MSK imaging

Question 1

which 2 types of fractures are most common in peds?

Answer 1

torus, greenstick

Question 2

what causes a torus aka buckle fracture?

Answer 2

axial loading/compression

Question 3

valgus

Answer 3

distal part of the bone is more lateral than it should be

Question 4

what does SALTR used for? stand for?

Answer 4

pediatric fractures. straight, above, lower, transverse, rammed

Question 5

which Salter-Harris types usually happen to age 10+?

Answer 5

type 2 and 3

Question 6

what fracture is common in high impact sports when people put their wrist out to break their fall?

Answer 6

Colles fracture

Question 7

describe a Colles fracture

Answer 7

Fracture of the distal radial metaphyseal region
Dorsal angulation and impaction
No involvement of articular surface

Question 8

type of splint for colles fracture post-reduction

Answer 8

sugar-tong splint (prevents pronation and supination)

Question 9

how is Barton’s different from Colles fracture?

Answer 9

Bartons involves the articular surface, is often ASW dislocation of the radiocarpal joint, and extends throught the dorsal aspect of the distal radius but NOT the palmar

Question 10

what normally causes Smith’s fracture?

Answer 10

fall on a flexed wrist or direct blow

Question 11

Galeazzi fracture

Answer 11

Distal/mid radius fracture with dislocation of the radioulnar joint
Reqs xray of wrist and forearm to see it

Question 12

what is the opposite of a Galeazzi fracture?

Answer 12

Monteggia. Fracture of the ulnar shaft w/ dislocation of radial head

Question 13

most common carpal bone fracture

Answer 13

scaphoid

Question 14

snuffbox tenderness, Terry Thomas aka Madonna sign (Scapholunate dislocation (widening between the schpaoid and lunate)

Answer 14

scaphoid fracture

Question 15

splint for scaphoid fracture

Answer 15

thumb spica splint

Question 16

Weber classification is for what?

Answer 16

lateral malleolar fracture

Question 17

weber fracture class C

Answer 17

always unstable
Often with medial malleolus fracture
Syndesmotic ligament disruption
Deltoid ligament injury

Question 18

Distal tibiofibular syndesmosis disruption
Associated medial malleolar fracture, medial collateral ligament rupture, and proximal fibular fracture
High Weber C, unstable ankle joint
Traumatic external rotation
Complex, unstable

Answer 18

Maisonneuve Fracture

Question 19

Distal tibia fracture
Compression injury
Related to a fall from a height
Check for associated talar or calcaneal fracture

Answer 19

Pilon fracture

Question 20

of degrees in Bohler’s angle in calcaneal fracture

Answer 20

<20 degrees

Question 21

posterior fat pad sign and sail sign are ASW what fracture?

Answer 21

supracondylar

Question 22

sail sign but no visible fracture: how to treat it?

Answer 22

treat it like a fracture

Question 23

95% of shoulder dislocations

Answer 23

anterior

Question 24

3 xray view for shoulder dislocation

Answer 24

AP, oblique, Y view

Question 25

2 views needed for clavicle fracture xrays

Answer 25

AP, cephalic tilt (45 degrees)

Question 26

which 2 of the 5 types of clavicle fractures need surgery?

Answer 26

types 2 and 5

Question 27

how to rule in/out an occult hip fracture

Answer 27

MRI (emergently or urgently)

Question 28

imaging for necrotising fasciitis

Answer 28

CT w/ contrast (venous)

Question 29

which imaging: Facial fractures Vertebral fractures (first line) Occult pelvic/sacral fractures Multiple rib fractures on x-ray/occult rib fractures Pre-operative planning (gives better detail of bony anatomy) Complex fractures: tibial plateau fractures (prox tibia), pelvic/sacral fractures, etc

Answer 29

CT w/o contrast

Question 30

what imaging: Peripheral arterial disease/arterial occlusion Arterial dissection

Answer 30

CT angiography of the extremities

Question 31

what imaging: Foreign body localization (esp if not metal/bone that would show on xray) Superficial abscess detection and drainage

Answer 31

US

Question 32

Pt had fall, neg xray but trouble bearing weight. what next?

Answer 32

get MRI

Question 33

what imaging? Malignancy/mass Infection

Answer 33

MRi w and w/o contrast

Question 34

what imaging for an “overview” of metastatic skeletal lesions , as opposed to MRI for specific lesions/masses?

Answer 34

bone PET scan

Question 35

which tests are ok for unstable trauma pt?

Answer 35

E-FAST exam (abdomen and chest US) | bedside xray

Question 36

when to order Ct w/ contrast for stable trauma pt? (what areas)

Answer 36

chest, abdomen/pelvis