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MUSCULOSKELETAL RADIOLOGY (Radiological Evidence of Joint Disease…
MUSCULOSKELETAL RADIOLOGY
Uses of musculoskeletal imaging
Detect
Lameness
Swelling
Pain
Localised mass effect
Known trauma
Screening tool
Type of responses of bone to insult
New bone formation
Osteophytosis
New bone at JOINT SURFACES
Enthesiophytosis including Spondylosis deformans
disorder involving ligament/ tendon attachments to bones
Periosteal reaction
Stimulation of the periosteum
Causes
Trauma
Chronic irritation
Bone healing
Infection
Neoplasia
Can indicate the aggression of the disease process
Type
Smooth
Lamellar
Palisading
Irregular
Spicular
Hyperostosis
Excessive growth of bone
Examples
DISH
Craniomandibular osteopathy
Calvarial hyperostosis
Osteosclerosis
Increase in bone density and opacity without change in shape
Diseases with osteosclerosis
Osteopetrosis
Defective osteoclastic resorption with loss of medullary cavity
Canine Panosteitis/ Equine Enostosis
Fibrous CT within the medullary cavity
Normal adaptive response to increased loading
Osteolysis
The aggressiveness of a bone lesion is related to:
Destruction of the cortex? (YES/NO)
Character of the periosteal reaction
Transition zone (LONG/SHORT)
Location
Rate of progression
Reponse to infection, neoplasia or chronic inflammation
Bone Atrophy
Something slow growing exerting chronic pressure on bone causing thinning and deviation of adjacent bone structures
Osteopenia/ Osteoporosis
Reduction in bone mineral density
Types
Metabolic Osteopenia
Generalised Osteopenia
Excessive Ca resorption from bone to maintain depleted blood Ca levels
Hyperparathyroidism
Nutritional, renal
Parathyroid neoplasia
Paraneoplastic Syndrome
Disuse Osteopenia
Fractures
Types
Traumatic
Pathological
Fatigue
Classification
Location
Direction: Transverse vs. oblique vs. spiral
Complete vs. incomplete
Simple vs. comminuted vs. segmental
Open vs. closed
Displaced vs. non-displaced
Salter-Harris Fractures
I
Physis
II
Physis and metaphysis
III
Physis, epiphysis and are usually articular fractures
IV
Physis, epiphysis, metaphysis, usually articular fractures
V
Crushing/ compression fractures that involve the physis, frequently cause premature closure of all/ a portion of the physis leading to growth deformities
Fracture healing
Haematoma formation > Woven bone + cartilage > Ossification of cartilage > Lamellar bone > Recontoured lamellar bone
Bone Inflammation and Infection
Osteomyelitis
Most commonly periosteal reaction + osteolysis
Inflammation of bone with medulla
Ostetis
Inflammation of bone without medulla
Can be caused by
local wound, trauma or infected implant
Haematogenous infection
Radiological Evidence of Joint Disease
Osteophytosis
Alterations in the subchondral bone opacity
Altered joint space
Subluxation/ luxation
Periarticular sturctures
Increased synovial volume
Subchondral cyst formation
Altered perichondral bone opacity
Perichondral bony proliferation
Mineralisation of joint soft tissues
Intraarticular calcified bodies
Joint displacement/ incongruency
Joint malformation
Intraarticular gas
Soft tissue changes
Generalised/localised swelling
Soft tissue masses
Calcification of soft tissues
Joint swelling
Wounds