(1,3) Upper Extremity Variants

Question 1

What is a pseudotumor of the humerus?

Answer 1

mach effect where the greater tuberosity appears as a lytic mass
(NOT a Dx)

Question 2

What is a supracondylar process?

Answer 2

exostosis proximal to the medial epicondyle, pointing toward the elbow joint

Question 3

What is the differential diagnosis for a supracondylar process?

Answer 3

pedunculated osteochondroma
(points away from elbow joint)

Question 4

What is the anomalous soft tissue structure associated with this radiographic diagnosis?

Answer 4

Struthers ligament
(Dx = supracondylar process)

Question 5

What nerve is most likely affected by a supracondylar process?

Answer 5

median n

Question 6

What may cause symptoms in a patient with a supracondylar process?

Answer 6

• median neuropathy
• brachial a compromise
• Fx

Question 7

What is positive ulnar variance?

Answer 7

Ulna is >2mm above the radius

Question 8

What is the clinical significance of positive ulnar variance?

Answer 8

• ulnar impingement syndrome
• TFCC tear

Question 9

What is negative ulnar variance?

Answer 9

ulna is >2mm below the radius

Question 10

What is the clinical significance of negative ulnar variance?

Answer 10

lunate AVN (Keinbock disease)

Question 11

What is Keinbock disease?

Answer 11

AVN of the lunate

Question 12

What are the radiographic signs of avascular necrosis?

Answer 12

• sclerosis
• flattening
• fragmentation

Question 13

What is Madelung deformity?

Answer 13

short bowed radius with DRUJ dislocation due to failure of medial growth at distal radial physis

Question 14

What is carpal coalition?

Answer 14

congenital fusion of carpal bones

Question 15

What type of carpal coalition is clinically significant?

Answer 15

involving proximal to distal row can have significant biomechanical results or indicate dysplasia
(just 1 row involved is NOT signif.)

Question 16

What are the most common types of carpal coalition?

Answer 16

1. lunotriquetral
2. capitate-hamate
   (for lab: just say “carpal coalition”)

Question 17

What is polydactlyly?

Answer 17

extra fingers/toes/bones

Question 18

What is syndactlyly?

Answer 18

manifests in the form of fusion of the skin between the digits (syndactlyly) or fusion of the osseous phalanges of adjacent digits (synostosis)

Question 19

What is symphalangism?

Answer 19

ankylosis/synostosis of the interphalangeal joints in toes or fingers

Question 20

What is the diagnosis?

Answer 20

Rhomboid fossa

Question 21

What is the diagnosis?

Answer 21

Rhomboid fossa

Question 22

What is the diagnosis?

Answer 22

Os acromiale

Question 23

What is the diagnosis?

Answer 23

Os acromiale

Question 24

What is the diagnosis?

Answer 24

Supracondylar process

Question 25

What is the diagnosis?

Answer 25

Proximal radioulnar synostosis

Question 26

What is the diagnosis?

Answer 26

Madelung deformity

Question 27

What is the diagnosis?

Answer 27

Proximal radioulnar synostosis

Question 28

What is the diagnosis?

Answer 28

Madelung deformity

Question 29

What is the diagnosis?

Answer 29

Enlarged conoid tubercle

Question 30

What is the diagnosis?

Answer 30

Olecranon foramen

Question 31

What is the diagnosis?

Answer 31

Negative ulnar variance

Question 32

What is the diagnosis?

Answer 32

Positive ulnar variance

Question 33

What is the diagnosis?

Answer 33

Carpal coalition

Question 34

What is the clinical significance?

Answer 34

None

Question 35

What is the diagnosis?

Answer 35

Carpal coalition

Question 36

What is the diagnosis?

Answer 36

Polydactyly

Question 37

What is the clinical significance?

Answer 37

Significant biomechanical results (Carpal coalition involving proximal to distal row)

Question 38

What is the diagnosis?

Answer 38

Syndactyly

Question 39

What is the diagnosis?

Answer 39

Brachymetacarpy