bone
DESCRIPTION
Bone. Prepared by Dr.Salah Mohammad Fateh MBChB,DMRD,FIBMS(radiology). Lecture no. 1. Vertebral column. Lecture no. 1. Radiological approach to Bone diseases. Prepared by Dr.Salah Mhamad Fateh MBChB,DMRD,FIBMS(radiology). Imaging techniques;. X-ray Isotope US CT MRI. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/1.jpg)
Prepared by Dr.Salah Mohammad FatehMBChB,DMRD,FIBMS(radiology)
Lecture no. 1
![Page 2: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/2.jpg)
![Page 3: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/3.jpg)
![Page 4: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/4.jpg)
![Page 5: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/5.jpg)
![Page 6: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/6.jpg)
![Page 7: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/7.jpg)
Vertebral column
![Page 8: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/8.jpg)
![Page 9: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/9.jpg)
![Page 10: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/10.jpg)
Prepared by Dr.Salah Mhamad FatehMBChB,DMRD,FIBMS(radiology)
Lecture no. 1
![Page 11: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/11.jpg)
X-rayIsotope US CT MRI
![Page 12: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/12.jpg)
1-Plain bone radiograph
![Page 13: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/13.jpg)
Initially, a musculoskeletal lesion should be simply imaged with a plain film. It should be remembered that plain films remain the most reliable imaging method for assessment of both biological activity and probable histological diagnosis of an osseous lesion.
![Page 14: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/14.jpg)
Signs of bone diseases in plain X-ray are;
![Page 15: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/15.jpg)
1-Decreased bone density2-Increased bone density
(sclerosis).3- Periosteal reaction4- Cortical thickening5- Alteration in the trabecular pattern6- Alteration in the shape of a bone7-Altreration in bone age
![Page 16: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/16.jpg)
Localize (lytic area or area of ‘ bone distruction’)
Generalize
![Page 17: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/17.jpg)
![Page 18: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/18.jpg)
![Page 19: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/19.jpg)
2-increased bone density (sclerosis).
Focal Generalized
![Page 20: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/20.jpg)
![Page 21: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/21.jpg)
![Page 22: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/22.jpg)
It refers to excessive bone produced by the periosteum, which occur in response to infection , trauma & tumors
![Page 23: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/23.jpg)
Patterns of periosteal reaction;
![Page 24: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/24.jpg)
1- Linear
![Page 25: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/25.jpg)
![Page 26: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/26.jpg)
![Page 27: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/27.jpg)
![Page 28: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/28.jpg)
Also involve laying down of new bone by the periosteum,but the process is very slow & it has the same homogeneous density as does the normal cortex& there is no separate lines or specules of calcification as seen in a periosteal reaction
![Page 29: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/29.jpg)
![Page 30: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/30.jpg)
causes 1- chronic osteomyelitis. 2-healed trauma 3- response to chronic stress or benign
tumor
![Page 31: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/31.jpg)
Usually involving a reduction in the no. of trabeculae with an alteration in the remaining trabeculae.
e.g in osteoporosis, there is reduction in the no. of the trabeculae & remaining trabiculae are more prominent than usual associated with thinning of the cortex.
in paget‘s disease , there is thickening of the trabeculae & associated with thickening of the cortex & bone expansion
![Page 32: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/32.jpg)
Normal
![Page 33: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/33.jpg)
Local osteoporosis ( femur) Normal
![Page 34: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/34.jpg)
Paget disease
![Page 35: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/35.jpg)
Congenital Acquired , e.g Acromegaly, expanding bone
tumors
![Page 36: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/36.jpg)
![Page 37: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/37.jpg)
![Page 38: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/38.jpg)
US can not demonstrate bone pathology but does have a complementary imaging role;
Detecting tenosynovitis, tendon tear & rupture.
In diagnosis of arthritis & osteomyelitis
![Page 39: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/39.jpg)
Technetium-99m lablled phosphate complexes
![Page 40: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/40.jpg)
Detection of metastasis. Detection of osteomyelitis . Determination of whether a lesion in solitary or multiple. Investigation of clinically suspected lesion when the Plain
radiograph is –ve. Investigation of radiographically equivocal cases whether is
significant or not.
Investigation of pain full prosthesis .
![Page 41: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/41.jpg)
![Page 42: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/42.jpg)
Is only needed in selected cases. Indications for bone CT are1. Demonstrating abnormalities in the areas where
interpretation of plain films are frequently difficult for exam. Spine , hip &pelvis
2. As a guide for bone biopsy.
3. Demonstration of the extent &characterization of the bone tumor in selected cases to complement MRI
![Page 43: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/43.jpg)
![Page 44: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/44.jpg)
![Page 45: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/45.jpg)
![Page 46: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/46.jpg)
Play a vital important role in musculoskeletal disorders.
In can demonstrate bone marrow directly but calcified tissues & cortical bones produces no signal.
MRI particularly good for showing soft tissue abnormalities
![Page 47: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/47.jpg)
Disc herniation & spinal cord or nerve roots compression.
Dx of bone metastasis. Extend of primary bone tumor. To image soft tissue masses To Dx osteomyelitis & shows any soft
tissue abscess. To Dx avascular necrosis & other joint
pathologies
![Page 48: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/48.jpg)
![Page 49: Bone](https://reader036.vdocuments.us/reader036/viewer/2022062409/56814e64550346895dbc0371/html5/thumbnails/49.jpg)