MSK Search pattern

John C.S. Cho, DC

Department of Radiology

Logan College of Chiropractic

Cervical Spine

Lumbar Spine

Shoulder

Elbow

Wrist

Hand

Knee

Ankle

Foot

Quiz

1. 25 y.o male with LBP

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2. 50 y.o female asymptomatic

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3. Foot pain

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4. Multiple joint pain

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5. 45 y.o male neck pain

6. 11 y.o male with left leg pain

Answer

1. Ankylosing Spondylitis

•M:F= 3:1-10:1•HLA-B 27 in 96%•“Dagger sign”•“Trolley-track sign”

2. Paget’s disease

Elevated alkaline phosphatase; normal/hypercalcemia; hydroxyproline

3 phases Cx- malignant

degeneration (~1%) Osteosarcoma>

fibrosarcoma, MFH, chondrosarcoma

3. Jones fx.

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•1.5 cm distal to the 5th metatarsal tuberosity

4. Rheumatoid Arthritis

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5. Plasmacytoma

Malignant proliferation of plasma cell

Early stage of multiple myeloma

Bence Jones proteinuria; A/G ratio; Hypercalcemia; normochromic normocytic anemia

20% 5-yr survival rate

6. Osteosarcoma

10-25; 60-75 Lung

metastases (15%); Skeletal mets uncommon

Malignant degeneration from radiation, paget’s

References:

University of Washington: www. rad.washing.edu Learning Radiology