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CCEB PART B; X-RAY EXAM QUESTIONS AND ANSWERS
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CCEB PART B; X-RAY EXAM QUESTIONS ANDANSWERS
Paget's disease, also known as osteitis deformans, is a condition with an unknown
aetiology that causes severe bone deterioration followed by aberrant bone healing.
Paget's disease affects approximately 3% of those over the age of 40.
• Male predominance
Rare before age 40; most prevalent after 55.
Bone symptoms associated with softening - ANSWER Bowing
Tinnitus and Hearing Loss
Increase the vascular output.
Paget's name signs—answer Shepherds Crook
Sabre Shin
Blade of grass.
Acetabular Protrusion
Basilar Invagination
Mosaic Pattern
Picture frame the vertebrae.
Cotton wool skull (blastic)
Osteoporosis circumscripta (lytic)
,Shepherd's crook deformity: ANSWER Pagets and fibrous dysplasia.
Sabre shin deformity - ANSWER: Bowing outward of bone.
Blade of grass sign - ANSWER spotted at Paget's
Protrusio Acetabuli - Answer RA
Paget's
Osteomalacia
Basilar impression - answer
Picture frame vertebral body - ANSWER Thickened cortex of vertebral bodies may
be found in people with Paget disease.
Cotton wool skull - Paget's!
Check for osteoporosis circumscripta (osteolysis in the frontal and occipital bones).
Osteoporosis circumscripta - ANSWER Initial radiolucency in Paget disease;
matches the pattern found in osseous dysplasia.
ANSWER: Brim sign in the pelvis or blade of grass in the femur.
Paget's complication: Spinal stenosis - Compressive neuropathy.
Anaemia
,Paget's disease could be complicated by an osteosarcoma MC tumour.
Paget's lab findings - ANSWER: very high alkaline phosphate
increased breakdown of bone collagen leads to excessive urine excretion of
hydroxyproline.
Calcium and phosphorus readings are normal.
A homogeneous rise in radiopacity of the vertebral body results in ivory vertebrae.
ANSWER: Raindrop skull - Multiple myeloma.
Swiss cheese - Mets
O Circumscripta, then Cotton Wool - Pagets
Salt & Pepper - HPT
Fibrous dysplasia is a bone condition with an unknown aetiology that destroys
normal bone structure and replaces it with fibrous tissue.
Fibrous dysplasia demographic - ANSWER 8-14 years.
McCune-Albright syndrome is defined by a triad of fibrous dysplasia of the bone,
endocrine abnormalities (such as early puberty or hyperthyroidism), and
cafe-au-lait spots.
Fibrous Dysplasia Cafe au lait spots - ANSWER Coast of Maine border with cafe
au lait (irregular border)
, More than 6 and 1.5 cm.
"Coast of Maine" locations - ANSWER
Fibrous dysplasia name signs: ANSWER Shepherd's crook
Ground glass look.
Two types of FD: monostotic and polyostotic.
ANSWER Monostotic Fibrous Dysplasia (solitary lesion) is most usually detected
in the ribs, femur (proximal), tibia (anterior cortex), and skull (75% of cases).
Polyostotic fibrous dysplasia affects many bones, including the femur, cranium,
tibia, humerus, ribs, fibula, radius, and ulna.
▪ Vertebral involvement is infrequent.
When present, it affects the vertebral body rather than the arch and is typically
observed in the polyostotic type of the disease.
Expansile Rib Lesion: Fibrous Dysplasia or METS.
(Extrapleural Sign)
FD inside the Mandible = Cherubism radiographic characteristics - ANSWER The
face expands and the eyes retreat.
The rind of sclerosis - ANSWER clearly defines the lesion.
Smoky, hazy ground glass look with sclerosis rind.
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