Term
| True or False: The bony skeleton is a very dynamic organ system undergoing constant change. |
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Definition
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Term
| When ______ activity is in balance with ______ activity, the radioacity of bone is normal. |
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Definition
-osteoclastic
-osteoblastic |
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Term
| Describe the radiographic appearance of a normal bone. |
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Definition
-smooth, sharply marginated periosteal surfaces
-uniform, homogeneous thickness and opacity of cortical bone
-well-defined trabecular pattern of cancellous bone
-distinct endosteal surfaces
-uniform lucency of medullary region |
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Term
| What physiologically results in an abnormal radiopacity of bone? |
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Definition
| -when osteoclastic and osteoblastic activity are out of balance |
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Term
Definition: Osetolysis
-how long does it take to be radiographically evident? |
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Definition
-bone loss: doesn't show until 30-60% of mineralized vone is lost
-takes 7 days to be radiographically evident |
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Term
Definition: Osteogenesis
-what are some examples? |
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Definition
-aka sclerosis
-increased radiopacity of bone
-usually associated with increased production: subchondral thickening, endosteal reactions, periosteal reactions |
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Term
| What are the three patterns of bony change in disease? |
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Definition
-purely destructive (lytic change)
-purely sclerotic (productive change)
-mixture of above (both changes simultaneously) |
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Term
Definition: Geographic osteolysis
-what are well defined lesions associated with? poorely defined? |
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Definition
-large areas of osteolysis
-well defined = benign or non-aggressive lesions
-poorly defined/ coalescing = aggressive lesions |
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Term
Definition: Moth-eaten osteolysis
-aggressive or docile? |
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Definition
-multiple smaller, less well-defined areas of lysis
-wider zone of transition to normal bone
-more aggressive dz processes |
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Term
| Definition: Permeative osteolysis |
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Definition
-numerous, small, poorly defined areas of lysis with a wide zone of transition to normal bone
-highly aggressive |
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Term
Defition: Mixed osteolysis
-how do we determine the nature of the lesion? |
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Definition
-more htan one pattern type present
-most common
-nature of the lesion is based on the most aggressive pattern that is recognized |
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Term
Definition: Smooth Periostela Reactions
-early or late healing?
-benign or aggressive? |
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Definition
-chronic, well-defined borders
-end stage o healing
-benign process |
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Term
Definition: Lamellar periosteal rection
-benign or aggressive? |
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Definition
-chronic multiple episodes of periosteal elevation with onion skin appearance with well-defined borders
-more benign processes |
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Term
Definition: Palisading periosteal reactions
-benign or aggressive? |
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Definition
-new bone formation perpendicular to cortical bone
-mild to moderately aggressive processes |
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Term
Definition: Spicular Periosteal Reactions
-benign or aggressive? |
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Definition
-new bone formation perpendicular to cortical bone, which tends to be longer with more space between spicules when compared to palisading reaction with less defined borders
-moderately aggressive process |
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Term
Definition: Sunburst Periosteal Reactions
-benign or aggressive?
-what does it indicate? |
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Definition
-new bone formation of radiating spicules from a more central point with less defined borders
-aggressive process
-indicates a lesion erupting past the cortex and into the surrounding soft tissues |
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Term
Definition: Amorphous periosteal reactions
-benign or aggressive? |
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Definition
-an unorganized and irregular bone production with poorly defined borders => extensive extension into soft tissues
-most aggressive process |
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Term
Definition: Codman's triangle
-benign or aggressive
-commonly seen with what? |
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Definition
-a solid triangle of new bone at the edge of a periosteal ractions (represents elevation of the perioteum)
-tends to be rpesent in more aggressive processes
-commonly seen with neoplasia but NOT pathognomonic for neoplasia |
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Term
Definition: Mixed Periosteal Reaction
-benign or aggressive?
-commonly seen with what? |
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Definition
-more aggressive diseases will often have a mix of varying periosteal reactions
-the nature of the disease should be based on the most aggressive process seen
-commonly seen with osteosarcomas |
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Term
| Definition: Transition zone |
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Definition
| -the character of the junction of the osseous lesion adjacent normal bone |
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Term
| Transition zones are typically characterized as what 4 characteristics? |
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Definition
-long
-short
-well-delineated
-poorly-delineated |
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Term
| Definition: Pathologic fracture |
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Definition
| -secondary to an underlying disease process that interferes with normal osteogenesis |
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Term
| What are the 4 common causes of pathologic fractures? |
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Definition
| -neoplasia/tumors, metabolic disease, infections, congenital diseases |
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Term
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Definition
| -single, solitary lesion involving only one bone disease |
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Term
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Definition
| -multifocal lesions involving several bones but nor entire skeleton |
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Term
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Definition
| -the entire skeleton involved with a generalized disease |
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Term
| Scale the periosteal reactions from most benign to most aggressive. |
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Definition
| -smooth => lamellar => palisading => spicular => sunburst => amorphous |
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