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SUMRAD > RAD-MSK-LE > Flashcards

RAD-MSK-LE Flashcards

1
Q

What’s the most common fracture in the thoracic spine?

A

Compression fractures from a significant mechanism

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2
Q

What percentage of thoracic spine fractures/dislocations involve a spinal cord injury?

A

60-70%– get an MRi. CT -FX

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3
Q

What’re the standard films for lumbar spine?

A

-standard: AP + lateral
-special: lumbosacral spot and oblique.
LS NOT Common ordered plain films

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4
Q

What’s the approach to reaching lumbar films?

A 
ABC's: alignment, bones, cartilage and soft tissue 
AP-1. spinous process alignment 
2. intrapedicular distance 
3. traverse processes 
4. vertebral body width

LATERAL 5. vertebral body height, width and cortex

    1. posterior vertebral line
      7. disc spaces

BOTH-

  1. soft tissue
  2. freebies
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5
Q

What’s that cause of a wedge compression fracture?

A

hyperflexion from a fall, pathological, or osteoporosis

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6
Q

What is a wedge compression fracture?

A
  • loss of height *anterior vertebral body only (anterior column)
  • **posterior body height and post vertebral line intact
  • greater loss of height = greater severity
  • 25% 75yo
  • CT to r/o burst fracture
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7
Q

What is a burst fracture?

A

Axial load like a jump or fall

  • comminuted both anterior and middle columns -***posterior vertebral line disruption
  • inter-pedicle space disruption
  • **unstable=posterior column fx
  • fx fragment *retropulsion into spinal cord -CT, MRI if neuro deficit
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8
Q

What is a chance fracture?

A

seatbelt fracture hyperflexion at the thoracolumbar junction

  • Horizontal fx thru body, post arch, spinous process Ligamentous injury retropulsion of fragments
  • unstable.
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9
Q

What is spondylolysis?

A
  • bony defect of the pars interarticularis
  • non-displaced fracture
  • MC L4/L5 + L5-S1
  • repetitive stress, congenital
  • FX results in a collar around pars/neck of the scotty dog in an LATERAL oblique view
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10
Q

What is spondylolisthesis?

A
  • anterior slippage of the vertebral column relative to the vertebral body below it
  • usually a result of bilateral spondylolysis
  • MC occurs at L3/4, L4/L5 or L5-S1
  • results in spinal stenosis
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11
Q

What’s a true spondylolisthesis?

A

UNSTABLE Fracture of pars interarticularis *with displacement
w. Step off ABOVE slippage level

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12
Q

What’s a pseudo-spondylolisthesis?

A

*no pars interarticularis fx present

w/ STEP off BELOW slip level

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13
Q

What is DJD?

A

Degenerative joint disease aka spondylosis- cortical sclerosis(outer edges white irreg), disc space narrowing, spurs

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14
Q

What is seen with Ankylosing Spondylitis?

A

VB narrowed towards edges,
long oval, with bulge.
Fusing together
Bamboo spine

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15
Q

What’s the judet view, special view w/ AP?

A

It’s supine, hip at 45 deg.

viewing the acetabulum.

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16
Q

What’s the inlet view?

A

40d caudad to see the pelvic ring

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17
Q

What’s the outlet view?

A

40d cephal to see the sacroiliac. Ideal POST op

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18
Q

What’re the stable pelvis fractures?

A

-avulsion(ASIS),
-Ramus
-Duverney-iliac wing,
-sacral
Coccyx -2/3
ARDS

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19
Q

What’re the unstable pelvic fractures?

A

M-algaigne- 1 side SI dislocation FX 1 side
O-PEN BOOK–diastasis (separation) of the SI joint or pubic symphysis
Bucket handle-1 SI jt and ramus opp side
-pelvic ring dislocated in 2+ places
Straddle-B/L FX rami
Dislocation

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20
Q

What causes of hip fractures?

A

Trauma, osteoporosis, steroids. High risk bleeder to nearby vessels and nerves

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21
Q

If one hip hurts what should you order?

A

*AP to compare.
Toe touching- IR see Great troch.
Frog Leg- ER absent greater troch

22
Q

What line is drawn from Less troch of hip to superior rami?

A

Shenton’s line- if shortent or neck w/in line, +Femoral neck FX

23
Q

What are the types of Proximal Femur FX with AVN risk?

A

Capital-top of femur,
Subcapital-below capital,
Transcervical-neck*
Displaced femoral neck FX

24
Q

Are hip dislocations usually posterior or anterior?

A

90% are posterior

25
Q

Describe posterior hip dislocations.

A

-Femoral head lateral, superior to the acetabulum
-LE IR and shortened
-Axial force along flexed hip and knee
-Sciatic nerve injury 10%
Hiden hip

26
Q

Describe an anterior hip dislocation.

A

-External rotation
-Shortened
-Femoral head is inferior, medial
Open hip

27
Q

What’s the mechanism of a femoral shaft fracture?

A

High energy/force Often a pathologic fracture. Shortened d/t MSK contraction

28
Q

Why are femoral fractures at high risk for bleeding?

A

Femoral artery. high risk for compartment syndrome

29
Q

What’re standard views of the knee? Special views?

A
  • standard: AP and lateral

- special: sunrise and intercondylar notch (“tunnel view”)

30
Q

What’s the intracondylar notch/tunnel view?

A

Knee flexion

31
Q

Describe a tibial plateau fracture.

A
  • axial load, valgus force
  • jumpers
  • high risk of ligamentous injury
  • CT scan for all tibial plateau FX - ORIF
32
Q

Describe a tibial plateau compression fracture.

A
  • subtle and easy to miss
  • MC lateral plateau
  • localized increase in density
  • tibia appears lateral to femur
  • joint wide on affected side
33
Q

What’re patella fractures?

A
  • direct blow mechanism most often
  • the patella is the largest sesamoid
  • ex: horizontal, vertical, stellate-star or marginal- margin piece
34
Q

What can be seen in AP OR TUNNEL view of Knee jt?

A

Proximal fib FX.

Tibia condyle fX-Segond avulsion >75% ACL. ACL tear

35
Q

What is thought to be a FX in the patella, but isn’t bc/ smooth cortical, and eval. Pt?

A

Bipartite Patella

36
Q

Describe a patellar dislocation.

A

Sunrise view- axial. from a sudden quad contraction

  • majority are lateral
  • will self reduce
  • x-ray for patella fx post-reduction
  • 30% w/ ligamentous or meniscus injury
37
Q

Describe a patellar tendon rupture.

A
  • pt cannot extend knee
  • high-riding patella
  • effusion
  • mechanism: sudden muscle contraction (direction change) or direct blow
38
Q

What is a butterfly FX?

A

Triangular fragment in long bones

39
Q

What is ordered for Ankle injury?

A

AP, Lateral and Mortise-20deg angle,
Width<4mm,
Tib-fib space <5mm, slight distal tib fib overlap. .

40
Q

What should be noted in ankle injury?

A

Mortise jt of stability. Wide, Narrow-determine ligamentous disruption

41
Q

What should be noted in bimalleolar FX?

A

Tri malleoli. Follow the cortex. Med and Lat and Post-UNSTABLE

42
Q

What is Maisonneuve FX?

A

Spiral FX of proximal fibula;
Widened mortise.
Wide syndesmosis-
+/- distal fib. Check above and below

43
Q

What FX occurs at the roof of the mortise jt?

A

Plafond FX- distal tibia/joint talus- comminuted- intraarticulur-impacted-
UNSTABE- CT

44
Q

What are risk with Talus fX?

A

Missed- Chronic pain if note treated d/t AVN, malunion. CT!- ORIF

45
Q

What are seen posteriorly and thought to be FX?

A

Ossicle- os trigonum talus, Os

46
Q

What is MC tarsal FX and require CT or MRI of LS?

A

Calcaneus FX- high force

47
Q

Draw Bohler’s angle and what does it indicate?

A

Line A- sup posterior to subtalar articulation Line B- Inf talus tip of subtalar jt to ANT process of calcaneus. Ant Angle= 20-40deg. DEC angle= compression FX. BUT normal does not R/O FX still CT

48
Q

Gissane angle?

A

N- 120-140 INC= FX. Line btwn navicular and calcaneus+ talus and navicular

49
Q

What is a FX btwn base and shaft of 5th MT?

A

Jones FX- slight more distal from styloid. CAST- ORIF. Risk NOn union

50
Q

What is avulsion of 5th MT at base?

A

Pseudo Jones- Dancers.
Peronus brevis tendon-
Walking cast.

STRESS FX- MC shaft of 5th

51
Q

What is a LIsfranc FX?

A
  1. Midfoot slide laterally d/t FX and dislocation
  2. Check 1-2MT alignment with/ 1st and 2nd cunieform
  3. 5th MT w/ cuboid
  4. FX at proximal 2 MT
  5. MT cuboid space on AP obligue.
  6. MOA DF -
    7 UNSTABLE ORIF
  7. ligament is 1st cuneiform and medial 2nd MT

SUMRAD (13 decks)

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