Question:

Which of the following answer choices is false?
1. Spontaneous fractures frequently involve the talus.
2. Oedema and hyperaemia occur in a bone after an insufficiency fracture.
3. After fractures there is a change of the signal intensity of the bone marrow on MR imaging.
4. Bone contusion demonstrates T1 hypointensity and T2 hyperintensity.
5. Inflammatory reaction is hyperintense on T2.





Answer:

The correct answer for the question "Which of the following answer choices is false?" is:

1. Spontaneous fractures frequently involve the talus.



Explanation
1. Talus is a rare site of spontaneous fractures. [Spontaneous fractures predominantly involve the second metatarsal, the calcaneus and less frequently the navicular bone and the talus.]

2. The bone is charaterized by oedema, hyperaemia and osteoclastic activity, soon after an insufficiency fracture. [In the early phase of insufficiency fractures, the bone is characterized by oedema, hyperaemia and osteoclastic activity.]

3. Fractures alter the normal intensity of bone marrow on MR imaging. [MR imaging shows a poorly defined, abnormal signal intensity of the bone marrow.]

4. On MRI bone contusion is hypointense on T1-weighted images and hyperintense on T2-weighted images. [Similar to that of bone contusion with a ill-defined area of hypointensity on T1-weighted images and hyperintensity on T2-weighted images.]

5. Inflammatory reaction has an high signal intensity on T2-weighted images. [The periosteum is separated from the underlying cortex by hyperintense tissue on T2-weighted images, most likely representing inflammatory reaction.]



From the manuscript:
Spontaneous talar and calcaneal fracture in rheumatoid arthritis: a case report
Radiology Case. 2011 July; 5(7):15-23


This article belongs to the MSK section.




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From the manuscript

Spontaneous talar and calcaneal fracture in rheumatoid arthritis: a case report

Free full text article: Spontaneous talar and calcaneal fracture in rheumatoid arthritis: a case report

Abstract
Rheumatoid arthritis (RA) leads to a progressive weakening of the skeleton which may result in bone fractures. However, spontaneous fractures (exclusive of stress fractures, vertebral collapse, and superficial articular fragmentation) in patients with rheumatoid arthritis have been only occasionally reported in the medical literature. A case of spontaneous talar and calcaneal fracture in rheumatoid arthritis is described. Bone lesions were identified on radiographs, MR images and scintigraphy in a patient with right ankle pain. The absence of episodes of acute trauma, and the presence of acute clinical manifestations should guide the clinical suspicion.






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