MSK Flashcards
How fast do phalanges heal?
quickly. 3 weeks
How fast does the tibia heal?
slowly. 10 weeks
How fast do bones typically heal?
6-8 weeks
What does AVN look like on T1
dark
What band is most important in scapho lunate ligament?
dorsal
What is considered widening of scapho lunate space?
> 3mm
What ligament disruption and fracture is associated with mid carpal dislocation?
triquetrial fracture
triquetro lunate ligament
lunate dislocation occurs with what ligament injury?
dorsal radiolunate ligament
DISI injury
radial sided, SL ligament injury
VISI injury
LT ligament
normal scaphoid lunate angle?
30-60 angle
DISI angle
> 60
VISI angle
<30
Two fractures at the base of the first metacarpal?
bennett and rolando
THe pull of what tendon causes dorsolateral dislocation in Bennett Fracture?
abductor pollicis longus
What is gamekeepers thumb?
avulsion at base of proximal first phalanx with ulnar collateral ligament disruption
What is a Stener Lesion?
adductor tendon gets caught in torn edges of UCL (in gamekeepers thumb)
yoyo appearance on MRI
stener lesion
Carpal tunnel syndrome is associated with what four things?
dialysis, pregnancy, DM, hypothyroidism
Guyons canal is formed by what bones?
pisiform and hamate
What gets entrapped in guyons canal?
ulnar nerve
What is handle bar palsy?
ulnar nerve entrapment in guyon canal
Colles fracture
dorsal angulation
Smith fracture
volar angulation
What is a barton fracture?
radial rim fracture with radial carpal dislocation
How do you know a lateral wrist radiograph is true?
volar cortex of pisiform overlies central 1/3 of interval between scaphoid and capitate
Which tendon is associated with the TFCC?
extensor carpi ulnaris/compartment 6
Injury where in the TFCC is good?
peripheral
Fracture of what is associated with posterior dislocation of the elbow?
capitellum
What is Essex Lopressi fracture?
fracture or radial head and anterior dislocation of DRUJ
What is osbornes ligament?
epicondylo olecranon ligament, covering cubital tunnel
Cubital tunnel syndrome can be secondary to what acessory muscle?
anconeus
What is the rim sign?
no overlap of glenoid and humeral head due to posterior dislocation
What is the trough sign?
reverse hill sachs due to impaction on anterior humerus in posterior dislocation
What are the 4 main types of shoulder prosthesis?
humeral head resurfacing, hemi arthroplasty, total shoulder arthroplasty, reverse total shoulder arthroplasty
Glenoid and cuff intact
resurfacing or hemi
glenoid intact, cuff deficient
hemi or reverse
glenoid deficient, cuff intact
TSA
glenoid and cuff deficient
reverse
What is the most common complication of total shoulder?
loosening of the glenoid component
What is the anterior escape complication in total shoulder?
anterior migration of humeral head after subscap failure
What is a reverse shoulder complication
posterior acromion fracture due to deltoid tugging
ASIS avulsion
sartorius
AIIS avulsion
rectus femoris
Pubic symphysis avulsion
adductor
ischial tuberosity avulsion
hamstrings
lesser trochanter avulsion
illiopsoas
greater trochanter avulsion
gluteus medius and minimus
What are three types of snapping hip syndrome?
extrenal internal intra articular
What is the most common type of snapping hip syndrome?
external. IT band over greater trochanter
What is internal snapping hip syndrome?
illiopsoas over illiopectineal eminence or femoral head
What is the intra articular snapping hip syndrome?
labral tears or joint bodies
What age is CAM FAI seen in?
young males
What is a segond fracture?
lateral tibial plateau a/w ACL tear, occurs with interal rotation
What is a reverse segond fracture?
medial tibial plateau fracture a/w pcl tear due to external rotation. also medial meniscus injury
What is arcuate sign?
avulsion of proximal fibula, associated with PCL tear
What is the deep intercondylar notch sign?
depressed lateral femoral condyle a/w acl tear
What ist he classic association with patella alta?
SLE
bilateral patellar rupture=
chronic steroids
What ist he most common type of tibial plateua fracture?
type 2 split and depressed lateral plateau
What is a pilon fracture?
tibial plafond fracture
What is a tillaux fracture?
salter harris type 3 through tibial epiphysis
What is a triplane fracture?
salter harris 4
Maisonneuve fracture?
medial malleolus and proximal fibular fx
What is the casanova fracture?
bilateral calcaneal w/ spine fracture
Bohlers angle less than what is concerning for fracture?
20 degrees
Where is a Jones fracture?
base of fifth metatarsal, 1.5cm from tuberosity
What is fifth metatarsal avulsion fracture due to?
tug from lateral cord of plantar aponeurosis or peroneus brevis
What is the most common dislocation of the foot?
lisfranc
What is the fleck sign?
osseous fragment in lisfranc space a/w LF ligament disruption
Two diseases with looser zones?
rickets and osteomalacia
T score is what?
relative to young adults
Osteopenia =
-1 to -2.5
Reflex sympathetic dystrophy is also called what?
complex regional pain syndrome or sudeck atrophy
looks like unilateral RA with preserved joint spaces?
RSD
Transient osteoporosis of the hip is most common in what type of patient?
pregnant third trimester
joint pain that improves, but then migrates?
regional migratory osteoporosis
What are the four stages of OCD?
1: stable, covered by cartilage
2: stable on probing
3: unstable on probing
4: dislocated fragment
Kohlers
navicular , male 4-6
freiberg infraction
2nd metatarsal head, young girls
severs
calcaneal apophysis
panners
capitellum, 5-10 yo, thrower
perthes
femoral head, 4-8 yo white kid
kienbock
lunate
What is in the first compartment of the wrist and what disease?
APL, EPB de quervains
What is in the third compartment?
EPL beside listers tubercle
What is in the sixth compartment?
ECU can get early tenosynovitis in RA
What are the 4 bony prominences of the carpal tunnel?
pisifrom, scaphoid tubercle, hook of hamate, trapezium tubercle
What does the carpal tunnel lie deep to?
palmaris longus
What ten things are in the carpal tunnel?
4 flexor profundus, 4 flexor superficials, 1 flexor pollicis longus, 1 median nerve
What synovial spaces normally communicate in the wrist?
pisiform recess and radiocarpal joint
Do the glenohumeral joint and subacromial bursa communicate normally?
NO. if they do concerning for full RC tear
Does ankle join normally communicate with lateral peronal tendon sheath?
NO. implies tear of calcaneofibular ligament
Achilles tendon and posterior subtalar joint communicate?
NO. achilles does not have true tendon sheath
What is intersection syndrome?
seen in rowers. first extensor compartment crosses over second leading to ECR brevis and longus tenosynovitis
What is most affected in nontuberculous mycobacterial tenosynovitis?
hand and wrist