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MSK > trauma > Flashcards

trauma Flashcards

1
Q

Describe the 5 lines of the cervical spine on lateral films

A 
1 - anterior soft tissues
2 - anterior vertebral body
3- posterior vertebral body
4 - spinolaminar line
5 - spinous process line
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2
Q

What is a jefferson fracture?

A

Axial load trauma leading to disruption of the C1 “ring”

Lateral bodies of C1 will extend beyond the margins of C2 on the odontoid view

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3
Q

What is rotary fixation of the atlantoaxial joint?

How is it diagnosed?

What can it represent?

A

Atlantoaxial joint becomes fixed, and C1 and C2 bodies move as one unit

Open mouth odontoid views will show persistent asymmetric widening of one side of the C1 C2 articulation

Can represent rupture of the transverse ligament

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4
Q

What is a clay shovelers fracture?

A

Fracture of the C6 or C7 spinous process

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5
Q

What is a hangmans fracture?

how is it caused?

A

Fracture of the posterior elements of C2 with displacement of the C2 body anterior to the C3 body

Hyperextension and distraction - eg hitting head on dashboard

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6
Q

What is a flexion teardrop fracture?

A

Disruption of the posterior ligaments and anterior compression of a vertebral body with a “teardrop” fragment

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7
Q

What are locked facets?

How do they occur?

A

Overriding facets joints

Due to rupture of the apophyseal ligaments with distraction and rotation

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8
Q

What are the seatbelt fractures?

Which level do they usually affect

A

Due to hyperflexion at the waist

L1 and L2

Smiths - fracture of the posterior body

Chance - fracture through spinous process

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9
Q

What is thought to cause spondylolysis?

A

Stress related fracture from infancy when toddlers try to walk and repeatedly fall on buttocks

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10
Q

What is kummells disease?

A

AVN of the vertebral body

Delayed collapse of a vertebral body (1-2 weeks) following an anterior compression deformation

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11
Q

What two arthritic disease have a higher risk of spinal fracture?

A

AS and DISH

AS has marked osteoporosis as well which increases risk

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12
Q

What is a bennetts fracture?

What is the treatment? Why?

A

Fracture of the base of the thumb into the CMC joint

Surgical internal fixation - due to insertion of adductors on the base of the thumb, it will continue to sublux without fixation

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13
Q

What is a rolando fracture?

What is the treatment?

A

Comminuted bennett fracture - Y or T shaped fracture at the first metacarpal base

Fixation for the same reasons as a bennetts

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14
Q

What is a mallett finger?

What is the treatment

A

Avulsion injury at the base of a distal phalanx at the insertion of the extensor digitorum

Finger is held in flexion due to unopposition from lack of extensor attachment

Fixation

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15
Q

What is a gamekeepers thumb?

What is the treatment?

A

Avulsion of the ulnar aspect of the first MCP joint with involvement of the ulnar collateral ligament of that joint

Fixation/pinning

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16
Q

What is the difference between lunate and perilunate dislocation?

What is the radiolunate line?

What is the feared complication if this isnt treated?

A

Disruption of the capitolunate ligaments can result in dislocation of these two bones

Radiolunate line: Perpindicular line drawn from the middle of the radius through the lunate and capitate

Perilunate: dislocation of the capitate and all its surrounding bones (including the metacarpals) to lie doersal to the radiolunate line.

Lunate: capitate pushes the lunate volarly and tips it over, with the capitate and surrounding bones remaining in the radiolunate line.

Median nerve damage

17
Q

How does a lunate dislocation appear on AP views?

A

Like a triangle or pie shaped

18
Q

What fractures are associated with lunate dislocation?

A

Transscaphoid

Capitate, radial styloid, and triquetral fractures as well

19
Q

What is the carpal tunnel view useful for?

A

Hook of the hamate fractures

20
Q

What is the normal scapholunate distance?

A
21
Q

What is the protocol for a negative XR when scaphoid fx is suspected?

A

MRI or follow up XR in 7-10 days

22
Q

What is a sign of AVN of the scaphoid following fracture?

A

Sclerosis of the proximal fragment

23
Q

What is Kienbocks malacia?

What is an association?

What is the treatment?

A

AVN of the lunate

Negative ulnar variance

Surgical bone grafting and occasional removal or proximal carpal row fusion

24
Q

What is associated with negative ulnar variance? Positive ulnar variance?

A

Neg - kienbocks malacia

Pos - TFCC tears

25
Q

Small chip of bone on the dorsum of the wrist seen on lateral films is pathognomonic of what?

A

Triquetral fracture

26
Q

What is a colles fracture? Smiths?

A

Fracture of the radius and ulna with dorsal angulation of the distal fragments

smiths - volar angulation

27
Q

What is a bowing deformity of the forearm? How is it treated?

A

Bending of the radius and ulna without a frank fracture

Treated by breaking the bone and resetting them

28
Q

What is a monteggia fracture?
What is a galeazzi fracture?
What is an essex lopresti fracture?

A

Fracture of the ulna with dislocation of the proximal radius

Fracture of the radius with dislocation of the distal ulna

Fracture of radial head with DRUJ disloaction

MuGr Efur

29
Q

Which fat pad is more reliable to determine elbow pathology?

A

Posterior fat pad

30
Q

Which shoulder dislocation is more common?

A

Anterior (95%)

31
Q

How does an anterior shoulder dislocation appear on AP film?

A

Displaced inferomedially

32
Q

What are two signs that indicate a posterior shoulder dislocation?

A

Crescent sign/widening of the glenohumeral distance

Lightbulb sign

33
Q

What causes inferolateral displacement of the humeral head?

A

Hemarthrosis

34
Q

Who gets sacral stress fractures?

How do they appear radiographically?

A

Osteoporotics and post radiation patients

Patchy or linear sclerosis and sacral ala that may or may not show cortical disruption.

Interruption of the arcuate lines

35
Q

Where are the common sites for pelvic avulsion injuries? What muscles attach at those sites?

A

Ischium - hamstrings
ASIS - sartorious, TFL
AIIS - rectus femoris, iliopsoas
Iliac crest

36
Q

What are the three types of femoral neck stress fracture?

What is the treatment?

A

1 - sclerosis without evident fracture line
2 - lucent fracture line without displacement
3 - displaced fracture evident

Bed rest for type 1
Surgery for 2 and 3

37
Q

What is the radiographic appearance of a stress fracture in the long bones of the leg?

A

Sclerosis in a weight bearing bone that has a horizontal or oblique linear pattern

38
Q

What is a normal boehlers angle? What is it?

A

20-40 degrees

Angle between lines drawn from the calcaneal apex to the anterior process and posterior process

Indicates calcaneal fracture

MSK (8 decks)

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