MSK Flashcards
1
Q
How fast do phalanges heal?
A
quickly. 3 weeks
2
Q
How fast does the tibia heal?
A
slowly. 10 weeks
3
Q
How fast do bones typically heal?
A
6-8 weeks
4
Q
What does AVN look like on T1
A
dark
5
Q
What band is most important in scapho lunate ligament?
A
dorsal
6
Q
What is considered widening of scapho lunate space?
A
> 3mm
7
Q
What ligament disruption and fracture is associated with mid carpal dislocation?
A
triquetrial fracture
triquetro lunate ligament
8
Q
lunate dislocation occurs with what ligament injury?
A
dorsal radiolunate ligament
9
Q
DISI injury
A
radial sided, SL ligament injury
10
Q
VISI injury
A
LT ligament
11
Q
normal scaphoid lunate angle?
A
30-60 angle
12
Q
DISI angle
A
> 60
13
Q
VISI angle
A
<30
14
Q
Two fractures at the base of the first metacarpal?
A
bennett and rolando
15
Q
THe pull of what tendon causes dorsolateral dislocation in Bennett Fracture?
A
abductor pollicis longus
16
Q
What is gamekeepers thumb?
A
avulsion at base of proximal first phalanx with ulnar collateral ligament disruption
17
Q
What is a Stener Lesion?
A
adductor tendon gets caught in torn edges of UCL (in gamekeepers thumb)
18
Q
yoyo appearance on MRI
A
stener lesion
19
Q
Carpal tunnel syndrome is associated with what four things?
A
dialysis, pregnancy, DM, hypothyroidism
20
Q
Guyons canal is formed by what bones?
A
pisiform and hamate
21
Q
What gets entrapped in guyons canal?
A
ulnar nerve
22
Q
What is handle bar palsy?
A
ulnar nerve entrapment in guyon canal
23
Q
Colles fracture
A
dorsal angulation
24
Q
Smith fracture
A
volar angulation
25
What is a barton fracture?
radial rim fracture with radial carpal dislocation
26
How do you know a lateral wrist radiograph is true?
volar cortex of pisiform overlies central 1/3 of interval between scaphoid and capitate
27
Which tendon is associated with the TFCC?
extensor carpi ulnaris/compartment 6
28
Injury where in the TFCC is good?
peripheral
29
Fracture of what is associated with posterior dislocation of the elbow?
capitellum
30
What is Essex Lopressi fracture?
fracture or radial head and anterior dislocation of DRUJ
31
What is osbornes ligament?
epicondylo olecranon ligament, covering cubital tunnel
32
Cubital tunnel syndrome can be secondary to what acessory muscle?
anconeus
33
What is the rim sign?
no overlap of glenoid and humeral head due to posterior dislocation
34
What is the trough sign?
reverse hill sachs due to impaction on anterior humerus in posterior dislocation
35
What are the 4 main types of shoulder prosthesis?
humeral head resurfacing, hemi arthroplasty, total shoulder arthroplasty, reverse total shoulder arthroplasty
36
Glenoid and cuff intact
resurfacing or hemi
37
glenoid intact, cuff deficient
hemi or reverse
38
glenoid deficient, cuff intact
TSA
39
glenoid and cuff deficient
reverse
40
What is the most common complication of total shoulder?
loosening of the glenoid component
41
What is the anterior escape complication in total shoulder?
anterior migration of humeral head after subscap failure
42
What is a reverse shoulder complication
posterior acromion fracture due to deltoid tugging
43
ASIS avulsion
sartorius
44
AIIS avulsion
rectus femoris
45
Pubic symphysis avulsion
adductor
46
ischial tuberosity avulsion
hamstrings
47
lesser trochanter avulsion
illiopsoas
48
greater trochanter avulsion
gluteus medius and minimus
49
What are three types of snapping hip syndrome?
extrenal internal intra articular
50
What is the most common type of snapping hip syndrome?
external. IT band over greater trochanter
51
What is internal snapping hip syndrome?
illiopsoas over illiopectineal eminence or femoral head
52
What is the intra articular snapping hip syndrome?
labral tears or joint bodies
53
What age is CAM FAI seen in?
young males
54
What is a segond fracture?
lateral tibial plateau a/w ACL tear, occurs with interal rotation
55
What is a reverse segond fracture?
medial tibial plateau fracture a/w pcl tear due to external rotation. also medial meniscus injury
56
What is arcuate sign?
avulsion of proximal fibula, associated with PCL tear
57
What is the deep intercondylar notch sign?
depressed lateral femoral condyle a/w acl tear
58
What ist he classic association with patella alta?
SLE
59
bilateral patellar rupture=
chronic steroids
60
What ist he most common type of tibial plateua fracture?
type 2 split and depressed lateral plateau
61
What is a pilon fracture?
tibial plafond fracture
62
What is a tillaux fracture?
salter harris type 3 through tibial epiphysis
63
What is a triplane fracture?
salter harris 4
64
Maisonneuve fracture?
medial malleolus and proximal fibular fx
65
What is the casanova fracture?
bilateral calcaneal w/ spine fracture
66
Bohlers angle less than what is concerning for fracture?
20 degrees
67
Where is a Jones fracture?
base of fifth metatarsal, 1.5cm from tuberosity
68
What is fifth metatarsal avulsion fracture due to?
tug from lateral cord of plantar aponeurosis or peroneus brevis
69
What is the most common dislocation of the foot?
lisfranc
70
What is the fleck sign?
osseous fragment in lisfranc space a/w LF ligament disruption
71
Two diseases with looser zones?
rickets and osteomalacia
72
T score is what?
relative to young adults
73
Osteopenia =
-1 to -2.5
74
Reflex sympathetic dystrophy is also called what?
complex regional pain syndrome or sudeck atrophy
75
looks like unilateral RA with preserved joint spaces?
RSD
76
Transient osteoporosis of the hip is most common in what type of patient?
pregnant third trimester
77
joint pain that improves, but then migrates?
regional migratory osteoporosis
78
What are the four stages of OCD?
1: stable, covered by cartilage
2: stable on probing
3: unstable on probing
4: dislocated fragment
79
Kohlers
navicular , male 4-6
80
freiberg infraction
2nd metatarsal head, young girls
81
severs
calcaneal apophysis
82
panners
capitellum, 5-10 yo, thrower
83
perthes
femoral head, 4-8 yo white kid
84
kienbock
lunate
85
What is in the first compartment of the wrist and what disease?
APL, EPB de quervains
86
What is in the third compartment?
EPL beside listers tubercle
87
What is in the sixth compartment?
ECU can get early tenosynovitis in RA
88
What are the 4 bony prominences of the carpal tunnel?
pisifrom, scaphoid tubercle, hook of hamate, trapezium tubercle
89
What does the carpal tunnel lie deep to?
palmaris longus
90
What ten things are in the carpal tunnel?
4 flexor profundus, 4 flexor superficials, 1 flexor pollicis longus, 1 median nerve
91
What synovial spaces normally communicate in the wrist?
pisiform recess and radiocarpal joint
92
Do the glenohumeral joint and subacromial bursa communicate normally?
NO. if they do concerning for full RC tear
93
Does ankle join normally communicate with lateral peronal tendon sheath?
NO. implies tear of calcaneofibular ligament
94
Achilles tendon and posterior subtalar joint communicate?
NO. achilles does not have true tendon sheath
95
What is intersection syndrome?
seen in rowers. first extensor compartment crosses over second leading to ECR brevis and longus tenosynovitis
96
What is most affected in nontuberculous mycobacterial tenosynovitis?
hand and wrist
97
isolated 1st compartment
dequervains
98
1st and 2nd compartment
intersecting
99
isolated 6th
early RA
100
multiple flexor compartents
RA
101
What are the three common finger tumors?
glomus, giant cell tumor, fibroma
102
Glomus tumor painful?
YES but diasppaears with tourniquet= hildreth sign
103
What does glomus tumor look like on MRI?
T2 bright, enhances avidly
104
Painless finger tumor with history of trauma
epidermoid
105
GCT characterisistics on MRI
T1 T2 dark, bloom on gradient
106
FIbroma characteristics on MRI
T1 T2 dark, will NOT bloom
107
Where doe the ulnar collateral ligament attach?
medial coronoid-sublime tubercle
108
What is the Tsign?
partial UCL tear
109
What age is panners?
5-10
110
Lateral epicondylitis what tendon?
extensor carpi radialis brevis. tennis.
111
Medial epiconsylitis tendon?
common flexor tendon and ulnar nerve. golfer
112
What are the three causes of external impingement of the rotator cuff?
hooked acromion, subcromial osteophyte formation, subcoracoid impingement
113
subacromial impingement damages what tendon?
supraspinatus
114
subcoracoid impingement damages what tendon?
subscapularis
115
posterior superior internal impingement damages what tendon?
undersurface of infraspinatus
116
loss of fat in rotator cuff interval=
adhesive capsulitis
117
thickened inferior and posterior capsule=
adhesive capsulitis shoulder
118
decreased glenohumeral volume-
adhesive capsulitis (increased is multidirectional instability)
119
enhancement of rotator cuff interval=
adhesive capsulitis
120
where is the sublabral recess?
incompolete attachment at 12 o clock
121
Where is the sublabral foramen?
1-3 o clock
122
What is the buford complex?
absent labrum 1-3 o clock with thickened middle glenohumeral ligament
123
GLAD
glenolabral articular disruption. superficial anterior inferior labral tear
124
perthes
detachement of labrum 3-6 o clock with stripped but intact periosteum
125
ALPSA
anterior labral periosteal sleeve avulsion. periosteum intact. medially displaoced GH complex
126
true bankart
periosteum is disrupted
127
reverse osseous bankart
gtsvyfracture of posterior inferior rim of glenoid
128
POLPSA?
posterior labrum and posterior scapular periosteum stripped from glenoid
129
bennett lesion
extra articular curvilinear calcification due to injury of posterior inferior glenohumeral ligament
130
kims lesion
avulsed posterior inferior labrum. glenoid cartilage and posterior labrum relationship preserved
131
Hagl
humeral avulsion glenohumeral ligament. avulsion of inferior gh ligament
132
cyst at level of suprascapular notch affects
supraspinatus and infraspinatus
133
cyst at the level of spinoglenoid notch affects
infraspinatus
134
What are the four borders of the quadrilateral space?
teres minor above, ters major below,humeral neck lateral, triceps medial
135
What is quadrilateral space sydnrome?
axillary nerve leads to teres minor atrophy
136
What is the blood supply of the menisci?
geniculate arteries
137
What ar ethe two menisco femoral ligaments?
wriserg and humprey. wrisberg humps humphrey
138
What ist he conjoint tendon made up of?
bicep femoris, LCL
139
What is the meniscal ossicle?
ossification of the posterior horn of the meidal meniscus
140
What is odonoghues unhappy triad
acl mcl tears with medial meniscal injury
141
Posterior lateral corner involves what anatomy?
LCL IT band biceps femoris popliteus tendon
142
what is the primary factor in preventing impingement in acl repair?
position of tibial tunnel
143
what is the primary factor in maintaining isometry in acl repair?
position of femoral tunnel
144
graft tear is most likely to occur when
4-8 months post op
145
What ligament of the ankle is most frequently injurged?
ATFL
146
acute flat arch=
posterior tibial tendon tear at insertion on navicular
147
chronic ptt tear=
medial malleolus
148
meniscoid mass in lateral gutter of ankle=
anterolateral impingement syndrome
149
mortons neuroma is where?
between third and fourth metatarsal heads
150
sequestration ddx=
osteo eg lymphoma fibrosarcoma
151
What mimics spinal tb?
brucellosis
152
diaphyseal expansile lesion with soft tissue swelling of bones of hands and feet=
tb dactylitis (spina ventosa)
153
rice bodies seen in 2
TB, end stage RA
154
What are the three reasons to be concerned for pathollogic fracture
lytic lesion
lesion over 3 cm
lesions involving over 50% of cortex
155
Parosteal osteosarcoma is located where?
posterior distal femur
156
string sign=
parosteal osteosarcoma
157
periosteal osteosarcoma where?
posterior medial femur
158
age group for periosteal osteosarcoma
15-25
159
age group for parosteal osteosarcoma
early adult/middle age
160
bone infarcts can turn into
MFH
161
MFH what age group and body part?
elderly proximal arms/legs
162
MFH on T2?
intermediate
163
Synovial sarcoma age and location
20-40, peripheral lower extremities
164
synovial sarcoma on t2?
triple sign
165
bowl of grapes=
synovial sarcoma
166
what is the translocation in synovial sarcoma?
x 18
167
What is the most common malignancy in teens of the lower extremity?
synovial sarcoma
168
What is the most common liposarcoma in patients under 20?
myxoid liposarcoma
169
What is Mazabraud?
polyostotic fibrous dysplasia and multiple soft tissue myxomas
170
osteosarcoma treatment?
chemo first then wide excision
171
Ewing treatment?
cheo rad then wide excision
172
chondrosarcoma treatment?
only wide excision
173
Giant cell tumor treatment?
arthroplasty
174
What does myositis ossificans look like?
centeral lucency with peripheral calcifications
175
5 lesions under 30?
EG ABC NOF chondroblastoma SBC
176
Epiphyseal lesions? 4
AIGC
ABC infection giant cell chondroblastoma
177
What are the four epiphyseal equivalents?
carpals, patella, greater trochanter, calcaneus
178
long lesion in long bone=
fibrous dysplasia
179
shepherd crook deformity
femur, fibrous dysplasia
180
What are the features of mccune albright?
polyostotic fibrous dysplasia, cafe au lait spots, precocious puberty, girl
181
tibial lesion resembling fibrous dysplasia?
adamantinoma
182
What does an enchondroma look like?
lytic with speckled calcs, chondroid matrix
183
What does an enchondroma look like in the hands and feet?
lytic lesions
184
How to differentiate between enchondroma and chondrosarcoma low grade?
pain
185
DDX for osseous sequestrum?
osteomyelitis, lymphoma, fibrosarcoma, eg, osteoid osteoma
186
3 features of GCT?
physis must be closed, non scelrotic border, abuts articular surface
187
age of GCT?
20-30
188
NOF features?
eccentric with thin scelortic border
189
What is Jaffe campanacci syndrome?
NOFS, cafe au lait, MR, hypogonadism, cardiac malformations
190
3 ddx for lucent lesions in posterior elements
osteoblastoma, abc, tb
191
chondroblastoma features
kid, tibial epiphysis or epiphyseal equivalent with thin sclerotic rim and extension across physeal plate
192
chondromyxoid fibroma
eccentric metaphysea lesion with cortical expansion and bite like configuration
193
greater trochanter 4 ddx
chondroblastoma, abc infection GCT
194
intertrochanteric region ddx 3
lipoma, sbc, monostotic fibrous dysplasia
195
3 classic blastic mets
prostate carcinoid medulloblastoma
196
two classic lytic mets
renal and thyroid
197
mini brain appearance in vertebral body
plasmacytoma
198
What is POEMS?
myeloma with sclerotic mets
199
liposclerosing myxofibroma characteristics
geographic lytic lesion with sclerotic margin at intertrochanteric region
200
what is the only benign skeletal tumor associated with radiation?
osteochondroma
201
cap over what size of osteochondroma is concerning for malignant transformation?
over 1.5cm
202
What is trevor disease?
dyspasia epiphysealis hemimelica; osteochondroma in epiphyses leading to joint deformity
203
what nerve does a supracondylar spur compress?
median nerve if ligament of struthers compresses
204
kid finger lesion with saucerization of cortex
periosteal chondroma
205
looks like NOF in anterior tibia with bowing in kid
osteofibrous dysplasia
206
erosive OA 3 characteristics
gull wing, central erosions favors DIPs
207
characteristics of RA
osteoporosis, soft tissue swelling, marginal erosion with uniform joint space narrowing. bilateral and symmetric
208
What is the first spot in the foot to be affected with RA?
5th metatarsal head
209
What is affected in hands in RA?
PIP then MCP. first CMC spared!
210
RA + SMG + neutropenia
felt
211
RA + pneumoconiosis
Caplan
212
classic description of psoriatic arthritis
erosive change with bone proliferation IP>MCP
213
fuzzy bone appearance around joint=
PA
214
ivory phalanx=
PA
215
mouse ears=
PA
216
acro osteolysis=
PA
217
ankylosis in hand= 2
erosive OA or psoriasis
218
Reiters characteristics?
bone proliferation and erosion, asymmetric SI, affects waist down
219
What are the 5 gout mimickers?
American Roentgen Ray Society Hooray
```
amyloid
RA
reticular histocytosis
sarcoid
hyperlipidemia
```
220
degenerative change in an uncommon joint=
CPPD
221
hooked osteophytes on MCP = 2
hemacromatosis or CPPD
222
hyper PTH buzzwords
subperosteal bone resorption
rugger jersey spine
brown tumors
tuft erosion
223
what is Milwaukee shoulder?
due to hydroxyapatite- joint destruction with loose bodies
224
cervical spine fusion = 2
klippel feil or RA juvenile
225
erosion of dens= 2
CPPD RA
226
bad cervical kyphosis =
NF1
227
what is jacouds arthropathy
ulnar deviation of hand with post rheumatic fever (ddx lupus)
228
what antibody is positive in mixed connective tissue disease?
RNP
229
epiphyseal overgrowth=
juvenile idiopathic arthritis
230
what does JIA look like in the hand
jacked carpals with ankylosis
231
particle disease occurs when?
1-5 years post surgery (smooth scalloping)
232
what is the pattern of marrow conversion?
epiphyses, diaphysis, distal metaphysis, proximal metaphysis
233
destructive mass in bone of a leukemia patient
granulocytic sarcoma/chloroma
234
What is Engleman's disease?
progressive diaphyseal dysplasia/PDD with fusiform bony enlargement and sclerosis of long bones
235
What is PVNS?
synovial proliferation and hemosiderin deposition->blooms on GRE`
236
synovial chondromatosis
multiple cartilaginous nodules of joint synovium. with loose bodies. calcifies
237
widening in joint space of adult hip=
gigantism
238
What are the five stages of osteonecrosis?
```
0 normal
1. normal xr, edema on MR
2. mixed lytic/sclerotic
3 crescent sign, articular collapse, joint space preserved
4. secondary osteoarthritis
```
239
What are buzzwords in thalassemia?
hair on end skull, rodent faces, expanded ribs/jail bars
240
What is the most common complication of pagets?
deafness
241
What does pagets look like on bone scan?
hot on all three phases
242
plantar fasciits involves which band?
central band
