Aunt Minni Flashcards
Describe the findings, mention the diagnosis and associated findings
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
Female with shoulder pain. Describe findings, diagnosis and important information
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.
What is the typical location for hydroxyappetite deposition disease and what is the complication?
shoulder
complication; destruction of the joint space causing Milwaukee shoulder
Description, diagnosis, common tyes, investigation of choice and sign
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
Description, Diagnosis, Complications, typical presentation
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.
Description, Common presentation, Diagnosis, other possible findings
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
Description, Diagnosis, Age of presentation and progression, Sign, Commonly involved bones
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
Description, diagnosis, typical presentation
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
Des, Dx, Comp, Pres, Associated syndrome
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
What is the history for a patient presenting with pigmented villonodular synovitis and how does that affect the MRI sequences?
Hemorrhagic knee effusion causing hemosiderin deposition causing low T1 and T2
Where does pigmented villonodular synovitis usually occur?
Intra-articular and usually knee
What excludes the diagnosis of pigmented villonodular synovitis?
Evidence of calcification or metaplastic cartilage in essence excludes the diagnosis of PVNS.
In the anterior shoulder dislocation, where are the bankart and hill sach lesions located?
Posterio-lateral humerus - hill sach
Anterior inferior glenoid - bankart
What is the diagnostic test used after fibrocartilagenous bankart lesion is detected?
MR or CT arthrography
How does patellar tendinosis look like of MRI? What is the other diagnostic study?
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.
Negative ulnar variance with sclerosis of the lunate is called
Keinbock disease
If there is negative ulnar variance and the patient is symptomaic however the xray is unremarkable what do you do next?
MRI
What is the sign for ACL tear on Xray?
Deep sulcus sign especially if more than 1.5 mm
Whats the appearance of ACL tear on MRI?
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.
Double PCL sign indicates
Displaced bucket-handle tear of the medial meniscus
OR
Full-thickness tear of the ACL
What are the signs for PCL tears on MRI?
Flipped meniscus sign
Double PCL sign
What is a Segond fracture?
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
Define os acromiale and what is it’s clinical significance?
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
What’s the fancy name for inferior shoulder dislocation?
Luxatio erecta
What are serious complications of luxatio erecta?
Brachial plexus and axillary artery injury
What alignment should be assessed in a patient with suspected Lisfranc fracture -dislocation?
The medial aspect of the 2nd cuneiform should align with the 2nd metatarsal.
What are the types of Lisfranc fracture- dislocation?
Homolateral and Divergent
What is the usual history of a patient with Lisfranc fracture?
Diabetes
Describe the image findings
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.
Whats the long term complication of the sinus tract in chronic osteomyelitis?
Squamous cell carcinoma
