RADIOLOGY- SKELETAL SYSTEM PATHOLOGY

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Avulsion fractures are generally small fragments torn from bony prominences; they are usually the result of indirectly applied tension forces within attached ligaments and tendons rather than direct blows.

Boxer’s fracture is a transverse fracture of the neck of the fifth metacarpal with volar (palmar) angulation of the distal fragment. This injury is typically the result of a blow struck with the fist.

Bimalleolar fracture is one involving both the medial and the lateral malleoli. Because of the mechanism of injury, the fracture on one side is transverse, whereas the fracture on the opposite side is oblique or spiral.

Colles’ fracture is a transverse fracture through the distal radius with dorsal (posterior) angulation and often overriding of the distal fracture fragment. In more than half the cases, there is an associated avulsion fracture of the ulnar styloid process. Colles’ fracture is usually caused by a fall on the outstretched hand and is the most common fracture of the wrist.

Comminuted fracture is composed of more than two fragments.

Kyphosis is anterior convexity in the curvature of the thoracic spine, sacrum and coccyx, as viewed from the side.

Monteggia fracture is an isolated fracture of the shaft of the ulna associated with anterior dislocation of the radius at the elbow.

Multiple myeloma is a disseminated (widespread) malignancy of plasma cells that may be associated with bone destruction, bone marrow failure, hypercalcemia, renal failure, and recurrent infections. The classic radiographic appearance of multiple myeloma is multiple punched out osteolytic lesions scattered throughout the skeletal system and best seen on lateral views of the skull.

Pott’s fracture involves both malleoli (i.e., of tibia and fibula) with dislocation of the ankle joint.


Osteoarthritis is an extremely common generalized disorder characterized pathologically by loss of joint cartilage and reactive new bone formation. Part of the wear and tear of the aging process, degenerative joint disease tends to predominantly affect the weight-bearing joints (spine, hip, knee, ankle) and the interphalangeal joints of the fingers. The earliest radiographic findings in degenerative joint disease are narrowing of the joint space, caused by thinning of the articular cartilage, and development of small bony spurs (osteophytes) along the margins of the articular edges of the bones. In contrast to the smooth, even narrowing of the joint space in rheumatoid arthritis, the joint space narrowing in degenerative joint disease is irregular and more pronounced in that part of the joint where weight-bearing stress is greatest and where degeneration of the articular cartilage is most noticeable.

Osteogenic sarcoma generally occurs in the end of a long bone in the metaphysis (especially about the knee). This tumor consists of osteoblasts, which produce osteoid and spicules of calcified bone. The typical radiographic appearance of osteogenic sarcoma is a mixed destructive and sclerotic lesion associated with a soft tissue mass, irregular periosteal reaction, and reactive new bone formation. In the classic sunburst pattern, horizontal bony spicules extend in radiating fashion into the soft tissue mass.

Osteoporosis is a generalized or localized deficiency of bone matrix in which the mass of bone per unit volume is decreased in amount but normal in composition. The radiographic appearance is somewhat similar in all conditions producing osteoporosis. The most striking change is cortical thinning, with irregularity and resorption of the endosteal (inner) surfaces. These findings are most evident in the spine and pelvis.

Transitional vertebra has characteristics of vertebrae on both sides of a major division of the spine. Transitional vertebrae most frequently occur at the lumbosacral junction and contain expanded transverse processes, which may form actual unilateral or bilateral joints with the sacrum.

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