An osteolytic lesion is a type of bone lesion characterized by the destruction of bone tissue, leading to a decrease in bone density.
CT-guided radiofrequency ablation (RFA) is a minimally invasive procedure used for the treatment of osteoid osteomas, performed with CT guidance, where a radiofrequency probe or laser fiber is introduced to deliver energy for ablation.
Articular surfaces that appear blurred or poorly defined, often due to joint damage or disease.
Loss of bone tissue in the femoral head and neck area, commonly seen in inflammatory arthritis.
Unsharpness of articular surfaces refers to the loss of clear definition of the joint surfaces, often indicating degenerative changes or pathology.
The anterior aspect of the talus is a critical area to assess for lesions, as it can indicate underlying pathologies such as osteolytic lesions.
Particulate agents are embolizing materials that can be either absorbable (temporary) like autologous blood clot and Gelfoam, or nonabsorbable (permanent) such as polyvinyl alcohol particles and microspheres.
Liquid agents are nonabsorbable (permanent) embolizing materials that include isobutyl 2-cyanoacrylate, ethanol, and sodium tetradecyl sulfate.
The lumbar puncture needle is placed into the disc under fluoroscopy to facilitate the delivery of laser energy for treatment.
The procedure can be performed under general anesthesia or conscious sedation, depending on the patient's needs and the complexity of the case.
A technique considered in the treatment algorithm for primary or secondary bone tumors, particularly beneficial in cases with high risk of bleeding or spinal involvement.
A minimally invasive procedure where a lumbar puncture needle is placed into the disc under fluoroscopy, followed by the injection of ozone gas prepared from an ozone generator.
A technique used to treat osteoid osteoma by placing a bone biopsy needle into the lesion under CT guidance and introducing an RF probe to ablate the tumor.
Thermal energy sources such as radiofrequency, laser, or microwave energy are used in the treatment of both benign and malignant bone tumors.
A targeted cancer treatment that delivers chemotherapy directly into the blood vessels supplying a tumor, often used for extremity osteosarcoma and malignant fibrous histiocytoma (MFH).
Altered marrow signal intensity appearing hypointense on T1 and hyperintense on STIR suggests changes in the bone marrow, often indicative of edema, necrosis, or other pathological processes.
Radiologically, chronic tubercular shoulder disease shows osteoporosis with erosion of articular margins, osteolytic lesions involving the head of the humerus and glenoid, and may mimic a giant cell tumor.
Inferior subluxation of the humeral head can occur in advanced cases of tubercular shoulder disease, leading to fibrous ankylosis.
The classical dry type of tubercular shoulder disease is more common in adults and runs a benign course, unlike the fulminating variety which is more common in children and may involve cold abscess or sinus formation.
The initial focus may be in the synovium or subchondral bone of the distal femur, proximal tibia, or patella.
Juxta-articular osteopenia refers to a localized decrease in bone density around a joint, often seen in conditions like arthritis or infections, leading to fuzziness of articular margins and loss of joint space.
A fat-saturation technique in MRI that results in decreased signal intensity from fat and increased signal from fluid and edema, making it sensitive for detecting tissue and marrow pathology.
Erosion of the lateral aspect of the femur head and neck indicates joint degeneration and is associated with markedly reduced joint space, suggesting potential underlying pathology.
A type of arthritis caused by tuberculosis infection, characterized by joint inflammation and damage.
Clinical features include insidious onset, low-grade fever, anorexia, weight loss, night sweats, night pains, painful limitation of movement, muscle wasting, regional lymph node involvement, and neurologic symptoms.
Various substances used in embolization procedures, categorized based on their duration and physical properties, such as short, intermediate, long-acting, particulate, or liquid agents.
MRI can show the extent of bone destruction and any associated soft tissue abnormalities, providing detailed imaging of lesions.
Kyphoplasty is a technique that involves inflating a bone tamp within the vertebral body to restore its height, followed by placing bone cement for strength augmentation.
A treatment that decreases the chance of recurrence of hemangiomas by reducing their size and controlling persistent left-to-right shunts.
A reduction in bone density around a joint, often associated with inflammatory conditions like arthritis.
The needle position can be checked by performing a rotation angiogram and creating a three-dimensional (3D) reconstruction image.
Reduction of joint space is a sign of joint degeneration or disease, often associated with conditions like osteoarthritis.
Complications include cement leaks causing pain or neurological damage, inaccurate needle placement injuring nerve roots or spinal cord, pain exacerbation from substantial cement leaks, and rare occurrences of puncture site infection and bleeding.
Caries sicca refers to a benign course of tubercular affliction of the shoulder without pus formation, characterized by small pitted erosions on the humeral head.
The contraindications are patients with hemorrhagic diathesis and puncture site infection.
Intra-arterial chemotherapy is a treatment where a chemotherapeutic drug is injected into the tumor bed using an angiographic catheter placed in the artery supplying the tumor, allowing for limb-sparing resection with less morbidity.
The maintenance of the space between joint surfaces despite other signs of joint damage.
Both benign lesions like osteoid osteoma, osteoblastoma, and enchondroma, as well as malignant lesions such as metastatic tumors.
Fluoroscopy is used to guide the placement of the bone biopsy needle and the injection of PMMA cement into the vertebral body during the vertebroplasty procedure.
A procedure that involves inflating a balloon in the vertebral body to restore height and then filling the space with cement to stabilize the fracture.
The patient is typically monitored in a supine position for 3 hours after the procedure and is discharged after 6 hours.
Synovial hypertrophy is an increase in the size of the synovial membrane, commonly seen in osteoarticular tuberculosis (TB) on MRI.
Hip involvement is seen in about 15% of cases of osteoarticular tuberculosis.
A technique used to reduce intraoperative blood loss by injecting Gelfoam into blood vessels, particularly in patients with vascular malformations.
Mechanical agents are nonabsorbable (permanent) embolizing materials that include steel coils and detachable balloons.
A procedure used to relieve chronic pain due to tumors by embolizing major vessels of supply, often with materials like Gelfoam and steel coils.
'Wandering acetabulum' refers to the displacement of the acetabulum due to destruction and subluxation of the upper end of the femur, often resulting in abnormal joint mechanics.
RFA shows a significant reduction in hospitalization cost and duration, along with almost negligible postprocedural complications and a low rate of recurrence.
A procedure used to treat painful metastatic deposits in the spine by blocking blood flow to the affected area.
Arteriography is a radiological technique used to visualize the blood vessels in bone tumors, aiding in diagnosis and management.
Imaging studies that show the blood vessels before and after the embolization procedure, illustrating the changes in blood flow.
Angiography plays a crucial role in the management of musculoskeletal tumors by providing detailed images of blood vessels, which can help in treatment planning.
A benign tumor made up of blood vessels, which can occur in various regions, including the submandibular area.
A pseudoaneurysm of the popliteal artery is a vascular complication that can occur as a result of an osteochondroma, characterized by a false aneurysm formation.
Ultrasonography helps demonstrate joint effusion, synovitis, and capsular thickening, with synovial thickening appearing as hypoechoic intra-articular soft tissue.
Signs include osteoporosis, soft tissue swelling due to synovial effusion, thickened synovium, and capsule.
In tenosynovitis, thickening of the synovial sheath along tendons suggests chronic tenosynovitis and may indicate the presence of associated soft tissue abscesses.
It can lead to effusion, osteoporosis, accelerated growth, and maturation resulting in big bulbous squared epiphysis.
Selective intra-arterial embolization is a targeted procedure used to occlude blood vessels supplying bone tumors, serving as an adjunct in their management.
There is loss of definition of articular surfaces, marginal erosions, decreased joint space, and destruction of bones.
Technetium-99m is the most sensitive isotope used in skeletal scintigraphy, helping to localize suspicious regions and aiding in follow-up, although it is not specific.
A form of tuberculosis that affects short tubular bones, resulting in infection and inflammation in those areas.
It indicates a thin intermediate signal intensity rim along the periphery of a bone or soft tissue abscess on unenhanced T1WI, useful for identifying soft tissue abscesses.
Marginal erosions are characteristic of TB in weight-bearing joints such as the hip, knee, and ankle, and wedge-shaped necrotic foci may become evident on either side of the joint.
The rim of synovial lesions on pregadolinium T1-weighted images may help in characterizing the lesion as tubercular when radiographs are normal.
Embolization can be used to occlude blood flow in recurrent or residual arteriovenous malformations when intravascular access is difficult.
The primary purpose of vertebroplasty is to provide pain relief, although it is not very effective for restoring vertebral body height.
Pathologic affliction can be categorized as inflammatory edema and exudates (predestructive stage), necrosis and cavitation, destruction and deformation, and healing and repair.
Tubercular infection in bones is said to develop 2–3 years after the primary focus.
A common complication following embolization, characterized by symptoms such as nausea, vomiting, fever, and pain due to tissue ischemia.
An optical fiber is advanced through the needle to deposit laser energy into the disc.
The 'mortar and pestle appearance' refers to the gross destruction of the femoral head and neck contained within an enlarged acetabulum, typically seen in certain pathological conditions.
A medical procedure that involves the intentional blockage of blood vessels to treat arteriovenous malformations, often performed via direct percutaneous puncture.
The Perthes’ type appearance suggests irregularity, partial collapse, and sclerosis of the epiphysis of the femoral head, indicative of avascular necrosis or similar conditions.
Early presenting features include swelling, limp, and pain, particularly evident in front of the joint and around the malleoli and tendoachilles insertion.
Arteriography is valuable in the management of aneurysmal bone cysts as it helps in visualizing the vascular supply and planning interventions.
To improve survival rates by using combined intra-arterial and intravenous agents to treat high-grade osteosarcoma and malignant fibrous histiocytoma.
Angiographic manifestations of soft tissue and osseous hemangiopericytomas include specific vascular patterns that can aid in diagnosis.
A Tubercular lesion may start in the greater trochanter or the overlying bursa, potentially causing surface erosion or lytic lesions in the greater trochanter.
CT is helpful in demonstrating lytic areas and marginal erosions much earlier than plain radiographs, and it can also evaluate swelling in soft tissues and early calcification.
In the Stage of Synovitis, the patient may present with an irritable hip, normal plain radiographs, soft tissue swelling, marked deossification, and significant osteoporosis appearing 12–18 weeks after symptoms.
There is bony destruction with joint space reduction and deformity, and translocation of the tibia can occur with respect to the femur.
18 F-FDG-PET is useful in localizing tubercular disease and differentiating soft tissue infections from osseous infections.
In tubercular affliction of the foot, common involvement includes the calcaneum, subtalar, and midtarsal joints, with the anterior two-thirds of the calcaneum being frequently affected.
'Rice bodies' are necrosed cartilage and fibrinous material that form in synovial joints, tendon sheaths, and bursae during tubercular infections.
Diffuse osteopenia is a condition characterized by reduced bone density, which can be seen in cases of tuberculosis, such as in the lateral articular margin of the tibia.
Tenosynovitis may be seen in active (hygromatous) and chronic (serofibrinous) phases, appearing as distended bursa or multiple small abscesses.
A radiological classification for tuberculosis of the hip that assesses the relationship between various radiological types and functional outcomes.
Patients may present with pain, limitation of movement, swelling, and general clinical features of tuberculosis.
A sequestrum is a small irregular piece of necrotic bone that can be identified within an osteolytic lesion, often seen on MRI.
A condition where tuberculosis affects the joints, specifically leading to tubercular arthritis, which can involve the hip joint and other areas.
A form of tuberculosis that specifically affects the joints, leading to inflammation and potential destruction of joint structures.
A type of tuberculosis that affects long and flat bones, leading to infection and inflammation of the bone.
They are sensitive in detecting high signal of joint fluid, making them effective for identifying joint effusion.
Hypointense areas on T2-weighted images suggest hemosiderin deposition, which can indicate the presence of certain lesions.
In the Stage of Advanced Arthritis, there is destruction of articular cartilage, acetabulum, femoral head, capsule, and ligaments, leading to a thickened and contracted capsule and potential displacement of the femur.
Further changes in bone on plain radiograph are usually appreciable 2–4 months after the onset of disease in the bone.
In early synovial disease, there is soft tissue swelling and joint widening due to effusion and synovial hypertrophy. The first radiological sign may be juxta-articular osteoporosis, with patchy areas of trabecular or bony destruction evident. In the center of osteolytic lesions, there may be sequestrum or calcification of caseous tissue, giving an irregular soft, feathery appearance.
The primary purpose of vertebroplasty is to relieve pain, decrease analgesic use, and provide structural support to prevent further collapse of the vertebra.
Regional osteopenia is significant as it indicates bone density loss, which can be associated with various joint pathologies, including infections like tuberculosis.
Early loss of articular joint space is more typically seen in rheumatoid arthritis, helping to differentiate it from tubercular osteoarthritis.
Osteoarticular TB begins in the synovium or in the metaphyseal spongiosa.
Vesselplasty has shown statistically significant benefits in patients with symptomatic vertebral compression fractures.
The differential diagnosis for tubercular affliction includes maduramycosis, neuropathic foot due to various causes, and osteochondritis dissecans of the talus.
Tubercular disease in the shoulder joint typically involves the humeral head, scapula (including glenoid, coracoid process, and spine), and acromioclavicular joint, often leading to widespread destruction.
They give a characteristic hypointense signal to the synovium.
Weight-bearing joints such as hip, knee, and ankle are commonly involved, though any part of the skeleton can be affected.
The Phemister triad refers to juxta-articular osteopenia, peripherally located osseous lesions, and gradual narrowing of joint space, which are pathognomonic of tubercular osteoarthritis.
In advanced cases, there is collapse of bone, subluxation or dislocation, migration of bone, and resultant deformity of the joint. With healing, there is remineralization, and cortical and articular margins become distinct.
The patient is placed in a prone position on the angiography/fluoroscopy table during the vertebroplasty procedure.
Marginal erosions are bone losses at the edges of a joint, typically associated with inflammatory conditions such as arthritis or infections, indicating damage to the joint structure.
A minimally invasive technique that uses heat generated by radiofrequency waves to destroy tumor cells in bone tumors.
PLDD is a minimally invasive procedure where laser energy is delivered into the nucleus pulposus through a needle to vaporize a small portion, reducing intradiscal pressure and disc herniation.
The 'mortar and pestle' appearance refers to the gross destruction and collapse of the femoral head and neck in an enlarged acetabulum.
PMMA stands for polymethyl methacrylate, a type of acrylic bone cement used in vertebroplasty, which is mixed just before injection to provide support to the vertebra.
An interventional procedure used to treat painful vertebral lesions by injecting a cement-like material into the vertebra.
Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis, which is endemic throughout the Indian subcontinent and is of concern due to drug-resistant cases and an increase in immunocompromised patients.
The causative etiological agent for tubercular affliction of bone is Mycobacterium tuberculosis.
Vesselplasty is a technique alternative to vertebroplasty and kyphoplasty, designed to prevent the leakage of bone cement and restore vertebral body height by injecting cement into a balloon positioned in the vertebral body.
An anatomical area where lesions can arise in the hip joint, specifically involving the acetabulum, synovium, femoral epiphysis, or metaphysis.
A condition characterized by the formation of a thrombus in the brachial artery following trauma, which can lead to reduced blood flow.
A medical procedure that involves the administration of thrombolytic agents directly into an artery to dissolve blood clots.
The section thickness used in the pelvis is 7 mm.
A minimally invasive procedure that stabilizes vertebral fractures by injecting bone cement into the affected vertebrae to relieve pain and restore stability.
Fluid analysis or synovial biopsy provides pathologic confirmation of joint diseases by allowing for the examination of joint fluid for signs of infection, inflammation, or malignancy.
A new technical approach designed to treat symptomatic vertebral compression fractures by restoring vertebral body height and alleviating pain.
Ultrasound, CT, and MRI are more sensitive in this stage to detect increased joint space and accumulation of fluid, with investigations repeated at 3–6 weeks’ intervals to help establish the diagnosis.
It shows marked enhancement, particularly useful for visualizing synovial proliferation.
MRI can detect bone marrow inflammation, intraosseous abscess, sequestrum, cortical destruction, cloaca, and sinus tract formation.
Fluoroscopy or CT guidance is used to accurately position a lumbar puncture needle into the center of the disc for procedures like PLDD and percutaneous ozone therapy.
Osteolytic lesions are areas of bone destruction visible on radiographs, which can indicate infections, tumors, or other pathological processes affecting bone integrity.
In the Stage of Arthritis, there is deformity of the hip joint, localized erosions in the periarticular region, and destruction of articular cartilage leading to erosion of the acetabular margin and femoral head.
Percutaneous ozone therapy involves administering a mixture of ozone-oxygen gas into the nucleus pulposus, which affects the proteoglycans, leading to the release of water molecules and reduction of volume.
Fluid loculations with enhancing synovial rims and erosions on postgadolinium images may help in characterizing the lesion as tubercular.
It may result in severe, prolonged muscle pain if acute muscle ischemia occurs, necessitating cautious use for pain palliation.
BCG osteitis is a benign condition that can occur following BCG vaccination, characterized by localization of the Bacillus in the epiphysis and metaphysis with extension across the growth plate, resembling chronic osteomyelitis radiologically but responding to antitubercular therapy.
To decrease intraoperative blood loss, improve surgical vision, and allow for safer and faster surgical procedures.
