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CNIH > MSK- part b > Flashcards

MSK- part b Flashcards

1
Q

What is Tendinopathy?

A
  • bothtendon inflammation andsmall tears that sometimes develop intissue surrounding the tendon
  • associate tendinopathy withdeterioration ofa tendon where it connects to the bone (entheses)
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2
Q

partial or complete tears are due to? (5)

A 
Trauma
Aging
Calcification
Cortisteroid therapy
Systemic diseases
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3
Q

sono signs of tears?

A
  • Partial or complete discontinuity of fibers
  • Focal thinning tendon
  • Hematoma
  • Bone fragment
  • Nonvisualization of retracted tendon (complete)
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4
Q

what is Tendinosis?

A
  • degeneration of the tendon’s collagen in response to chronic overuse without signs of inflammation
  • Patellar and Achilles tendon
  • Nodular thickening of tendon
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5
Q

sono apperance of tendinosis?

A
  • focal or diffuse areas of decreased echogenicity

- tendon enlargement

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6
Q

what is enthesopathy?

A
  • pathologic change of the insertion of tendons, ligaments and joint capsules on the bone
  • spondyloarthropathies (SpA), other rheumatic disease
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7
Q

sono apperance of enthesopathy?

A
  • swollen, hypoechoic tendon insertion
  • calcification – chronic
  • bursitis
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8
Q

what is Tendinitis?

- where is it most common (4)

A
  • inflammation or irritation of a tendon — any one of the thick fibrous cords that attaches muscle to bone
  • causes pain and tenderness just outside a joint
  • most common around shoulders, elbows, wrists and heels
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9
Q

Some common names for various tendinitis problems are? (5)

A 
Tennis elbow
Golfer's elbow
Pitcher's shoulder
Swimmer's shoulder
Jumper's knee
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10
Q

Sonographic Signs Tendinitis?

A
  • Thickening of tendon
  • Decreased echogenicity
  • Blurred margins
  • Increased color Doppler flow
  • Calcifications – chronic
  • Deformed margins - chronic
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11
Q

what is Tenosynovitis?

A

pain andinflammationin a tendon sheath

both the tendon and the sheath can become painful andinflamed

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12
Q

Sonographic Signs of Tenosynovitis?

  • actue
  • chronic
A

acute:
- fluid in sheath
- internal echoes from debris

chronic:

  • hypoechoic thickening of sheath
  • no fluid
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13
Q

what is bursitis?

A

inflammation of a bursa, a tiny fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body

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14
Q

what causes bursitis?

A

become inflamed from injury, infection, or due to an underlying rheumatic condition

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15
Q

s/s bursitis?

A

localized pain or swelling, tenderness, and pain with motion of the tissues in the affected area

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16
Q

Sonographic Appearance of normal bursa?

A

thin hypoechoic line no more than 1–2mm in height with hyperechoic boundaries reflective of a fluid tissue interface

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17
Q

sono apperance of bursitis?

  • acute
  • chronic
A

acute: sonolucent fluid filled collection with poorly defined margins

chronic:
- complex
- internal debris
- doppler - increased flow in thickened wall

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18
Q

what are disorders of joints?

A
  • tissues involved in diseases of synovial joints are sunovial membrane, hyaline cartilage, and bone
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19
Q

what is arthritis?

A

inflammation of one or more joints

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20
Q

what is Rheumatoid arthritis?

A
  • chronic progressive inflammatory autoimmune disease mainly affecting peripheral synovial joints
  • systemic disorder in which inflammatory changes affect not only joints but also many other sites including the heart, blood vessels and skin
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21
Q

Rheumatoid arthritis risk factors?

  • gender
  • age
A
  • more common in females than males

- can affect all ages, including children (Still’s disease), usually develops between the ages of 35 and 55 years

22
Q

what is rheumatoid factor?

A
  • 90% of cases will have this
  • High levels of RF, especially early in the disease, are strongly associated with accelerated and more severe disease
  • Symptoms include joint pain and stiffness, particularly in the morning and after rest
  • Joints can be visibly swollen, hot and tender
23
Q

Rheumatoid arthritis- most commonly affected joints? 2

A
  • hands and feet
24
Q

What is growth of inflammatory granulation tissue, pannus?

A

distorts the joint and destroys articular cartilage, exposing the bone below and causing further damage. Fibrosis of the pannus reduces joint mobility

25
Q

what is Osteoarthritis?

A
  • degenerative non-inflammatory disease that results in pain and restricted movement of affected joints
  • early stages, often asymptomatic.
  • very common, with the majority of over-65s showing some degree
  • articular cartilage gradually becomes thinner because its renewal does not keep pace with its breakdown
  • bony articular surfaces come in contact and the bones begin to degenerate, the articular surfaces become misshapen
  • chronic inflammation develops with effusion
  • abnormal outgrowth of cartilage at the edges of bones becomes ossified, formingosteophytes.
26
Q

what bones does osteoarthritis mainly affect?

A
  • affects large weight-bearing joints, i.e. the hips, knees and joints of the cervical and lower lumbar spine
  • many cases only one joint is involved
27
Q

what is gout caused by?

A

the deposition of sodium urate crystals in joints and tendons, provoking an acute inflammatory response

28
Q

gout risk factors?

A
  • more prevalent in males than females
  • familial tendency
  • obesity
  • hyperuricemia
  • high alcohol intake
29
Q

what is primary gout?

A

commonest form, almost always in men ,associated with reduced ability to excrete urate or increased urate production

30
Q

what is secondary gout?

A

consequence of diuretic treatment or kidney failure, both of which reduce urate excretion.

31
Q

gout s/s?

A

many cases only one joint is involved (monoarthritis)- red, hot and extremely painful

32
Q

gout- sites most commonly affected?

A

metatarsophalangeal joint of the big toe and the ankle, knee, wrist and elbow joints

33
Q

gout complications?

A

development of renal calculi

34
Q

Effusions?

A
  • appear as black collections of fluid within the joint space
  • usually clinically evident, but may be subtle
  • presence of irregular internal echoes or material may indicate pus, fibrinous material, or a complicated effusion
35
Q

what is osteomyelitis?

A
  • bacterial infection of bone
  • follow an open fracture or surgical procedures, which allow microbial entry through broken skin
  • consequence of blood-borne infection from a focus elsewhere, such as the ear, throat or skin; most commonly seen in children
  • infection can resolve without permanent damage, or become chronic, with sinus formation draining pus to the skin, fever and pain
36
Q

Benign tumours?

A
  • Single or multiple tumours may develop for unknown reasons in bone and cartilage
  • may cause pathological fractures or pressure damage to soft tissues, e.g. a benign vertebral tumour may damage the spinal cord or a spinal nerve
  • benign tumours of cartilage have a tendency to undergo malignant change
37
Q

apperance of Giant cell tumor?

A
  • demonstrated varied appearances (hypoechoic, hyperechoic, or mixed) with increased vascularity on Doppler USG.
  • Posterior acoustic enhancement may be seen in some giant cell tumors
38
Q

Osteochondroma?

A

part of thegrowth platewhich separates and continues growing independently, without an associated epiphysis, usually away from the nearby capped byhyaline cartilage

39
Q

Osteochondroma account of what % of bone tumors and what % of benign bone tumors?

A

very common and account for 10 - 15% of allbone tumoursand 20 - 50% of all benign bone tumours

40
Q

Osteochondroma sono apperance?

A

cartilage cap seen as a hypoechoic region bounded by bone on its deep surface and muscle / fat superficially

41
Q

Chondrosarcoma?

A
  • relatively slow-growing tumours -usually the result of malignant change in benign tumours of cartilage cells
  • occur mainly between the ages of 40 and 70 years
42
Q

fractures sono apperance?

A
  • Fractures appear as a sharp discontinuity of the bright line of boney cortex.
  • Sometimes hypoechoic hematoma/effusion of the immediately surrounding soft tissue is visible as well
43
Q

what are myopathies?

A

muscle disorders

44
Q

what is a strain?

A

injuries to skeletal muscles caused by overexertion or trauma

45
Q

how are muscle strains characterized?

A

muscle pain, ormyalgia, and involve overstretching or tearing of muscle fibers

46
Q

whats a sprain?

A
  • injury occurs in the area of a joint and ligament is damaged
47
Q

what is myositis?

A
  • muscle inflammation, including that caused by a muscle strain
48
Q

what is fibromyositis?

A
  • tendon inflammation occurs with myositis
49
Q

Ultrasound-guided musculoskeletal soft tissue biopsies?

A
  • Image-guided MSK biopsies- safe, minimally invasive, effective, lower risks compared with open biopsies, offer high diagnostic results
  • procedure is done under local anesthetic
  • patient’s biopsy site is then prepared in a sterile manner
  • ultrasound probe is covered with a sterile bag containing small amount of sterile gel as a coupling agent
  • sterile gel is then placed on the patient’s site of biopsy
50
Q

Ultrasound-guided Injections?

A
  • Cortisone is a type of steroid that is produced naturally by adrenal gland
  • inject a corticosteroid medication around a tendon to relieve tendinitis
    reduce inflammation, help ease pain
  • work within a few days, and the effects canlast up to several weeks
  • repeated injections may weaken a tendon, increasing your risk of rupturing the tendon
51
Q

Arthrocentesis?

A
  • joint aspiration - procedure whereby a sterile needle and syringe are used to drain fluid from the joint
  • Analysis of joint fluid can help to define causes of joint swelling orarthritis, such as infection,gout, andrheumatoid disease, as well as cultured to detect infection

CNIH (69 decks)

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