Deck 18: Extremity Patterns

Question 1

Which of the following radiographic diagnoses best accounts for the changes observed on the area marked by the crossed arrows in Figure 18-2?

A) Neurotrophic disease
B) Psoriatic arthritis
C) Scleroderma
D) Hyperparathyroidism

Answer 1

Hyperparathyroidism

Question 2

What further action/diagnostic testing is necessary to manage this patient specific to the radiographic abnormalities noted in Figure 18-4?

A) No further action
B) Radiographic survey of the major joints
C) Referral to an oncologist
D) Referral to a rheumatologist

Answer 2

No further action

Question 3

Which of the following radiographic findings supports your answer to the most likely cause of the abnormalities observed in Figure 18-3?

A) Nonuniform reduction of joint spacing
B) Polyarticular involvement
C) Soft tissue swelling
D) Joint disintegration

Answer 3

Nonuniform reduction of joint spacing

Question 4

Soft tissue calcifications in patients with the abnormality marked by the black arrows in Figure 18-2 are associated with __________ and __________.

A) Hyperparathyroidism, scleroderma
B) Sarcoidosis, thermal injury
C) Psoriatic arthritis, hyperparathyroidism
D) Scleroderma, arteriosclerosis obliterans

Question 5

The location of the lesion and Figure 18-1 is best described as__________.

A) Metaphyseal cortex
B) Metaphyseal medullary cavity
C) Epiphyseal cortex
D) Intra-articular

Question 6

Which of the following diagnoses would be most likely if the radiographs demonstrate changes similar to those marked by the black arrows, with diffuse sclerosis observed in the bones of the hand in a patient with short stature?

A) Arteriosclerosis obliterans
B) Sarcoidosis
C) Pyknodysostosis
D) Progressive systemic sclerosis

Question 7

Which radiographic pattern of disease is noted in Figure 18-2, specific to the plain black arrows?

A) Acroosteolysis
B) Aggressive osteolytic lesions
C) Periosteal reaction
D) Change in size and shape of an epiphysis

Question 8

Which of the following is most likely to be the clinical complaint of the patient regarding his ankle?

A) No complaint
B) Polyarticular joint swelling
C) Acute pain with joint locking
D) Inability to bear weight

Question 9

With a history of mid and low back pain in an otherwise unremarkable 27-year-old female patient, which of the following is the best diagnosis of the abnormalities observed on the radiographs in Figure 18-4?

A) Foley areas disease
B) Osteonecrosis
C) Osteopoikilosis
D) Synovial chondrometaplasia

Question 10

Which radiographic pattern of disease is present Figure 18-1?

A) Change in size and shape of epiphysis
B) Cystic lesion of extremities and ribs
C) Radiolucent metaphyseal bands
D) Aggressive osteolytic lesions of the extremities and ribs

Question 11

Lesions observed in these radiographs are microscopically identical to a(n) __________.

A) Osteochondroma
B) Enostosis
C) Enchondroma
D) Nonossifying fibroma

Question 12

Which radiographic pattern of disease is observed in Figure 18-4?

A) Calcified intra-articular loose bodies
B) Aggressive osteolytic lesions of the ribs and extremities
C) Osteosclerotic bone lesions
D) Periosteal reactions

Question 13

Which radiographic finding in the spine is associated with the underlying disease observed in Figure 18-2?

A) Ivory vertebra
B) Rugger jersey
C) Sandwich vertebra
D) Vertebra plana

Question 14

Which of the following diagnoses accounts for this radiographic presentation?

A) Eosinophilic granuloma
B) Metastasis
C) Infection
D) Leukemia

Question 15

On the basis of Figure 18-1, what is the approximate age of this patient?

A) 0-5
B) 11-15
C) 21-25
D) 61-65

Question 16

The classic treatment for this lesion is __________.

A) Drainage, curettage, antibiotics
B) Amputation
C) Chemotherapy
D) This condition is self-resolving

Question 17

If similar radiographic presentation is observed in a patient older than 40 years of age with pain in the areas of radiographic abnormality, as well as personal history of previous malignancy, which of the following diagnostic studies would help assess for skeletal metastasis?

A) Diagnostic ultrasound
B) Skeletal x-ray survey
C) Fluoroscopy
D) Radionuclide scintigraphy

Question 18

Which of the following is the most likely cause of the abnormalities observed on these radiographs?

A) Neurotrophic joint disease
B) Crystal deposition disease
C) Infection
D) Degenerative joint disease

Question 19

A history of __________ is the most likely factor predisposing a patient to develop this presentation of joint disease.

A) Poor nutrition
B) Intravenous drug use
C) Trauma
D) Familial disease

Question 20

Which radiographic pattern of disease is observed in Figure 18-3?

A) Radiodense metaphyseal bands
B) Osteosclerotic bone lesions
C) Cystic lesions of the extremities and ribs
D) Calcified intra-articular loose bodies