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Crack the Core > MSK > Flashcards

MSK Flashcards

1
Q

Healing time for bones (general)

A

6-8 weeks

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2
Q

Slowest and fastest bones to heal?

A

slowest: tibia (3 months)
fastest: phalanges (3 weeks)

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3
Q

which band of scapholunate ligament is most important for carpal stability

A

dorsal

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4
Q

which band of lunotriquetal ligament is most important for carpal stability?

A

volar

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5
Q

from least to most severe, what are the types of carpal dislocations?

A

1) Scapholunate dissociation
2) perilunate dislocation
3) midcarpal dislocation
4) lunate dislocation

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6
Q

Space of poirier

A

liagment free area in the wrist; between the greater and lesser arc

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7
Q

DISI

A

dorsal intercalated segmental instability; occurs after radial sided injury and the lunate tends to rock dorsally; more common than VISI

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8
Q

VISI

A

volar intercalated segmental instability; occurs from ulnar sided injury (lunotriquetral side); disruption of T-L ligment –> lunate gets ripped volar with the scaphoid

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9
Q

what tendon’s causes dorsolateral dislocation in a Bennett Fracture?

A

abductor pollicis longus (APL)

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10
Q

What is a Stener lesion?

A

when the adductor pollicis tendon gets caught in torn edges of the ulnar collateral ligament in the setting of an avulsion fracture of the UCL at the base of the proximal 1st phalanx (Gamekeeper’s or skier’s thumb)

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11
Q

Colles Fracture

A

fracture of distal radius with dorsal angulation; ulnar styloid commonly associated; old ladies

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12
Q

Smith Fracture

A

fracture of distal radius with volar angulation; ulnar styloid commonly associated; younger patient

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13
Q

Barton Fracture

A

radial rim fracture; volar or dorsal but volar is more common; radial-carpal dislocation is hallmark; typically surgical

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14
Q

What tendon is associated with the TFCC?

A

extensor carpi lunaris (compartment 6)

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15
Q

Monteggia fracture

A

proximal ulnar fx with anterior radial head dislocation

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16
Q

galeazzi fracture

A

radial shaft fx with dislocation of ulnar at the DRUJ

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17
Q

Essex-Lopresti

A

radial head fracture and anterior dislocation with anterior dislocation of the distal radial ulnar joint (DRUJ); unstable; with rupture of interosseous membrane

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18
Q

most common causes of cubital tunnel syndrom

A

1) repetitive valgus stress

2) accessory anconeus epitrochlearis (on medial side)

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19
Q

what is Osborne’s ligament

A

aka epicondylo-olecranon ligament; the site where the ulnar nerve passes beneath the cubital tunnel retinaculum

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20
Q

tillaux fracture

A

salter harris 3 fracture of distal tibial epiphysis in the anterolateral aspect; occurs in adolescents because the distal tibial growth plate closes from medial to lateral

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21
Q

High risk stress fractures

A

lateral femoral neck; anterior tibial; 5th metatarsal; transverse patellar; navicular; sesamoids of great toe
talus

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22
Q

Low risk stress fractures

A

medial femoral neck; posteromedial tibia; 2nd and 3rd metatarsals; calcaneus; longitudinal patellar

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23
Q

Kohler’s disease

A

osteonecrosis of navicular; more common in boys; tx is not surgical

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24
Q

Freiberg’s disease

A

AVN of head of 2nd metatarsal - more common in girls

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25
Q

Sever’s disease

A

osteonecrosis of the calcaneal apophysis

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26
Q

Panner’s disease

A

osteonecrosis of the capitellum; kids 5-10; no loose bodies

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27
Q

Scheuermann’s disease

A

osteonecrosis of the thoracic spine, resulting in kyphosis (3 adjacent levels with wedging + thoracic kyphosis of > 40 degrees)

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28
Q

dequervain’s tenosynovitis

A

inflammation of the 1st extensor compartment - extensor pollicis brevis and abductor pollicis longus

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29
Q

intersection syndrome

A

occurs where 1st extensor compartment crosses over the 2nd; affects the extensor carpi radialis longus and previs

30
Q

Buford complex

A

absent anterior/superior labrum with thickened middle glenohumeral ligmaent; labral tear mimic

31
Q

sublabral foramen

A

unattached portion of labrum from 1 to 3 o’clock; mimics SLAP tear; should not extend below 3 o’clock (horizontal)

32
Q

What are the types of Bankart lesions?

A

GLAD, Perthes, ALPSA, cartiagineous, osseous

33
Q

GLAD

A

Glenolabral Articular disruption; most mild version; superficial anterior inferior labral tear with associated articular cartilge damage; no instability

34
Q

Perthes

A

detachment of anterior inferior labrum (3-6 o’clock) with medially stripped but intact periosteum

35
Q

ALPSA

A

Anterior labral periosteal sleeve avulsion; medially displaced labroligamentous complex with absence of the labrum on the glenoid rim; intact periosteum

36
Q

True bankart

A

cartilagenous or osseous; periosteum is disrupted

37
Q

What are the types of reverse bankart lesions?

A

reverse osseous; POLPSA; bennett lesion, Kim’s lesion

38
Q

Reverse osseous bankart

A

fracture of posterior inferior rim of glenoid

39
Q

POLPSA

A

posterior labrum and posterior scapular periosteum are stripped from glenoid, resulting in a recess that communicates with the joint space; periosteum remains intact

40
Q

Bennett lesion:

A

extra-articular curvilinear calcification associated with posterior labral tears; related to injury of posterior band of the inferior glenohumeral ligament

41
Q

Kim’s lesion

A

incompletely avulsed/flattened/mashed posteiror-inferior labrum; glenoid cartilage and posterior labrum relationship is preserved

42
Q

HAGL

A

Humeral avulsion glenohumeral ligament; non bankart lesion; avulsion of inferior glenohumerla ligament, often results from anterior shoudler dislocation; J sign - normal U shaped inferior glenohumeral recess is retracted away from the humerus and looks like a J

43
Q

What muscle is atrophied in quadrilateral space syndrome?

A

teres minor (From compression of axillary nerve)

44
Q

Parsonage Turner syndrome

A

idiopathic involvement of brachial plexus; pathology in 2 or more nerve distributions

45
Q

Master Knot of Henry

A

where the flexor digitorum longus and flexor hallucis longus cross at the medial ankle

46
Q

Most common location for Morton’s neuroma

A

between 3rd and 4th metatarsal heads

47
Q

features of TB in the spine

A
  • spares disc space
  • multi level skip involvement
  • large paraspinal abscess
  • calcified psoas abscess
  • gibbus deformity - destructive kyphosis
48
Q

mimic for TB in the spine

A

Brucellosis

49
Q

what are rice bodies

A

sloughed, infarcted synovium; seen in end stage RA and TB infection

50
Q

Tuberculosis dactylitis

A

kids > adults

  • involves short tubular bones of hands and feet
  • diaphyseal expansile lesion with soft tissue swelling
51
Q

Factors favoring low grade chondrosarcoma over enchondroma

A
  • pain
  • cortical destruction
  • scalloping of > 2/3 of cortex
    > 5 cm in size
  • changing matrix
52
Q

what is X-18 translocation associated with?

A

synovial sarcoma

53
Q

Mazabraud syndrome

A
  • polyostotic fibrous dysplasia

- multiple softi tissue myxomas (T2 bright, T1 darker than muscle)

54
Q

Don’t touch bone lesions

A
  • myositis ossificans
  • cortical desmoid
  • synovial herniation pit
  • avulsion injury
55
Q

3 classic appearances of EG in a kid

A

1) vertebra plana
2) lucent skull lesion with beveld edge
3) Floating tooth - lytic lesion in alveolar ridge of mandible

56
Q

Jaffe Campanacci syndrome

A
  • multiple NOFs
  • cafe au lait spots
  • cardiac malforamtions
  • hypogonadism
  • mental retardation
57
Q

POEMS

A
  • myeloma with slcerotic mets; rare

- plasma cell proliferation, neuropathy, and organomegaly

58
Q

Trevor’s disease

A

multiple osteochondromas developing in the epiphyses

- aka dysplasia epiphysealis hemimelica

59
Q

differential for tibial bowing

A
  • NF-1: anterior; hypoplastic fibula with pseudoarthrosis
  • Physiologic: lateral; 18 months - 2 years
  • Rickets: lateral
  • Hypophosphatasi: lateral; rickets in a new born
  • blount’s disase - tibia vara in a fat black kid; associated with early walking
  • Osteogenesis imperfcta
  • dwarfism
60
Q

Felty syndrome

A

RA for > 10 years
splenomegaly
neutropenia

61
Q

CPPD locations

A
  • TFCC
  • peri-odontoid tissue and intervertebral discs
  • shoulder
  • elbow
  • patellofemoral joint
  • radiocarpal joint
62
Q

Milwaukee Shoulder

A
  • apocalyptic destruction of shoulder due to hydroxyapatite
  • occurs in old women with history of trauma to the joint
  • similar to neuropathic destruction
63
Q

SLE arthritis

A
  • reducible ulnar subluxations at the MCPs on Norgaard view; reduce on AP view
  • NO articular erosions
  • SLE also predisposes to patellar dislocations
64
Q

Jaccoud’s arthropathy

A

similar to SLE in the hand
- ulnar deviation of 2nd - 5th fingers at MCP
- non erosive
history of rheumatic fever

65
Q

red marrow –> yellow marrow conversion order

A
  • extremities –> axial skeleton (hands/feet first)

- epiphyses/apophyses –> diaphysis –> distal metaphysis –> proximal metaphysios

66
Q

Normal red marrow variants

A
  • proximal femoral metaphysis - teenagers

- distal femoral metaphysis - teenagers + menstruating women

67
Q

best sequence for determining Active Paget’s vs. malignant transformation

A
  • T1 pre-con

- both will be T2 bright and enhance

68
Q

Chloroma

A

granulocytic sarcoma; destructive mass in a bone of a patient with leukemia

69
Q

Engelmann’s disease

A

progressive diaphyseal dysplasia (PDD); fusiform bony enlargement with sclerosis of the long bones

70
Q

Bone findings in thalassemia

A
  • hair on end skulls
  • expansion of facial bones
  • expanded ribs
  • extramedullary hematopoisis
  • obliterates sinuses (vs. sickle cell)

Crack the Core (12 decks)

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