Blount’s disease

• tibia vara, causes genu varum.
• metaphyseal-diaphyseal angle >11 degrees
• bilateral ~infantile type
• pain in adolescent

Red Marrow

• more water content, bright on T2
• amorphous and feathery, flame shaped
• metaphyseal and metadiaphyseal
• smoking and obesity, middle aged females

MRI Ankle Checklist

Great post at RadDaily.com about MRI Ankle….

MRI Shoulder Checklist

Great post at RadDaily.com about MRI Shoulder…

MRI Knee Checklist

Extensor mechanism:

• patellar cartilage (axial T2 SPIR, sag PD)
• femoral trochlear cartilage (axial T2 SPIR, sag PD)
• patellar tendon / quad tendon (sag PD)
• effusion, meniscal and synovial cysts (T2W sequences)
• meniscii (PD sequences)

Ligaments:

• ACL – (ax T2 SPIR, sag PD, sag T2 SPIR)
• PCL – (ax T2 SPIR, sag PD, sag T2 SPIR)
• MCL, LCL – (coronal PD)

Lateral Compartment:

• Femoral Condylar Cartilage (sag and coronal PD and sag T2)
• Lateral Meniscus – (coronal PD and sag T2 SPIR)

Medial Compartment:

• Femoral Condylar Cartilage (sag and coronal PD and sag T2)
• Medial Meniscus – (coronal PD and sag T2 SPIR)

Other:

• Baker’s cyst (Ax T2 SPIR)
• Knee effusion (sag T2 SPIR)
• Prepatellar edema

Taken from: RadDaily.com

See dictation

Bankart and Bankart variant lesion

Classification of Bankart and Bankart variant lesions. a Bankart lesion, b bony Bankart lesion, c Perthes lesion, d ALPSA (anterior labro-ligamentous periosteal sleeveavulsion) lesion, e GLAD (glenolabral articular disruption) lesion, f HAGL (humeralavulsion of glenohumeral ligaments) lesion. (LLC anteroinferior labro-ligamentous complex, P scapular periosteum, HH humeral head, AC articular cartilage of glenoid,IGHL inferior glenohumeral ligament)

Lytic Bone Lesions Based on Margin

Geographic IA: (well defined, geographic, sclerotic)

• bone cyst
• brodie abscess
• cartilage lesions (chondroblastoma, chondromyxoid fibroma, enchondroma)
• fibroxanthoma
• fibrous dysplasia

Geographic IB: (no sclerosis)

• giant cell tumor
• myeloma/mets
• bone cyst
• cartilage lesions

Geographic 1C: (ill-define border, single focal lesion)

• chondrosarcoma
• enchondroma
• MFH/ibrosarcoma
• Giant cell tumor/ABC/CMF
• Osteosarcoma
• Mets/myeloma

Permeative/Motheaten:

• Ewing sarcoma
• round cell tumors
• malignant fibrous histiocytoma/fibrosarcoma
• osteomyelitis
• osteosarcoma
• Langerhans cell histiocytosis
• mets/myeloma

3 Phase Bone Scan Interpretation

3 phases: Flow, Blood Pool, Delayed

• Cellulitis: +/+/-
• Osteomyelitis: +/+/+
• Fracture: +/+/+
• Noninflammatory: -/-/+

Vertebra Plana MELTs

• Metastasis, myeloma
• Eosinophilic granuloma
• Lymphoma
• Trauma / TB

Enlarged Epiphysis Differential

• JRA
• Trevor’s disease
• Haemophiliac
• Infectious

Erlenmeyer flask deformity differential

• hemglobinopathies
• anemia
• fibrous dysplasia
• Gaucher’s disease
• Niemann Pick’s disease
• osteopetrosis
• craniometaphyseal dysplasia
• heavy metal poisoning

Pellegrini Stieda Lesion

• curvilnear calcification or ossification adjacent to femoral attachment of MCL
• old MCL injury

Hip Columns

Ill-defined irregular breast opacities

Benign

• fat necrosis
• previous surgery
• radial scar/CSL
• Hamartoma
• breast abscess
• composite opacity

Malignant

• Carcinoma

Craniosynostosis

• premature fusion of cranial suture
• sagittal > coronal > metopic >>> lambdoid
• “reverse Klingon sign” = Sagittal synostosis
  • elongated AP = dolichocephaly, scaphocephalic
• Coronal synostosis
  • unilateral: plagiocephaly, “harlequin” appearance of orgit
  • bilateral: brachycephaly
• Metopic synostosis
  • triagular head configuration = trigonocephaly
• Apert’s syndrome
  • Klebblattschadel = closure of coronal, lambdoid, and sagittal sutures = “clover-leaf” deformity of the skull
• Crouzon’s disease = craniofacial dysostosis
• Tracher Collins syndrome = mandibulofacial dysostosis
  
  

Child Abuse Nonaccidental Trauma

• skull fractures: depressed, bilateral, healing
• intracranial hemorrhage: subdural hematoms, other
• cerebral infarction, anoxic brain injury
• retinal hemorrhages
• metaphyseal corner fractures
• posterior rib fractures
• scapular fractures
• spiral fractures of long bones

Paget’s Disease

• middle/elderly age
• M>F
• stages
  • osteolytic stage
  • mixed
  • osteoblastic stage
  • inactive
• Cortical thickening
• Trabecullar thickening
• Expansile
• Uniform and continuous
• osteoporosis circumscripta
• DDx: fibrous dysplasia (kids), metastases, hyperostosis frontalis
• neoplasm within pagetoid bone: sarcomatous degeneration, giant cell tumor, myeloma, lymphoma, metastases
• hot on bone scan
• read more

SAPHO

• Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis
• soft tissue calcification between medial clavicle, anterior upper ribs, manubrium
• HLA-B27 positive

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Erosive Arthritis

• osteoarthritis with inflammatory symptoms
• middle-aged women
• gull-wing appearance of DIP

Reactive Arthritis

• Reiter syndrome = conjunctivitis, urethritis/cervicitis, arthritis
• RF negative, 80% HLA-B27 positive
• prior Chlamydia, Salmonella, Shigella, Yersinia, Campylobacter infection
• calcaneal erosive disease and spur formation
• M>F

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