image Q. 124 - House of pain

Q.    Which of these has highest constituent of prostaglandins?


a. Synovial sarcoma
b. Subungual glomus tumor
c. Malignant Fibrous histiocytoma
d. Osteoid osteoma
e. Bone infarcts

Answer -
d

 Osteoid forming benign bone tumor osteoid osteoma has small foci and radiologically presents as small nidus with reactive sclerosis around.

Thin slice CT or bone scan may be additional imaging modalities.

Night pain with dramatic relief on taking NSAIDS is characteristic feature and is due to high prostaglandins present in the lesion especially PGE2 and PGI2.

image Q . 123 - Teething trouble

Q.     'Tooth sign' is not related to teeth but is found in ?


a. Carpal bones
b. Upper cervical vertebrae
c. tarsal bones
d. Patella
e. Skull bones

Answer -
d

Tooth sign is radiological sign suggestive of quadriceps insertional degeneration, tendinopathy or enthesopathy.

The resulting picture is of vertical ridging or spurring and osteophyte over patella at insertion site of quadriceps tendon (schematic image below )

Better seen in skyline patella views.

image Q. 122 - Under tension

Q.  Tension band injuries is commonly found in?

a. Patella
b. Greater trochanter
c. Spine
d. Pelvis
e. Ankle

Answer -
c

The posterior column of spine behaves like tension band against injury forces and thus acts as posterior restraining structure.

Eg. in thoracic injuries posterior facet and posterior ligamentous structures.

Thus in thoracic spine these injuries are also called 'tension band injuries' as these affect posteroligamentous complex (PLC) or tension band of the normal spine.




Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804719/