Osteochondrosis @ other sites

Question 1

What is AVn of humeral head called and features

Answer 1

Hass disorder

-Irregular shape of head w/ sclerotic rim

Question 2

What is sonk- onset (age) and cause

Answer 2

Mc medial ffemoral condyle in adults
-onset >60
Unknown etiology (insidious)

Question 3

When is surgery indicated for sonk

Answer 3

If defect occupies >50% of articular surface-> surgical arthroplasty indicated

Question 4

SONK imaging findings (first signs and later signs)

Answer 4

Initial films neg (MRI/Bone scans better)

• Earliest findings- flattening of articular surface
• may see loose bodies
• subchondral bone density mixed sclerosis + lucency

Question 5

When represents a fx in SONK

Answer 5

Crescent sign represents subchondral fx

Question 6

How will SONK look on MR

Answer 6

T2- high signal on medial condyle marrow

T1- low signal on area of medial condyle

Question 7

OSteochondritis Dissecans- age, mc locations, s/s

Answer 7

11-20 yoa males (sonk but for younger)

• Knee, ankle, elbow, hip
• Swelling, pain, clicking locking

Question 8

MC site of osteochondritis dissecans

Answer 8

Femoral condyle (85%, bilateral 30%)- on medial condyle but more lat on the condyle than SONK

Question 9

pathophys of osteochondritis dissecans

Answer 9

Small necrotic segement of subchondral bone( fragemnt may become a loose body)

Question 10

What is the 2nd mc site of osteochondritis dissecans- age and why

Answer 10

MEdial talar one
-common in active indv aged 20-40
mech- compressive, shearing force from a combo of inversion, rot and plantar flex

Question 11

What is the 3rd mc site of osteochondritis dissecans- population and imaging

Answer 11

capitellum of humerus

• little league pitchers
• flattening of articular surface

Question 12

What is freibergs disease- age, m:f, signs

Answer 12

Avn of 2nd metatarsal head mc
13-18 y female
1:5 m:f

-Involved head appears enlarged, flattened and fragmented

Question 13

What is kienbocks disease- age, gender

Answer 13

Avn of carpal lunate

mc in 20-40 M9:1F

Question 14

imaging of kienbocks diease

Answer 14

radiography neg for months then lunate will appear w increased density with later fragmentation and collapse w mized density

Question 15

What is kienbocks disease associated w

Answer 15

Negative ulnar variance in up to 75% of cases

Question 16

Panners disease- mc loc, age, signs

Answer 16

AVN of capitulum

• mc in 5-10 (younger than OCD)
• no loose bodies
• flattening and lucencies w rim

Question 17

Osgood-schlatter- cause, age, gender

Answer 17

Patellar tendinitis or partial disruption of lig attachment (pain) (biilat 25-50%)

• ages 11-15
• males>females

Question 18

Scheuermans disease- age, gender, loc

Answer 18

Adolescent onset (13-17)

• Mc in males
• usually mid and lower t spine

Question 19

What are the clinical fx of scheurermanns disease

Answer 19

• pain, fatigue and defective posture
• increased rigid kyphosis
• hyperlordosis lumbar and cervical spine
• protuberent abdomen
• hypertonic hams, iliopsoas, pecs

Question 20

What must you have imaging wise to dx scheuermans (5)

Answer 20

• kyphosis in 3 continous segs
• Wedging of more than 5 degrees of each seg
• Iregular endplates (scmorles nodes0
• Loss of disc height
• wide vert bodies

Question 21

Management of scheurmans disease

Answer 21

Self limiting after maturity (but deformity maintained)

• physical therapy
• bracing/surgery if severe

Question 22

Kummels disease- what is it, signs

Answer 22

Delayed collapse of vert body subsequent to trauma/unrecognized fx

Key sign- air lucency withing body

Question 23

What is a risk of kummels disease

Answer 23

can cause probs of stenosis due to collapse