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MSK ultrasound > MSK Pathology > Flashcards

MSK Pathology Flashcards

1
Q

What pathology in tendons are the final stage of progressive destruction of fibers?

A

Rupture

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2
Q

What are 2 INDIRECT signs of a partial thickness tear?

A
  1. Bursal thickening
  2. Fluid in tendon sheath
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3
Q

What pathology is defined as ‘forcible separation or detachment’ or ‘tearing away a body part’

A

Avulsions - when tendon or muscle is pulled away from the bone and bone fragments are seen within the muscle or tendon

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4
Q

What pathology is defined as “degenerative changes w/out signs of inflammation”

A

Tendinosis - caused by repetitive microtrauma of overuse injuries

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5
Q

With color and power doppler, does Tendinosis have blood flow occurring at the deep or superficial side of the tendon?

A

Deep side - neovascularity

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6
Q

What Tendon’s are usually affected by tendinosis?

A

Patellar tendon - jumpers knee - usually affects the upper insertion of the tendon

Achilles tendon - usually affects the middle 1/3rd of the tendon

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7
Q

What tendon is involved in ‘jumpers knee’?

A

Patellar tendon

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8
Q

What pathology is defined as “edema associated w/ inflammation and causes thickening and decreased echogenicity of tendons”

A

Tendonitis

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9
Q

SF of acute tendonitis?

A
  1. Decreased echogenicity
  2. Thickened
  3. Irregular margins
  4. Increased vascularity within the tendon
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10
Q

SF of chronic tendonitis?

A
  1. Deformed tendon margins/bumpy appearance
  2. Intra-tendon calcifications
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11
Q

What pathology is known as the inflammation of the tendon sheath?

A

Tenosynovitis

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12
Q

What 3 locations does synovitis typically occur?

A
  1. Hand
  2. Wrist
  3. Ankle
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13
Q

Acute cases of tenosynovitis are most often caused by what two things?

A
  1. Pyogenic infection
  2. Microtrauma
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14
Q

What are the acute vs. chronic SF of tenosynovitis?

A

Acute - fluid in sheath

Chronic - thickened sheath with some or no fluid

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15
Q

What pathology is defined as the “inflammation of the 2 tendons and their sheath that control the movement of thumb over the radius”?

A

De-Quervain’s tenosynovitis- affects compartment 1

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16
Q

What pathology is defined as inflammation of the INSERTION of tendons on to bones?

A

Enthesopathy

17
Q

Enthesopathy is most common at what 3 sites in the body?

A
  1. Achilles tendon
  2. Patellar tendon
  3. Plantar Fascia
18
Q

T or F? Soft tissue tumors are cell growths that emerge anywhere in the body?

A

TRUE

19
Q

On ultrasound while scanning the index finger, you see a hypoechoic mass with lobulated contours on a 40 year old woman with internal vascularity. What is the most likely diagnosis? slide 14

A

Giant cell tumor of the tendon sheath which is BENIGN

20
Q

What is the name of the malignant tumor that arises from the tendon sheath?

A

Synovial Sarcomas - hypoechoic mass, lobulated, with calcifications

21
Q

What pathology is seen when a nodule is compressible with transducer pressure and has NO posterior shadowing or color flow?

A

Pseudo-tumour

22
Q

What MSK pathology appears as a homogeneous, oval, isoechoic mass, with little or no flow on color or power Doppler imaging, soft and pliable with transducer pressure?

A

Lipoma

23
Q

Foreign Body appearance over time?

A

Acute <3 days: Hyperechoic with posterior shadow due to air

Intermediate 3-10 days: Hypoechoic halo surrounding foreign body - air replaced with fluid

Chronic >10 days: Granulation formation and may have a shadow

24
Q

What are the SF of nerve entrapment?

A
  1. Hypoechoic swelling of the nerve proximally at entrapment site
  2. Distal compression of the nerve
  3. Pain with transducer pressure
25
Q

What is the most common cause of bursitis?

A

Trauma
Often occurs in the presence of Tendinosis

26
Q

Acute vs chronic SF of bursitis?

A

Acute - Fluid collection

Chronic - Hypervascular walls, complex, debris, possible calcifications

27
Q

What pathology is composed of benign lumps that develop from a joint or tendon sheath, most commonly found in the hand or wrist?

A

Ganglion cysts - anechoic round appearance and filled with a hard jelly-like substance - are NOT compressible

28
Q

What pathology is caused by abnormal distension of the gastrocnemiosemimembranous bursa, which communicates w/ knee joint?

A

Baker’s cyst - medial gastrocnemius and semi- membranous tendon

29
Q

A tear of the muscle is the most common muscle pathology and is often associated with what?

A

Hematoma

30
Q

What pathology demonstrates a ‘clapper in a bell’ sign?

A

Complete muscle tear - retracted muscle surrounded by a hematoma

31
Q

What are the 3 grades of acute muscle injury?

A

Grade 1: No fiber disruption seen

Grade 2: Partial tear, moderate fiber disruption, compromised strength

Grade 3: Complete fiber disruption and retraction

32
Q

What are the 3 types of muscle injuries?

A
  1. Direct - usually muscle demonstrates disorganized fibers
  2. Stretch - common where muscles spans over two joints
  3. Penetrating - usually result in partial or full thickness tears. Gas can be introduced into the injury site.
33
Q

Which muscle injury is most common in children?

A

Stretch injury

34
Q

SF of chronic muscle injury?

A

Hyperechoic and atrophied muscle

35
Q

A damaged muscle can ossify and you will be able to see the mineralization on U/S before CT. What is this called? (called myositis ossificans)

A

Myositis Ossificans

35
Q

SF of hemorrhage by stage?

A

Initial injury - hyperechoic

After 36+ hours - becomes anechoic as it liquifies and becomes smaller as it reabsorbs

Chronic - Becomes echogenic at surrounding edges

36
Q

What are the different types of bone fractures?

A

Acute fracture - discontinuity of the bone and often seen with hemorrhage

Stress fracture - Focal hypoechoic area beside bone - patient may feel focal pain and tenderness

Osteophytes or bone spurs - bony growths occurring at margins of synovial joints - usually DO NOT present with tenderness or pain

MSK ultrasound (9 decks)

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