Misc

Question 1

Arthrogram technique in shoulder, where to aim?

Arthrogram in hip, where to aim

Answer 1

1. Superior medial target
2. Lateral target

Question 2

How much Gad do you use for MR cocktail of shoulder arthrogram?

Answer 2

0.1 CCs of GAD.

4 CCs of lidocaine, 8 CCs of visipaque

Question 3

Gamekeeper’s thumb:

1. what is ligament pulling the fragment?
2. How often is there an avulsion fragment?

Answer 3

1. Ulnar collateral ligament of thumb
2. 1/3 of time they have avulsion

Question 4

Stenner lesion

Answer 4

Balled up, proximally retracted UCL (yo-yo on a string sign)

Intact adductor aponeurosis prevents contact of UCL and proximal phalanx and proper healing.

Question 5

Name 4 stress fractures in foot. Which one is high risk?

Answer 5

1. Navicular, march fracture (2nd mtt), calcaneus, 5th metatarsal stress fracture
2. Navicular has a bad prognosis with a high nonunion rate

Question 6

1. Explain tensile vs. compressive fracture of femoral neck
2. explain tensile vs. compressive in tibia

Answer 6

1. Compressive side fracture is a fracture of medial neck. This is good because you put weight you are aligning it.

Tensile side is the lateral side, and it is bad because when you put weight, you are spreading it out

2. Tibia: Compressive side is posteriomedial.

Tensile side is anterior

Question 7

Name the osteochondroses/joint ifarctions of the following sites

Navicular

Femoral head

2nd metatarsal head

Lunate (a/w ulnar negative variance)

tibial tuberosity

Capitellum

Calcaneus (growing pain)

Inferior part of patella

Answer 7

Navicular - Kohler’s

Femoral head - Perthes

2nd metatarsal head - Freiberg

Lunate (a/w ulnar negative variance) - Kienbock

tibial tuberosity - Osgood Schlatter

Capitellum - Panner

Calcaneus (growing pain) - Sever

inferior part of patella - Sinding Larsen Johanson

Question 8

Kohler’s disease general info

Answer 8

Osteochondrosis/ AVN of navicular bone. More common in boys. Self-limiting

Question 9

Freiberg disease

Answer 9

Osteochondrosis/AVN of 2nd metatarsal: occurs in adolsecent girls. May be due to tight shoes. Can lead to secondary OA

Question 10

Panners disease

Answer 10

Osteochondrosis/AVN of capitellum. Occurs in kids 5-10. Doesn’t have loose bodies

Question 11

What is Supracondylar process/Avian spur?

What is a rare complication?

Answer 11

Normal variant.

Can rarely have compression of median nerve via ligament of struthers

Question 12

Describe Morel-Lavvallee

Answer 12

Morel-Lavvallee lesion

Shear lesion

Complex pocket of blood/lymph

Seen along hip and knee