MSK Flashcards

(235 cards)

0
Q

What is the first joint to show to show degenerative changes in the SLAC wrist?

A

Radioscaphoid

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1
Q

What is the most common location of a labrel acetabular tear?

A

anterior-superior

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2
Q

Findings in scapholunate dissociation?

A

Scapholunate ligament is disrupted - >3 mm of widening = terry thomas sign

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3
Q

Perilunate dislocation is most commonly associated with?

A

Scaphoid fractures

The capitate will migrate dorsally but lunate will remain in position

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4
Q

Midcarpal dislocation is associated with?

A

Triquetrolunate interosseous ligament disruption or triquetral fracture

the capitate migrates dorsally and the lunate is displaced volar

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5
Q

Lunate Dislocation is associated with?

A

Dorsal radiolunate ligament injury

Lunate is displaced toward the volar aspect

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6
Q

DISI

A

Cup of lunate faces dorsum of hand, Scapholunate angle is >60 degrees

Radial side ligamentous injury

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7
Q

VISI

A

Cup of lunate faces volar surface, Scapholunate angle < 30 degrees

Ulnar side ligamentous injury

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8
Q

What causes the dorsolateral dislocation of the Bennett Fracture?

A

Abductor Pollicis Longus

Rolando and Bennett are fractures of the first meta carpal (rolando is comminuted)

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9
Q

Avulsion of ___________ causes a gamekeeper’s thumb injury?

A

Ulnar collateral ligament

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10
Q

What is a stener lesion?

A

adductor tendon is caught under the ulnar collateral ligament, requires surgery, won’t heal

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11
Q

Causes of Carpal Tunnel Syndrome?

A

Trauma, pregnancy, dialysis

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12
Q

What does the ulnar nerve pass through?

A

Gunyon’s Canal- formed by the pisiform and hamate

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13
Q

Most common elbow fracture in pediatrics?

A

Supracondylar

Radial head is most common in adults

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14
Q

What fracture is associated with a posterior elbow dislocation?

A

Capitellum

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15
Q

Essex-Lopresti?

A

Fracture of radial head with anterior dislocation of the DRUJ

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16
Q

Impingement on the ulnar nerve by an accessory muscle?

A

Anconeus Epitrochleris

Ulnar nerve runs in the cubital tunnel, retinaculum is known as eipcondylo-olecranon ligament or osbornes band

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17
Q

Best view for evaluation of a Hill-Sacks?

A

Internal rotation

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18
Q

Inferior dislocation (luxation erecta humeri) can result in?

A

axillary nerve injury

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19
Q

Lateral femoral neck fracture is associated with?

A

Bisphosphonates

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20
Q

Corona Mortis ?

A

anastamosis of inferior epigastric and obturator

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21
Q

What corresponds with the risk of AVN in femur fractures?

A

Degree of displacement

circumflex femoral

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22
Q

Iliac crest avulsion?

A

Abdominal muscles

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23
Q

Anterior inferior iliac spine avulsion?

A

rectus femoris

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24
Greater trochantor avulsion?
Gluteus medius and gluteus minimus
25
Lesser Trochanter avulsion?
Illiopsoas
26
Ischial tuberosity avulsion?
hamstrings
27
Pubic symphysis avulsion?
Adductor muscles
28
Snapping Hip Syndrome Types?
External- Iliotibial band over greater trochanter Internal- Illiopsoas over illiopectineal eminence or femoral head Intra-articular- loose body in the joint/labral tear
29
What is the cross-over sign?
sign of pincer type femoroactabular impingement - anterior and posterior rims of acetabulum cross over each other making a figure 8
30
Segond fracture (lateral tibial plateau) is assocatied with?
ACL injury Reverse Segond (medial tibial plateau) is associated with PCL injury
31
Arcuate Sign?
Avulsion of proximal fibula, associated with PCL injury
32
Deep intracondylar notch sign A/W?
ACL tear
33
Common assocaited wiht patellar tendon tear (patella alta)?
Lupus/SLE bilateral patellar tendon tear- chronic steroids
34
Most common type of tibial plateau fracture?
Type II, lateral plateau is most commonly injured
35
Tillaux fracture is SH Type______?
3- through the anterolateral tibial epiphysis
36
Triplane fracture?
SH Type 4
37
Do maisonneuve fractures extend into the hindfoot?
NO
38
What is the next step in evaluating a patient with bilateral calcaneal fractures?
Evaluate spine for burst fracture
39
What Bohler's angle is concerning for a fracture?
.
40
Avulsion fracture of the base of the 5th metatarsal?
Peroneus brevis
41
Most common dislocation of the foot?
Lis Franc- medial cuneiform to 2nd metatarsal head All metatarsals can go lateral or the first and second can diverge if injured Can't exclude on non-weight bearing films
42
SONK (spontaneous osteonecrosis of the knee) is actually?
insufficiency fracture- most common in medial condyle, assocaited with meniscal injury
43
Looser zones are associated with?
Osteomalacia and riskets Lucent bands perpendicular to the cortex Insufficiency fracture
44
T- score values?
T >1.0 is normal T -1.0- -2.5 = osteopenia T- >-2.5 = osteoporosis
45
Transient osteoporosis of the hip findings ?
Osteopenia on XRAY Edema on MRI Increased uptake, at risk for fracture 3rd trimester of pregnancy and men
46
Staging of Osteochondritis Dissecans/Osteochondral lesions?
Stage 1: stable, covered by intact cartilage Stage 2: Stable on probing, partially not intact with host bone Stage 3: Unstable, complete discontinuity with bone Stage 4L dislocated fragment Look for T2 signal undercutting fragment to call unstable
47
Kohler's?
Navicular, Male 4-6 (treatment is not surgical)
48
Freiberg?
Second metatarsal head
49
Severs
Calcaneal apophysis
50
Panners?
Capitellum, "thrower"
51
Perthes
Femoral head
52
Keinbock
Lunate, associated with negative ulnar variance
53
De Quervain's involves?
Abductor Pollicus Longus and Extensor Pollicus Breveis (first extensor compartment, thumb
54
Which extensor compartment can demonstrate early tenosynovitis in RA?
Sixth- extensor carpi ulnaris Can also see RA in multiple flexors
55
What defines the carpal tunnel?
Deep the the palmaris longus tendon pisiform, hook of hamate, scaphoid, trapezium tubercle Contents are wrapped in the transverse carpal ligament fibrous sheath
56
What does the carpal tunnel contain
4 flexor profundus, 4 flexor superficialis, 1 flexor pollicus longus, and 1 median nerve
57
Which synovial spaces in the wrist communicate?
pisiform recess and radiocarpal joint
58
Should the glenohumoral joint and subarcromial bursa communicate?
NO, suggests a full thickness rotator cuff tear
59
Do the ankle joint and Lateral peroneal tendon sheath communicate?
NO, suggests calcaneofibular ligament tear
60
What is intersection syndrome?
First extensor compartment crosses the seconda-> extensor carpi radialis brevis and longus tenosynovitis
61
Lucency in distal phalanx that corresponds to enhancing T2 bright mass on MR?
Glomus tumor
62
Giant cell tumor of the tendon sheath?
Like PVNS, T1, T2 dark bloom on gradient DDX: tendon sheath fibroma- will not bloom
63
Elbow- Where does the ulnar collateral ligament insert?
Sublime tubercle Anterior Bundle of UCL is most important Typically in throwers
64
Panner vs. Osteochondirits dessicans?
Both involve the Capitellum Panner- younger children, OD- teenare No loose bodies in panner
65
Epitrochlear Lymphadenopathy
Cat Scratch
66
Rotator cuff- Subacromial impingement most commonly affects?
Supraspinatus tendon
67
Subcoracoid Impingement affects?
Subscapularis
68
Posterior superior Internal Impingement (from overhead throwing)?
Damages the infraspinatus
69
Most common rotator cuff tear affects?
Supraspinatus partial tear is
70
SLAP tear?
Tear of the superior labrum (anterior to posterior), adjacent to the biceps tendon, no istability Detachment of the labrum and biceps from glenoid gets surgery (type II) Extension into the biceps muscle is Type IV
71
What is the bankhart lesion spectrum?
least to most: GLAD->Perthes ->ALPSA -> true bankhart
72
GLAD?
anterior inferior labral tear with assocaited cartilage damage, no instability
73
Perthes?
detachment of anteroinferior labrum but intact periosteum
74
ALPSA?
anterior labral periosteal sleeve avulsion, absence of labrum on glenoid rim- intact periosteum The labrum is displaced medially along the glenoid
75
True bankhart?
periosteum is disrupted
76
HAGL?
Avulsion of the inferior glenohumoral ligament, "J" sign on coronal MR associated with anterior dislocation
77
A cyst in the suprascapular notch affects?
Supraspinatus and infraspinatus
78
Cyst in the spinoglenoid notch will effect?
infraspinatus
79
What makes the quadrilateral space?
teres minor (above), teres major (below), humoral neck, triceps
80
What is impinged in quadrilateral space syndrome?
Axillary nerve- teres minor atrophy
81
Parsonage Turner?
Painful Inflammation of muscles- brachial plexus neuropathy
82
Medial dislocation of the long head of the biceps is associated with?
Subscapularis tendon tear
83
Buford complex?
Thickened middle glenohumoral ligament Congenitally absent anterior/superior labrum
84
Which aspect of the meniscus is most likely to heal after tear?
peripheral- increased blood supply
85
Which meniscus looks like a true "C" with equal width anteriorly and posteriorly?
Lateral The medial is thinner anteriorly
86
What are the two meniscofemoral ligaments?
Humphrey and Wrisberg Humphrey is anterior "alphabetical"
87
Conjoint tendon is made of?
biceps femoris and LCL (lateral collateral ligament)
88
Which is the first part of the MCL to tear?
capsular ligament - results in meniscal capsular separation
89
Which discoid meniscus is the most prone to injury?
Wrisberg Variant
90
Double PCL sign in bucket handle tear proves?
ACL is intact
91
What are signs of ACL injury?
Segond fracutre Kissing contusion- lateral femoral condyle impacts the posterior lateral tibial plateau
92
O'Donoghue's Unhappy Triad?
ACL tear, MCL tear, medial meniscus
93
Celery Stick ACL?
mucoid degeneration
94
ACL repair- what is the primary factor in preventing impingement?
positioning of the tibial tunnel (can't be too far anterior)
95
What determines isometry of ACL repair? (constant length and tension)
Femoral tunnel of the graft
96
What is complication of ACL repair in a patient presenting with inability to fully extend the knee?
Arthrofibrosis- cyclops lesion
97
When is ACL graft most susceptible to tear?
During remodeling 4-8 months
98
What is typically torn in patellar dislocation?
MPFL- medial patellar femoral ligament
99
What tendons are in the medial ankle?
Posterior Tibial Flexor digitorum Flexor Hallicus
100
What tendons are in the lateral ankle?
Peroneus Longus Peroneus Brevis
101
What is the master know of henry?
Where dick crosses harry in the medial ankle "harry dick"- felxor digitorum crosses flexor hallicus
102
What is the most commonly injured ligament during inversion?
anterior talofibular ligament
103
Most common cause of a flat foot/pes planus?
Posterior tibial injury (chronic- behind medial malleolus or acute- navicular) secondary supporter of the arch- spring ligament, will have hindfoot valgus
104
Split peroneus brevis tear is associated with?
lateral ligament injury
105
"Meniscoid" mass in the lateral gutter of the ankle?
Anterolateral impingement syndrome-> scar tissue production
106
Sinus tarsi syndrome?
obliteration of fat and replacement with scar (space between lateral talus and calcaneous)
107
Pain in the distribution of the first 3 toes?
Tibial nerve - tarsal tunnel syndrome
108
In Achilles' tendon rupture the ability to plantar flex is lost unless?
The plantaris is intact
109
Plantar fascitis presentation?
Pain worse in morning, increased with dorsi-flexion Fascia >4mm
110
Most common site of a morton's neuroma?
3-4th metatarsals perineural fibrosis from compression/entrapment of the plantar digital nerve
111
Osteomyelitis in spine with gibbus deformity?
TB
112
Ghost sign in neuropathic patient?
bone with poor definition and margins on T1 but becomes better defined after contrast administration, more likely to be osteomyelitis
113
What metastsis is a frequent cause of occult pnumothorax?
Osteosarcoma
114
Which is more developed or dense centrally osteosarcoma or myositis ossificans?
osteosarcoma
115
Where is the most common location for a parosteal osteosarcoma?
Distal posterior femoral metaphysis BULKY
116
What looks like a chondroblastoma but in an adult?
clear cell chondrosarcoma
117
Most common location of a chordoma?
sacrum, next is clivus
118
Most common soft tissue sarcoma in adults?
Malignant fibrous histiocytoma bone infarcts can degenerate into MFH
119
Painful soft tissue mass with soft tissue calcifications and bone erosion?
Synovial sarcoma - Don't involve joint - Have translocation of X-18
120
Epiphyseal equivalents?
carpals, patella, greater trochanter, calcaneous
121
Epipyseal lesions?
GCT, chondroblastoma, Infection
122
McCune Albright?
Polyostotic fibrous dysplasia Cafe-au-lait spots Precocious puberty
123
Mazabraud?
Polyostotic fibrous dysplasia Myxomas Increased risk of malignant transformation
124
Ollier's?
Multiple enchondromas
125
Marfucci's?
Hemangiomas and enchondromas (increased malignant potential)
126
EG findings?
vertebrae plana Floating tooth Skull with beveled edge lucent lesions
127
Differential diagnosis for vertebrae plana?
lymphoma EG Mets, myeloma
128
Key features of a Giant cell tumor?
physes must be closed non-sclerotic border extends to articualr surface
129
Jaffe- Campanacci Syndrome?
Multiple non-ossifying fibromas, cafe-au-lait spots, mental retardation, hypogonadism, cardiac malformation
130
Painful scoliosis?
osteoid osteoma/osteoblastoma
131
Mini-brain in vertebral body?
Plasmacytoma
132
POEMS?
myeloma with sclerotic mets- neuropathy, organomegaly
133
Fallen fragment sign?
unicamral bone cyst
134
Which benign lesions have marked edema?
osteoid osteoma and chondroblastoma
135
Chondromyxoid Fibroma?
lucent, eccentric, elongated lesion "bite"- like
136
Common Calcaneal lesions?
unicamral bone cyst- fallen fragment intraosseous lipoma-fat density or central bone fragment Others- ABC, GCT, chondroblastoma
137
Most common location fro liposclerosing myxofibroma?
intratrochanteric region- sclerotic margin
138
Cartilage cap that is concerning for malignant degeneration of osteochondroma?
2 cm or greater - point away from joint - Medullary continuity
139
Trevor Disease
osteochondromas developing in joint- marked deformity
140
Supracondylar spur
Points toward the joint Can compress median nerve with the ligament of struthers
141
Periosteal Chondroma?
Looks like lucent plate extensing from periosteum (surroundign sclerosis)
142
Osteofibrous Dysplasia?
Looks like NOF in anterior tibial with tibial bowing -Typically in children
143
Anterior lateral tibial bowing?
NF1
144
Felty Syndrome?
RA + splenomegaly + neutropenia
145
Caplan Syndrome?
RA, +pneumoconiosis
146
Asymmetric eosive changes with bony proliferation and NO osteopenia?
Psoriasis
147
Lung disease in ankylosing spndylitis?
upper lobe predominant
148
Where is erosions occur in sacroilitis?
iliac side first- thinner hyaline cartilage
149
Symmetric SI joint involvement?
IBD, ankylosing spondylitis Asymmetric- reactive arthritis, psoriatic
150
Gout mimickers?
Amyloid, Cystic RA, reticular histiocytosis, sarcoid, hyperlipidemia
151
What resembles CPPD? Hooked osteophytes, chondrocalcinosis
Hemochromatosis
152
Milwaukee Shoulder?
Intraarticualr destruction due to hydroxyapetite deposition
153
Spine: Shiny corners? Bridging lateral osetophyte?
SC- ankylosing spon. Bridging Osteophyte- Psoriatic
154
Appearance of SLE in hands?
reducible joint deformities rarely have joint space narrowing or erosions
155
DISH involves at least ______ levels?
4
156
Findings of JIA?
Osteopenia, ankylosis knee- widening of the intracondylar notch (similar to hemophilia)
157
Osteopoikilosis transmission is?
Autosomal dominant
158
Primary synovial osteochondromatosis is considered a ______ process?
metaplastic/neoplastic
159
Engelmann's Disease?
progressive diaphyseal dysplasia favors long bones hot on bone scan can cause optic nerve compression in skull
160
Most common site of diabetic myonecrosis?
thigh (marked edema and enahancment)
161
Stages of osteonecrosis/ avascular necrosis ?
``` 0- normal 1- edema on MR, XRAY= normal 2- Mixed lytic and sclerotic 3- crescent sign, articular collapse 4 - OA ```
162
Thalassemia
Hair on end skull will obliterate sinuses rodent faces expanded ribs
163
Most common complication of pagets?
deafness can form osteosarcomas or giant cell tumors
164
Anisotropy in tendons?
Tendon can appear hypoechoic when not perpendicular to sound beam Greatest culprits- supraspinatus and long head of biceps
165
Arthrogram Injection for hip and shoulder aim for?
hip- superior femoral head and neck junction Shoulder- middle third and inferior third of the humoral head 2 mm inside cortex
166
Although benign, what tumors can produce metastases?
Chordoma and Giant cell tumor
167
What are 2 lesions associated with melorheostosis in the axial skeleton?
AVMs and fibrolipomatous lesions
168
What is Trevor's Disease?
Osteochondromas in the epiphysis
169
What is a capitellar fracture associated with?
Ulnar collateral ligament rupture
170
What is the most common coalition in the hand?
lunotriquetral
171
Bridging ossification in Fibrousdysplasia Ossificans progressiva first occurs in the?
Sternocleidomastoid muscles
172
Findings in developmental dysplasia of the hip?
Coxa Magna (large flattened femoral head and neck) Up-turning of acetabular roof and retroversion of the acetabulum
173
What is associated with a solitary fibrous tumor/hemangiopericytoma?
hypoglycemia
174
What prevents proximal retraction of the biceps tendon even with complete disruption of the tendon?
lacertus fibrosis
175
What extensors are in compartment 1?
abductor pollicis longus and extensor pollicis brevis
176
What extensors are in compartment II?
extensor carpi radialis longus and extensor carpi radialis brevis
177
Extensor in compartment III?
Extensor pollicis longus
178
Compartment IV extensor tendons?
Extensor digitorum and extensor indicies
179
Compartment V extensor?
extensor digiti minimi
180
Compartment VI extensors?
extensor carpi ulnaris
181
What does listers tubercle seperate?
Compartment II and III
182
Most common site of Achilles' tendon tear?
mid-substance
183
Movement of the fracture fragment in a Bennett fractures is due to the unopposed action of?
abductor pollicis
184
Grades I-III AC joint injury?
I- sprain of AC ligament II- complete disruption of AC ligament III- Complete disruption of coracoclavicular ligament
185
The arcuate sign (fibular head avulsion) is assocaited with?
postero-lateral corner injury
186
Stress fracture grades?
``` 0- normal I- periosteal edema II-periosteal and marrow edema on T2 III- periosteal and marrow edema on T1 and T2 IV- visible stress fracture ```
187
Volar plate injury appearence?
results from hyperextension, with injury along the palmar PIP joints can see avulsion fracture at base of MCP
188
Injury to what nerve at what location results in foot drop?
peroneal- fibular head
189
Pellagrini-Steida injury is associated with?
MCL injury
190
Essex-Lopresti?
radial head fracture with dislocation at DRUJ Galleazi- involves radial shaft
191
Reverse segund fracture is associated with?
PCL and medial meniscus injury
192
What muscle is classically spared in eupinator/posterior intraosseous nerve syndrome?
extensor carpi radialis longus
193
Sever disease?
osteochondrosis involving the immature calcaneal apophysis
194
When is a heel pad thickened and concerning for acromegaly?
2.3 cm
195
Soft tissue calcifications in renal Osteodystrophy are composed of?
calcium hydroxyapetite deposition
196
Which portion of bone marrow converts to yellow marrow last?
metaphysis
197
What do joint space findings in CPPD look like, typically?
Large subchondral cysts and hooked osteophytes
198
What could be the only differentiating factor for hemochormatosis and CPPD?
osteopenia/osteoporosis can be seen in Hemochormatosis but not CPPD
199
Most location of meniscal ossicle?
posterior horn of medial meniscus
200
What position should arm be in form imaging the biceps tendon on MRI?
FABS Flexed, abducted, and supinated
201
Most common nerve injured in posterior hip dislocation? What changes clinical management of posterior hip dislocation?
sciatic nerve injury Fragments in hip joint- surgery
202
Where does subperiosteal resorption first occur in renal osteodystrophy?
Radial side of the 2nd and 3rd middle phalanx
203
Causes of distal clavicle resorption?
RA, hyperparathyroidism, trauma (osteolysis), cleidocranial dysplasia, mets/myeloma
204
Most common location for involvement of reactive arthritis in extremities?
retrocalcaneal bursitis or calcaneal erosion psoriasis favors hands, reactive- feet
205
Double PCL sign?
Medial meniscus Lateral meniscus forms double delta- anterior horn sign
206
Vertebra plana?
``` -Fracture – EG – Tumor (leukemia, lymphoma, neuroblastoma, mets/myeloma) – Infection (TB) – Steroids – Hemangioma ```
207
Patellar Tendinopathy/Jumper's Knee does not affect?
Anterior fibers of the patella
208
Which hip fractures have the highest risk of AVN and non-union?
Subcapital
209
Most common site of Achilles' tendon tear?
Watershed vascular area, approximately 2-6 cm above calcaneous
210
What is a chopart fracture/dislocation?
Involves the hindfoot-midfoot joint
211
How does melorheostosis progress?
Progresses from an end of the bone to the center
212
Erlenmeyer flask deformity
• DDx: hemoglobinopathy (sickle cell, thalassemia), Gaucher, Niemann-Pick, osteopetrosis, fibrous dysplasia
213
Epiphyseal equivalents?
patella, calcaneus, carpal/tarsal bones, apophyses (greater and lesser trochanters of femur, tuberosities of humerus)
214
Lesser trochanter avulsion in adults?
Consider metstasis Children-iliopsoas avulsion
215
Hemochormatosis is like-
CPPD
216
Camurati-Engelmann disease?
Diaphyseal dysplasia - smooth cortical thickening with obliteration of medullary cavity
217
Jefferson fracture?
-Burst fx of C1 -Unstable, as transverse atlantal ligament may be disrupted
218
Knee findings in hemophilia?
– Epiphyseal overgrowth, due to chronic hyperemia | – Knees: elongation or squaring of patella, widening of intercondylar notch
219
Vertebral disc calcifications?
Onchronosis
220
Congenital Syphilis Bone Findings?
-Diffuse periostitis – Symmetric destruction of medial proximal tibial metaphyses (Wimberger sign) – Lucent metaphyseal bands
221
Diffusely increased bone sclerosis?
``` – Renal osteodystrophy – Sickle cell disease – Myelofibrosis – Osteopetrosis – Pyknodysostosis – Mets – Mastocytosis – Paget disease – Athletes – Fluorosis ```
222
DDx marrow depletion (fat signal on MR)?
aplastic anemia, post radiation, some chemotherapy regimens
223
DDx marrow infiltration (low T 1 on MR)?
polycythemia vera, hemochromatosis, amyloidosis, Gaucher, | lymphoma, myelofibrosis, myeloma, mets
224
How are parosteal osteosarcomas treated?
Tx: wide, en bloc excision; chemotherapy generally not necessary – Once it violates cortex of adjacent bone, treated as conventional osteosarcoma
225
Imaging appearance of Periosteal osteosarcoma?
Soft tissue mass with ray like periosteal reaction, scallops or cups adjacent cortex typically diaphyseal
226
Congenital rubella?
Celery stalk appearance of metaphysis
227
Most common ligament injured in patellar displocation?
Medial petellofemoral ligament MPFL extends from adductor tubercle to medial superior pole of patella
228
Causes of short 4th metacarpal?
Turner syndrome, Klinefelter syndrome, pseudohypoparathyroidism, pseudopseudohypoparathyroidism
229
What can have a boney Sequestrum besides osteomyelitis?
Malignant fibrous histiocytoma
230
Madelung deformity is associated with?
Hurler's, Turner's
231
Little Leaguer's Elbow results from ?
Valgus compression on the capitellum
232
What are the normal shoulder labral variants?
Sublabral recess-11-1 o'clock, follows curve of glenoid Sublabral foramen- 1-3 O'clock, follows glenoid, smooth Buford Complex- Congenital labral variant (absent in the 1-3 O'Clock position with hypertrophy of middle glenohumoral ligament)
233
What are the two primary classification of Labral tears?
SLAP- superior labral anterior to posterior, typically involves the insertion of the biceps Bankhart lesions- anterior inferior labrum, typically related to dislocation (3-6 O'Clock). Only exception is reverse bankhart
234
Vanishing bone disease?
Gorham-Stoud