Revise Radiology MSK Flashcards
T1 dark line in vertebral body with normal signal elsewhere
Osteoporotic compression fracture
Sequestrum
Piece of necrotic bone surrounded by granulation tissue.
Sign of active osteomyelitis
Thickening of flexor tendon sheath with locking sensation
Trigger finger
Associated with aneurysmal bone cyst
Chondroblastoma,
Osteoblastoma,
Giant cell tumour,
Fibroxanthoma,
Smoldering infection in hands without periosteal reaction in children
Tuberculous dactylitis
Achondroplasia spinal appearances
Posterior vertebral scalloping,
Gibbus deformity,
short pedicle canal stenosis
Decreasing interpedicular distance
Widening of intervertebral discs
Chronic kidney disease causes (endocrine)
Hyperparathyroidism
Tibial stress fracture risk of malunion
Anterior = high risk
Posteriomedial = low risk
Wrist deformities and relevant angles
Normal SL = 30-60. Normal CL < 30
SLAC: SL > 60, CL < 30
DISI: SL > 60, CL > 30
VISI: SL <30, CL >30
Pedunculated bone tumour arising from metaphysis of long bones with cartilaginous cap
Osteochondroma
Marrow darker than muscle on T1, Lucent metaphyseal bands on X-ray, child
Leukaemia
Lodwick classification of lytic lesions
1a: geographic with thin, sclerotic margin
1b: well defined border without sclerosis
1c: ill defined border
2: moth eaten
3: permeative
DIP and PIP joint involvement with central erosions
Erosive osteoarthritis
Bulky mass, posterior distal femoral metaphysis, string sign
Parosteal osteosarcoma
Parosteal vs periosteal sarcoma
Metaphysis vs diaphysis
50% vs no marrow extension
Outer vs inner layer of periosteum
Maffucci vs Ollier
Ollier: multiple enchondromas, slight increase in chondrosarcoma risk
Maffucci: multiple enchondromas, haemangiomas, higher sarcoma risk
Normal atlanto-occipital distance
<5mm
elastofibroma dorsi
Benign soft tissue lesion, usually infrascapular. Can show PET uptake. Similar density to muscle with fat component
Well defined lucent lesion in proximal humerus with intact trabeculae
Pseudocyst of humerus. Get CT
Well defined lytic lesion with non-sclerotic margin
Giant cell tumour
Spotty osteoporosis following recent ORIF
RSD
Geographic lytic lesion with sclerotic margin in intertrochanteric NOF
Liposclerosing myxofibroma (10% risk of malignant degeneration)
Osteochondromas pointing towards the joint, originating from the epiphysis
Trevor disease
Scaphoid fracture mechanism of injury
Hyperextension
Fibrous lesion between planter portions of metatarsal heads
Morton’s neuroma
Eccentric lytic lesion in knee with thin sclerotic border
Fibrous cortical defect (<3cm)
Non-ossifying fibroma (>3cm)
Linear or triangular T1/T2 bright structure projecting from centre of posterior vertebral bodies
Basivertebral veins
Anserine bursa of the knee
Consists of Sartorius, Gracilis and Semitendinosus tendons, can become inflamed leading to pes anserine bursitis, characterised by medial knee pain
Chronic wrist pain, positive ulnar variance, cystic changes in lunate bone
Ulnar impaction syndrome
Multiple loose bodies with varying calcification in the knee with joint effusion
Synovial chondromatosis
Most common pulley injury in competitive sports
A2
Types of SLAP tear
Type 1: Superior labrum frayed but still attached
Type 2: Superior labrum and biceps anchor detached from glenoid rim
Type 3: bucket handle tear
Type 4: Bucket handle tear extending into biceps tendon
Anterior tibial lesion in child with anterior tibial bowing
Osseofibrous dysplasia
Mild fever, chronic pain, well defined lytic lesion with sclerotic rim
Brodie’s abscess
Infant, symmetrical metaphyseal fractures with diaphyseal diffuse periosteal reaction
Congenital syphilis
Bilateral periostitis of distal long bones
Hypertrophic osteoarthropathy
Vertebral body squaring with Romanus lesions
Seen in early ank spond
Klippel-Feil syndrome associated with
Unilateral renal agenesis
Epidural collection along the ALL
TB spondylitis (Pott’s disease)
Primary hyperparathyroidism features
Subperiosteal resorption of bone
Osteopenia with reduced joint space and cartilage calcification in hands
Haemochromotosis
Commonest soft tissue injury associated with avulsion of medial proximal tibia
MCL tear
DDH causes increased risk of
Labral tears
Retro-achilles bursitis, thickening of achilles tendon, calcaneal bony prominence
Mullholland deformity/Haglund’s disease
Avulsion fracture at base of proximal first phalanx with UCL disruption
Gamekeeper’s thumb
Longitudinal temporal bone fractures
Associated with inco-stapedal joint dislocation
Hypoechoic swelling of the median nerve with increased cross sectional area
Carpal tunnel syndrome
Best sequence to assess Triangular fibrocartilage complex tear
T2 coronal
washed out hand with proximal distribution, premature fusion of growth plates
Juvenile idiopathic arthritis
Double density sign on bone scintigraphy
Osteoid osteoma
Gorlin Goltz associated with
Increased risk of medulloblastomas
Best modality to assess pathological fractures
CT
Femoral fracture with long periosteal reaction and underlying pagets
Atypical fracture, due to bisphosphonate
Fragment near the medial process of calcaneal tuberosity, often associated with plantar spur
Plantar Fascia rupture
Kaposi sarcoma (MRI)
Intermediate T2, high T2 signal in lower extremeties with variable gadolinium enhancement
Melorhheostosis management
Conservative
AVN grading
Ficat and Arlet classification:
Grade 2: Osteopenia, sclerosis and cysts with no crescent sign.
Grade 3: crescent sign
Hill sachs vs bankart
Hill sacs are more common and affect posteriosuperior humeral head
Bankart affects anterior inferior glenoid
Syrinx associated with
Neuropathic arthropathy
Most sensitive test for HOA
MRI
Marfans vs homocysteinuria
Upward vs downward lens dislocation
Subligamentous collection along the anterior spine
TB
Lesion arising from muscle causing cortical bone erosion
Malignant Fibrous Histiocytoma
Talocalcaneal coalition associated with
Pes planus
Fibrous dysplasia PET
hot
Long fibula associated with
Achondroplasia
Erosive arthritis
Central erosions, gullwing appearance
incomplete femoral neck fractures associated with
Pagets
Loss of lamina dura
Scleroderma
Bennett vs Rolando
Both fractures through base of thumb metacarpal. Rolando is comminuted
Heterogenous lesion in distal diaphysis with sclerotic margins
Medullary infarct
High T2 loose bodies in the knee
Primary synovial chondromatosis
Fever, irritability, coarse & irregular periosteal reaction with soft tissue swelling
Caffey disease - Infantile cortical hyperostosis
FAST scan can reliably detect how much free fluid
> 200ml
ECU tendon moved from original position
Tendon sheath synovitis
Best position for supraspinatus imaging
ADduction and Internal rotation (back pocket)
Best position for biceps tendon visualisation
Arm ADducted, internally rotated (slight) and palm facing up
Subscapularis best position
Arm ABducted, externally rotated
Infraspinatus best position
Arm flexed, placed across chest
Bilateral cortical thickening and sclerosis, with patchy marrow changes
Erdheim Chester disease
Geographic bone destruction with wide zone of transition, fluid levels and aneurysmal dilatation
Telangiectatic osteosarcoma
Ix to further investigate wrist fractures/dislocations
CT
Jefferson fracture
Fracture of the ring of the atlas due to axial loading
VACTERL spinal anomalies
Spina bifida occulta
Complex presacral mass in baby
Sacrococcygeal teratoma
diffuse osteosclerosis with splenomegaly
Myelofibrosis
Flexion teardrop fractures associated with
Anterior cervical cord syndrome
Expansile, lytic lesion with sclerotic rim in metaphysis, with internal septations and calcifications
Chondromyxoid fibroma
Phemister Triad
Peri-articular osteoporosis
peripherally located osseous erosion,
gradual joint space narrowing
Suggests TB arthropathy
Thin sclerotic rim, extension across physeal plate, occurs in epiphyses or equivalents
Chondroblastoma
Large, lobular or cystic calcium deposits near joints
Tumoural calcinosis
Communication between ankle joint and common peroneal tendon sheath
Calcaneofibular ligament rupture
Posterior superior shoulder impingement
Involves infraspinatus and posterior fibres of supraspinatus. Seen in throwers
Causes of sclerotic bone mets
Prostate, breast, lung