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302 MEDIMAGE > 8c. MSK pathologies > Flashcards

8c. MSK pathologies Flashcards

1
Q

what is the function of a joint

A

controlled movement and for stability

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2
Q

what constitutes as a synovial joint

A

articular cartilage over bone

synovial lined joint capsule with synovial fluid

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3
Q

what do ligaments connect

A

bone to bone

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4
Q

what do tendons connect

A

muscle to bones

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5
Q

what is acute trauma

A

bone cartilage and soft tissues (tendon/ligament/muscle) involved

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6
Q

what is chronic trauma

A

wear and tear

eg OA (bone, articular cartilage) or rotator cuff (tendon)

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7
Q

what joint is critical space for rotator cuff injuries

A

joint between acromion and HOH

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8
Q

what is the rotator cuff muscles

A

tendons that surround the shoulder joint

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9
Q

what are the 4 rotator cuff muscles

A

supraspinatus, infraspinatus, teres minor, subscapularis

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10
Q

what causes rotator cuff tears

A

repetitive overhead activities with arms up

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11
Q

what is rotator cuff tear

A

progressive degeneration of the supraspinatus tendon which is worn down or torn in sub acromial space

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12
Q

what is chronic trauma of the rotator cuff

A

reduced sub acromial space due to osteophytes

Space between head of humerus and acromion is gone - very little space for supraspinatus tendon to attach on HOH, bits that go through will get worn out by osteophytes caused by degenerative joint

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13
Q

what happens to the torn tendon and muscle when there is a chronic rotator cuff trauma

A

Worn away and snapped so muscle retracts and muscle undergoes fatty degeneration and this increases over time

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14
Q

what movement is difficult when there is a chronic rotator cuff trauma

A

Difficult to abduct arm overhead without supraspinatus

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15
Q

if a fracture goes through the joint surface what can happen

A

degenerative disease

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16
Q

what is done to shoulder dislocations before imaging

A

it is reduced

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17
Q

what are 3 scenarios in which shoulder dislocations are imaged

A

complex injury

post reduction to look for defect or fracture such as hill sach defect in HOH

planning corrective surgery

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18
Q

what is considered as a complex fracture dislocation

A

chunk of bone pulled off

If muscle is attached to bone fragment and it retracts that bit of bone will never heal as the muscles will pull it apart

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19
Q

what can happen if you dont oppose a glenoid fracture

A

can end up with OA

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20
Q

why can hill sach occur in head of humerus in shoulder dislocations

A

in people with chronic shoulder dislocations each time the shoulder is dislocated it has chipped away at some of the HOH bone so gets hill sachs

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21
Q

what 2 structures is the coronal section good for looking at

A

menisci and cruciate ligaments

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22
Q

how is menisci tears related to blood supply and healing

A

There is only blood supply to outer 25-30% of meniscus itself, if its in the center of the menisci it wont heal, need to chop it out rather than have it become loose body in joint

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23
Q

what happens when there is a full/partial tear in the cruciate ligament rupture and what is seen on imaging

A

area will be edematous and thick so will be bright on T2 MRI

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24
Q

what is a haemarthrosis

what are the layers and why

A

Fracture complex of tibia and blood from bone marrow of tibia has leaked into joint and there is fat anterior to the joint

Fat is lighter than blood so sits on top of blood in joint

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25
Q

what is the danger with haemarthrosis

A

Danger is that fat can get into veins and get to lungs causing fat emboli

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26
Q

in a knee dislocation what is a worry

A

Worried about integrity of the structures behind the knee

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27
Q

what are the structures behind the knee

A

Popliteal artery, vein and tibial and peroneal nerves

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28
Q

what can happen to the structures behind the knee in a posterior knee dislocation

A

Tibia displaced posteriorly and can press on artery behind it and could get ischemia of muscles below site of obstruction which is worse situation of injury can end up with gangrenous leg that needs amputation

Reduced blood flow below dislocation

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29
Q

what is haemarthrosis hemophilia

A

inherited condition where there is reduced ability of the blood to clot and can bleed into the joints after trivial trauma

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30
Q

what can be a severe outcome of haemarthrosis hemophilia

A

End up with joint full of blood and can lead to early arthritis that destroys the join

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31
Q

what is the tibiofibular joint in the ankle responsible for

A

dorsi/plantar flexion

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32
Q

what is the subtalar joint in the ankle responsible for

A

inversion/eversion

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33
Q

what is MRI good for in imaging ankles

A

imaging tendons

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34
Q

what is CT good for in imaging ankles

A

fractures and reconstructions

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35
Q

what happens if tendons rupture or tear

A

becomes oedematous

36
Q

what is osteoarthritis

A

articular cartilage breakdown causes inflammation in joint

37
Q

can OA be reversed

A

no

38
Q

what does OA affect

A

entire joint - bone and connective tissues

39
Q

what is OA treated with

A

pain relief and joint replacement

40
Q

what are 7 risk factors for OA

A 
older age
F>M
obesity
joint injuries
repeated stress on joint
genetics
metabolic diseases
41
Q

what are 7 symptoms of OA

A 
pain
stiffness
loss of flexibility
grating sensation
bone spurs around edge of joint
swelling
depression/sleep disturbances
42
Q

what are 3 characteristics of OA on images

A

loss of joint space
osteophytes
sclerotic margins

43
Q

what can happen to osteophytes in joints in terms of OA

A

overgrowth of bone can break off into joint

44
Q

what is rheumatoid arthritis

A

chronic systemic inflammatory disorder due to autoimmune disorder that affects the synovium of joints

45
Q

what are 3 characteristics symptoms of rheumatoid arthritis

A

painful swelling
bone erosion
joint deformity

46
Q

what does rheumatoid arthritis do to synovial

A

thickens synovium

47
Q

what happens to ligaments in rheumatoid arthritis

A

become lax resulting in joint deformity

48
Q

what are 4 rheumatoid arthritis symptoms

A

tender/war/swollen joint
joint stiffness
fatigue/fever/loss of appetite
severity can alter between flares and remission

49
Q

what is a radiographic characteristic on images in terms of rheumatoid arthritis

A

symmetrical

50
Q

what joints do rheumatoid arthritis affect first

A

smaller joints first

51
Q

what does rheumatoid arthritis do to the synovium and cartilage/bone

A

thickens synovium

destroys cartilage and bone

52
Q

what does rheumatoid arthritis do to tendons and ligaments

A

weaken and stretch

53
Q

what are 5 risk factors for rheumatoid arthritis

A 
F>M
family hx
smoking
environmental exposures
obesity
54
Q

what are 7 complications of rheumatoid arthritis

A 
osteoporosis
rheumatoid nodules
infections
dry eyes and mouth
abnormal body composition
carpal tunnel syndrome
heart problems, lung disease, lymphoma
55
Q

what are 3 things that are characteristic in the appearance of rheumatoid arthritis in images in terms of what the bone looks like

A

bone looks moth eaten and there are round lesions/multiple areas of lucency where nodules have destroyed the bone

56
Q

what is gout

A

deposition of monosodium urate crystals in and around joints

57
Q

what is clinical presentation of gout

A

acute gouty - monoarticular red inflamed swollen joint

58
Q

where does gout normally occur

A

typically in lower limb usually affecting the first metatarsophalangeal joint

59
Q

what 2 phases are there with gout

A

acute phase 7-10days

asymptomatic period between acute flares

60
Q

what is gout associated with

A

chronic uncontrolled hyperuricemia and kidney disease

61
Q

people with gout can develop what

A

tophaceous gout

chronic inflammatory and destructive changes in surrounding connective tissues

62
Q

what are tophi

A

solid urate crystal collections

63
Q

how to tophi appear on images

A

radiopaque

64
Q

what are the 3 radiographic features of gout

A

punched out lytic bone lesions with overhanging sclerotic margins

periarticular soft tissue swelling due to crystal deposition in tophi around joints

soft tissues swelling may be hyperdense due to crystal

65
Q

what is joint infection commonly associated with

A

joint replacement and intervention such as steroid injections

66
Q

what is joint infection seen as on images

A

lucency around bone destruction in later stage

pus around prosthetic implant

67
Q

joint infections with pus around prosthetics will result in what

A

will be loose so may fall out or bone could break so need to take out joint replacement and put another one in

68
Q

what is scurvy caused by

A

vit C deficiency

69
Q

is scurvy treatable

A

yes

70
Q

who is scurvy most prevalent in

A

low socioeconomic status and smokers

71
Q

what occurs in scurvy and where do they occur

A

metaphyseal abnormalities

distal femur and proximal and distal tibia sub ephyseal horizontally oriented foci of lucency with intervening parallel bands of sclerosis

72
Q

why does low vit c lead to scurvy

A

low levels of circulating vit C results in poor collagen fiber formation that leads to demineralized bones, microfractures and poor healing

73
Q

who is ewing sarcoma more common in

A

<20years

M>F

74
Q

what is ewings sarcoma associated with

A

large soft tissue component

75
Q

where does ewings sarcoma occur in

A

ribs

limbs

76
Q

what are the 3 components in ewing sarcoma in radiographic images

A

bone destruction
onion skinning over periosteum
soft tissue mass

77
Q

what is pigmented villonodular synovitis in terms of what is affected

A

diffuse/localized hyperplastic outgrowth of synovial membranes of joints, bursae, tendon sheaths, or combo of these tissues

78
Q

what can pigmented villonodular synovitis be considered as

A

benign tumor of the synovium

79
Q

what can pigmented villonodular synovitis do to the surrounding structures if left untreated

A

displays aggressive invasion to adjacent bone and cartilage

80
Q

what is hemosiderosis

A

disorder of RBC function that results in deposition of iron in bones

81
Q

hoe does hemosiderosis appear on images

A

dark areas on T2 MRI due to iron deposits

82
Q

what is sickle cell disease

A

disorder of haemaglobin in RBC

83
Q

wat is sickle cell disease caused by

A

deformation and early destruction of red cells

84
Q

what can sickle cell disease lead to

A

ischemia and infarcts

85
Q

how can sickle cell disease appear on imaging

A

diffuse diminished bone density with prominent trabecular pattern of spine and pelvic bones

302 MEDIMAGE (20 decks)

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