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CORE MSK > MSK CORE 2 - Sheet1 > Flashcards

MSK CORE 2 - Sheet1 Flashcards

1
Q

2 fractures of the base of the first metacarpal?

A

Bennett and Rolando (comminuted)

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2
Q

gamekeeper’s thumb

A

avulsion fracture of the base of the proximal phalax (+ UCL disruption)

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3
Q

what ligament in disrupted with gamekeeper’s thumb?

A

ulnar collateral ligament

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4
Q

Stener lesion is associated with what named fracture?

A

gamekeeper’s thumb - the Adductor tendon gets caught in the torn edges of the UCL.

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5
Q

median nerve distribution

A

thumb to radial aspect of 4th digit

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6
Q

accessory muscle associated with cubital tunnel syndrome

A

anconeus epitrochlearis

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7
Q

the site where the ulnar nerve passes beneath the cubital tunnel retinaculum is aka

A

the epicondylo-olecranon ligament or Osborne band

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8
Q

Hill-Sachs is best seen on which view?

A

internal rotation view

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9
Q

which nerve is injured in 60% of inferior shoulder dislocations?

A

axillary

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10
Q

bisphosphate fracture is typically on which side of the femur?

A

lateral

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11
Q

stress fracture is typically on which side of femur?

A

medial

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12
Q

SONK is not actually osteonecrosis, but is

A

an insufficiency fracture that favors the medial femoral condyle of old ladies

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13
Q

what do Looser Zones look like?

A

wide lucent bands that transverse bone at right angles to the cortex

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14
Q

ligament torn in “Terry Thomas” sign?

A

scapholunate ligament

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15
Q

tendons involved in De Quervains tenosynovitis?

A

first dorsal (extensor) compartment (extensor pollicis brevis and abductor pollicis longus).

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16
Q

Dupuytren Contracture:

A

nodular mass on the palmar aspect of the aponeurosis that progresses to cord-like thickening and eventual contracture (usually involving the 4th finger).

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17
Q

T-sign (MRI elbow)

A

UCL partial tear

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18
Q

which elbow part is most commonly involved in Panner and OCD?

A

capitellum

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19
Q

Panner vs. OCD: age

A

Panner: 5-10 OCD: teenager

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20
Q

tendon/ligament involved with lateral epicondylitis (tennis)

A

Extensory tendon injury (classically extensor carpi radialis brevis) and Radial Collateral Ligament Complex - Tears due to varus stress

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21
Q

tendon/nerve involved in Medial Epicondylitis (golfers)

A

Common flexor tendon and ulnar nerve may enlarge from chronic injury

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22
Q

most common form of shoulder impingement

A

subacromial - attrition of coracoacromial arch

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23
Q

which tendon is damanged in subacromial impingement?

A

supraspinatus

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24
Q

mechanism of subcoracoid impingement?

A

lesser tuberosity and coracoid do the pinching

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25
Q

which tendon is damanged in subcoracoid impingement?

A

subscapularis

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26
Q

who gets posterior superior internal impingement?

A

Athletes who make overhead movements.Greater tuberosity and posterior inferior labrum do the pinching.

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27
Q

which tendon is damanged in posterior superior impingement?

A

lnfraspinatus (and posterior fibers of the supraspinatus).

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28
Q

SLAP acronym

A

“superior labral tear from anterior to posterior”

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29
Q

SLAP under 40yo

A

bankart lesion

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30
Q

SLAP over 40yo

A

rotator cuff tear

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31
Q

Spectrum of Bankart Lesions (least to most severe)

A

GLAD –> Perthes –> ALPSA –> True Bankart

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32
Q

definition: GLAD lesion

A

Glenolabral Articular Disruption. No instability (aren’t you GLAD there is no instability)

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33
Q

definition: Perthes

A

Detachment of the anteroir lnferior labrum (3-6 o’clock) with medially stripped but intact periosteum.

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34
Q

definition: ALPSA

A

Anterior Labral Periosteal Sleeve Avulsion. Medially displaced labroligamentous complex with absence of the labrum on the glenoid rim.

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35
Q

HAGL

A

humeral avulsion (of the inferior) glenohumeral ligament

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36
Q

spinoglenoid notch

A

infraspinatus atrophy

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37
Q

suprascapular notch

A

supraspinatus

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38
Q

quadrilateral space syndrome

A

axillary nerve - atrophy of teres minor

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39
Q

what if you see atrophy of muscles in 2+ nerve distributions?

A

parsonage-turner - idiopathic involvement of the brachial plexus

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40
Q

other injury commonly associated with subscapularis tear?

A

medial dislocation of the long head of the biceps tendon

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41
Q

“double PCL” can only occur in the setting of an intact…

A

ACL - bucket handle tear of usually the medial meniscus

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42
Q

meniscal ossicle

A

focal ossification of the posterior horn or the lateral meniscus,

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43
Q

O’Donoghue’s Unhappy Triad:

A

ACL Tear, MCL Tear, Medial Meniscal

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44
Q

When I say “kissing contusion”, you say

A

ACL tear

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45
Q

What’s the Master Knot of Henry?

A

It’s a “Harry Dick” (where Dick (FDL) crosses Harry (FHL) at the medial ankle)

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46
Q

I Say PTT (posterior tibial tendon) is out, You Say

A

Spring Ligament is Thickened, and Hindfoot Valgus

47
Q

MRI finding in sinus tarsi syndrome

A

MRI finding is obliteration of fat in the sinus tarsi space and replacement with scar.

48
Q

Tarsal Tunnel Syndrome:

A

Pain in the distribution of the tibial nerve (first 3 toes), from compression as it passes through the tarsal tunnel (behind the medial malleolus).

49
Q

how do you maintain the ability to plantar flex in the setting of Achilles tendon rupture?

A

if your plantaris muscle is intact

50
Q

plantar fasciitis is worse at what time of day?

A

morning

51
Q

definition: sequestrum

A

a segment of necrotic bone that is separated from living bone by granulation tissue

52
Q

definition: involucrum

A

a layer of living bone that has formed about dead bone; it can become perforated by tracts

53
Q

definition: cloaca

A

An opening in the involucrum

54
Q

osteomyelitis <1 month

A

multicentric involvement with joint involvement (bone scan often neg)

55
Q

osteomyelitis <18 month

A

spread to epiphysis through blood

56
Q

osteomyelitis 2-16 years

A

transphyseal vessels are closed (primary focus is metaphysis)

57
Q

what primary bone tumor can cause occult pneumothorax

A

osteosarcoma met to the lung

58
Q

most common primary malignancy of the sacrum?

A

chordoma

59
Q

when involving the spine (instead of the sacrum), chordoma is most common at what level?

A

C2 (and very T2 bright!)

60
Q

treatment for osteosarcoma

A

Chemo tirst (to kill micro mcts) , followed by wide excision

61
Q

treatment for Ewings

A

Both Chemo and Radiation, followed by wide excision.

62
Q

treatment for chondrosarcoma

A

usually just wide excision

63
Q

treatment for giant cell tumor

A

Because it extends to the articular surface usually requires arthroplasty.

64
Q

classic location of cortical desmoid

A

radiolucent cortical irregularity involving posteromedial aspect of the distal femoral metaphysis at the attachment of the adductor magnus tendon

65
Q

epiphyseal equivalents you should remember

A

carpals, patella, greater trochanter, calcaneous - epiphyseal lesions can happen here too

66
Q

Shepard Crook deformity

A

fibrous dysplasia in the femur

67
Q

Mazabraud = polyostotic fibrous dysplasia + what other soft tissue finding

A

soft tissue myxomas - also increased risk of osseous malignant transformation

68
Q

McCune Albright

A

polyostotic fibrous dysplasia + girl + cafe au lait + precocious puberty

69
Q

3 classic appearances of EG

A
  1. vertebra plana in a kid 2. skull with lucent “beveled edge” lesions 3. “floating tooth” with lytic lesion in alveolar ridge
70
Q

what age gets EG?

A

less than 30

71
Q

class ddx for vertebra plana (MELT)

A

mets/myeloma, EG, lymphoma, trauma/tb

72
Q

most common age for giant cell tumor?

A

20-30 (physis must be closed)

73
Q

Jaffe-Campanacci Syndrome:

A

Syndrome of multiple NOFs, cafe-au-lait spots, mental retardation, hypogonadism, and cardiac malformations.

74
Q

‘Pain at night, relieved by aspirin. “

A

osteoid osteoma

75
Q

osteoblastoma vs. osteoid osteoma

A

osteoblastoma = osteoid osteoma > 2cm, patients <30yo, posterior elements

76
Q

3 classic blastic mets

A

prostate, carcinoid, medulloblastoma

77
Q

2 classic lytic mets

A

renal and thyroid

78
Q

uncommon/classic presentation of MM

A

diffuse osteopenia

79
Q

classic ddx for lucent lesion in posterior elements (3)

A

osteoblastoma, ABC, TB

80
Q

age for ABC

A

<30 yo

81
Q

age for chondroblastoma

A

kids 2-25

82
Q

3 classic lesions of the intertrochanteric region

A

lipoma, solitary bone cyts, monostotic fibrous dysplasia

83
Q

classic location of liposclerosing myxofibroma

A

intertrochanteric region of the femur (geographic lytic lesion w/sclerotic margin)

84
Q

what’s the other name for osteochondroma?

A

exostosis

85
Q

what’s another name for Trevor disease?

A

(Dysplasia Epiphysealis Hemimelica - DEH): osteochondromas in the ankle/knee epiphyses with joint deformity in young kids

86
Q

which way does avian spur point?

A

toward the joint (exostosis is away)

87
Q

when I say avian spur, you say

A

ligament of struthers (smashes the median nerve if symptomatic)

88
Q

when is tibial bowing normal?

A

18 months - 2 years

89
Q

When I say Ankylosis in the Hand, You Say

A

Erosive OA or Psoriatic

90
Q

Reiter’s is rare in the

A

hands (Just remember Reiters below the waist.)

91
Q

ARRS Hooray!

A

Gout mimickers: Amyloid, RA, Reticular histiocytosis, Sarcoid, Hyperlipidemia

92
Q

2 things that give you hooked MCP osteophytes

A

Hemochromatosis or CPPD (with chondrocalcinosis in the TFCC)

93
Q

milwaukee shoulder

A

almost-neuropathic looking shoulder 2/2 hydroxyapatite

94
Q

5 Classic ways of showing hyperparathyroidism (renal osteodystrophy)

A
  1. rib notching 2. resorption along radial aspect of fingers AND brown tumors 3. tuft resorption 4. rugger jersey spine 5. pelvis with “constricting” femoral necks + wide SI joints
95
Q

cervical spine fusion (2)

A

Congenital (Klippel-Feil) or JIA

96
Q

erosion of the dens (2)

A

CPPD or RA

97
Q

bad kyphosis of the c-spine

A

NF1

98
Q

big bridging lateral osteophytes (spine)

A

psoriatic arthritis

99
Q

“flowing syndesmophytes”

A

ank spond

100
Q

reversible ulnar deviation without erosions

A

SLE

101
Q

non-erosive ulnar deviation s/p rheumatic fever

A

Jacoud’s arthropathy

102
Q

ossification of the ALL with sparing of disc spaces

A

DISH (T-spine most common)

103
Q

yellow marrow increases with

A

age

104
Q

normal pattern of bone marrow conversion

A

The epiphyses convert to fatty marrow almost immediately after ossification. Distal then proceeds medial (diaphysis first, then metaphysis).

105
Q

normal pattern of bone marrow reconversion?

A

reverse order of normal marrow conversion, beginning in the axial skeleton and heading peripheral.

106
Q

What areas are spared/normal variants in bone marrow conversion?

A

proximal femoral metaphysis of teenagers.The distal femoral sparing is especially true in teenagers and menstruating women.

107
Q

what does bone marrow look like in leukemia?

A

darker than muscle (and normal discs) on T1

108
Q

most frequent tendon involved in hydroxyapatite deposition?

A

supraspinatus (near the greater tuberosity); also like to test longus coli

109
Q

transmission method of osteopoikilosis

A

AD

110
Q

Engelmann’s disease

A

progressive diaphyseal dysplasia - fusiform bony enlargement with sclerosis of the long bones (starts in kids)

111
Q

“widening of the joint space in an adult hip”

A

Pituitary Gigantism

112
Q

most common complication of Paget’s

A

deafness

113
Q

abnormal lab in mixed phase of Paget’s

A

elevated alkaline phosphate

114
Q

abnormal lab in sclerotic phase of Paget’s

A

elevated hydroxyproline

CORE MSK (2 decks)

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