重要的名解

Osteoporosis: refers to a decrease in normal bone tissue per unit volume, in which mineral and organic matters decrease in proportion, leaving a qualitatively normal but quantitatively deficient bone tissue. The deficient bone becomes more fragile and more vulnerable to fractures. In plain film, it appears to be a decrease in bone density generally, thin and sparse trabeculae, wide intertrabecular space, and a thinner and stratiform cortical bone. It often occurs in the elderly, menopause in women, and other circumstances such as tumor, infection, endocrine disorders, etc.

Osteomalacia: refers to a defect in calcification of the bone per unit volume. The bone has normal organic matters but a decrease in mineral. The bone will become softer, which may easily lead to deformation of the bone under continuous pressure. In plain film, it appears to be a decrease in bone density generally, as well as thin and blurring trabeculae and cortex. Looser’s Zones may also be seen. It usually occurs in VitD deficiency or metabolic disorders of Ca and P.

Osteosclerosis and Hyperostosis: refers to an increase in normal bone tissue per unit volume. In plain film, it appears to be an increase in bone density generally, with thickened cortex and trabeculae. The medullary space is narrowed or even vanished, and sometimes the cortical bone and spongy bone cannot be distinguished. It is usually seen in tumor, inflammation, and trauma.

Periosteal reaction: when the periosteum is irritated pathologically, osteoblasts in the inner layer will be activated and produce sub-periosteal new bone. In plain film, it appears to be a high density shadow parallel to the cortex, with various patterns as linear, luminar, or lacelike. It usually indicates a destruction or injury of the bone.

Bone destruction: localized absence of normal bone tissue and replaced by pathological tissues. Both the cortical and spongy bone are destructed because of either the absorption of bone tissues or the activation of osteoclasts by the pathological tissue. In plain film, it appears to be a decrease in bone density locally, absence of normal bone tissue, and probably worm-eaten or sievelike cortical bone.

Osteonecrosis: a localized cessation of metabolism which directly leads to cell death. The necrotic bone tissue is called sequestrum. In plain film, it appears to be an increase in bone density locally. It is often seen in inflammation, trauma, and infarction.

Degeneration of joint: degenerated and necrotic articular cartilage, replaced by fibrous tissues gradually. When the bony surface is involved, it can cause hyperostosis of the bone, which leads to rough articular surface, formation of osteophyte, and ossification of ligament. It is often seen in weight-bearing or frequently used joints.

Ankylosis of joint: bony or fibrous tissues connect the articular surface. In plain film, it is characterized by a narrowed articular space. Whether the trabeculae pass through the articular space distinguishes bony or fibrous ankylosis.

Fracture: a complete/ incomplete break in the continuity of a bone or a cartilage. Incomplete fractures include crack ~ and greenstick ~. Complete fractures include transverse, oblique, vertical, spiral, fragmented, impacted, compression , and avulsion ~.

Greenstick fracture:an incomplete ~ occurs in the shaft of long bones in

children. Since there are more organic matters in the bone in children, the bone does not break completely that easily under a mild to moderate external force. Instead, only part of the bone is buckled or distorted, without the existence of a fracture line.

Epiphyseal fracture:occurs in children’s long bone, for the epiphysis has not linked with metaphysic, so they may separate when there is an external force acting. In plain film, the epiphysis and metaphysis are not in the normal place, or the epiphyseal plate is broader than normal. The fracture line does not exist.

Colles Fracture: a complete fracture occurs 2-3cm from the distal articular end of the radius. In a lateral film, the distal fragment is displaced dorsally and forms a palmar angulation. In a PA film, the distal fragment moves to the radial side.

A fracture line can be seen. It is often associated with fracture of the styloid process of the ulna and separation of the radioulnar joint. It is often seen in the elderly.

Codman’s triangle: when a malignant bone tumor involves periosteum and soft tissues surrounding the bone, and triggers the periosteal reaction, the tumor can again destroy the sub-periosteal new bone, leaving a triangular area with high density. It is an important sign of malignant bone tumors. Schmorl’s nodule:Prolapse of the nucleus pulposus through the vertebral body endplate into the spongiosa of the vertebra, accompanied by responsive hyperostosis.

Lung markings: consisting of pulmonary a.,v., bronchi, and lymph tissues. In plain film, it appears to be branch like shadow radiating outward from the hilum and disappear with a gradual reduction in size.

Accessory lobe:additional pleura extending into the pulmonary segments, forming additional pulmonary lobe. The most commonly seen are azygos lobe in the inner zone superior to the right hilum, and inferior accessory lobe in the inner zone of inferior lobe.

Cavity: formed as a result of the expulsion of necrotic tissues through bronchus. It can be devided into worm-eaten, thin-walled, and thick-walled cavities. often seen in TB, pulmonary abscess, and lung cancer.

Intrapulmonary air containing space: pathological distension of physiological space in the lung. It appears to be a round translucency with a smooth wall about 1mm in X-rays. such as bullae and air containing bronchial cysts.

Tree-budded sign:bronchiolus, diffuse panbronchiolitis, bronchogenic dissemination

Subpleural line:thickened adjacent interlobular septa connects together, dermatasclerosis, asbestosis

Honeycombing sign:

Air bronchogram sign:

Primary complex: a combination of primary pulmonary tuberculous focus, hilar tuberculous lymphangitis and lymphadenitis. fomrs a typical dumbbell-like X-ray image.

Inverted S curve sign: PA film, atelectasis of the right superior lobe, elevated horizontal fissure, hilar mass, central bronchogenic carcinoma in the right superior lobe

Pleural indentation: V-shaped or cordlike, dense shadow between the mass and pleura, contraction of scar tissue in tumor, adenocarcinoma, bronchioalveolar carcinoma

CTR: the ratio between maximal transverse diameter of the heart: summation of maximal diameter from left and right margin of the heart respectively to the mid line, and maximal width of the thorax: a horizontal line passing through the right diaphragmatic apex between inner edges of the thorax. maximum in adults: 0.5

Hilar dance: under fluorescence, there will be an obviously enhanced pulsation of the hilar arteries in pulmonary hypertension, seen in congenital heart diseases with left-to-right shunt.

Kerley line:pulmonary interstitial edema, formed due to thickening interalveolar septa in different area. A: stretching form the outer zone to the hilum obliquely, seen in acute LHF; B: in the costophrenic angle, 2-3cm long, stretches horizontally, seen in MS and chronic LHF; C: in the inferior field, netlike, seen in severe pulmonary venous hypertension.

Pancoast’s tumor:peripheral bronchogenic carcinoma in the apex. can infiltrate into neighboring vertebrae and ribs, involves cervical sympathetic nerve and cause Horner’s syndrome.

Double contour: in PA film, occurs when the LA is enlarged and reaches or even exceeds the margin of the RA, forming a double margin shadow of the right margin of the heart. Seen in diseases leading to a enlarged LA such as MS.