Deck 11: Imaging of Bone Disease and Endocrine Disorders

Question 1

All of the following imaging modalities may be useful for diagnosing Paget's disease at some point in the disease's progression EXCEPT:

A) ultrasound.
B) radiography.
C) CT.
D) radionuclide bone scan.

Answer 1

ultrasound.

Question 2

What is the most widely used definitive imaging modality for determining whether a patient is osteoporotic?

A) QCT
B) DEXA
C) Heel ultrasound
D) MRI

Answer 2

DEXA

Question 3

When a lateral chest radiograph demonstrates a possible osteoporotic compression fracture in an elderly woman, which of the following tests IS NOT indicated?

A) A follow-up DEXA scan is valuable to determine if the patient truly has osteoporosis.
B) If the patient has back pain, an MRI is useful to determine whether the fracture is old or recent.
C) A spine series of radiographs is recommended to determine whether there is spinal stenosis.
D) If the patient has a contraindication for undergoing MRI, a radionuclide bone scan is useful to differentiate an old from a recent vertebral insufficiency fracture.

Answer 3

A spine series of radiographs is recommended to determine whether there is spinal stenosis.

Question 4

On a DEXA scan, a T-score (standard deviation) below which value is diagnosed as osteoporosis?

A) 1
B) 2.5
C) 5
D) 10

Question 5

Which of the following statements is INCORRECT for patients with hyperparathyroidism?

A) Ultrasound is an appropriate initial imaging modality.
B) A radionuclide Tc^99m sestamibi scan has good sensitivity and specificity for parathyroid adenomas.
C) MRI may be used to search for ectopic parathyroid adenomas.
D) CT is always needed for preoperative planning of a parathyroidectomy.

Question 6

Ultrasonography in a patient with Graves' disease will likely show:

A) thyromegaly.
B) "white knight."
C) cystic mass.
D) consistent and homogeneous increase in echogenicity.

Question 7

The imaging modality of choice for suspected endocrine dysfunction related to the pituitary is:

A) radionuclide scan.
B) MRI without and with contrast enhancement.
C) CT scan with IV-contrast injection and multiplanar reconstructions.
D) Water's view and lateral radiographs of the sella turcica.

Question 8

An incidental adrenal tumor found on routine contrast-enhanced abdominal CT:

A) is always a hormonally significant adrenal adenoma, and the patient likely has Cushing's disease.
B) requires CT-guided biopsy to determine if the lesion is malignant or benign.
C) may not be definitively evaluated on contrast-enhanced CT because unenhanced CT density of an adrenal lesion is an important issue.
D) should be evaluated further with radionuclide adrenal scanning.