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General MSK

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... Avascular necrosis Avascular necrosis General MSK Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor General MSK You know you re in medicine when: ... – PowerPoint PPT presentation

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Title: General MSK


1
General MSK
  • Laurie Lomasney, MD
  • Professor
  • Department of Radiology

2
General MSK
  • Disease Categories
  • Arthropathy
  • Infection
  • Congenital
  • Vascular
  • Tumor
  • Locale
  • Axial
  • Appendicular

3
General MSK by Disease Category
  • Disease processes often follow predictable
    patterns of radiographic change
  • Disease processes usually follow particular
    distribution patterns
  • Pretest probability enhances image interpretation
    and directed reporting

4
General MSK
  • Disease Categories
  • Arthropathy
  • Infection
  • Congenital
  • Vascular
  • Tumor

5
Arthropathy
  • Characteristics
  • Bone density
  • Erosions
  • Alignment
  • Distribution
  • Poly vs mono
  • Symmetric vs asymmetric
  • Peripheral small vs central large

6
Arthropathy
Rheumatoid Arthritis
Periartic demin
Prox/Symmetric swelling
Wrist/MCP erosions
Palmar/Ulnar deviat
7
Arthropathy
Psoriasis
Preserved density
Asymmetric swelling
Prox Distal asymm erosions
8
Arthropathy
Osteoarthritis
Variable density
No erosions
Eccentric joint narrow
Marginal proliferation
9
Arthropathy
Preserved density
Debris
Sclerosis
Malalignment
Charcot Arthropathy
10
General MSK
  • Disease Categories
  • Arthropathy
  • Infection
  • Congenital
  • Vascular
  • Tumor

11
Infection
  • Characteristics
  • Periarticular demineralization
  • Bone erosion
  • Periosteal new bone
  • (Adjacent ST defect or Foreign body)
  • Distribution
  • Focal/monostotic vs Multifocal (uncommon)

12
Infection
Metaphyseal osteomyelitis
13
Infection
DIP Pyarthrosis
Hip Pyarthrosis
14
General MSK
  • Disease Categories
  • Arthropathy
  • Infection
  • Congenital
  • Vascular
  • Tumor

15
Congenital
  • Variable appearance
  • Variable consequence
  • Incidental
  • Pathologic
  • Always
  • Sometimes
  • Unknown

16
Congenital
  • Ossification neural groove

17
Congenital
Os Acromiale
18
Congenital
Os tibiale externum
19
Congenital
80
Narrow Bony Canal
20
General MSK
  • Disease Categories
  • Arthropathy
  • Infection
  • Congenital
  • Vascular
  • Tumor

21
Vascular (Avascular necrosis)
  • Multiple etiologies
  • Steroid therapy
  • Collagen vascular disease
  • Post-traumatic
  • Staged appearance
  • Sclerosis
  • Collapse
  • Secondary osteoarthritis

22
Avascular necrosis
Lunate AVN
23
Avascular necrosis
Femoral head AVN
24
General MSK
  • Disease Categories
  • Arthropathy
  • Infection
  • Congenital
  • Vascular
  • Tumor

25
Tumor
  • Etiologies Multiple
  • Distribution Specific to process
  • Axial vs appendicular
  • Monostotic vs polyostotic
  • Medullary vs eccentric
  • Child vs Adult

26
Tumor
  • Characteristics to observe
  • Well-defined vs permeative
  • Cortical destruction
  • Periosteal new bone
  • Internal matrix
  • Soft tissue mineralization/mass

27
Tumor
Non-ossifying fibroma
28
Tumor
Giant cell tumor
29
Tumor
Enchondroma
30
Tumor
Chondrosarcoma
31
Tumor
Osteogenic sarcoma
32
Tumor
Osteosarcoma Gross pathology
33
General MSK
  • Radiology is a four-year residency
  • Pathology generally follows a predictable imaging
    pattern
  • Knowledge of patterns can enhance image
    interpretation

34
You know youre in medicine when
  • You compliment strangers on the size of their
    veins. 
  • You occasionally have to leave a patient's room
    before you start laughing uncontrollably.. 
  • You have recurring nightmares about being knocked
    to the floor and run over by a portable x-ray
    machine.

35
(No Transcript)
36
Thank you
  • Laurie Lomasney, MD
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