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Sports injury anatomy > radiology: pelvis, hip and knee > Flashcards

radiology: pelvis, hip and knee Flashcards

1
Q

where do stress fractures commonly occur in the lower limb?

A

femoral neck: runners, military recruits
sacrum:insufficiency fractures
inferior pubic rami: runners (causes groin pain)

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2
Q

what is the main function of the trochanters of the femur?

A

provide strong attachments for muscles

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3
Q

what ligaments are commonly damaged in the pelvis in motorsport injuries?

A

sacroiliac and sacrotuberous due to high force

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4
Q

what is the trendlenburg test?

A

stand on one leg, positive if drop of the limb opposite to that effected. means problem with gluteus medius/minimus (wekaness in abductors)

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5
Q

what can cause trochanteric bursa pain?

A

iliotibial band rubbing

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6
Q

what are the symptoms and causes of iliopsoas bursa pain?

A

pain on inside of thigh

inflamed and thickened

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7
Q

what are the symptoms of ischial bursitis

A

ischiogluteal bursa inflamed

hurts to sit down

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8
Q

what muscles is obturator internus between?

A

the 2 gemelli muscles

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9
Q

which muscles is quadratus femoris under?

A

obturator internus and the gemelli muscles

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10
Q

what is the anterior compartment of the thigh innervated by?

A

femoral nerve

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11
Q

which is bigger out of the 2 semi muscles

A

semimembranosus

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12
Q

what inserts at the pes anserinus and the order?

A

sartorius most superior, then gracilis, then semitendinosus

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13
Q

what is the posterior compartment of the thigh innervated by?

A

sciatic nerve

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14
Q

what is the medial compartment of the thigh innervated by?

A

obturator nerve

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15
Q

what is in the anterior compartment of the thigh?

A

sartorius, vastus medialis, rectus femoris, vastus intermedius, vastus lateralis
saphenous nerve, femoral artery and vein, nerve to vastus medialis

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16
Q

what is in the posterior compartment of the thigh?

A

semimembrnosus, semitendinosus, biceps femoris

sciatic nerver

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17
Q

what is in the medial compartment of the thigh?

A

gracilis, adductor magnus, adductor brevis, adductor longus

deep femoral artery and vein

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18
Q

what are the intermuscular septa forming the compartments of the thigh?

A

medial and lateral

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19
Q

what is the lateral border of the femoral triangle?

A

medial border sartorius

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20
Q

what forms the roof of the femoral triangle?

A

fascia lata

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21
Q

what forms the floor of the femoral triangle?

A

mardked muscles with adductor brevis just showing, it has the anterior division of the obturator nerve on thesurface

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22
Q

what is the superior border of the femoral triangle@

A

inguinal ligament

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23
Q

what forms the medial border of the femoral triangle?

A

medial border adductor longus

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24
Q

what does the femoral triangle contain?

A

femoral nerve, artery and vein. deep inguinal nodes

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25
Q

where is a common place for femoral hernia?

A

femoral triangle

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26
Q

what forms the borders of the popliteal fossa?

A

semimembranosus, biceps femoris, gastrocnemius medial and lateral heads, plantaris

27
Q

what does the popliteal fossa contain?

A

popliteal artery, popliteal vein, tibial nerve, common fibular nerve

28
Q

which collateral ligament is biggest at the knee joint?

A

medial

29
Q

how is the anterior cruciate ligament injured?

A

foot planted, valgus twist with impact, knee straight or slightly bent

30
Q

how is the posterior cruciate ligament injured?

A

knee flexed, frontal impact or hyperextension

31
Q

how is the lateral collateral ligament injured?

A

varus force

32
Q

how is the medial collateral ligament injured?

A

valgus force

33
Q

which cruciate ligament can you see from the front?

A

anterior

34
Q

which part of the patella is most superior?

A

base

35
Q

which muscles are more likely to cause groin strain?

A

those crossing 2 joints

36
Q

what are the grades of groin strain?

A

1: tear a few muscle fibres, light pain and minimal impairment
2: damage to significant number of fibres, moderate loss of function
3: complete rupture (avulsion) of muscle, severe functional loss

37
Q

describe the pathology of groin strain

A

haemorhage and muscle fibre disruption, inflammatory reaction (pain andswelling), replacement of the inflammatory tissue with fibrous tissue

38
Q

what imagin is used for groin strains?

A

US or MRI
MRI: acute use T2 weighted as shows water (white area=high signal=blood or odema), T1 weighted for chronic to see anatomy

39
Q

give some complications of muscle strain.

A

muscle fibrosis, myositis ossificans (muscle turns to bone), weakness

40
Q

which tendons in the lower limb are commonly injured and where?

A

adductors, rectus abdominus, rectus femoris, hamstrings

origin (hamstrings), musculotendinous junction

41
Q

what are the symptoms of snapping hip?

A

greater trochanteric pain: radiates to buttock and thigh
maybe audible with or without pain
external snapping hip: iliotibial band
internal snapping hip: ilipsoas (when going from flexion to external rotation and internal rotation)

42
Q

what causes snapping hip and what imaging is used for it?

A

involves both tendons (ITB or iliopsoas) and bursa (trochanteric or iliopsoas). they become thickened and inflammed
T2 weighted MRI

43
Q

what is osteitis pubis and its symptoms

A

inflammation not infection, may be erosion of joint, may be due to shear of the joint due to increased movement
painful symphysis pubis

44
Q

what imagin is used for osteitis pubis?

A

XR hanging leg: look for movement symphysis pubis

MRI: T2 shows oedema

45
Q

what are the risk factors for osteitis pubis?

A

pregnancy (progesterone makes ligaments loser), urologic infections, obesity

46
Q

what are the symptoms and ix of gluteal tendinopathy and how is it more common in?

A

pain on outside of hip (could also be bursitis or tightening ITB)
gluteus medius and minimus
MRI
older overweight recreational athletes

47
Q

what imaging is needed for stress fractures?

A

XR often normal

need CT or MRI (oedema arouns stress fracture in T2 weighted)

48
Q

how does rectus femoris avulsion injury commonly occur and its sx?

A

children aged 14-19 years, bone is weaker than tendon and muscle, groin pain
occurs when go to kick ball hard but miss and hit floor, sudden deceleration of foot, muscle contracts so violantly it pulls off AIIS
can’t straight leg raise

49
Q

how does hamstring avulsion occur and its symptosm and signs?

A

“water skiiers injury”
sudden pull leads to forced flexion of hip and acute knee extension
with (adolescents) or without (older) fracture ischial tuberosity
can’t flex knee against gravity, lump 10-15cm below ischial tuberosity where hamstrong bunced up

50
Q

what can cause deep gluteal syndrome?

A

ischial bursitis
hamstring tendinopathy
gluteal sciatic pain: irritation of the sciatic nerve but local structures. compression, traction by adhesion and fibrosis

51
Q

what imagin is used for deep gluteal syndrome

A

MRI

52
Q

what causes avascular necrosis of the hip?

A

trauma (femoral neck fracture), thrombosis, alcohol, driving, diving, radiation, steroids, sickle cell anaemia, idiopathic
fragile blood supply as retrograde

53
Q

what imaging is used for avascular necrosis of the hip?

A

XR: collapsed, cystic
MRI: can catch earlier

54
Q

give a sx avascular necrosis of the hip.

A

groin pain

55
Q

what are the symptoms of a labral tear

A

groin pain, clicking/snapping, pain on flexion and internal rotation

56
Q

what does femoroacetabular impingement cause and how?

A

labrum damage
pincer: abnormal acetabulum, spread further around femoral head leadding to impingement
cam: more common, build up of bone on femoral neck, pushes into acetabular labrum causing tears and pain
can have both combined

57
Q

how is acetabular labrum injury treated?

A

cant just treat labral tear, also need to do osteoplasty to remove excess bone or will tear again

58
Q

what are the symptoms of meralgia paraesthetica?

A

tingling, numbness and burning pain in outer thigh

59
Q

what causes meralgia paraesthetica?

A

compression of lateral femoral cutaneous nerve. nerve branches from near asis

60
Q

what features of the XR are characteristic of osteoarthhritis?

A

loss of join space
osteophytes (extra pieces of bone)
subchondral sclerosis (whiteness underneath)
subchondral cysts

61
Q

how is osteoarthritis characterised?

A

mild, moderate, severe

based on how much joint space is left

62
Q

what are the most common causes of groin pain

A

muscle strains, avulsion injuries, stress fractures, impingement

63
Q

what are some less common causes of groin pain sthat still need to be considered?

A

L5/S1 facet joint degeneratio
hernias
endometriosis

Sports injury anatomy (8 decks)

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