MSK Flashcards
1
Q
PVNS
Osteochondral defect
A
X-ray
- Joint effusion
- Lucency at joint suggesting osteochondral injury
MRI ankle
- Fluid within the joint
- Distention of joint with material that is intermediate to high signal on PD and PDFS.
- Low signal rim on GRE - haemosiderin
- Extensive enhancement post contrast
- Osteochondral injruy at superolateral aspect of the talar dome.
- Subchondral high T2 signal
- Irregular subchondral cortical plate
- Cystic change
- bone oedema
- similar changes in tibial plafond
- Thickened ATFL
2
Q
Insufficient fracture
A
MRI knee scan
- Subchondral fracture of the medial femoral condyle- measurement
- Contains linear fluid signal
- Bone oedema
- Flattening deformity of the cortex
- Overlying cartilage is intact
- Radial tear of the posterior horn of the medial meniscus.
- Involves root attachment
- Extrusion of meniscus.
- Oedematous body and posterior horn.
- PCL, MCL, LCL are intact.
- Lateral meniscus is intact
- Extensor mechanism is intact.
- Patellofemoral compartment normal.
- Articular cartilage is overall maintained.
- Bone oedema proximal mid tibia
- Joint effusion with synovitis
- Focal tendinosis of semimembanous insertion,
- Split tear of semitendinosis
- Oedema pes anserine insertion
Diagnosis
- Insufficiency fracture
- Radial tear/ root avulsion of posterior medial meniscus
Differential
Management
- DEXA ( most related to osteoporosis)
3
Q
Lipoma aborescens
A
MRI:
- Fronds arising of the synovium within the suprapatellar compartment of the knee.
- High T1
- Suppresses on Fat Sat
- No blooming on GE
- No layering of fluid within the joint.
- Complex synovial cyst
- Horizontal tear of the medial and lateral meniscus.
Minor findings
- Grade 2 ( <50%) cartillage medial patelllar facet
- Grade 3 ( >50%) catillage lateral patellar facet
- ACL, PCL intact
- MCL, LCL and extensor tendon intact
4
Q
Trisomy 13
A
1st trimester scan
- Single live intrauterine pregnanacy
- The cervix is long and closed
- The placenta is anterior/ fundal
- The umbilical artery SD ratio is normal
- 4 quadrant AFI Normal- liquor volume normal
- Large intra cranial extra-axial CSF space
- Thickened nuchal fold
- Abnormal profile
- Bilateral cleft lip and palate
- polydactly
- IUGR
- Echogenic intra-cardiac focus
- Atrial septal defect
5
Q
Distal phalanx lesions
A
- Glomus
- Epidermoid inclusion cyst
- ACRAL met
- Male- lung cancer- distal phalanx
- Female- Breast to the toe
Middle phalanx tumour
- Always enchondroma
- Always brown tumour
6
Q
Median nerve schwanomma
A
MRI - Mass identified -
- Arises from median nerve anatomically
- Eccentric to nerve (indicating likely Schwannoma)
Signal description: -
- Intermediate (to muscle) on T1WI
- Predominantly high signal on T2WI with slightly lower signal heterogeneous central areas and more peripheral rim of high signal = “hyperintense rim sign”
- Intense enhancement post gadolinium with central non enhancing region
- Split fat sign
Differential diagnosis
- Neurofibroma
- Malignant Peripheral Nerve Sheath Tumour
Referral
- Neuro
- Orthopaedic
- Plastic Surgeon referral
7
Q
Cervical spine radiograph
A
- Technical adequate
- base of skull to C6
- Cervicothroacic junction not adeqautely assesed
- Perform swimmers view to assess cervicothoracic junction
- Allignment
- Facets
- Odontoid peg allignment is maintained
8
Q
Synovial based mass
A
- Tumour
- Chondromatosis
- PVNs
- Arthropath (pannus)
- Psoriatic
- Gout
- Rheumatoid
- Not to miss
- SYNOVIAL SARCOMA
- Hamangioma
9
Q
Ankle review areas
A
- Anterior proxess of the calcanues
- Base of 5th MT
- Lateral proxess of talus
- Talar done and syndemsosis
10
Q
Scaphoid fracture management
A
- Immobilis and repeat in 7-10 days
11
Q
A
