4

Musculoskeletal imaging
 Hypertrophic osteoarthropathy

Nasopharyngeal Carcinoma
Gastric ulcer
Gastric carcinoma
Liver abscess
Chronic hepatitis
Cirrhosis
Primary biliary cholangitis
Cholangiocarcinoma

Pancreatic carcinoma

Amebic dysentery
Ulcerative colitis
Crohns disease
Whipple’s disease
Celiac disease
Lymphoma
CML
 Bone
marrow
process

Permeative (mouth eaten ) pattern in mid shaft

Histiocytosis

Osteomyelitis

Neuroblastoma
Osteosarcoma
Ewings sarcoma
Lymphoma
Leukemia
Calcified loose bodies in joint

synovial osteochondromatosis
osteochondral fractures
osteochondritis dissecans
tenosynovial giant cell tumour
osteoarthritis or severe degenerative disease

neuropathic joints
Charcot joint

meniscal fragmentation and its calcification

fragmented/fractured osteophytes
intra-articular fracture fragments
 Endosteal scalloping refers to
the focal resorption of the
inner layer of the cortex (i.e.
the endosteum) of bones,
most typically long bones,
due to slow-growing
medullary lesions

Endosteal scalloping
Gauchers disease
Eosinophilic granuloma

• benign
◦ enchondroma
◦ chondromyxoid fibroma
◦ chondroblastoma
◦ brown tumour
◦ skeletal amyloidosis
◦ osteomyelitis
◦ fibrous dysplasia
◦ anaemias
◦ periprosthetic osteolysis

• malignant
◦ chondrosarcoma (usually low grade)
Leukemia
Lymphoma
◦ bone metastases
◦ multiple myeloma
Excessive callus formation:
NRSOM CPB
Osteogenesis imperfecta
Steroids
Multiple myeloma

Congenital insensitivity to pain

Paralysis
battered baby

Neuropathic arthropathy
Renal osteodystrophy
 Pseudoarthrosis
Fracture non union
Failed bone graft

Ankylosing spondylitis (post-trauma)

DISH ( post-trauma)

Congenital Pseudoarthrosis
DDH
Proximal femoral deficiency

Ehler danlos syndrome

Bertolotti syndrome
Ochronosis

Neurofibromatosis
Osteogenesis imperfecta
Fibrous dysplasia
Cleidocranial dysostosis .

Types
• • hypertrophic pseudoarthrosis
◦ rich in callus (elephant foot)

◦ poor in callus (horse hoof)

• oligotrophic pseudoarthrosis
◦ no callus on radiographs, rounded fracture ends

• atrophic pseudoarthrosis
◦ bone resorption due to infection or impaired blood supply

• hypotrophic (non-vital) pseudoarthrosis

◦ necrotic fragments (increasing fragment density without callus formation)

• defect pseudoarthrosis
◦ missing fragments

• infected pseudoarthrosis: see: osteomyelitis

Respiratory
CF , DM
 Polystetic FD W
I

↑ endocrine & Skin

>
- Soto's $

Fibrous dysplasia

Localized enlargement of bone

Diaphyseal achalasia
Gaucher’s disease

Hemophilia

Proteus syndrome
7. Sickle cell anemia
8. Infarcts
Multiple ossification centers in the epiphysis
1 cretinism
2 Down’s syndrome
3 Morquios syndrome
4 chondrodysplasia punctata
5 avascular necrosis
6 fetal warfarin syndrome
7 fetal alcohol syndrome
8 trisomy 18

Fragmented epiphysis
1 cretinism
2 Down’s syndrome
3 Morquios syndrome
4 chondrodysplasia punctata
5 epiphyseal dysplasia

Epiphysiolysis
SRSHR
S Steroids
R raddiation
S SUFE
H hypothyroidism
R Renal osteodystrophy
Hypothyroidism
Skull defect with sclerosis

Epidermoid cyst
Meningocele
Hemangioma
Frontal sinus mucocele
Histiocytosis
Chronic osteomyelitis
Fibrous dysplasia

Intraorbital calcification

Drusen

Retinoblastoma

Vitrous hemorrhage
leontiasis ossea
gigantism
craniofacial fibrous dysplasia
cranio- metaphyseal dysplasia
craniosynostosis
tumours of the paranasal sinuses
Paget disease
syphilitic osteoperiostitis
uraemia with secondary hyperparathyroidism

Delayed eruption of teeth

Down’s syndrome
Congenital Hypothyroidism
Hypophosphatasia

Osteogenesis imperfecta
Cleidocranial dysostosis
Frontometaphysial dysplasia
Osteopetrosis

Gauchers disease
Cornelia de lange syndrome
Radiotherapy
Myxedema
 Thrombosis, embolism

Absent pul a.
Pul. Stenosis

Thalassemia
Hyperparathyroidism
Poliomyelitis
 Ribbon ribs
Osteogenesis imperfecta
Sever osteoporosis
Resection

Rheumatoid arthritis
Scleroderma
Hyperparathyroidism
Neurofibromatosis
Poliomyelitis

Morquios disease
juvenile idiopathic arthritis
Dense rib
Sickle Cell Disease
Mastocytosos
Metastases
Flurosis
Osteopetrosis
Pyknodysostosis
Other sclerosing dysplasia

Hyperlucent rib
Acromegaly
Cushings
Scurvey
Osteopetrosis
Distal clavicular erosion
SHORT PPPPCCMM
S scleroderma
H Hyperparathyroidism
O osteomyelitis
R rheumatoid arthritis
T trauma
P pagets
P progeria
P pyknodysostosis
P psoriasis
C CA
C cleidocranial dysostosis
M myeloma
M metastasis

Medial clavicular erosion

Sarcoma
Lymphoma
Metastasis
Tuberculosis
Eosinophilic granuloma
Acro-osteolysis
:
PEN HVSM PRT Dermal Injury
P progeria
E Ehler danlos syndrome
N neurofibromatosis
H Hyperparathyroidism
V venyl chloride poisoning
S syringomyelia
M Morton’s disease
P pyknodysostosis
R Reiter’s syndrome,
T TAO thrombangitis obliterance
Psoriasis, epidermolysis bullosa, leprosy, dermatomyositis, atherosclerosis
Insensitivity to pain , burns , frostbite, Raynaud’s, diabetes
Finger tip calcification
Scleroderma
SLE
CREST syndrome
Dermatomyositis
Raynaud’s
Hyperparathyroidism

Terminal phalengeal sclerosis

Scleroderma
SLE
Sarcoidosis
Rheumatoid arthritis
Syndactyly Polydactyly
Carpenter’s syndrome Carpenter’s syndrome
Down’s syndrome Ellis-van creveld $
Polands syndrome Trisomy 13
Neurofibromatosis Laurance-moon Biedel $
Meckel Gruber $

Clinodactyly Brachydactyly
Down’s syndrome Turner’s syndrome
Trauma Ellis-van creveled syndrome
Arthritis Basal cell nevus syndrome
Contractures
Dysplasias
Pseudohypoparathyroidism
Pseudopseudohypoparathyroidism

Trauma
Arthritis
Osteomyelitis
Shortening of the fourth/fifth
metacarpals (brachymetacarpia)
and less commonly metatarsals
(brachymetatarsia) is seen in a
variety of apparently disparate
conditions.
Aetiology
Common causes :
• idiopathic
• post-infective
(e.g. osteomyelitis, yaws, tuberculosis
dactylitis)
• pseudohypoparathyroidism/
pseudopseudohypoparathyroidism
• post-traumatic (acute or chronic/
healed and particularly those involving
growth plate)
• Turner syndrome
Uncommon causes :
• Klineferlters syndrome
• basal cell naevus syndrome (Gorlin
syndrome)
• Cornelia de Lange syndrome
• Melorhostosis
• hereditary multiple exostosis
• juvenile idiopathic arthritis
• sickle cell disease with secondary
infarction
• homocystinuria
• Langer-Giedion syndrome
Diaphysial acalasia
Isolated shortening of the 5th
metacarpals has been recently described
in a familial variant of type 1 diabetes
mellitus.
 TB
Hemophilia Psoriasis
JRA Gant
RA PVS
 >10 mm newborn
>8mm adult

Pregnancy
Lytic Metastasis
Trauma

Prune belly syndrome

Ectopia vesicae
Bladder exstrophy
Epispadias
Hypospidas

Hyperparathyroidism
Hypothyroidism

Osteitis pubis
Osteomyelitis

Rheumatoid Arthritis
Ankylosing spondylitis
Cleidocranial dysostosis
Osteogenisis imperfecta
Seronegative arthritis :
Ankylosing spondylitis
Riters disease
Psoriasis
And occasionally in :
DISH
RA
Osteoarthritis
Flat capital femoral epiphysis
Steroids
Cushing’s syndrome
Cretinism
Osteoporosis
Osteogenesis imperfecta
Multiple epiphyseal dysplasia

NAI
neuropathic arthropathy
Renal osteodystrophy
Myeloma
 >21.5 mm
>23 mm

Heel pad thickening

Obesity
Acromegaly

Edema
Myxedema

Phenytoin toxicity
Epileptics

Infection
 Congenital talipes equinovarus is
considered the most common
anomaly affecting the feet diagnosed
on antenatal ultrasound.

talipes equinovarus: adduction of

the forefoot, inversion of the heel
and plantar flexion of the forefoot
and ankle

#
&NFX
Association of club foot
Spina bifida
Myelomeningocele
Neurofibromatosis
Chondrodysplasia punctata
Arthrogryposis multiplex congenita