4b. Ankles

Question 1

what is the mechanism of injury for a calcaneofibular ligament tear

Answer 1

inversion and eversion

Question 2

what happens when the ankle is inverted

Answer 2

fracture the calcaneofibular ligament and avulse the distal end of the lateral malleolus

can also avulse both malleoli

Question 3

what happens when the ankle is everted

Answer 3

can # medial malleolus and can rupture syndesmosis and intraosseous membrane or higher up on the tibia

Question 4

what are the soft tissue sign of ankle injuries

Answer 4

effusion/blood in joint and will get raising of fat pad and seen best in front

dark area in triangle of space where Achilles tendon is

Question 5

what are the 3 types of malleoli fractures

Answer 5

uni/bi/trimalleolar

Question 6

what is a uni malleolar fracture

Answer 6

only one malleolus is fractured

Question 7

what is a bimalleolar fracture

Answer 7

both the medial and lateral malleoli are fractured

Question 8

what is a trimalleolar fracture

Answer 8

med/lat malleoli fracture and posterior part of tibia

Question 9

what is a webers A injury

Answer 9

Weber A is decided upon where the # is on the fibula or lateral malleolus, if its very low down below the syndesmosis - could be bi malleolar

Question 10

what is a webers B injury

Answer 10

B is almost always spiral # and goes through syndesmosis

Question 11

what is a webers C injury

Answer 11

C is higher up fibular and through interosseous memb and through syndesmosis and med malleolus

Question 12

which webers classification is most unstable

Answer 12

C

Question 13

what is a gravity stress view used for

Answer 13

checking for movement of talus laterally to show ligamentous rupture - deltoid ligament

Question 14

why are gravity stress views useful

Answer 14

If talus hasn’t moved but looks like it has moved a tiny bit it can be proved by putting gentle stress on distal part and widens the gap and can see that the ligament has been compromised may not be completely ruptured

Question 15

what is a maisonneuve fracture

Answer 15

high weber C fracture

Question 16

what does a maisonneuve fracture look like on an image

Answer 16

Interosseous membrane and syndesmosis tears and results in widened joint spaces

Angle that looks like its subluxed and widened joint space but no obvious fracture but as it’s a ring structure, there must be another injury

Question 17

what is os trigonum

Answer 17

small extra bone that sits at the back of the ankle joint as the ossification centre hasnt fused so looks like fracture

Question 18

what is osteochondritis dissecans of the talus and why does it occur

Answer 18

Vascular injury

Occurs when athletic people has stress injury and eventually the little divet becomes fractured and there is no blood supply to it and will flake away and cause loose body in joint

joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow

Question 19

what are the signs of osteochondritis dissecans of the talus on an image

Answer 19

osteochondral lesion with/without detachment and on a side of the talar dome

Question 20

what is brodies abscess

Answer 20

sub acute infection

Question 21

where is the brodies abscess commonly found

Answer 21

metaphysis

Question 22

what does osteomyelitis look like on an xray

Answer 22

infection in bone turns everything to pus and mush

Question 23

what are the 4 signs of OA

Answer 23

narrowed joint space
sclerotic margin
osteophytes
subchondral cysts

Question 24

what is talo calcaneal coalition

Answer 24

calcaneus and talas have not separated in formation when child was made

Question 25

what is calcaneo navicular coalition

Answer 25

calcaneum and navicular have not separated in formation

Question 26

what are 2 signs on the xray image for pagets disease

Answer 26

striations and marked trabecular patterns

Question 27

what is a neuropathic joint secondary to

Answer 27

diabetes

Question 28

what is a neuropathic joint

Answer 28

bone and joint changes that occur secondary to loss of sensation

Question 29

what are the 3 radiographic signs of neuropathic joint

Answer 29

destruction of articular surfaces
opaque subchondral ossifications
joint debris, deformity and dislocation