Chapter 14: MSK, Breast And Superficial Structures Flashcards
Tendons connect what to what
Muscles to bone
Ligaments connect what to what
Bone to bone
Describe tendonitis
Inflammation of a tendon
Can be focal or diffuse
Hyperemic flow
Pain swelling and fever
What is tendosynovitis
Fluid within the synovial sheath
Describe partial tear of a tendon
Focal hypoechoic areas within tendon
Describe complete tear of a tendon
Anechoic or heterogenous area within the tendon, often indicative of hematoma
Complete ruptures may have _________ shadowing in the area of the separated tendon with gunk in the gap there like hematoma, fat
Refractive
Achilles tendon is also called
Calcaneal tendon
The Achilles tendon connects what to what
Calf muscle to heel
When the Achilles tendon is inflamed or ruptured, pts will complain of
Posterior ankle and leg pain, and they might say they heard a snap sound
What is the Thompson test
Performed to see if there’s a complete tear of Achilles tendon
Calf is squeezed and foot should plantar flex in a healthy pt
What is the gold standard for breast imaging
Mammography
Name the three layers of breast tissue from most superficial to deepest
Subcutaneous
Mammary
Retromammary
What is the functional layer of the breast
Mammary layer
Describe the echogenicity of the subcutaneous layer
Hypoechoic, mostly fat
Whats the echogenicity of the mammary layer
Hyperechoic, contains ducts of glandular tissue
Whats the echogenicity of the retromammary layer
Hypoechoic, contains fat
What is mastitis
Breast infection, often associated with lactation or trauma
What is puerperal mastitis
Type of mastitis associated with breastfeeding
What are the symptoms of mastitis
Pain redness fever leukocytosis swelling
What does mastitis look like on ultrasound
I’ll defined areas of echogenicity with diffuse edema and hypoechoic fluid within subcutaneous layer that outlines fat lobules
Enlarged lymph nodes may be seen
Mastitis can cause the development of an _______
Abscess
What does an abscess look like
Palpable painful lump
Focal complex fluid collection containing debris
Peripheral hyperemia around it
Enlarged lymph nodes
What are complications after a breast surgery
Mastitis
Abscess
Hematoma
Seroma
Lymphedema
What is a seroma
Simple serous sterile fluid fills the vacated region
What is a galactocele
Milk filled cyst that can develop after an abrupt termination to breastfeeding or result from duct obstruction
What does a galactocele look like
Palpable periareolar mass with pain
Round mass with gold borders may appear complex or contain fluid-fluid level
When is gynecomastia most commonly encountered
After birth
Puberty
50- 80 years old
Gynecomastia can be associated with high levels of ____, which may be produced by some tumors in the testis
HCG
What are the symptoms of gynecomastia
Tender palpable retroareolar breast mass that is firm to the touch
What does gynecomastia look like on ultrasound
Triangular hypoechoic mass posterior to areola
Gynecomastia can also be associated with high levels of _______, adrenal tumors, hepatoblastoma, Klinefelter syndrome and some drugs
Estrogen
What is a superficial epidermal cyst
Potentially the result of an obstructed hair follicle
Can be congenital or the result of trauma
Palpable asymptomatic mass that raises the skin
What does a superficial epidermal cyst look like on ultrasound
Can look anechoic, hypo or hyperechoic or complex
Pseudotestis look
What is a ganglion cyst
Common mass found along the dorsal aspect of the hand and wrist
Can also arise from any other joint
What are bible bumps
Large ganglion cysts in the wrist
Ganglion cysts within the wrist are called ______ ganglion cysts
Dorsal
Describe a volar ganglion cyst
Located near radial artery
What does a ganglion cyst look like on ultrasound
Non compressible anechoic mass with acoustic enhancement
May contain debris and septations
What is a lipoma
Asymptomatic Benign fatty tumor usually compressible and oval in shape
Isoechoic to adjacent fat
What is a hemangioma
Asymptomatic Benign mass composed of vascular channels
Raised red or purple mass on skin
Hypoechoic with blood flow
What is the meniscus
Thin fibrocstilaginous tissue between the surfaces of some joints
What are meniscal cysts
Caused by a fluid collection following a meniscal tear after a trauma or degenerative changes
Usually found in the knee
What are other names for a baker cyst
popliteal cyst or synovial cyst
Baker cysts are often seen with what conditions
Rheumatoid arthritis or osteoarthritis
What is a pilonidal cyst
Nest of hair located in the gluteal cleft (between the buttocks)
What are pilonidal sinus
Like pilonidal cysts but within the fingers or toes
What patients are prone to pilonidal cysts
People who sit for long periods of time and hair dressers
What is cellulitis
Infection and inflammation of the skin and subcutaneous tissue
Most often caused by staphylococcus and strep
What are the clinical findings of cellulitis
Red warm tender skin, leukocytosis especially if there is an abscess,
What does cellulitis look like on ultrasound
Hypoechoic, edematous strands within soft tissue (cobblestone appearance)
Malignant melanoma consists of __ % of all skin cancers
11
What does primary AND metastatic melanoma look like
Hypoechoic with high vascularity
When imaging foreign objects, distance from the skin to the _________ should be obtained to aid in removal
Object
Describe developmental dysplasia of the hip
Congenital anomaly described as shallow hip pocket
Developmental dysplasia is caused by what
Abnormal fetal ligament development within the hip.
Intensified by excessive levels of maternal estrogen
Developmental hyperplasia is most common in female patients O SEA YO and which side
Left
What are the two clinical tests performed to evaluate developmental dysplasia of the hip
Barlow test and Ortolani test
Describe Barlow test
Used to evaluate the hip for dislocation and requires leg to be adducted
Describe ortolani test
Evaluates the reduction or relocation of a dislocated hip and is performed by abducting and lifting the thigh relocating the hip back into the acetabulum
A click may be heard
Ultrasound of the hip is done both in flexión and at ____
Rest
Describe the subluxation position of the femur head
Indicates Partial dislocation of the hip
Infant hip is examined in what two planes
Coronal and transverse
What is the Graf technique
Obtained in coronal view
Used to measure the relationship of the femoral head and acetabulum by evaluating alpha and beta angles created por las dos estructuras esas
The ______ the alpha angle and the _____ the beta angle, the most likely the infant has DDH
Smaller, larger
Coverage of the femoral head by the acetabulum of greater than ___% is normal
55
Nonsurgical treatment for developmental dysplasia can be done with casting or _____ harness
Pavlik
Hip effusion is typically seen in what ages
5-10
Hip effusion is most likely the result of ___________
Transient synovitis
What are the clinical findings of infant hip joint effusion
Leg/knee pain, hard to walk, low grade fever, mild leukocytosis
A joint effusion will elevate the anterior joint capsule, and it will measure
More than 5mm
