wk 9- upper extremity (elbow, hand, wrist) Flashcards
located on the dorsum wrist at level of scapho-lunate ligament
ganglion cyst
treatment for ganglion cyst
surgery or injected with steroid
tumor arise from tendon sheath bit DO NOT move with tendon motion
giant cell tumor
giant cell tumor origin
volar surface thumb, index and middle finger of DISTAL interphalangeal joining
common name for “nodular synovitis”
giant cell tumor
- solid
- hypoechoic
- well defined margins
- hypervascular on colour doppler
giant cell tumor
t/f: giant tumors move with tendon motion
false
often associated with raspberry skin
hemangioma
t/f hemangioma is malignant
false
hemangioma are ___ growing
slow
appear as hypo or hyperechoic and solid with varying degrees of vascularity
hemangioma
t/f: glomus tumors are very common
false
arise from neuromyoarterial apparatus in the dermis. Occurring under finger/ toe nails or at volar surface of finger tip
glomus tumor
few mm in size, solid, well defined with hypoechoic internal echogenicity & hypervascularity on doppler
glomus tumor
schwannoma are ____ located whereas neurofibroma are located ____
eccentrically
centrally
most ___ occur along the flexor surface of the forearm or hand
schwannoma
schwannoma age range
30-60yrs
neurofibroma age range
20-30 yrs
arise from the shwann cells of nerve
schwannoma
arise from the fasciculi, centrally within nerve
neurofibroma
nerve tumor that causes symptoms of tingling or pain
neurofibroma
t/f: schwannoma are asymptomatic
true
4 tendon pathologies
- tenosynovitis
- de quervian’s
- trigger finger
- trauma
inflammation of the synovial lining of the tendon sheath
tenosynovitis
fluid filled sheath with tendon seen in it. Fluid may be echo-free or have internal echoes/ debris
tenosynovitis
involves the 1st extensor compartment
-abductor pollicis longus and extensor pollicisbrevis sheath
de quervian’s
de quervian’s is related to ___ side pain especially affected with ___ movement
radial
thumb
fluid in tendon sheath surrounding normal appearing tendon at 1st extensor compartment
de quervian’s
in de quervian’s the tendon sheath can be ____ & ____
thick & hypoechoic
trigger finger most often affect the ___
thumb
common age & gender for trigger finger is ___
female 40-60yrs
presents with locking of the affected digit
trigger finger
hypoechoic nodule on flexor tendon surface prox to A1 pulley system . Can have fluid in sheath and thickening of sheath. Also seen is small peritendinous cysts
trigger finger
treatment of trigger finger
- splinting
- non-steroid drugs
- injections
- surgery
avulsion of flexor digitorum tendon or ulnar collateral ligament avulsion
trauma
sport that commonly causes avulsion of flexor digitorum tendon
volley ball
avulsion flexor digitorum tendon occurs during
forced extension
unable to flex the distal interphalangeal joint and avulsed tendon end recoils
avulsion of flexor digitorum tendon
sport that commonly causes ulnar collateral ligament avulsion
skiing - falling with skii pole in hand
abducted thumb becomes HYPERabducted avulsing in insertion of the ulnar collateral ligament from it’s proximal phalangeal insertion
ulnar ligament avulsion
“stener lesion” results from
ulnar collateral ligament displacement
ulnar collateral ligament avulsion at the level of the __ metacarpophalangeal joint of thumb
1st
median nerve entrapment syndrome
carpal tunnel syndrome (CTS)
chronic tingling fingers often worse at night
CTS
CTS is more common at age __ and gender ___
30-60yrs
female
t/f: CTS is often bilateral
true
a median nerve cross sectional area >__mm-squared is consistent with carpal tunnel syndrome (CTS)
15
what is an indicator of joint pathology
joint effusion
often secondary to cartilaginous loose body (freely moving in joint capsule post trauma)
joint effusion
hyaline cartilage is no thicker than ___mm, if thicker than this then joint effusion is suspicious
1
originate from synovial lining of joint or tendon sheath
elbow ganglion
seen in the presence of inflammation or fluid as fluid filled with thickened synovium
olecranon bursitis
lateral epicondylitis occurs ___ than medial epicondylitis
more
tennis elbow
lateral epicondylitis
golfers elbow
medial epicondylitis
___appears as:
-thickened, hypoechoic extensor tendon just proximal to joint space
epicondylitis
