Question 1

Marie-Strümpell disease or "bamboo spine" is a symptom of the pathology known as

Accepted Answer

Marie-Strümpell disease, also known as ankylosing spondylitis, is a chronic inflammatory disease affecting the joints and ligaments in the spine, leading to fusion of the vertebrae and formation of a rigid "bamboo spine" appearance on X-ray.

Question 2

Which neoplasm involves a nidus?

Accepted Answer

A nidus refers to a central region of the tumor around which the tumor cells are arranged. Osteoid osteoma is a benign bone tumor that typically involves a small nidus of osteoid tissue surrounded by reactive bone formation. Osteoblastoma, osteosarcoma, and Paget disease do not typically have a nidus.

Question 3

The forward slippage of one vertebra on another describes the pathology

Accepted Answer

Forward slippage of one vertebra on another is known as spondylolisthesis. Spondylitis is an inflammation of one or more vertebrae, spondylolysis is a defect or fracture of the pars interarticularis (a small bony arch in the back of the vertebra), and spina bifida is a congenital defect in which the neural tube fails to close properly during fetal development.

Question 4

A 15-year-old male patient presents for a right knee series after sustaining a varus injury while playing football.AP, lateral, and both oblique radiographs of the knee demonstrate an avulsion fracture of the lateral tibial plateau (Segond fracture).What additional imaging modality would be best utilized in the diagnosis for this patient?

Accepted Answer

MRI is the best imaging modality for further evaluation of Segond fractures as it can help detect associated ligamentous injuries, meniscal tears, and cartilage damage. CT may be useful in certain cases to evaluate fracture displacement or articular surface involvement, but it is not as sensitive as MRI in evaluating soft tissue injuries. Knee arthrography and nuclear medicine are not indicated for this type of injury.

Question 5

Which primary bone tumor should be investigated with the utilization of CT?

Accepted Answer

Osteoid osteoma is particularly well visualized by CT scan, which can accurately depict the tumor's nidus and surrounding sclerosis, making it the preferred imaging modality for diagnosis and surgical planning.

Question 6

A patient presents to his physician with anterior shoulder pain for several months.He has had no recent injury and there is no relief with NSAIDs, ice, heat, and gentle range-of-motion exercises.Radiographs of the shoulder demonstrate small microcalcifications of the subacromial space.What is the differential diagnosis?

Accepted Answer

The presence of small microcalcifications in the subacromial space is most consistent with a diagnosis of calcific tendinitis. Rotator cuff tears may also present with anterior shoulder pain, but the imaging findings would typically show a tear or degeneration of the rotator cuff tendon. Labral tears and anterior shoulder dislocations may also cause anterior shoulder pain, but the imaging findings would show a tear or displacement of the labrum or the humeral head respectively.

Question 7

Osteopetrosis requires what type of technical factor change?

Accepted Answer

Osteopetrosis, also known as marble bone disease, results in abnormally dense bones. Due to this increased density, more X-ray penetration is required to produce a diagnostic image, necessitating an increase in technical factors.

Question 8

Which of the following characteristics does NOT assist in the differentiation between a primary metastatic bone lesion as compared to a secondary metastatic bone lesion?

Accepted Answer

Calcification of blood vessels is not a characteristic used to differentiate between primary and secondary metastatic bone lesions. It is more related to vascular changes and not specific to the origin of bone tumors.

Question 9

Heberden nodes and Bouchard nodes are associated with what skeletal pathology?

Accepted Answer

Heberden nodes and Bouchard nodes are bony nodules that develop at the distal and proximal interphalangeal joints of individuals with osteoarthritis.

Question 10

Which disease is congenital?

Accepted Answer

Osteogenesis imperfecta is a congenital disease, also known as brittle bone disease, that results in weak bones that can fracture easily due to a deficiency in collagen production. Pott disease is a form of tuberculosis that affects the spine, while osteoporosis and Paget disease are not congenital conditions.

Question 11

The most common form of arthritis is

Accepted Answer

Osteoarthritis is the most common form of arthritis, affecting over 30 million adults in the United States alone. It is a degenerative joint disease that occurs when the protective cartilage between the joints wears down over time. Gouty and psoriatic arthritis are less common types of arthritis, while rheumatoid arthritis affects fewer people than osteoarthritis.

Question 12

Congenital clubfoot is also known as

Accepted Answer

Congenital clubfoot is also known as talipes. The other options, DDH, syndactyly, and fibrous dysplasia, are all different conditions unrelated to clubfoot.

Question 13

Tenosynovitis requires what type of technical factor change?

Accepted Answer

Tenosynovitis, an inflammation of the sheath surrounding a tendon, does not require a change in technical factors for imaging. The condition itself does not significantly alter the density or composition of the area being imaged in a way that would necessitate an adjustment in x-ray exposure parameters.

Question 14

Which anatomic structure is NOT a common area for metastasis?

Accepted Answer

Carpals (wrist bones) are a very rare site for metastasis compared to the other options listed. The pelvis, skull, and bony thorax are all common sites for metastasis for various types of cancer.

Question 15

"Brittle bone" disease is also known as

Accepted Answer

Brittle bone disease is a term commonly used to refer to Osteogenesis Imperfecta, which is a genetic disorder characterized by fragile bones that are prone to breaking easily. Option A refers to a type of dwarfism, Option B refers to developmental dysplasia of the hip, and Option D refers to a rare condition in which bones become abnormally dense and prone to fractures.

Question 16

What type of arthritis has tophi associated with it?

Accepted Answer

Tophi are deposits of uric acid crystals that can form in the joints and soft tissues of people with gouty arthritis. They typically appear as small, white, or yellowish lumps under the skin and can be a sign of advanced disease. Osteoarthritis, psoriatic arthritis, and rheumatoid arthritis do not typically cause tophi.

Question 17

What skeletal pathology presents radiographically with a "soap bubble" appearance?

Accepted Answer

Giant cell tumors can present radiographically with a "soap bubble" appearance due to the presence of a large number of osteoclast-like giant cells and areas of hemorrhage within the lesion. The tumor typically occurs in the epiphyses of long bones, particularly the distal femur, proximal tibia, and distal radius.

Question 18

Diploë is specific to cancellous bone located in what anatomic structure?

Accepted Answer

Diploë refers to the cancellous bone located inside the compact bone of the skull. Therefore, the only anatomic structure listed that contains diploë is the skull.

Question 19

What skeletal pathology could be a contributing factor for a cervical rib?

Accepted Answer

Transitional vertebrae, particularly the presence of a C7-T1 transitional vertebra, can increase the likelihood of a cervical rib developing.

Question 20

Spondylolysis is a result of a cleft or defect in the vertebral

Accepted Answer

Spondylolysis is a defect in the pars interarticularis, which is the area between the superior and inferior articular processes. This defect can lead to spondylolisthesis, which is a forward displacement of the vertebrae. A cleft or defect in the other options (pedicle, lamina, and spinous process) can also lead to spinal problems, but they are not specifically related to spondylolysis.

Quiz 2: Skeletal System