CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSISEISENBERG

1. 22Underconstriction or
Undertubulation (Wide
Diametaphysis)

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig B 22-1 Gaucher's disease. The distal ends
of the femurs show typical underconstriction
and cortical thinning (Erlenmeyer flask
appearance).33

4. • Fig B 22-2 Niemann-Pick disease. Thin cortices
and a lack of normal modeling of the distal
femurs simulate the pattern in Gaucher disease.4

5. • Fig B 22-3 Thalassemia. Pronounced widening of
the medullary spaces with thinning of the
cortices. Note the absence of normal modeling
due to the pressure of the expanding marrow
space. Localized radiolucencies simulating
multiple osteolytic lesions represent tumorous
collections of hyperplastic marrow.

6. • Fig B 22-4 Fibrous dysplasia. Smudgy, ground-
glass appearance of the medullary cavities
with failure of normal modeling.

7. • Fig B 22-5 Multiple exostoses. Bilateral
involvement of the distal femurs and proximal
tibias.

8. • Fig B 22-6 Metaphyseal dysplasia. Frontal views
of (A) the knee and (B) the proximal humerus
show defective modeling leading to extreme
widening of the metaphyseal areas of the
visualized long bones. The cortices are markedly
thin in the metaphyseal area.34

9. • Fig B 22-7 Multiple enchondromatosis.
Multiple globular and expansile lucent filling
defects involving virtually all the metacarpals
and the proximal and distal phalanges

10. • Fig B 22-8 Progressive diaphyseal dysplasia.
Dense endosteal and periosteal cortical
thickening causes fusiform enlargement of the
midshaft of the femur.

11. • Fig B 22-9 Osteopetrosis. Dense, uniform,
symmetric increase in the density of the femur
with failure of proper modeling.

12. • Fig B 22-10 Healing rickets. Widening of the metacarpals associated with diffuse
periosteal reaction. There is still some bony demineralization and residual cupping
and fraying of the distal radius and ulna.