Febuary Quiz Answers

Great job Dr. Dey, Lussier, Vosburgh, and Bonney!

Answers:

1. C (1 point)

2. C (1 point)

3. F (1 point)

4. Knee, wrist, 2nd and 3rd MCP joints (1 point)

5. Large Beak-like osteophytes (1 point) - hemochromatosis arthropathy.

6. Amyloidosis (1 point)

7. False (1 point)

8. Extent of disease in 2 planes, femoral head flattening/collapse and extent, contralateral involvement, presence of secondary osteoarthritis, an any progression over time (1 point)

9. 4 yo. More time to remodel (2 points)

10. Synovial chondromatosis; OA with loose bodies, OCD with loose bodies, AVN, chronic joint infections (2 points)

11. May represent Hypertrophic osteoarthropathy or thyroid acropachy. Should look for pulmonary (especially cancer) dz, cyanotic heart disease, IBD, GI like biliary cirrhosis, voriconazole, or hx of thyroid resection for hyperthyroidism (3 points)

12. Soft tissue thickening in phalanges and heel pad. Spade like distal phalangeal tufts.Widened metacarpals.  Excresences at tendon insertions.  Beak-like osteophytes. (3 points)

13. Widened SI joints (1 point)

14. Hyperparathyroidism - brown tumor - accumulations of osteoclasts and fibrous tissue with variable cystic change (1 point)

15. Pseudofractures - linear foci of undermineralized osteoid at sites of mechanical loading - often perpendicularly oriented to cortex of the bone and often incomplete and bilateral (1 point)

16. Rachitic rosary (flaring of costochondral junctions) (1 point)

17. Decreased central vertebral density with sclerosis of endplates that look like a Rugby Jersey - sign of renal osteodystrophy (2 points)

18. Normal, Heavy metal poisoning, Hypervitaminosis D, metaphyseal stress lines, posttreatment rickets, scurvy (1 point)

19. Myelofibrosis, Mastocystosis, Mets, Sickle cell, Paget, Pyknodystostosis, Renal osteodystrophy, osteopetrosis, fluorosis (1 point)

20. Wimberger - sclerotic epiphyseal rim, Frankel line - dense metaphyseal line adjacent the physis; Trummerfeld zone - lucency proximal to the Frankel line; Associated with Scurvy; Limey - The British Navy would use lime juice to prevent Scurvy (5 points).

Total 31+ points