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Radiology > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

Polyostotic fibrous dysplasia: unilateral or bilateral

A

Unilateral and monomelic (one limb)

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2
Q

What aggressive lesion can present as an expansile, well-defined lytic lesion with endosteal scalloping?

A

Chondrosarcoma

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3
Q

Name 4 joints that exhibit erosions as a manifestation of degenerative joint disease

A

TMJ

AC joint

SI joints

Pubic symphysis

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4
Q

Name 4 bony lesions that can have sequestrum

A

Osteomyelitis

Lymphoma

EG

Fibrosarcoma

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5
Q

What’s associated with +ve and -ve ulnar variance?

A

Positive: TFCC tear

Negative: Kienbock disease

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6
Q

Difference between tibial stress fracture and shin splint on bone scan?

A

Stress fracture: focal, fusiform activity

Shin splint (medial tibial stress syndrome): linear increased activity along posteromedial tibial cortex

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7
Q

Young fit man (no fever) with acute knee pain- symmetrical joint space narrowing and osteophytes.

A

Reactive arthritis: uniform joint space narrowing, erosions and osteophytes

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8
Q

How often do gouty tophus calcify?

A

Rare, unless renal failure

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9
Q

30M with soft tissue mass (low T2) around knee. Lots of calcifications on CT.

A

Synovial sarcoma (20-40 Y) and 30% calcify

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10
Q

RA typical age and sign of early joint involvement?

A

40-70 F and juxta-articular osteopaenia

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11
Q

Cause of low back pain radiating down legs in dwarfism

A

Short pedicles

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12
Q

Morton neuroma- common location and MRI features

A

Symptomatic perineural fibrosis

Low T1/ T2 and intense enhancement. High on PD FS and STIR

3rd WS most common followed by 2nd WS

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13
Q

80M with rib pain and fusiform uptake in single rib on bone scan

A

Fracture (mets usually multiple and myeloma had poor sensitivity on bone scan)

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14
Q

False regarding OA

A

Reduced mineralisation. Usually get sclerosis

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15
Q

Best views of tendons on X-ray

A

ER: supra and infra

IR subscap and teres minor

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16
Q

Best view on X-ray for Hill-Sachs

A

Internal rotation

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17
Q

Focal vs broad-based disc herniation

A

Focal is less than 25%

Broad-base is 50-25%

Disc bulge is more than 50%

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18
Q

DISH

A

Diffuse idiopathic skeletal hyperostosis:

florid osteophyte formation

eventually ankylosis

disc space preserved

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19
Q

What causes annular tears?

A

Chronic wear and tear

Not acute trauma

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20
Q

Modic changes on MRI

A

Modic type I: low T1 high T2 (water)

Modic type II: high T1/ T2 (fatty marrow)

Modic type III: low T1/ T2 (sclerosis)

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21
Q

What percentage of Morton neuroma bilateral?

A

10%

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22
Q

What bone in foot/ ankle is NOT a toddler’s fracture?

A

Navicular

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23
Q

What is T-score and Z-score in DEXA?

A

Z-score is age-matched

T-score compares BMD to healthy young adult

Both are sex-matched

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24
Q

What is osteopaenia and osteoporosis in terms of T score?

A

Normal: T score > -1

Osteopaenia: between -2.5 to -1

Osteoporosis: less than -2.5

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25
Where do SS tears start?
Critical zone: 1 cm medial to insertion anteriorly
26
Fibrous cortical defect- painful?
No. Unless fractured
27
Vertebral haemangioma- complication?
Rarely may be aggressive with epidural extension and cord compression Bone scans usually NORMAL
28
Vertebral haemangioma- complication?
Rarely may be aggressive with epidural extension and cord compression Bone scans usually NORMAL
29
Neonatal viral infection- bony changes?
Vertical metaphyseal lucent bands- celery stalk sign
30
Location of Brodie's abscess
Typicallly metaphyseal. Can be epiphyseal in infants
31
Not a cause of Erlenmeyer flask deformity?
NF Common causes: thalassaemia, osteopetrosis, leukaemia, olliers
32
False re: SUFE?
Chondrolysis is reversible 20-40 bilateral and AVN 15%
33
Cervical spine injuries in kids
Atlanto-axial dislocation 5X more common In less in 5 years, most injuries occiput to C2 Anterior wedging of C5 in a 3 year old can be normal. But abnormal if 8-9 years
34
Most common location for parosteal sarcoma?
Metaphysis most common (periosteal sarcoma diaphysis) Lucency b/w tumour and bone (string sign)
35
Most common location for parosteal sarcoma?
Metaphysis most common (periosteal sarcoma diaphysis) | Lucency b/w tumour and bone (string sign)
36
Vit C def vs Vit D def
Scurvy: reduced osteoid but normal mineralisation Rickets: normal osteoid but reduced mineralisation
37
Where do skin rheumatoid nodules occur?
Regions of skin subjected to pressure: ulnar aspect of forearm and elbow
38
Gouty tophi?
Pathognomonic for gout
39
Name 3 benign cartilaginous lesions that can give rise to chondrosarcoma.
Osteochondroma Enchondroma Chondroblastoma
40
Name 3 morphological variants of chondrosarcoma
Conventional intramedullary Juxtacortical (arise from osteochondroma) Clear cell (young patients and epiphyseal)
41
Lytic phase of Paget on histolgy. What virus has been implicated?
Large, multinucleated osteoclasts in the lytic phase New bone is woven or lamellar and remodelled into lamellar bone in a haphazard manner- mosaic or jigsaw pattern Paramyxovirus
42
How to differentiate chondrosarcoma from other chondroid lesions on histology?
Intramedullary chondroid matrix surrounding trabeculae
43
How do bisphosphonates work?
Reduce osteoclastic activity
44
Chondrosarcoma vs enchondroma in terms of location
CS rarely involves peripheral bones. Usually central: pelvis, shoulder, ribs, skull base
45
Name 4 conditions associated with CPPD
Hyperparathyroidism Haemochromatosis Gout (40% of gout have CPPD) Hypomagnesaemia
46
What's Letterer-Siwe and Hand-Schuller-Christian?
Aggressive forms of LCH LS: less than 2 years with prominent extra-osseus involvement. Multiple lytic lesions in skull- raindrop skull HSC: associated with DI (infiltration of posterior pituitary)
47
Name 2 cxs of GCT
5% lung mets and 10% sarcomatous transformation
48
Histology of GCT. Can it be associated with Paget?
Multinucleated osteoclast-like giant cells on a background of mononuclear cells. May be associated with Pagets
49
Interspinous inflammation in spine
Baastrup disease
50
Sacral GCT
2nd most common primary sacral tumour after chordoma Low T1 with areas of low T2 due to haemosiderin/ fibrosis
51
What percentage of sacral chordomas are calcified?
70%
52
What percentage of scaphoid fracture missed on initial film?
30%
53
Minimum volume of free fluid detected by FAST scan?
200 mls
54
Name 3 features of melorrheostosis
Sclerotomal distribution Soft tissue calcifications and contractures NO malignant transformation
55
Perthes lesion of shoulder?
Undisplaced Bankart with periosteal stripping
56
GLAD lesion of shoulder?
Anteroinferior labral tear Associated glenoid cartilage injury
57
GCT: what percentage malignant and mets?
10% malignant 5% mets but excellent prognosis (benign metastasizing GCT)
58
Name the 4 types of acromion
Flat, curved, hooked (impingement) and upturned
59
Painless osteosarcoma?
Paraosteal osteosarcoma: slow growing and best Px
60
What nerve is most commonly damaged in knee dislocation?
Common peroneal nerve
61
Bone scan: infection vs loosening of hip prosthesis
Fracture and infection will show increased uptake on blood pool due to hyperaemia. Loosening usually not. WC scan can distinguish between infection and loosening
62
Inclusion body myositis
Flexors of hand and wrists Starts DISTALLY as opposed to dermatomyositis and polymyositis
63
Signal characteristics of gouty tophus?
Intermediate T1, low T2 and enhances
64
Plantar fibromatosis: M vs F?
More common in males
65
Not associated with short limbs?
Cleidocranial dysplasia (AD)
66
Chondrosarcoma- Px and Rx
Mostly indolent Needs wide excision. Chemo and XRT usually not useful.

Radiology (16 decks)

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