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Musculoskeletal Radiology

Erosive osteoarthritis.

Erosive Osteoarthritis

Inflammatory form of OA that affects postmenopausal middle aged women Often limited to the hands, especially PIP and DIP, and 1st carpometacarpal and STT joints Gull...


Findings –Atrophy and tapering of soft tissues of fingers –Acroosteolysis –Subcutaneous Ca+ or joint Ca+ –Erosions (late finding) with predilection for PIP and DIP –Flexion contractures –Very distinctive feature is...
Frontal radiograph of shoulder shows a humeral head in internal rotation (lightbulb sign), decreased distance between humeral head and glenoid and a “trough fracture” or “reverse Hill-Sachs” deformity of the medial humeral head.

Posterior Shoulder Dislocation

Causes: electrocution and seizures Findings –Trough sign: vertical compression fx of anteromedial humeral head –Rim sign: widening of glenohumeral joint > 6 mm –Absent crescent sign:...
subchondral erosions of the fourth left distal interphalangeal joint and right third and fourth proximal interphalangeal joints with periosteal reaction.

Psoriatic Arthritis

Psoriatic and reactive arthritis –Erosive and productive change (also seen in erosive OA) –Erosions have fuzzy margins and wisps of periostitis –Distal predominance and soft tissue swelling –In...
Blade-of-grass sign. 

Paget Disease

  Blade of grass: V-shaped lucency in metadiaphysis, usually in long bone, representing lytic phase Most often seen in femur and tibia In skull,...
Salt and pepper skull.

Hyperparathyroidism/Renal Osteodystrophy

Findings –Subperiosteal resorption along radial aspects of middle phalanges, especially 2nd and 3rd –Brown tumors (lytic lesions) –Soft tissue Ca+ –Acroosteolysis –Cortical tunneling, osteopenia, subchondral resorption mimicking erosions –Occasionally, diffuse...

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    1.  What is the diagnosis?  A.  SNUC B.   Inverting Papilloma C.   Fungal Sinusitis D.  Esthesioneuroblastoma 2. This cancer originates from? A.   The submucosal cells of the sinonasal...

Neurofibromatosis type 2

1. What is the diagnosis? A. Von Hippel Lindau B. NF-1 C. NF-2 D. Tuberous Sclerosis 2. Unlike NF-1, NF-2 is NOT associated with? A. Schwannomas B. Meningiomas C. Ependymomas D. Neurofibromas 3. Which...
Fibrous Dysplasia

Paresent with headache

1. What is the diagnosis? A. Chondrosarcoma B. Osteosarcoma C. Fibrous Dysplasia D. Mets (breast or lung) 2. Fibrous Dysplasia vs Pagets? A. Fibrous Dysplasia involves the inner table B....