOEMS
Paget's HPTOsteomyelitisEGMets, MyelomaSarcoidosis
SKULLBasilar Invagination
CONGENITAL Osteogenesis Imperfecta Klippel Feil syndrome Achondroplasia Chiari Malformation Cleidocranial dysplasiaAcquired bone softening Pagets dx HPT Osteomalacia, rickets
SpineVertebral bodiesAbnormal densityPICTURE FRAME
Paget's (cortex too prominent)Osteoporosis (center too lucent)
SpineVertebral bodiesAbnormal densityIVORY VERTEBRAL BODY
MetsPagetsLymphomaInfection
Vertebral bodiesAbnormal densitySTRIATED VERTEBRAL BODY
MyelomaHemangiomaOsteoporosisPagets
Spine Vertebral BodiesShape abnormalities
Fish VertebraSickle cell dxthalasemiaSquared vertebraASPagetspsoriasis, Reiters
Vertebral Outgrowths
SyndesmophytesASFlowing paraspinal ossificationDISHSmall osteophytesDJDLarge osteophytesPsoriasis (common)Reter's (uncommon)
SpinePosterior Spinal Fusion
Congenital Klippel Feil SyndSurgical FusionAthritides JRA AS Psoriasis Reiters
Vertebral Body lesion
MetsMyelomaLymphomaBENIGNEGGCThemangioma
Posterior Element Vertebral Lesions
Osteoid osteomaOsteoblastomaABC
Solitary Vertebral LesionsA HOG
ABCHemangiomaOseoblastomaGCT
Posterior Vertebral Scalloping
INCREASED I(NTRASPINAL PRESSURESpinal canal tumoursSyrinxCommunicationg hydrocephalusDURAL ECTASIANeurofibromatosisMarfan SyndEhlers-Danlos SyndCONGENITALAchondroplasiaMuchopolysacharidosesOsteogenis ImperfectaBONE RESORBTIONAcromegaly
Anterior Vertebral Scalloping
Aortic AneurysmLymphadenopathyTB spondylitis
Anterior Vertebral Beak
Moriquio (central beak)(all others inf. beak)HurlersAchondroplasiaCretinismDowms
Platysponyly
DIFFUSEThanotropic DwarfOsteogenesis ImperfectaSolitary or MultifocalLeukemiaEGMet/myelomaSickle cell disease
PelvisProtrusio Acetabuli
RAPagetsOsteomalacia, RicketsTraumaAS
Sacroiliitis
BILATERAL SYMMETRICASEnteropathicPsoriaticHPTBILATERAL ASYMMETRICReter'sPsoriasisUNILATERALInfectionDJDtrauma
Lytic Lesions of the Sacrum
MetsChordomaPlasmycytomaChondrosarcomaGCT
Lytic lesion of the Ilium
Fibrous DysplasiaABCUBCHemophilic TumorMALIGNANT LesionsMetsLymphomaPlasmycytomaChondrosarcomaEwings
Widened Pubic Symphyis
CONGENITALBladder ExtrophyEpispadiusCleidocranial DysplasiaBONE RESORPTION / DESRUCTIONPregnancyOsteitis PubisInfectionMetsHPT
Lower ExtremityErlenmyer Flask DeformityCHONG
Craniometaphaseal dysplasiasHemaglobinopathies Thalasemia Sickle Cell (often with AVM)OsteopetrosisNieman Pick diseaseGaucher's
Gracile BonesNIMROD
NerofibromatosisImmobilizationMuscular dystrophiesJRAOsteogenesis imperfectaDysplasia (Marfan, homocystinurea)
Femoral Head AVNASEPTIC LEG
AlcoholismSickle CellExogenous steroidsPancreatitisTrauma SCFE/ # dislocationInfectionCaisson DiseaseLegg-Calve PertheEpiphyseal dyslplasiaGaucher's
Medial Tibial Spur
OsteochondromaBlount DiseaseTurner SyndromePost traumatic lesion
Tibial Diaphyseal Cortical Lesion
AdamantinomaOssifying FibromaFibrous DysplasiaEGMets
Heal Pad ThicknessMAD COP
Criteria > 25 mmMyxedema (hypothyrodism)AcromegalyDilantinCallusObesityPeripheral edema
Lytic Lesion of the Finger
EnchondromaGlomus tumorForeign body reactionMets (lung)SarcoidInfectionErrosive Arthropathy
Radial Hypoplasia
VACTERLThrombocytopenia absent radiusHolt OramFanconi's anemia
Short 4th/5th Metacarpal
PseudohypoparathyroidismPseudopseudohypoparathyroidismChromasomal Anomalies (Turner's, Klinefelter's)
Madelung DeformityPremature Fusion of the ulnar aspect of the radial epiphysis resulting in:
Ulnar angulation of the distal radiusDecreased carpal angleDorsal subluxation of the ulnaUnilateral or bilateral
Madelung DeformityHIT DOG
Hurler SyndInfectionTraumaDyschondosteosisChromasomal XO
Missing Distal Clavicle
Erossive RAHPTpost traumatic osteolysisInfectionMets/ MyelomaAbsent Cleidocarial DysplasiaPyknodysostosis
High Riding Shoulder
RACPPDRotator Cuff Tear
Soft Tissue CacificationTIC MTV
TUMORTumoral CalcinosisSoft tissue tumorInflammation, InfectionDermatomyositisSclerodermaParasitesLeprosyCongenitalEhrlers-DanlosMyositis Ossificans ProgressivaMetabolicHPTCPPDCalcium hydroxyapetitTaumaMyositis ossificansBurnsHematomaVascularCalcification
Soft tissue Masses
TumorMFHFatty tumor lipoma, liposarcoma Vascular Tumor hemangiomaNerve Tumors Schanoma, NeurofibromaMetsBurnsHematomaMuscle Rhabdomyosarcoma, leiomyosarcomaAneurysmAbscess
Lucent bone lesions in the Medulla, Well defined, Marginal Sclerosis, No expansion
GeodeHealing benign or malignant bone lesionBrodie's AbcessBenigh Bone Neoplasms UBC, Enchondroma, ChondroblastomaFibrous dysplasia
Lucent bone lesions in the Medulla, Well defined, NO marginal Sclerosis, No expansion
MetsMyelomaEGBrowns TumorBenigh Bone Neoplasms UBC, Enchondroma
Lucent bone lesions in the Medulla-Ill Defined
MetsMyelomaOsteomyelitisLymphoma of the boneLong Bone sarcoma Osteosarcoma Ewings Central Chondrosarcoma Fibrosarcoma , MFH
Lucent bone lesions in the Medulla, Well defined, Eccentric Expansion
GCTABCEnchondromaNOFChodromyxoid Fibroma
Lucent bone lesions - Grossly ExpansileMalignant Bone Neoplasms
MetsPlasmacytomaCentral chondrosarcoma/lymphomaTelangiectasia Osteosarcoma
Lucent bone lesions - Grossly ExpansileBenign Bone Neoplasms
ABCGCTEnchondroma
Lucent bone lesions - Grossly ExpansileNon Neoplastic
Fibrous DysplasiaHemophilic TumorBrown's TumorHydatid
Pseudoarthrosis
non-union of a fractureCongenital (in the middle to lower third of the fibula and tibia)NeurofibromatosisOsteogenesis imperfectaCleidocranial dysplasiaFibrous dysplasiaAnkylosing Spondylitis
Irregular or Stippled Epiphysis
Normal (distal femur)AVNCongenital HypothyroidismMultiple Epiphyseal dysplasiaTrisomy 18 21 Prenatal infectionsWarfarin EmbyopathyZellwegers Synd (cerebrohepatorenal syn)Fetal Alcohol Syndrome
Solitary Metaphyseal Radiolucent Band
Any severe ilnessMetaphyseal #Healing RicketsLeukemia, LymphomaCongenital InfectionsScurvy
Alternating radiolucent and Dense Metaphyseal bands
Growth arrest or park's linesRickets treatedOsteopetrosisChemotherapyChronic anemia SC/thalasemiaTreated Leukemia
Solitary Dense Metaphyseal Band
Lead Poisining(dense line in the proximal femur delineates this from other poisining including biemuth, arsenic, fluorideCongenital hypothyroidismOsteopetrosisHypevitaminosis D
Dense vertical Metaphyseal Lines
Congenital Rubella (cellary stalk)Osteopathia striataHypophosphotasia
Fraying of the Metaphyses
RicketsHypophosphotasiaChronic Stress in the wrist of young gymnastsCopper deficiency
Cupping of Metaphyses
RicketsTraumaBone Dysplasias eg achondroplasiaScurvy
Erosions of the Medial Metaphyses of the Proximal Humerus
NormalLeukemiaMetastatic neuroblastomaGaucherHPTRA
Erosions of the Outer End of the Clavicle
RAHPTMyelomaMeyspost traumaticCleidocranial DysplasiaPyknodysostosis
Focal Rib Lesion
METSAdult male lung, kidney prostaeAdult female breastPrimary MalignantMyeloma/plasmacytomaChondrosarcomaEwings childAskin tumor of intercostal nerveBenignOsteochondromaEnchondromaLCHNon neoplasticHealed rib #Fibrous dysplasiaPagets DiseaseBrown's TumorOsteomyelitis
Rib Notching Inferior Surface
ARTERIALCoarctation of the aortaAortic thrombosisSubclavian Obstructionpulmonary OligemiaVENOUSSVC obstructionArteriovenousPulmonary AVMChest wall AVMNeurogenicNeurofibromatosis
Rib Notching Superir Surface
CONNECTIVE TISSUE DISEASERA, SLE, Scleroderma, SjorgenMETABOLICHPTMISCNeurofibromatosis, osteogenesis imperfecta, progeria
Wide or Thick Ribs
Chronic AnemiasFibrous DysplasiaPaget's diseaseHealed # with callusAchondroplasia
Carpal Fusion
ISOLATEDtriquetral lunate 1% of pop.Capitate hamatetrapezium trapezoidSyndrome relatedTurnerApertsHolt OramAcquiredRA and JRAPyogenic ArthritisChronic TB arthritisPost traumatic or sx
ArachnodactylyElongated and slender tubular bones of the hands and feet
Marfans SyndromeHomocystinuria
Distal Phalangeal DestructionResorbtion of the Tuft
SclerodermaRaynauds DxPsoraitic arthropathyNeuropathic Dxs (DM, Leprosy, syringiomyelia)Thermal injuriesTraumaHPT
Distal Phalangeal DestructionResorption of the Mid-Portion
PVCAcro-osteolysis of Hadju CheneyHPT
Distal Phalangeal DestructionPeriarticular(erosion at the distal interphlangeal joint)
PsoriasisErosive arthropathiesHPTThermal InjuriesScleroderma
Distal Phalangeal DestructionPoorly Defined Lytic Lesions
OsteomylitismetsMyelomaABC rareGCTLeprosy
Distal Phalangeal DestructionWell defines Lytic Lesion
Implantation dermoid or epidermoid cystEnchondromaglomus tumorosteoid osteomaFibrous dysplasia
Fluid - fluid levels in Bone Lesions on CT and MRI
BENIGNABCChondroblastomaGCTUBCMALIGNATTelangiectatic OsteosarcomaMFHAny necrotic Bone Tumor
Increased Uptake on Bone Scans
MetsJoint Dxtraumatic #sPost SX jnt replacementPadgetsSuperscan (absent renal outline)Metabolic bone disease (same as superscan)Infection (increased uptake in vascular and blood pool)
Photopenic Areas on Bone Scans
Artefacts (coins, buckles)Avascular Lesions (cysts)Myeloma (may show increased uptake)Leukemia (may show increased uptake)Radiotherapy fieldsSpina BifidaAdvanced Ca (breast possibly due to breast Ca)
Abnormal Bone Scan with Normal or Minimal Radiographic Changes
EARLY DISEASEMets, Pagets, Osteomyelitis AVN Primary HPT, Osteodystrophy (pulmonary/ renal)
ScoliosisIDIOPATHIC
Infantile ( up to age 4)>90% thoracic and concave to the right > boys resolve spontaneouslyJuvenile (4-9) > girls almost always progressiveAdolescent (after age 10)> females. Majority concave to the left.
ScoliosisCONGENITAL
NEUROPATHICtethered cord, syryngiomyelia, Chiari malformation, disteatomyelia, myelomeningoceleNEUROMUSCULAR DISEASEmyelomeningocele, muscular dystrophy, cerebral palsyMESODERMAL AND NEUROECTODERMAL DISEASESNeurofibromatosis, Marfans Synd, HomocystinuriaPOST RADIOTHERAPYLEG LENGTH DISPARITYPAINFUL SCOLIOSISOsteoid osteoma, osteoblastoma, intraspinal tumor, Infection
Erosion, Destruction or Absence of a Pedicle
Mets, MyelomaNeurofibromaTBBenign bone tumorCongenital Absence
Solitary Dense Pedicle
Osteoblastic MetOsteoid OsteomaOsteoblastomaSecondary to spondlolysisSecondary to congenitally absent or hypoplastic controlateral posterior elements
intervertebral disc Calcification
Degenerative SpodylysisAlkaptonuriaCPPDAnkylosing SpondylitisJRAHemochromatosisDISH (diffuse idiopathix skeletal hyperostosis)GoutIdiopathicFollowing Spinal Fusion
Widened Interpeduncular Distance
MyelomeningoceleIntraspinal MassDiastematomyelia
Intraspinal MassesEXTRADURAL MASSES
Proloapsed or sequestrated intervertebral discMets, myeloma, lymphoma depositsNeurofibroma and GanglioneuromaMenigiomahematomaAbscessArachnoid cyst (uncommon)
Intraspinal MassesINTRADURAL MASSES
MenigiomaNeurofibromaMetsSubdural Empyema
Intraspinal MassesINTRAMEDULLARY MASS
EpendymomaAstrocytomaDermoid (lipoma, teratoma)InfarctHematoma
Monoarthritis
TraumaOsteoarthritisCrystal induced arthritisRATBPVNS (knee most common)sympatheticneuropathic arthropathy
Non Septic Monoarthritis
Gout Synovial ChondromatosisAmyloidosisPVNSNeuropathic ShoulderMilwaukee Shoulder (Ca hydroxyapetie/ca pyrophosphate depositionRapid destructive Arthritis of the Hip
Arthritis with Osteoporosis
RAJRASLEPyogenic ArthritisReters Synd.(acute phase)SclerodermaHemophilia
Arthritis with Preservation of Bone Density
OsteoarthritisCPPDGout Psoriatic ArthritisAnkylosing SpondylitisReiter's Synd.(chronic or recurrent dx)Neuropathic ArthropathyPVNSNeuropathic A
Arthritis with a Periostial Reaction
JRAReiter'sPyogenic arthritisPsoriaticRA (in less than 5%)HPOAHemophilia
Arthritis with Preserved or Widened Joint Space
Early infective or inflammatory arthritisPsoriatic ArthropathyAcromegalyGoutPVNS
Arthritis with Soft Tissue Nodules
GOUT RAPVNSAmyloidSarcoid
Arthritis Mutilans(pencil in cup)
RAJRAPsoriaticDiabetesLeprosyNeuropathic ArthropathyReiter's (in feet)
Diffuse Terminal Phalangeal Sclerosis
Normal Variant 10%RASclerodermaSLESarcoid
Calcified Loose Body
Detached OsteophyteOsteochondral fractureNeuropathic arthropathy
Calcification of Articular (hyaline) cartilage also called Chondrocalcinosis
CPDDHPTHemochromatosisAlkaptonuriaAcromegaly GoutWilson's Dx
SacroiliitisBILATERAL SYMMETRICAL(changes initially to the lower and middle third of the joint and iliac side is more affected)
Ank SpondIBDHPTParaplegiaPsoriaticOsteitis Condensans ilii (triangular segment on the inferior aspect of the iliac side of the joint multipareous young women)
SacroiliitisBILATERAL ASYMMETRICAL
reter'sPsoriasisRA rareGoutOsteoarthriris
SacroiliitisUNILATERAL
Infection
Protrusio Acetabuli
RAOsteoporosisMarfansOsteomalacia and RicketsPagetsAnk spond
Widening of the Symphysis PubisAcquired> 10mm in newborn> 9mm at age 3> 8 mm at 7 years
PregnancyTraumaOsteitis PubisOsteolytic metsInfectionAnk Spond RA early diseaseHPT
Widening of the Symphysis PubisCongenital (normal Ossification)
Extrophy of BladderEpispadiusHypospadiusPrune Belly
Widening of the Symphysis PubisCongenital (poorly ossified cartilage)
AchondrogenesisChondroplasia Punctata
Fusion or Bridging of the Symphysis Pubis
Post traumaticpost infectiousOsteitis pubisOAAnk SpondAlkaptonuriaFluorosis
Femoral Head and Neck AnomaliesCoxa Magna(remodlled femoral head becomes wider and flatter)
DDHPerthes DxSeptic Arthritis
Femoral Head and Neck AnomaliesCoxa Plana(flattened femoral head)
AVNASEPTIC DD
Femoral Head and Neck AnomaliesCoxa Valga
IDIOPATHICDEVELOPMENTALNeuromauscular Abductor muscle weaknessDiaphyseal Aclasia (multiple metaphyseal exostoses point away from the joint cartilagenous cap may show punctate calcification)INFLAMMATORYJRAPoliomyelitisTRAUMATIC femoral neck #
Femoral Head and Neck AnomaliesCoxa Vara (to midline)
DEVELOPMENTALNeuromuscular Dis.DDHFibrous DysplasiaINFLAMMATORYRAVASCULARPerthes DxAVNMETABOLICRenal OsteodystrophyRicketsPagets Dx
Erosion (Enlargement) of the Intercondylar notch of the Distal Femur
JRAHemophiliaPsoriatic ArthritisTB arthritisRA
Plantar Calcaneal Spur
IdiopathicDISHAnk SpondPsoriaticreter'sRA
Intrameniscal Signal Changes on Knee MRI
Myxoid DegenerationMeniscal TearPost operative scar tissue
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