Musculoskeletal knowledge Flashcards
5 types of SALTR
SALTR
1: slipped
2: above
3: lower
4: transverse
5. ruined
What are the two types of bone?
Cortical (outter hard surface with attachments), Cancellous (inner where blood is)
CT better than XRay at what?
Subtle fractures, articular fx, step-offs
What is a communicate fracture?
comminuted=more than 2 part break
MRI primarily used for what kind of tissue?
Soft tissue. Used when concerned about ligament or cartilage injury suspected
T2 MRI shows fluid as what color?
White
Why is MRI good in occult fx? (Hint: What lights up?)
Bone marrow lights up on T2
Do bone bruises show up on Xray?
No
What size slice needed in MRI?
3mm instead of 5mm
Define fracture?
any interruption in the cortex of a bone is a fracture. cortex is the hard exterior of the bone.
When is ultrasound used and for what?
In trauma setting, for soft tissue injury
What is most part of musculoskeletel exam?
History
How many views are needed for musculoskeletel xrays?
Two. AP and Lateral are usually sufficient.
Can an MRI show a bone bruise?
Yes. Xray cannot.
What do you look at to know if articular cartilage at joint is there or not?
Look at joint space. Less space means less cartilage.
Cortical bone becomes thicker or thinner as go down long bone? If broken midshaft what does that mean for energy of the break?
Cortical bone gives support. As go down in long bone the cortex become thicker as bears more weight. If broken midshaft then a lot of energy was required.
Most fractures appear as what kind of line on an xray?
Radiolucent line, aka “Lucent Line”
In a nondisplaced fracture is it easy or hard to see a lucent line?
Hard because lucent line is thin
A compression fracture of appears as what kind of line?
Sclerotic Line
Where are the two most common areas for a compression fracture?
Vetebral body, distal radius
Cortical Buckling usually happens in what age group?
Kids
What two sites is Cortical Buckling mostly seen?
Distal radius, radial neck
What is an intra-articular fracture? What line goes into where?
When lucent line goes into joint.
What is a displaced fracture versus nondisplaced fracture?
Displaced=Broken ends are not touching; Non-displaced= if both ends are touching
What is angulation?
Angulation of distal to proximal fragments
What is rotation and what’s special about the xrays?
When bone rotates at joint. Can only see one joint in one view and the other joint in another view (AP and lateral)
What is a distraction fracture?
Tug of different muscles. Gap with no overlap.
What is an avulsion fracture?
When tendon pulls bone off. Commonly on hand, foot, pelvis
What’s a joint effusion?
Blood in the joint due to injury
What is a transverse fx?
Peripendicular to long bone, most common in leg/forearm, most stable
What is an oblique fracture?
Caused by indirect force, shearing force, unstable and need OR
What is a spiral fracture?
Happens from twisting movement, rotational/shear forces, unstable, uncommon. Hard to tell apart from oblique.
What is a communited fx?
2 or more fragments
What is a greenstick fx?
Usually only in kids, incomplete break of longbone, usually in forearm
What is a buckle fx (Torus fracture)?
Mostly in kids, at metaphyseal-diaphyseal junction, usually doesn’t need casting
Who gets Salter-Harris FXs and where do they occur?
Common in children 10-15 y/o, epiphyseal plate fractures
How many Salter-Harris types are there and what does the number represent?
5 types, as number goes up FX gets worse
Most common type of Salter-Harris FX?
Type 2, FX passes across growth plate and up through the metaphysis
What is Salter-Harris Type 1?
FX only through growth plate, not bone
Define Salter-Harris Type 3
fx away from growth plate toward joint through epiphysis.
Define Salter-Harris Type 4
FX through metaphysis, physis, and epiphysis. About 10%.
Define Salter-Harris Type 5
Crush injury of physis, less than 1%, poor prognosis
Can clavicle fx heal on own?
Yes, usually
90% of shoulder dislocations happen in which direction?
Anterior
What is Monteggia Fracture Dislocation?
FX of ulna shaft, dislocation of radial head
Elbow dislocations happen in which direction?
most elbow dislocations are posterior
What is a Nightstick FX?
defensive wound with throwing arm up over forehead to protect self
What is a Colles Fracture?
FX of distal radius due to FOOSH. Very common.
What is a Smith FX? What is it opposite of?
FX of distal radius with volar angulation. Fall on flexed hand, opposite of Colles FX. Direct blow to back of wrist.
What is a Galeazzi Dislocation FX?
FX distal radius, dislocate distal ulna (but not broken ulna)
Acronym GRIMUS for Galezzi and Monteggia FXs
Galezzi Radius Inferior, Menteggia Ulna Superior
Metacarpal FX account for what percent of all FX and what percent of hand FX?
10% of all, 40% of hand FX. 5th MC is common break point
What is Slipped Capital Femoral Epiphysis? Who does it happen to?
Happens in chubby kids. Might complain of hip or knee pain. Femoral head slips off and loses blood supply causing bone necrosis. Vague hip or knee pain with no hx of trauma
What is a Maisonneuvue FX?
Spiral FX of proximal fibula AND ankle injury
What is the most common tarsal bone FX?
Calcaneus 60%, most intra-articular
What is cause of most calcaneal FXs?
Compression injury, ex jumping from second story window to run away from someone
