MSK Flashcards
tuft fracture type
open #
dont go to the OR. only ABx
healing time
6-8 wk av
phalanges: 3 wk
tibia: 2-3mo
delayed union
2X as long as expected
RF: CKd, PTH, NSAID, smoking, gastric bypass, IBD
non union
6-9 mo.
scaphiod. ant tibia. lat fem neck.
poor union
poor anatomic position
MCC of stress # in young ppl
postmedial tibia
compressive
spontaneous osteonecrosis of the knee SONK ass w/
M. condyle
subchondral insuff. #
unilat
meniscal injury
young pt post meniscal Sx.
navicular stress #
runner
march #
metatarsal stress #. military
MCC os tarsal bone #
calcaneus
intra-articular > extra
High risk #
femoral neck lat TRV patella # ant tibia 5th MTR talus navicular sesamiod great toe
Low risk #
med femoral neck long patella post med tibia 2nd, 3rd MTC calcanus
MCL of schap fracture
waist
MC imp SL lig
dorsal.
vs luno-triq» volar
Presiser diz
atraumatic AVN of scaph
OS Pz worst to best
2ry OS > IM > telengactastic > periosteal > para
best Px: para
peri: distal medial fem, diaph
DISI
radial side injury > SL lig injury > MCO
doriflexion of the lunate. volar flex of the scaphiod
angle > 60
VISI pattern
ulnar side injury > LT lig injury
volar flex of both lunate + scaph
angle < 30
which synovial space can communicate in the wrist
pisiform and RC space.»_space; site of arthrogram
which side heals in TFC inj
ulnar side > vascular
both smith and colle’s ass w/
ulnar styloid #
BArton’s #
IA#. volar ang > Sx.
penetrating tenosynovitis of the flexor tendon MX
SX ER. high risk of spread to flex tendons of the hand .
Myocobact marinium»_space; fishmen and azumi chef
intersection syn
ECRL and ECRB Tenosyn
Trigger finger
stenosing tenosynovitis involving the flexor digitorum superficialis at the level of the A1 pulley.
repetitive microinjury
Essex lopresti
unstable #
rad head #.
ant dis of distal RUJ
sep of the IO mem
MCC of cubital tunnel syn
rep valg
ancounus
lat epicondylitis
ECRB. varus injury. RCL lig
Med epicondylitis
golfer. flexor tendon.
partial UCL team
throwers.
T sign.
ant band of the UCL is the MIO
b/l bursitis
RA.
Gout
little leaguer’s elbow
Med epi. avulsion injury
cap OCD
least tendon to tupture
tricepis
ass w/ SH II of the olecronon
looser’s zone
band of lucency peripen to the cortex. fem neck. pubic rami > insuff #. rickets osteomalcia OI
Transient osteoporosis of the hip
preg, 3rd tri, LT
more common in men»_space; b/l
In uptake in BS
Reginal migratory OP
more common in men
Panner’s diz
osteochondrosis of the capitellum. the entire cap is affected
It should be distinguished from osteochondritis dissecans of the elbow which also affects the capitellum.
freiberg disease
AVN of 2nd MT head
Sever’s diz
calcanea apophysitis
MC Sp sign of active Ch.OM
Sequestrum
acute OM in neonate BS
-ve BS.
+ve joint involvement
Rice body
TB
end stage RA
TB dactylitis
diaphysial expansile lesion w/ STx swelling
look up pic
TB dactylitis
diaphysial expansile lesion w/ STx swelling
look up pic
MCC 1ry ca of the spine and sacrum
chordoma
MMC of maignant epiphseal lesion
clear cell chonsrosarc
Mzabruad syn
STx myxomas.
FD XXX
women
increase risk of malg degeneration
MC expansile rib lesions in adult
FD
2nd mmc rib lesion: enchondroma
mcc of bone cyst > 20 YO
calc
MM + sclerotic mets
POEMS
MM can be lytic, sclertotic or diffuse OP. they spare post. element !!!!1
liposclerosing myxofibroma
lytic lesion, sclerotic margin.
Strong predilection for intertrochanteric region
10% risk of malg. degen.
MCC of b9 bone tumor
osteochondroma.
the only B9 bone tumor induced by RTX
Dysplasia epiphysealis hemimelica = Trevor disease
is an extremely rare, non-hereditary disease that is characterized by osteochondromas arising from the epiphyses.
MCL: ankle, knee
Sx Rx
DDx of adamntinoma
osteofibrous dysplasia. look the same. cant tell on img
osteofibrous dysplasia : young pt
rotator cuff interval contains which lig
- long head of the biceps brachii
- the superior glenohumeral ligament.
This space is also bordered by the base of the coracoid process of the scapula and roofed by the coracohumeral ligament.
MCL of CH.OM
1st and 5th MT heads
earliest changes in septic arthritis
J eff
Paget
ass w/ hyper PTH. GCT spares the fibula even in diffuse diz involve the entire VB + post element hot on all phases on BS DDx; mastocytosis
H-shaped VB
SCA
Gaucher’s
best seq to tell malg degeneration Paget’s active diz
T1 pre con. non FS. to eval BM
MCC of hip snapping syn
external. iliotibial band over GR trochanter
arcuate sign of the fibula as w/
PCL avulsion injury
ANT. kissing contusion
edema in the ant tibia and femur > both in ACL and PCL tear. not the same as kissing contusion
hyperextension injury
planter fibromastosis
it is B9 tum
men
could be b/l
variable T2 and T1 C+ SI
MCL for bone harvesting
iliac crest >AI crest
MCL of O.O
femur
syn chondromatosis
low T1, high T2
C+ synv
bony erosions ++
mcl of mets from chrondrosarcoma
lung
mcl of primary chondrosarc: hip = innominate bone
MCL of extraosesous involvement of LCH
SKIN
Gorham diz
progressive osteolysis of the bone.
vascular diz. ab lymphatic proliferation
Sp is involved
chondromyxiod fibroma
rare, B9 tum.
eccentric, lytic, expansile geographic lesion
mcc of mass in the wrist
gang cyst
2nd: GCT of the tendon sheeth
Paraosteal vs periosteal sarcoma
para: distal femur. calc mass. mature calc, no IM extension, BM is invove
peri: diaph, cortical erosion, LYTIC, perios reaction. rare BM involvement
PVNS
low on all seq
lipoma arborsnese
frond like synv mass
synov chondromatosis: similar to bone/cartilage SI
MFH
STx mass rather than bone lesion»_space; no periosteal reaction
Nodular facitis
rapidly growing B9 lesion along subcut/IM. mimic cancer
MCL: UE.
in children MCL > H&N
solitary fibrous tumor paraneaplastic tum
HypoG
osteomalacia
- Bx approach of medial tibial ?
2. Bx approach of prox humrus
- antmed tibia
2. lat to deltopectorial
extra-abd fibromatosis ( demoid tum)
loc aggressive.
recurrance
invades formaen
Rx; Sx, CTX, RTX
MCL of achilles tendon rupture
The watershed zone 2 cm to 6 cm above the calcaneal insertion is most commonly torn.
increase the risk of a tear: fluoroquinolone, rheumatoid arthritis, gout, hyperparathyroidism,
bisphosphonate-related proximal femoral fractures loc
On nuclear medicine bone scan, increased osteoblastic activity is seen in the LAT proximal femur on technetium-99m bone scan.
IM nailing
bizarre parosteal osteochondromatous proliferation (BPOP) = Nora lesion.
This is a benign lesion characterized by a well-marginated bony growth with a wide base and arises from the cortical bone. It lacks medullary continuity, unlike osteochondroma.
Kohler disease in adult named ?
Mueller-Weiss syndrome is the adult equivalent of navicular osteonecrosis.
Kummell disease, osteonecrosis and collapse of a vertebral body are seen.
most common type of congenital carpal coalition,
Lunotriquetral coalition
b/l
giant cell tumors vs ABC
GCT: look at the nonsclerotic border. non FF in MRI. subarticular. mets to lung 4%
ABC: metaphyseal
MC injury to the 5th metatarsal
1st: avulsion
2nd: jones
3rd: stress MT shaft
reverse segond #
PCL
med Meniscus njury
supinator syndrome
- compression of the post. interos nerve at the sup ms.
- denervation edema of the extensors, supinator ms that spare ECRL.
- sensation is preservaed.
- jumper’s knee
- prox. patella tendonapthy
tennis leg
sudden poping sensation
med head of gastro rupture. plantaris ms rupture
mallet finger = baseball finger
avulsion of the extensors at DIP results in hyperlfexion deformity
MC ruptured quadriceps tendon
vastis intermedialis
femur arhrogram injection site
sup and lat
ACL tear
ant. transl of the TIBIA relative to the fem.findings seen in the med side of the knee.
pay attension to that the tibia dislocate relative to the femur
unicompartmental arthroplasty
total arthroplasty, hemiarthroplasty, unicompartmental arthroplasty, constrained versus nonconstrained, reverse arthroplasty
dynamic pelvic screw app
pic
both C1 and C2 fracture can be stable if no
displacemnet or vessels compromose
looser zones are
subtroch femur. pubic rami. ax margin of the scapula. prox. ulna.
earliest finding of H. pTH
2nd, 3rd digits periosteal respor
heel pad thickness in acromegaly
> 2.3 in male
> 2.15 in F
thyroid acropathy
- after Rx of graves
- UE > LL
- ## metacarpal bones > mcl.
Hemophilia
J. destruction 2/2 synovitis and bony overgrowth.
DDx; RJA, TB, PVNS. pay attension to the the growth plate
mcl: knee, 2nd: elbow»_space; radial head overgrowth.
calc insuff # 2/2
D.M
shoulder arthrogram injection site
Superior med humoral head
for CT arthrogram contrast ratio: 1:1 contrast: saline
hip MRI arhtrogram injection dose
0.1-0.2 ml Gad
20 ml of iaodanted con, saline or anesthetic
physiologic bowing of the radius and ulna in adult ass w/
negative ulnar variance but can be seen even without
madelung deformity
short distal radius
ulnar tilt of the radius
idiopathic, turner, sk dysplasia or 2/2 tru
mc S&S of bipartie patella
ant knee pain > T2 bone edema on MR
patella nail synd
ADD
iliac horns
nail changes»_space; mmc S,S
absent patella
How to Dx discoid men
bowtie men in 3 or > slices in sag.
> 1.4 cm men in cor
males,
> lat men
Juvenile OP
rare diffuse OP
resolves over time
mc dens fracture
type II > non stable
type I and III > stable
calc avulsion fracture
OP/Openia
DM
mcl of OCD
lat aspect of med femoral condyl
nail bed bleeding ass w/
distal SH fracture. at the site of nail insertion. it leaks to OM.
yellow marrow conversion seq
1st: epi/apophysis
2nd: dia
3rd: meta
feet and hand 1st then»_space; long bone
ABC + frracture where ?
spine
ABC Rx?
pre-op embolization
curtage
bone forming arthritis DDx
reactive and psoriatic
homolateral lisfrANC INJURY DEF
displacement of 1-5 MT laterally
or displacement only of the 2-5. the 1st remains in place
vs divergent: lat displacement of the 2-5 MTH and medial of the 1st
neer test
acromial shoulder impingement
psuedohypo PTH
high PTH.
high Po-4
low Ca
spinal cord herniation
kincking the cord result in prox syrinx
Mx of patella dislocation-relocation
50% rate of conservative Rx failure
so Sx Rx is curicial:
A- tibial tub osteotomy = transfer + Med PFL recons
or B_ Med PFL recons + lat PFL release»_space; high rate of med patella disloca»_space; iatrogenic
C- trochoplasty
MCL of insuf fracture
1st med femoral condyle
2nd: tibial plat
Rx: conservative
ostetitis pubis
non infectious inflam of the sym pubis. no resorption
weakest lig of LCL of the foot
ATFL
LCL: ATFL. ant/post tibiofib lig
why»_space; limbus VB
nucluous pulposes herniates between ring apophysis and VB
why skull develops normally in achondroplasia
bc AP affects only endochondrail ossification
Rx of traumatic pseudomeningocele
conserv. physical Tx
MC S&S of liposclerosing myxofiobroma
pain
b9
bennet fracture vs. bennet lesion
fracture: thumb
lesion: hyperostosis of IGHL. thrower
MC of bennet fracture vs ronaldo
bennet: con
ronaldo: Sx
what is subungual exostosis ?
b9 osteo-cartilegnous tum. of distal phalenx.
what is post hindfoort impingement?
lateral talar process edema and DJD changes 2/2 to acquired flat foot deformity in adult
what do you do first for CL concerning OM
RG if + for OM > Rx no need for MR
if -ve»_space; next MRI
growth arrest/ growth recovery lines
horizontal lines vs straita»_space; vertical
MCC of PV thrombosis
cirrhosis
Most SP sign of torsion
twisted pedicel
positive nuchal lucency
> 3mm
11-14 wk
has to be measured in certified FM unit
Sp ass w/ labs > 90% but NT alone > 80%
Rx of bisphonspnate related fracture
stop med
proph nailing
recominant PTH
Mx of scaphiod fracture
nondisplaced, distal pole and tuburcle #»_space; casting
displaced prox pole and waist»_space;> Sx.
How to tell med from lat on ax lnee MRI
lat: patella tubrcule is longer.
mechanism of patella dislocation
twisting morion when the knee is valgus, flexed and internally rotated
lace like phalanges
sarciodosis
B-thalasemia