Aunt Minni Flashcards

1
Q

Describe the findings, mention the diagnosis and associated findings

A

T2 findings suggestive of bone contusions within the medial patella and lateral femoral condyle with associated tear of the medial retinaculum.

Diagnosis; Acute patellar dislocation relocation

Associated findings: Meniscal or ligamentus injury

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2
Q

Female with shoulder pain. Describe findings, diagnosis and important information

A

Globular foci of calcification located at the expected site of the rotator cuff muscles namely the supra and intra spinaus and pectoralis major

Diagnosis: Hydroxyapetite deposition disease/ calcific tendinosis

Important fact: CT appearance can look aggressive and may be mistaken for malignancy.

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3
Q

What is the typical location for hydroxyappetite deposition disease and what is the complication?

A

shoulder

complication; destruction of the joint space causing Milwaukee shoulder

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4
Q

Description, diagnosis, common tyes, investigation of choice and sign

A

Description; Talar beaking, sclerosis between the talocalcaneal joint with fusion on CT scan

Diagnosis; Tarsal coalition
Investigstion of choice; CT
Common types; talocalcaneal, calcaneonavicular
Sign; Anteater/ C sign

Common types; talocalcaneal and calcaneonavicular

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5
Q

Description, Diagnosis, Complications, typical presentation

A

If multiple; multiple hereditary exostosis
aka diaphyseal achalisa, if solitary; osteochondroma

Complication; malignant transformation
Presentation; 10- 20 year old with palpable masses causing neurovascular compressive symptoms.

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6
Q

Description, Common presentation, Diagnosis, other possible findings

A

Diffuse sclerotic thickening, sandwich appeanace of the vertebral bodies

22 yearold with hearing or other cranial nerve deficiets, bleeding after tooth extraction, pancytopenia

Osteopetrosis

other; Erleynmeyer flask deformity; alternating bands of sclerosis and radiolucent bands causing metaphyseal widening

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7
Q

Description, Diagnosis, Age of presentation and progression, Sign, Commonly involved bones

A

well-circumscribed, geographic, lytic me­ taphyseal lesion with cortical thinning. The lesion has well-defined margins and no demonstrable matrix. A comminuted fracture has occurred, and fragments of the cortex have fallen to the dependent portion of the lesion

Diagnosis; unicameral bone cyst
Age; 2nd decade
Progression; metaphysis active then becomes diaphyseal inactive
Sign; fallen fragment sign
Invovled bones; proximal femur and humerus

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8
Q

Description, diagnosis, typical presentation

A

nonaggressive, well-defined lytic lesion in the anterior aspect of the calcaneus with a thin sclerotic border and central caldfication

Sagittal T1-weighted and short tau inversion recovery (STIR) demonstrate a lesion with signal characteristics of peripheral fat and a cystic center.

Dx; intraoseous lipoma
Pres; 40s, long leg bones or calcaneous

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9
Q

Des, Dx, Comp, Pres, Associated syndrome

A

Frontal rad, skel imm, solitary, cortical lesion involving the distal tibia with ground glass matrix, no articular extension, no cortical berakthrough, thin sclerotic margin, narrow zone of transition, no ass pathological fracture or soft tissue component.

fibrous cortical defect (less than 2) or non-ossifying fibroma

compl; pathological fracture
presentation; 2-20 y, lower limb
multiple lesions; neurofibromatosis, fibrous dysplasia

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10
Q

What is the history for a patient presenting with pigmented villonodular synovitis and how does that affect the MRI sequences?

A

Hemorrhagic knee effusion causing hemosiderin deposition causing low T1 and T2

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11
Q

Where does pigmented villonodular synovitis usually occur?

A

Intra-articular and usually knee

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12
Q

What excludes the diagnosis of pigmented villonodular synovitis?

A

Evidence of calcification or metaplastic cartilage in essence excludes the diagnosis of PVNS.

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13
Q

In the anterior shoulder dislocation, where are the bankart and hill sach lesions located?

A

Posterio-lateral humerus - hill sach
Anterior inferior glenoid - bankart

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14
Q

What is the diagnostic test used after fibrocartilagenous bankart lesion is detected?

A

MR or CT arthrography

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15
Q

How does patellar tendinosis look like of MRI? What is the other diagnostic study?

A

High signal intensity in the patellar tendon with possible bony fragmentation of the lower patella.

US can alternatively diagnose this entity. However, fat sat MRI sequences are preferred.

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16
Q

Negative ulnar variance with sclerosis of the lunate is called

A

Keinbock disease

17
Q

If there is negative ulnar variance and the patient is symptomaic however the xray is unremarkable what do you do next?

A

MRI

18
Q

What is the sign for ACL tear on Xray?

A

Deep sulcus sign especially if more than 1.5 mm

19
Q

Whats the appearance of ACL tear on MRI?

A

Anterior translation of the tibia
Kissing contusion of the posterior lateral tibia and anterior lateral femur
Increased signal of the ACL on all sequences with a pseudomass appearance.

20
Q

Double PCL sign indicates

A

Displaced bucket-handle tear of the medial meniscus
OR
Full-thickness tear of the ACL

21
Q

What are the signs for PCL tears on MRI?

A

Flipped meniscus sign
Double PCL sign

22
Q

What is a Segond fracture?

A

Avulsion fracture of the lateral tibial plateau usually associated with ACL tears and if present are also associated with meniscal tears. Because of this, kissing contusions may be present

23
Q

Define os acromiale and what is it’s clinical significance?

A

Well corticated triangular bony structure in the expected site of the acromion representing persistant separate ossification center of the acromion process associated with tendon impingment and tear

24
Q

What’s the fancy name for inferior shoulder dislocation?

A

Luxatio erecta

25
Q

What are serious complications of luxatio erecta?

A

Brachial plexus and axillary artery injury

26
Q

What alignment should be assessed in a patient with suspected Lisfranc fracture -dislocation?

A

The medial aspect of the 2nd cuneiform should align with the 2nd metatarsal.

27
Q

What are the types of Lisfranc fracture- dislocation?

A

Homolateral and Divergent

28
Q

What is the usual history of a patient with Lisfranc fracture?

A

Diabetes

29
Q

Describe the image findings

A

There is a linear lucency in an area of medullary sclerosis with lifting of the periostum and possible cortical thickening. Features could represent chronic osteomyelitis with sinus tract formation.

30
Q

Whats the long term complication of the sinus tract in chronic osteomyelitis?

A

Squamous cell carcinoma