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MSK Flashcards

1
Q

How fast do phalanges heal?

A

quickly. 3 weeks

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2
Q

How fast does the tibia heal?

A

slowly. 10 weeks

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3
Q

How fast do bones typically heal?

A

6-8 weeks

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4
Q

What does AVN look like on T1

A

dark

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5
Q

What band is most important in scapho lunate ligament?

A

dorsal

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6
Q

What is considered widening of scapho lunate space?

A

> 3mm

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7
Q

What ligament disruption and fracture is associated with mid carpal dislocation?

A

triquetrial fracture

triquetro lunate ligament

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8
Q

lunate dislocation occurs with what ligament injury?

A

dorsal radiolunate ligament

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9
Q

DISI injury

A

radial sided, SL ligament injury

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10
Q

VISI injury

A

LT ligament

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11
Q

normal scaphoid lunate angle?

A

30-60 angle

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12
Q

DISI angle

A

> 60

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13
Q

VISI angle

A

<30

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14
Q

Two fractures at the base of the first metacarpal?

A

bennett and rolando

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15
Q

THe pull of what tendon causes dorsolateral dislocation in Bennett Fracture?

A

abductor pollicis longus

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16
Q

What is gamekeepers thumb?

A

avulsion at base of proximal first phalanx with ulnar collateral ligament disruption

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17
Q

What is a Stener Lesion?

A

adductor tendon gets caught in torn edges of UCL (in gamekeepers thumb)

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18
Q

yoyo appearance on MRI

A

stener lesion

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19
Q

Carpal tunnel syndrome is associated with what four things?

A

dialysis, pregnancy, DM, hypothyroidism

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20
Q

Guyons canal is formed by what bones?

A

pisiform and hamate

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21
Q

What gets entrapped in guyons canal?

A

ulnar nerve

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22
Q

What is handle bar palsy?

A

ulnar nerve entrapment in guyon canal

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23
Q

Colles fracture

A

dorsal angulation

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24
Q

Smith fracture

A

volar angulation

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25
Q

What is a barton fracture?

A

radial rim fracture with radial carpal dislocation

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26
Q

How do you know a lateral wrist radiograph is true?

A

volar cortex of pisiform overlies central 1/3 of interval between scaphoid and capitate

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27
Q

Which tendon is associated with the TFCC?

A

extensor carpi ulnaris/compartment 6

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28
Q

Injury where in the TFCC is good?

A

peripheral

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29
Q

Fracture of what is associated with posterior dislocation of the elbow?

A

capitellum

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30
Q

What is Essex Lopressi fracture?

A

fracture or radial head and anterior dislocation of DRUJ

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31
Q

What is osbornes ligament?

A

epicondylo olecranon ligament, covering cubital tunnel

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32
Q

Cubital tunnel syndrome can be secondary to what acessory muscle?

A

anconeus

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33
Q

What is the rim sign?

A

no overlap of glenoid and humeral head due to posterior dislocation

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34
Q

What is the trough sign?

A

reverse hill sachs due to impaction on anterior humerus in posterior dislocation

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35
Q

What are the 4 main types of shoulder prosthesis?

A

humeral head resurfacing, hemi arthroplasty, total shoulder arthroplasty, reverse total shoulder arthroplasty

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36
Q

Glenoid and cuff intact

A

resurfacing or hemi

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37
Q

glenoid intact, cuff deficient

A

hemi or reverse

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38
Q

glenoid deficient, cuff intact

A

TSA

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39
Q

glenoid and cuff deficient

A

reverse

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40
Q

What is the most common complication of total shoulder?

A

loosening of the glenoid component

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41
Q

What is the anterior escape complication in total shoulder?

A

anterior migration of humeral head after subscap failure

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42
Q

What is a reverse shoulder complication

A

posterior acromion fracture due to deltoid tugging

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43
Q

ASIS avulsion

A

sartorius

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44
Q

AIIS avulsion

A

rectus femoris

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45
Q

Pubic symphysis avulsion

A

adductor

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46
Q

ischial tuberosity avulsion

A

hamstrings

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47
Q

lesser trochanter avulsion

A

illiopsoas

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48
Q

greater trochanter avulsion

A

gluteus medius and minimus

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49
Q

What are three types of snapping hip syndrome?

A

extrenal internal intra articular

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50
Q

What is the most common type of snapping hip syndrome?

A

external. IT band over greater trochanter

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51
Q

What is internal snapping hip syndrome?

A

illiopsoas over illiopectineal eminence or femoral head

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52
Q

What is the intra articular snapping hip syndrome?

A

labral tears or joint bodies

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53
Q

What age is CAM FAI seen in?

A

young males

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54
Q

What is a segond fracture?

A

lateral tibial plateau a/w ACL tear, occurs with interal rotation

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55
Q

What is a reverse segond fracture?

A

medial tibial plateau fracture a/w pcl tear due to external rotation. also medial meniscus injury

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56
Q

What is arcuate sign?

A

avulsion of proximal fibula, associated with PCL tear

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57
Q

What is the deep intercondylar notch sign?

A

depressed lateral femoral condyle a/w acl tear

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58
Q

What ist he classic association with patella alta?

A

SLE

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59
Q

bilateral patellar rupture=

A

chronic steroids

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60
Q

What ist he most common type of tibial plateua fracture?

A

type 2 split and depressed lateral plateau

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61
Q

What is a pilon fracture?

A

tibial plafond fracture

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62
Q

What is a tillaux fracture?

A

salter harris type 3 through tibial epiphysis

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63
Q

What is a triplane fracture?

A

salter harris 4

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64
Q

Maisonneuve fracture?

A

medial malleolus and proximal fibular fx

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65
Q

What is the casanova fracture?

A

bilateral calcaneal w/ spine fracture

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66
Q

Bohlers angle less than what is concerning for fracture?

A

20 degrees

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67
Q

Where is a Jones fracture?

A

base of fifth metatarsal, 1.5cm from tuberosity

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68
Q

What is fifth metatarsal avulsion fracture due to?

A

tug from lateral cord of plantar aponeurosis or peroneus brevis

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69
Q

What is the most common dislocation of the foot?

A

lisfranc

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70
Q

What is the fleck sign?

A

osseous fragment in lisfranc space a/w LF ligament disruption

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71
Q

Two diseases with looser zones?

A

rickets and osteomalacia

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72
Q

T score is what?

A

relative to young adults

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73
Q

Osteopenia =

A

-1 to -2.5

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74
Q

Reflex sympathetic dystrophy is also called what?

A

complex regional pain syndrome or sudeck atrophy

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75
Q

looks like unilateral RA with preserved joint spaces?

A

RSD

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76
Q

Transient osteoporosis of the hip is most common in what type of patient?

A

pregnant third trimester

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77
Q

joint pain that improves, but then migrates?

A

regional migratory osteoporosis

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78
Q

What are the four stages of OCD?

A

1: stable, covered by cartilage
2: stable on probing
3: unstable on probing
4: dislocated fragment

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79
Q

Kohlers

A

navicular , male 4-6

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80
Q

freiberg infraction

A

2nd metatarsal head, young girls

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81
Q

severs

A

calcaneal apophysis

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82
Q

panners

A

capitellum, 5-10 yo, thrower

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83
Q

perthes

A

femoral head, 4-8 yo white kid

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84
Q

kienbock

A

lunate

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85
Q

What is in the first compartment of the wrist and what disease?

A

APL, EPB de quervains

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86
Q

What is in the third compartment?

A

EPL beside listers tubercle

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87
Q

What is in the sixth compartment?

A

ECU can get early tenosynovitis in RA

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88
Q

What are the 4 bony prominences of the carpal tunnel?

A

pisifrom, scaphoid tubercle, hook of hamate, trapezium tubercle

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89
Q

What does the carpal tunnel lie deep to?

A

palmaris longus

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90
Q

What ten things are in the carpal tunnel?

A

4 flexor profundus, 4 flexor superficials, 1 flexor pollicis longus, 1 median nerve

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91
Q

What synovial spaces normally communicate in the wrist?

A

pisiform recess and radiocarpal joint

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92
Q

Do the glenohumeral joint and subacromial bursa communicate normally?

A

NO. if they do concerning for full RC tear

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93
Q

Does ankle join normally communicate with lateral peronal tendon sheath?

A

NO. implies tear of calcaneofibular ligament

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94
Q

Achilles tendon and posterior subtalar joint communicate?

A

NO. achilles does not have true tendon sheath

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95
Q

What is intersection syndrome?

A

seen in rowers. first extensor compartment crosses over second leading to ECR brevis and longus tenosynovitis

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96
Q

What is most affected in nontuberculous mycobacterial tenosynovitis?

A

hand and wrist

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97
Q

isolated 1st compartment

A

dequervains

98
Q

1st and 2nd compartment

A

intersecting

99
Q

isolated 6th

100
Q

multiple flexor compartents

101
Q

What are the three common finger tumors?

A

glomus, giant cell tumor, fibroma

102
Q

Glomus tumor painful?

A

YES but diasppaears with tourniquet= hildreth sign

103
Q

What does glomus tumor look like on MRI?

A

T2 bright, enhances avidly

104
Q

Painless finger tumor with history of trauma

A

epidermoid

105
Q

GCT characterisistics on MRI

A

T1 T2 dark, bloom on gradient

106
Q

FIbroma characteristics on MRI

A

T1 T2 dark, will NOT bloom

107
Q

Where doe the ulnar collateral ligament attach?

A

medial coronoid-sublime tubercle

108
Q

What is the Tsign?

A

partial UCL tear

109
Q

What age is panners?

110
Q

Lateral epicondylitis what tendon?

A

extensor carpi radialis brevis. tennis.

111
Q

Medial epiconsylitis tendon?

A

common flexor tendon and ulnar nerve. golfer

112
Q

What are the three causes of external impingement of the rotator cuff?

A

hooked acromion, subcromial osteophyte formation, subcoracoid impingement

113
Q

subacromial impingement damages what tendon?

A

supraspinatus

114
Q

subcoracoid impingement damages what tendon?

A

subscapularis

115
Q

posterior superior internal impingement damages what tendon?

A

undersurface of infraspinatus

116
Q

loss of fat in rotator cuff interval=

A

adhesive capsulitis

117
Q

thickened inferior and posterior capsule=

A

adhesive capsulitis shoulder

118
Q

decreased glenohumeral volume-

A

adhesive capsulitis (increased is multidirectional instability)

119
Q

enhancement of rotator cuff interval=

A

adhesive capsulitis

120
Q

where is the sublabral recess?

A

incompolete attachment at 12 o clock

121
Q

Where is the sublabral foramen?

A

1-3 o clock

122
Q

What is the buford complex?

A

absent labrum 1-3 o clock with thickened middle glenohumeral ligament

123
Q

GLAD

A

glenolabral articular disruption. superficial anterior inferior labral tear

124
Q

perthes

A

detachement of labrum 3-6 o clock with stripped but intact periosteum

125
Q

ALPSA

A

anterior labral periosteal sleeve avulsion. periosteum intact. medially displaoced GH complex

126
Q

true bankart

A

periosteum is disrupted

127
Q

reverse osseous bankart

A

gtsvyfracture of posterior inferior rim of glenoid

128
Q

POLPSA?

A

posterior labrum and posterior scapular periosteum stripped from glenoid

129
Q

bennett lesion

A

extra articular curvilinear calcification due to injury of posterior inferior glenohumeral ligament

130
Q

kims lesion

A

avulsed posterior inferior labrum. glenoid cartilage and posterior labrum relationship preserved

131
Q

Hagl

A

humeral avulsion glenohumeral ligament. avulsion of inferior gh ligament

132
Q

cyst at level of suprascapular notch affects

A

supraspinatus and infraspinatus

133
Q

cyst at the level of spinoglenoid notch affects

A

infraspinatus

134
Q

What are the four borders of the quadrilateral space?

A

teres minor above, ters major below,humeral neck lateral, triceps medial

135
Q

What is quadrilateral space sydnrome?

A

axillary nerve leads to teres minor atrophy

136
Q

What is the blood supply of the menisci?

A

geniculate arteries

137
Q

What ar ethe two menisco femoral ligaments?

A

wriserg and humprey. wrisberg humps humphrey

138
Q

What ist he conjoint tendon made up of?

A

bicep femoris, LCL

139
Q

What is the meniscal ossicle?

A

ossification of the posterior horn of the meidal meniscus

140
Q

What is odonoghues unhappy triad

A

acl mcl tears with medial meniscal injury

141
Q

Posterior lateral corner involves what anatomy?

A

LCL IT band biceps femoris popliteus tendon

142
Q

what is the primary factor in preventing impingement in acl repair?

A

position of tibial tunnel

143
Q

what is the primary factor in maintaining isometry in acl repair?

A

position of femoral tunnel

144
Q

graft tear is most likely to occur when

A

4-8 months post op

145
Q

What ligament of the ankle is most frequently injurged?

146
Q

acute flat arch=

A

posterior tibial tendon tear at insertion on navicular

147
Q

chronic ptt tear=

A

medial malleolus

148
Q

meniscoid mass in lateral gutter of ankle=

A

anterolateral impingement syndrome

149
Q

mortons neuroma is where?

A

between third and fourth metatarsal heads

150
Q

sequestration ddx=

A

osteo eg lymphoma fibrosarcoma

151
Q

What mimics spinal tb?

A

brucellosis

152
Q

diaphyseal expansile lesion with soft tissue swelling of bones of hands and feet=

A

tb dactylitis (spina ventosa)

153
Q

rice bodies seen in 2

A

TB, end stage RA

154
Q

What are the three reasons to be concerned for pathollogic fracture

A

lytic lesion
lesion over 3 cm
lesions involving over 50% of cortex

155
Q

Parosteal osteosarcoma is located where?

A

posterior distal femur

156
Q

string sign=

A

parosteal osteosarcoma

157
Q

periosteal osteosarcoma where?

A

posterior medial femur

158
Q

age group for periosteal osteosarcoma

159
Q

age group for parosteal osteosarcoma

A

early adult/middle age

160
Q

bone infarcts can turn into

161
Q

MFH what age group and body part?

A

elderly proximal arms/legs

162
Q

MFH on T2?

A

intermediate

163
Q

Synovial sarcoma age and location

A

20-40, peripheral lower extremities

164
Q

synovial sarcoma on t2?

A

triple sign

165
Q

bowl of grapes=

A

synovial sarcoma

166
Q

what is the translocation in synovial sarcoma?

167
Q

What is the most common malignancy in teens of the lower extremity?

A

synovial sarcoma

168
Q

What is the most common liposarcoma in patients under 20?

A

myxoid liposarcoma

169
Q

What is Mazabraud?

A

polyostotic fibrous dysplasia and multiple soft tissue myxomas

170
Q

osteosarcoma treatment?

A

chemo first then wide excision

171
Q

Ewing treatment?

A

cheo rad then wide excision

172
Q

chondrosarcoma treatment?

A

only wide excision

173
Q

Giant cell tumor treatment?

A

arthroplasty

174
Q

What does myositis ossificans look like?

A

centeral lucency with peripheral calcifications

175
Q

5 lesions under 30?

A

EG ABC NOF chondroblastoma SBC

176
Q

Epiphyseal lesions? 4

A

AIGC

ABC infection giant cell chondroblastoma

177
Q

What are the four epiphyseal equivalents?

A

carpals, patella, greater trochanter, calcaneus

178
Q

long lesion in long bone=

A

fibrous dysplasia

179
Q

shepherd crook deformity

A

femur, fibrous dysplasia

180
Q

What are the features of mccune albright?

A

polyostotic fibrous dysplasia, cafe au lait spots, precocious puberty, girl

181
Q

tibial lesion resembling fibrous dysplasia?

A

adamantinoma

182
Q

What does an enchondroma look like?

A

lytic with speckled calcs, chondroid matrix

183
Q

What does an enchondroma look like in the hands and feet?

A

lytic lesions

184
Q

How to differentiate between enchondroma and chondrosarcoma low grade?

185
Q

DDX for osseous sequestrum?

A

osteomyelitis, lymphoma, fibrosarcoma, eg, osteoid osteoma

186
Q

3 features of GCT?

A

physis must be closed, non scelrotic border, abuts articular surface

187
Q

age of GCT?

188
Q

NOF features?

A

eccentric with thin scelortic border

189
Q

What is Jaffe campanacci syndrome?

A

NOFS, cafe au lait, MR, hypogonadism, cardiac malformations

190
Q

3 ddx for lucent lesions in posterior elements

A

osteoblastoma, abc, tb

191
Q

chondroblastoma features

A

kid, tibial epiphysis or epiphyseal equivalent with thin sclerotic rim and extension across physeal plate

192
Q

chondromyxoid fibroma

A

eccentric metaphysea lesion with cortical expansion and bite like configuration

193
Q

greater trochanter 4 ddx

A

chondroblastoma, abc infection GCT

194
Q

intertrochanteric region ddx 3

A

lipoma, sbc, monostotic fibrous dysplasia

195
Q

3 classic blastic mets

A

prostate carcinoid medulloblastoma

196
Q

two classic lytic mets

A

renal and thyroid

197
Q

mini brain appearance in vertebral body

A

plasmacytoma

198
Q

What is POEMS?

A

myeloma with sclerotic mets

199
Q

liposclerosing myxofibroma characteristics

A

geographic lytic lesion with sclerotic margin at intertrochanteric region

200
Q

what is the only benign skeletal tumor associated with radiation?

A

osteochondroma

201
Q

cap over what size of osteochondroma is concerning for malignant transformation?

A

over 1.5cm

202
Q

What is trevor disease?

A

dyspasia epiphysealis hemimelica; osteochondroma in epiphyses leading to joint deformity

203
Q

what nerve does a supracondylar spur compress?

A

median nerve if ligament of struthers compresses

204
Q

kid finger lesion with saucerization of cortex

A

periosteal chondroma

205
Q

looks like NOF in anterior tibia with bowing in kid

A

osteofibrous dysplasia

206
Q

erosive OA 3 characteristics

A

gull wing, central erosions favors DIPs

207
Q

characteristics of RA

A

osteoporosis, soft tissue swelling, marginal erosion with uniform joint space narrowing. bilateral and symmetric

208
Q

What is the first spot in the foot to be affected with RA?

A

5th metatarsal head

209
Q

What is affected in hands in RA?

A

PIP then MCP. first CMC spared!

210
Q

RA + SMG + neutropenia

211
Q

RA + pneumoconiosis

212
Q

classic description of psoriatic arthritis

A

erosive change with bone proliferation IP>MCP

213
Q

fuzzy bone appearance around joint=

214
Q

ivory phalanx=

215
Q

mouse ears=

216
Q

acro osteolysis=

217
Q

ankylosis in hand= 2

A

erosive OA or psoriasis

218
Q

Reiters characteristics?

A

bone proliferation and erosion, asymmetric SI, affects waist down

219
Q

What are the 5 gout mimickers?

A

American Roentgen Ray Society Hooray

amyloid
RA
reticular histocytosis
sarcoid
hyperlipidemia
220
Q

degenerative change in an uncommon joint=

221
Q

hooked osteophytes on MCP = 2

A

hemacromatosis or CPPD

222
Q

hyper PTH buzzwords

A

subperosteal bone resorption
rugger jersey spine
brown tumors
tuft erosion

223
Q

what is Milwaukee shoulder?

A

due to hydroxyapatite- joint destruction with loose bodies

224
Q

cervical spine fusion = 2

A

klippel feil or RA juvenile

225
Q

erosion of dens= 2

226
Q

bad cervical kyphosis =

227
Q

what is jacouds arthropathy

A

ulnar deviation of hand with post rheumatic fever (ddx lupus)

228
Q

what antibody is positive in mixed connective tissue disease?

229
Q

epiphyseal overgrowth=

A

juvenile idiopathic arthritis

230
Q

what does JIA look like in the hand

A

jacked carpals with ankylosis

231
Q

particle disease occurs when?

A

1-5 years post surgery (smooth scalloping)

232
Q

what is the pattern of marrow conversion?

A

epiphyses, diaphysis, distal metaphysis, proximal metaphysis

233
Q

destructive mass in bone of a leukemia patient

A

granulocytic sarcoma/chloroma

234
Q

What is Engleman’s disease?

A

progressive diaphyseal dysplasia/PDD with fusiform bony enlargement and sclerosis of long bones

235
Q

What is PVNS?

A

synovial proliferation and hemosiderin deposition->blooms on GRE`

236
Q

synovial chondromatosis

A

multiple cartilaginous nodules of joint synovium. with loose bodies. calcifies

237
Q

widening in joint space of adult hip=

238
Q

What are the five stages of osteonecrosis?

A 
0 normal
1. normal xr, edema on MR
2. mixed lytic/sclerotic
3 crescent sign, articular collapse, joint space preserved
4. secondary osteoarthritis
239
Q

What are buzzwords in thalassemia?

A

hair on end skull, rodent faces, expanded ribs/jail bars

240
Q

What is the most common complication of pagets?

241
Q

What does pagets look like on bone scan?

A

hot on all three phases

242
Q

plantar fasciits involves which band?

A

central band

Rad (18 decks)

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