Radiology - Pediatrics

klistu's version from 2016-03-27 17:36

Section 1

Question Answer
When does the embryonal cartilaginous skeleton subdivide into the segments which will become the bones of the limbs?2nd month of fetal life
When do the major long bones begin to ossify? 8th and 9th weeks of fetal month
The primary ossification centers for ______ bones appear during fetal lifetubular
Proceeds via endochondral bone formationInterstitial Growth
Endosteal bone produced by osteoblasts, thickness of cortex and size of medullary canal maintained in proper balance by osteoclastsAppositional Growth
Bony penetration advances into cartilage, usually at a quicker rate from which border?Articular
Calcaneus appears at22-25 gestational weeks
Talus appears at 25-31 gestational weeks
Cubiod appears at37 gestational weeks - 16 postnatal weeks
Navicular appears at2.5 - 5 years of age
1st Cuneiform appears at1.5 years of age
2nd Cuneiform appears at 1 year of age
3rd Cuneiform appears at6 months of age
Metatarsals appear at 3rd gestational month
Phalanges appear at 9-16 gestational weeks
Sesamoids appear at7-9 years of age

Section 2

Question Answer
_______ may be irregular or not appear to be symmetrical in ossifying, but this is a normal finding in a childEpiphyseal plates
_______ may have an accessory ossification center in the distal phalanx or a bifid ossification center in the epiphysis of the proximal phalanxHallux
_______ are bony continuity with the shaft throughout development, do not contribute to longitudinal growthPseudoepiphyses
High incidence of absence of the epiphyseal ossification center of the _______middle and distal phalanges
Symphalangism of the _______ is the most common coalition of the foot 5th digit
Unlike many accessory bones, an accessory ______ may be clinically significant Navicular
______ is an outgrowth of bone that has never entirely separated from the bone of which they form a partApophysis
Double ossification center in the ______ may be a sign of Larsen's syndromeCalcaneus
The apophysis of the ________ has an ossification center that extends in the same direction as the shaft instead of being horizontal 5th metatarsal base

Section 3

Question Answer
Localized gigantism, caused by diffuse infiltration of subcutaneous fat in part of a limb, or associated with vascular anomalies or neurofibromatosis. Long standing hyperemia and increased blood supply to the growing cartilage can lead to this localized overgrowthMacrodactyly
Local gigantism of hands or feet, bone hypertrophy usually of one extremity, varicose veins, port wine hemangiomaKlippel-Trenaunay Syndrome
Multiple joint dislocations, especially large joints (e.g. knee), equinovarus or valgus foot, double ossification center of calcaneus, cleft palate, supernumerary carpal and tarsal bones, broad thumbs, shortening of metacarpals and distal phalanges, multiple vertebral anomoliesLarsen's Syndrome
Clinically will see Cafe au Lait spots, and skin neurofibromas, Radiologically will see enlargement of the foot abnormally shaped bones, kyphoscoliosis/dysplasia of the vertebral bodies, skull deformities, congenital pseudoarthroses, cortical thickening and increased bone density, hypoplasia in the pelvis causing dislocations Neurofibromatosis
Generalized undergrowth of bone that may be due to an inherited developmental abnormality, local factors that affect bone growth (e.g. trauma, infection, tumor) or due to external therapeutic radiation altering normal bone growthDwarfism
All bones are shorter, tibia shorter than fibula, hperplastic distal femoral metaphysis, cupping of tibial and fibular metaphysisAchondroplasia
A form of dwarfism that has predominate shortening of the proximal segmentRhizomelic
A form of dwarfism that has predominate shortening of the middle segmentMesomelic
A form of dwarfism that has predominate shortening of the distal segmentsAcromelic
A form of dwarfism that has shortening of the bones with flaring of the epiphyses and cup shaped distal femoral m metaphysis, as well as equinus deformity of the footDiastrophic
Clincially associated with dwarfism, mental retardation, coarse facial features, kyphosis, short neck, hepatosplenomegal, and mouth deformities. Radiographically the principle change is thickening of the shafts and tapering at the ends of the bones, may have irregular, wavy contour, UE > LE, angulated obliquity of growth plates, coxa valga, genu valgum, proximal tapering of metacarpals, skull larger than normal and distinctive changes in spineHurler's Syndrome
Defective development of a central portion of the arms or legs, or both, so that the hands and feet are attached close to the body resembling flippersPhocomelia
Absence of a portion of a limb, usually medial or lateralHemimelia
Most common form of excess malformation, can occur as an isolated abnormality or with other syndromes, 50% bilateral, 9x as common in African-Americans as whitesPolydactyly
A classification system where preaxial = located on the tibial side, and postaxial = located on the fibular sideTemtamy & McKusick
A classification system based on the morpholoogy of the corresponding metatarsalVenn-Watson
Short digits that are seen in pseudo- or pseudopseudohypoparahtyroidism, Turner's syndrome, sickle cell, Down's syndrome, fetal dilantin syndrome, but is usually idiopathicBrachydactyly
Side by side fusuion fo phalanges, can be simple, complete or partialSyndactyly
A congenital autosomal dominant syndrome with syndactyly of the hands and feet, premature synostosis of cranial sutures, synostosis of cervical spine, and mental retardationApert's Syndrome
A fusion deformity with clubhand and clubfoot deformities, synphalangism of DIPJ and PIPJ of digits, conduction deafness, ball and socket ankle joint, flexion deformities of fingers and toesNievergeldt-Pearlman Syndrome
Polysyndactyly and premature synostosis of cranial suturesCarpenter Syndrome
Simple syndactyly with hypoplasia of the digitsPoland Syndrome
Constriction rings around limbs, present at birth, occasionally followed by loss of the portion distal to the ringStreeter's Bands
A non-progressive upper motor neuron lesion that causes abnormalities due to muscle imbalances. The spastic form is most common and will lead to rigid rearfoot valgus, midfoot and forefoot abduction, and hallux valgusCerebral Palsy
A flaccid paralysis which results in foot and ankle deformities, commonly see rearfoot varus with or without equinus, can see congenital vertical talusMyelomeningocele

Section 4

Question Answer
Increased Kite's angle. If navicular is ossified, it will also appear lateral to its normal positionRearfoot Valgus
Decreased Kite's angle. Navicular appears medial to normal positionRearfoot Varus
Normal clacaneal inclination is decreased, usually worse than 90 degrees to the legRearfoot Equinus
Increased calcaneal inclinationRearfoot Calcaneus
Adduction + Inversion (supination)Forefoot Varus
Abduction + Eversion (pronation)Forefoot Valgus
Calcaneus abducted and everted, talus plantarflexed Congenital Pes Planovalgus (the most common form of RF Valgus)
Significant dorsiflexion, or increased calcaneal inclination seen on lateral projection. Digits are often in a flexed position and present as "clawing" clinicallyCongeintal Pes Cavus
Decreased talocalcaneal angle on AP and the line bisecting the talus will fall lateral to the 1st MT base. On lateral the calcaneus is plantarflexed and the talus and calcaneus are nearly parallelCongenital Talipes Equinovarus
On lateral will see a plantarflexed talus into a vertical position. Also present is dorsal dislocation of navicular onto the dorsum of the talus Congenital Vertical Talus