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My FRCR2A > MSK > Flashcards

MSK Flashcards

1
Q

Pathological vertebral fracture vs osteoporotic

A
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2
Q

Bone marrow on MRI

A
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3
Q

Tarlov cyst
-Dilatation of posterior nerve root sheath.

A

Dural ectasia
- Ballooning of the dural sac resulting in posterior vertebral scalloping

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4
Q

Disc Bulging and nerve compression
- In cervical spine C3/C4 will affect C4 etc

A
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5
Q

Causes of Marrow Reconveresion

A
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6
Q

Myelofibrosis

A

Bone marrow is gradually replaced by fibrous tissue
Fibrous tissue contains fewer water molecules
Low signal T1 + T2

Concurrent hepatosplenomegally
Cause of a super scan

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7
Q

Vertebral haemangioma

A

Typical: High signal T1 + T2 (Lipid rich)
Atypical: Low T1, high T2 (Lipid poor)
Avid enhancement

Sign—lateral (corduroy)

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8
Q

Differential for permeative bone destruction

A
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9
Q

Nerve compression secondary to disc bulging

A
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10
Q
A
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11
Q

Posterior vertebral scalloping
- SATAN

A
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12
Q

Anterior vertebral scalloping

A
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13
Q

Myotomes

A
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14
Q
A
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15
Q

Dermatomes

A
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16
Q

Osteoporosis v mets

A
17
Q

Causes for block vertebrae:

A
18
Q

Sprengel shoulder

A

Can occur in isolation or as part of Klippel-Feil syndrome
- both associated with renal anomalies

Congenital abnormality where scapula is attached to the cervical vertebrae by fibrous or osseous (omovertebral) connection

Result is elevation and medial rotation of hypoplastic scapula.

  • CAN BE SEEN ON PLAIN FILM
19
Q

Klippel - Feil syndrome

A

Segmentation anomaly with cervical fusion of 2or more vertebrae. C2-C3 most commonly involved.

Other associations:
Renal abnormalities
Scoliosis
Sprengel shoulder
Deafness (SN) (Nbb microtia, deformed ossicles)
Cervical ribs
Congential heart disease - ASD

20
Q

Ivory vertebrae - dense sclerosis of a solitary vertebrae without change in size/shape

A
21
Q

Holt-Oram syndrome

A

Associated with numerous skeletal and cardiac malformations

Cardiac : ASD, VSD, tetralogy of Fallot, coarctation.

MSK: Radial ray hypoplasia - absence of one or both thumbs

22
Q

Ependymoma
T1 hypointense, foci high T2 signal
Predominate in 4th ventricle (roof)
Toothpaste tumour

Spinal cord ependymoma is slightly different - most common intramedullary tumour in adult which shows intense enhancement
Can be associated with syrinx
NF2 - spinal ependymoma

A

Hemangioblastoma
Cyst with enhancing nodule
ISO or high T1, high T2.
Sometimes cause polycythaemia.

23
Q

Phemister triad - features of articular tuberculosis

Tuberculous spondylitis known as Pott disease
- L1 usually first affected
- anterior vertebrae affected first because of bacterial spread anterior longitudinal ligament

A
  1. Juxta-articular osteoporosis
  2. Marginal erosions
  3. Gradual reduction in joint space
24
Q

Tuberculous spondylitis v pyogenic spondylitis

A
25
Q

Widened interpedicular distance

A

Diastomatomyelia
Split cord
Two Dural sac type 1, one sac type 2

26
Q

Disc terminology

A
27
Q

Increased Atlantodental interval
Normal
- adults <3mm
- children <5mm

Also prevertebral space
- <7mm at c2
- <5mm C3/4
- <22mm C6 (14mm kids)

A
28
Q

Paget’s disease
Lytic phase: radiolucency with flame or blade of grass shape extends along the diaphysis. Osteoporosis circumscripta (lucent areas in skull).
Mixed phase: lytic and sclerotic
Sclerotic phase: densely sclerotic eg ivory vertebrae.

A

Clinically :
Raised ALP, normal Ca and phosphate
Pathological fracture although sclerotic
CN palsy secondary to neural foramina compression
Enlarging head/hat - Tam O’Shanter

Radiologically: bony expansion with coarsening of trabecular and cortices.

29
Q

Hyperparathyroidism
PTH increases calcium levels prompting renal re absorption or acting on osteoclasts to increase bone resorption.

A

Therefore generalised osteopenia, cortical thinning of subperiosteal bone.

30
Q

Osteoporosis
- loss of bone mass

Susceptible to fracture
- typically Colles fracture
- NOF fracture

A

DEXA
Density of bone calculated
Z score

Causes:

31
Q

Osteogenesis Imperfecta
Chromosome 7/17
Abnormal type 1 collagen
- Autosomal dominant fashion

A

On imaging diffuse undermineralisation of skeleton and cortical thinning.

Soft bones become bowed
Acetabula protrusion
Basilar invagination (C-spine v base of skull)
Wormian bones

32
Q

Madelung deformity
- problem with ulnar side of the distal radius
- distal radioulnar joint subluxes and ulna displaces dorsally
- positive ulnar variance
- lunate is triangular
- radioulnarcarpel joint angle <120 degrees

A
33
Q

Pseudo gout - CPPD

A

Can be acute or subacute
- similar characteristics to OA

Particular joint involvement
- patellofemoral joint
- TFCC calcification
- Radiocarpal joint

34
Q

Median nerve supply

A

L lateral 2 lumbricals
O Opponens policis
A Abductor pollicis brevis
F Flexor pollicis brevis

35
Q

Carpel tunnel

A
36
Q

Alkaptonuria (Ochronosis)

A

Autosommal recessive
Raised enzyme - HGA
Affinity for collagen and accumulates in CT throughout the body.
Causes a black staining

Chondrocalcinosis most prominent feature
Calcification and destruction intervertebral discs.
Premature OA changes hands, feet, shoulders, hips, knees.

37
Q

Haemachromatosis
Primary - excessive dietary iron accumulation
Secondary - blood transfusions with too little chelation.

A

On MRI
Iron paramagnetic, and therefore liver will be lower than expected, but spleen normal
Transfusion also siderosis spleen/bone marrow affected.

38
Q

Wilsons - excess copper

A
39
Q

Enteropathic arteropathy

A

My FRCR2A (7 decks)

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