11 erosion of multiple terminal phalangeal tufts (ACROOSTEOLYSIS)
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This document discusses erosion and resorption of the terminal phalangeal tufts (tips of the fingers and toes) in various conditions. It includes 10 figures showing examples in Raynaud's disease, diabetic gangrene, psoriatic arthritis, leprosy, hyperparathyroidism, Lesch-Nyhan syndrome, epidermolysis bullosa, progeria, familial acro-osteolysis, and pachydermoperiostosis. Each figure illustrates the characteristic bone changes and soft tissue involvement in the distal phalanges.
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Similar to 11 erosion of multiple terminal phalangeal tufts (ACROOSTEOLYSIS)
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Neuroarthropathy, also known as Charcot joint, is a condition where joints are destroyed due to loss of sensation. It can result from diseases that damage nerves like tabes dorsalis, syringomyelia, diabetes mellitus, congenital indifference to pain, and leprosy. The medical images show fragmentation, sclerosis, calcific debris, and destruction around various joints in the body that have been impacted by these conditions.
9 widespread or generalized periosteal reaction
This document discusses periosteal reaction seen on clinical imaging. It provides 6 examples of conditions that can cause widespread periosteal new bone formation, including hypertrophic osteoarthropathy seen in lung cancer/mesothelioma, battered child syndrome seen as healing fractures of the humeri, venous stasis seen as cloaking of the tibia and fibula, thyroid acropachy seen as spiculated new bone around the proximal phalanx, hypervitaminosis A seen initially as thin wavy cortical thickening and later as shrunken smooth sclerosis, and scurvy seen as a large calcifying subperiosteal hematoma of the femoral shaft.
31 dactylitis
This document contains 6 figures showing images of hands and feet with different pathological conditions that cause dactylitis. Each figure is labeled and briefly described. Figure B 31-1 shows bone changes in the hands due to sickle cell anemia. Figure B 31-2 depicts a phalanx with tuberculosis. Figure B 31-3 demonstrates granulomas and bone formation from yaws. Figure B 31-4 pictures a phalanx with destruction and calcification from congenital syphilis. Figure B 31-5 shows changes in the fingers from sarcoidosis. Figure B 31-6 portrays cysts and new bone growth in a finger due to tuberous sclerosis.
3 osteomalacia
This document discusses several cases of osteomalacia seen on clinical imaging:
1) A case of rickets showing severe metaphyseal changes in the legs that improved with vitamin D therapy.
2) A case of rickets caused by a renal tubular disorder, showing thickened vertebral cortices and increased trabeculation.
3) A case of hyperparathyroidism with generalized demineralization and prominent rib trabeculae.
4) A case of hypophosphatasia with ossification of muscle insertions in a short adult male.
5) A case of Wilson's disease showing demineralization, thin cortices, and a coarse
21 radiolucent metaphyseal bands
Radiolucent metaphyseal bands can be seen in several conditions:
1) Congenital syphilis presents with transverse bands of increased density across the metaphyses and patchy bone destruction in the diaphyses.
2) Rubella shows alternating lucent and sclerotic longitudinal striations perpendicular to the epiphyseal plate.
3) Leukemia displays radiolucent metaphyseal bands in addition to frank bone destruction and cortical erosion of many bones.
2 generalized osteoporosis
This document discusses generalized osteoporosis and shows radiological images of bones demonstrating varying degrees of demineralization and bone loss. Specific conditions mentioned that can cause generalized osteoporosis include aging, high-dose steroid therapy, Cushing's syndrome, multiple myeloma, leukemia, thalassemia, juvenile rheumatoid arthritis, osteogenesis imperfecta, muscular dystrophy, and Niemann-Pick disease. The images illustrate features such as thinning cortices, widened medullary spaces, loss of trabeculae, and bone deformities resulting from fractures that are characteristic of different types of osteoporosis.
5 generalized osteosclerosis
1. The document describes and shows images of various medical conditions that result in generalized osteosclerosis, or increased bone density, seen on clinical imaging.
2. These conditions include myelosclerosis, Paget's disease, sickle cell anemia, osteopetrosis, pyknodysostosis, melorheostosis, fluorosis, progressive diaphyseal dysplasia, polyostotic fibrous dysplasia, renal osteodystrophy, congenital syphilis, sclerotic myeloma, and hereditary hyperphosphatasia.
3. For each condition, the document provides a brief description and labeled image showing the patterns of sclerosis visible on imaging of the
7 narrowing of the intervertebral disk space and
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1 generalized vertebral osteoporosis
This document discusses and shows images of generalized vertebral osteoporosis seen in various conditions. It describes osteoporosis seen in aging, due to steroid use, Cushing's syndrome, multiple myeloma, sickle cell anemia, osteogenesis imperfecta, homocystinuria, and idiopathic juvenile osteoporosis. The images demonstrate features such as thinning cortical margins, biconcave vertebral deformities, loss of trabeculae, compression fractures, and scoliosis associated with different types of osteoporosis.
23 overconstriction or overtubulation (narrow diametaphysis)
This document discusses several conditions that can cause narrowing or thinning of bones in the lower leg:
1) Paralysis causes generalized narrowing of leg bones with cortical thinning and diffuse osteoporosis.
2) Muscular dystrophy results in generalized thinning of lower leg bones and thin fascial sheaths surrounded by fatty infiltrated muscle bundles.
3) Several other conditions are mentioned briefly, including Marfan's syndrome, osteogenesis imperfecta, juvenile rheumatoid arthritis, and progeria.
Similar to 11 erosion of multiple terminal phalangeal tufts (ACROOSTEOLYSIS) (10)
23 overconstriction or overtubulation (narrow diametaphysis)
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- 1. 11 Erosion of Multiple Terminal Phalangeal Tufts (Acro- Osteolysis)
- 2. CLINICAL IMAGAGING AN ATLAS OF DIFFERENTIAL DAIGNOSIS EISENBERG DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL
- 3. โข Fig B 11-1 Raynaud's disease. Severe trophic changes involve the distal phalanges with resorption of the terminal tufts.
- 4. โข Fig B 11-2 Diabetic gangrene. Diffuse destruction of the phalanges and the metatarsal head of the fifth digit. Note the large amount of gas in the soft tissues of the foot.
- 5. โข Fig B 11-3 Psoriatic arthritis. Arthritis mutilans of the foot and ankle. Severe pencil-like destruction of the metatarsals and phalanges with ankylosis of almost all the tarsal joints.
- 6. โข Fig B 11-4 Leprosy. Severe phalangeal resorption with evidence of typical pencil-like configurations.
- 7. โข Fig B 11-5 Hyperparathyroidism. Tuft resorption associated with subperiosteal bone resorption that predominantly involves the radial margins of the middle phalanges of the second, third, and fourth digits (arrows).
- 8. โข Fig B 11-6 Lesch-Nyhan syndrome. Amputation of the index and middle fingers from a self-inflicted bite. Although the child is 5 years old, the bone age is that of a 3-year-old.24
- 9. โข Fig B 11-7 Epidermolysis bullosa. Diffuse trophic changes about the distal phalanges associated with bilateral contracture deformities resulting in a claw hand. Note the peculiar pointed, hook-like appearance of the terminal phalanges of the thumbs.25
- 10. Fig B 11-8 Progeria. Progressive absorption of the ungual tufts with preservation of soft tissues occurring over a 5-year period.26
- 11. Fig B 11-9 Familial acro-osteolysis. Characteristic band-like areas of lucency crossing the waists of several phalanges.
- 12. โข Fig B 11-10 Pachydermoperiostosis. Elephant-like thickening of the skin causes clubbing of the distal fingers and exaggerated knuckle pads in addition to a generalized increase in the bulk of the soft tissues surrounding the phalanges. Loss of the tufts accompanies the increase in the overlying soft tissues.19