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part 2 / 3 boards > DIM > Flashcards

DIM Flashcards

1
Q

Osteochondroma

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Location :
Name Sign :

A

AKA : None
Type: BBT
Age : n/a
Symptom : tender at the soft tissue d/t growing bone in the area
Detail : Most Common BBT of the appendicular skeleton
Can be the following:
-pedunculated ( Aka coat hanger ) ( aka cauliflower like ) ( looks like the
bone is growing away from the joint )
-Sesile ( growing like a round bulb)
- HME ( hereditary multiple exostosis ) ( having multiple of enchondromas
Management : Refer to orthopedist, Biopsy , CT scan, MRI
Location : Long bones Ap
Name Sign : looks like bone growing on and can clearly see where it ends and not

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2
Q

Unicameral Bone Cyst

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Location :
Name Sign :

A

AKA : UBC, Simple Bone Cyst , SBC
Type : Benign bone tumor
Age : Less than 20 yo
Symptom : N/A
Detail :
Management : Refer to orthopedist, Biopsy , CT scan, MRI
Location : long bones, diaphysis/metaphysis area
: centrally located meaning it is in the middle of the long bone
Name Sign : Fall Fragment sign , fracture and some fragment went into the bone
: it looks like dark round inside the long bone in the middle

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3
Q

Benign bone tumor

There are 14

A

-Encapsulated ( see exactly where the boarders of the region is)
-Short zone of transition ( see exactly where the boarder of the region is)
-Geographic lesion ( clear where and not)
-incidental finding ( no pain / symptom )
-Management:
-Refer to orthopedist, Biopsy , CT scan, MRI

Osteochondroma
UBC
ABC
GCT
Chondroblastoma
Osteoid Osteoma
Brodie’s abscess
*Enchondroma
Hemangioma
Enostoma
Osteopoikilosis
Osteaoblastoma
Osteoma
Fibrous Dysplasia

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4
Q

Aneurysmal Bone Cyst

AKA :
Type :
Age : @@@
Symptom :
Detail :
Management :
Location :
Name Sign :

A

AKA : ABC
Type : BBT
Age : less than 20 yo
Symptom : N/A
Detail : Bone expansion more than SBC
Management : Refer to orthopedist, Biopsy , CT scan, MRI
Location : Diaphysis/metaphysis of long bones
Eccentrically meaning it is on the side of the lone bone
Name Sign : looks like lytic on the long bone but it is more on the left side than on the
center

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5
Q

Giant Cell Tumor

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Location :
Name Sign :

A

AKA : GCT
Type : BBT
Age : 20 - 40 yo
Symptom : N/A
Detail : 20% of the time is quasi malignant meaning not all but some can be malignant
Management : Refer to orthopedist, Biopsy , CT scan, MRI
Location : Epiphysis/Metaphysics
Name Sign : @@Soap bubble appearance ( saponaceous)@@

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6
Q

Chondroblastoma

Type :
Age :
Management :
Location :
Name Sign :

A

AKA :
Type : BBT
Age : less than 20 yo
Symptom : N/A
Detail :
Management : refer to orthopedist, biopsy, CT scan, MRI
Location : epiphysis/metaphysis
Name Sign : soap bubble appearance( saponaceous )

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7
Q

Osteoid Osteoma

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Location :
Name Sign :

A

AKA :
Type : BBT
Age :
Symptom : Night pain relieved by aspirin
Detail : tiny dot is the prostaglandinin/ tumor / white stuff is the reaction sclerosis
fighting off the tumor
: central nidus with severe sclerosis
Management : Refer to orthopedist, CT scan, MRI , Biopsy
Location : diaphysis
Name Sign : It looks like very blastic with a small lytic dot in the center

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8
Q

Brodie’s Abscess

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Location :
Name Sign :

A

AKA : Chronic Osteomyelitis
Type : BBT
Age :
Symptom : Night pain relieved by aspirin, Red , Hot , swollen, Fever
Detail : appears like Osteoid osteoma
: involcrum - new bone growth
: sequestrum - dead bone material
Management : Refer to Orthopedist,
Location : metaphysis
Name Sign : looks like something is starting to rot on the bone

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9
Q

Enchondroma

AKA :
Type :
Age :
Symptom :
Detail : what type of syndrome is associated?
Management :
Location :
Name Sign :

A

AKA :
Type : BBT
Age :
Symptom :
Detail : Most Common BBT of the hands
: Ollier’s disease - multiple enchondromas
- may present with permanent deformity
- 10 to 50% rate of malignancy
: Maffuci’s syndrome : soft tissue calcification
Management : Refer to orthopedist, biopsy, CT scan,
MRI
Location : hands
Name Sign : Stippled appearance ( lots of dots )
:

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10
Q

Hemangioma

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Location :
Name Sign :

A

AKA : Vascular tumor
Type : BBT
Age : N/A
Symptom : N/A
Detail : Most common BBT of the spine
: excess accumulation of blood vessels
: When there is 1 or 2 hemangioma it will still be
considered as hemangioma , but if there are 3, it
will be osteoperosis
Management : Refer to orthopedist , CT scan, MRI,
biopsy
Location : Spine , MC on the axial skeleton
Name Sign : Curduroy cloth appearance looks lytic with vertical lines on the vertebra

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11
Q

Enostoma

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Location :
Name Sign :

A

AKA : N/A
Type : BBT
Age : N/A
Symptom : N/A
Detail : N/A
Management : Refer to orthopedist, MRI, CT scan, Biopsy
Location : commonly seen in the pelvics but can be in the femur or ribs
Name Sign : Bone Island, looks like a blastic/radioopaque round circle.

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12
Q

Osteopoikilosis

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Location :
Name Sign :

A

AKA : N/A
Type : BBT
Age : N/A
Symptom : N/A
Detail : people might think that this is blastic metastatic but blastic mets does not usually go down the knees or elbows
Management : Refer to ortho, MRI, CT , Biopsy
Location : hands, pelvis, ribs, femur
Name Sign : Multiple bone islands

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13
Q

Osteoblastoma

AKA :
Type :
Age :
Symptom : @@@
Detail :
Management :
Location :
Name Sign :

A

AKA : N/A
Type : BBT
Age : N/A
Symptom : painful scoliosis
Detail : Most common BBT to affect the neural arch (C1)
: Loves the posterior aspect of our spine, all except the vertebral body
Management : refer ortho, MRI, ct scan, biopsy, surgical surretage
Location : everything on posterior of spine, NOT THE BODY
Name Sign :

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14
Q

Osteoma

AKA :
Type :
Age :
Symptom :
Detail : what view is seen best x-ray
Management :
Location :
Name Sign :

A

AKA :
Type : BBT
Age : N./A
Symptom : N/A
Detail : Best seen on Caldwell projection ( X-ray view)
: Most common BBT to affect the skull,
Management : Refer to ortho, MRI , ct , biopsy
Location : skull, frontal sinus area
Name Sign : looks blastic in the frontal sinus

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15
Q

Fibrous dysplasia

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Location :
Name Sign :

A

AKA : N/A
Type : BBT
Age : any age
Symptom :
Detail : Bone being replaced by fibrous tissue
Tibia = saber shin deformity
Femur = Sheppards crook deformity
Monostotic form = 70% of the time
Polystotic form = 30% of the time
Management :
Location : Tibia, Femur,
Name Sign : Makes bone appear lytic,
: YOU MUST see deformity in the bone
to diagnose as FD,
: Rind sign= looks like a round with outer
blastic and inner lytic
looking
: Ground glass=
: Coast of Maine = the cafe au lait ( skin
mark) border is sabog ( jagged)

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16
Q

Neurofibromatosis

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Location :
Name Sign :

A

AKA : Von Recklinghausen’s disease (NF 1)
Type : Tumor of nerves
Age : N/A
Symptom :
Detail :
Management : Refer to neurologist
Location : Spine
Name Sign : scoliosis, cervical kyphosis, posterior vertebral scalloping ( meaning instead of flat it is a bit curved ) with IVF enlargement, Cafe au liats ( coast of California)

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17
Q

Multiple Myeloma

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Labs:
Location :
Name Sign :

A

AKA : Plasmacytoma, Hematopoietic disease, Plasma cell sacroma
Type : Malignant
Age : Over 50
Symptom : Easy brusing, deep boring pain, worse at night
Detail : Most common primary malignancy of bone
Management : oncologist, CT , biopsy, Bone scan
Labs: M spike for IgG
: Elevated globulin, decreased albumin
: Bence- jones proteinuria
: ESR/ CRP
: Bone scan: COLD
@@: Normochromic normocytic anemia, Makes IGG@@
: Decreased : WBC = increase infection
Decreased Thrombocyes = easy bruising
Decreased Osteoblastic Activity = looks lytic no
bone growth
: Continue Osteoclastic activity
Location : Skull , Ribs, Pelvis, proximal humerus, femur,
VERTEBRAL BODIES only
Name Sign : Rain Drop skull
: Cannot eat the pedicle
: looks like a lot of lytic dots around the bone
marrow area
: Punched out lesions, Multiple dark
densities

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18
Q

Lytic Metastasis

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Labs:
Location :
Name Sign :

A

AKA :
Type : Malignant
Age : Over 40
Symptom : deep boring pain, worse at night
Detail : Metastasis = Most common malignancy on bone
: spread through [L]ymph [L]ytic
: Increase osteoblastic activity which is why bone
scan is hot, but tumor spreads faster and
stronger
Management : oncologist , CT ,
Labs: Bone scan: hot
: Increased Alkaline phosphatase
Location : Skull, Spine
Name Sign : Turns bone to look darker
: It can affect the pedicle
: Cannot diff with MM unless in skull
: Swiss cheese skull

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19
Q

Hodgkin’s Disease

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Labs: what for biopsy
Location :
Name Sign :

A

AKA :
Type : Malignant
Age : 20-40
Symptom : deep boring pain, worse at night
Detail : Unilateral hilarity lymphadenopathy in white
males see on P-A chest x-ray
Management : oncologist, CT, biopsy, bone scan
Labs: Biopsy = Reed Sternberg cells
Location : vertebra, chest
Name Sign : Ivory vertebra
: anterior body scalloping

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20
Q

Blastic Metastasis

AKA :
Type :
Age :
Symptom :
Detail : how is it spread ? what can it cause?
Management :
Labs:
Location :
Name Sign :

A

AKA :
Type : malignant
Age : Over 40
Symptom : deep boring pain, worse at night
Detail : Metastasis is the most common malignancy of
bone
: Spread through [B]lood [B]lastic
Management : oncologist, CT , biopsy, bone scan
Labs: Increased alkaline phosphatase
: Bone scan: hot
Location : vertebral body
Name Sign : Ivory white vertebra
: No enlargement, no scalloping, no cortical
thickening,
: Can cause pathological fractures

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21
Q

Paget’s Disease

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Labs: @@@
Location :
Name Sign :

A

AKA : Osteotitis deformans
Type : malignancy
Age : Over 50
Symptom : Bone pain, deep boring pain, worse at night
Detail : Stages: 1.) destructive or lytic
2.) lytic and blastic
3.) sclerotic healing - ivory vertebra
4.) malignant in this stage it becomes
osteosacroma
Management : Adjust above and below the affected
area IF NOT MALIGNANT meaning stage
1,2,3
: If not malignant , refer to rheumatologist,
endocrinologist
: if malignant, refer oncologist, Ct, Biopsy,
bone scan
Labs: Increased alkaline phosphatase
: Increased urinary hydroxyproline
: Bone scan: Hot
Location : Tibia, Femur, Skull, pelvis, vertebra
Name Sign : Saber shin deformity ( Tibia deformity)
: Sheppard’s crook deformity ( femur)
: Ivory white vertebra - enlargement-wider
: Picture frame vertebra
: Brim sign, unilateral or bilateral ( pelvis)
: Cotton wool appearance ( skull)
: Osteoporosis Circumscripta ( Large dark
lesion)
: Coarsened trabelulae- sheaves of wheat or
grain
: Basal invagination

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22
Q

Osteosacroma

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Labs:
Location :
Name Sign :

A

AKA :
Type : malignant
Age : 10-30
Symptom :
Detail : Most common malignancy in children
: stage 4 of pagets
Management : oncologist, CT, biopsy, bone scan
Labs: Increased Alkaline phosphatase
: Bone scan: hot
Location : diaphysis of long bone
Name Sign : Speculated / radiating / sunburst
appearance
: looks blastic that have spikes on the
diaphysis

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23
Q

Chondrosacroma & Fibrosacroma

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Labs:
Location :
Name Sign :

A

AKA :
Type : malignant
Age : over 40 yo
Symptom :
Detail : exact same as Osteosacoma but age is diff
Management : oncologist, CT, biopsy, bone scan
Labs: Increased alkaline phosphatase
Location : diaphysis of long bone
Name Sign : sunburst, radiating, speculated appearance
of diaphysis

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24
Q

Ewing’s sarcoma

AKA :
Type :
Age :
Symptom : @@@
Detail : @@@
Management :
Labs:
Location :
Name Sign : 5

A

AKA :
Type : malignant
Age : 10-25 yo
Symptom : red hot swollen
Detail : Increase density around lesion
Management : oncologist, bone scan, ct, biopsy
Labs:
Location : Common in diaphysis of long bone
Name Sign : multi parallel onion skin, type of periostea
reaction
: Liminated skin
: Codman triangle
: saucerization
: Bone expansion

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25
Q

Chordoma

AKA :
Type :
Age :
Symptom :
Detail :
Management :
Labs:
Location :
Name Sign :

A

AKA :
Type : malignant
Age : Over 40 yo
Symptom :
Detail : most commonly found in sacrum , 2nd in skull
Management : oncologist, ct, biopsy, bone scan
Labs:
Location :
Name Sign :

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26
Q

Ivory white vertebra

A

Hodgkin lymphoma- anterior scalloping - 20-40
blastic met - no change on vertebra - over 40
pagets - widening of vertebra - over 50

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27
Q

Decreased alkaline phosphatase

A

zinc,
malnutrition,
pernicious anemia,
thyroid disease,
Wilson disease
hypophosphatasia,

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28
Q

Increased Alkaline phosphatase

A

Pagets
Osteosacroma
Lytic and blastic met
fibrosarcoma & chondrosacroma
Hyperparathyroidism
Calcified prostate

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29
Q

Reed sternberge cells

A

Hodgkin lymphoma

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30
Q

Saber shin & shepperd crook

A

Paget
Fibrous Dysplasia

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31
Q

Bone scan : cold

A

MM

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32
Q

Over 50 yo

A

MM
Pagets

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33
Q

Over 40

A

Metastasis
Chordoma
Chondrosacroma & Fibrosarcoma

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34
Q

Malignant

9

A

MM
Lytic mets
Blastic mets
pagets
osteosacroma
Fibrosacroma & Chondrosacroma
Chordoma
Ewing sacroma
hodgkin lymphoma

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35
Q

Types of scoliosis

A

Rotatory = spinous is going on concavity
Simple = spinous is going to convexity

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36
Q

Lines of mensuration for scoliosis

A

Cobb’s = best method
risser furgeson

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37
Q

Test for scoliosis

A

Adam test

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38
Q

Scoliosis measurement for 25 yo and younger

A

under 20 = adjust and monitor
21-40 = refer to orthopedist for bracing ( Milwaukee/
boton brace
Over 40 = surgical consultation
Over 50 = cardio pulmonary compromise & did

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39
Q

scoilios for over 25 yo

A

adjust only
after growth plates closed = no need for referral

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40
Q

Monitor scoliosis progression

A

1.) left wrist X-ray = best
2.) riser sign = 2nd best
3.) tanner staging = least

  • the younger the father degree can go
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41
Q

Inflammatory Seropositives artritis

A

RA
Systemic lupus
Schleroderma

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42
Q

Inflammatory Seronegative artitis

A

psoriatic arthritis
Enteropathic arthropathy
AS
Reiter’s

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43
Q

Non inflammatory arthritis AKA degenerative

A

DJD = OA
DISH
Neurogenic arthropathy AKA Charcot joint
synoviochondrometaplacia

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44
Q

Metabolic artritis

A

Gout
CPPD
HAAD

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45
Q

other artritis

A

septic

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46
Q

+FANA

A

RA
Lupus

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47
Q

Rheumatoid Arthritis

AKA :
Type :
Age :
Symptom :
Management :
Labs:
Location :
Name Sign : 11

A

AKA : Still’s disease in children
Type : Seropositive Arthritis
Age : 20-40 female, Over 40 male
Symptom : Soren’s= When presenting with dry eyes
and mouth
Detail :
Ortho :
Management : adjust to tolerance, rheumatologist, check for instability for Atlanto-axial
Labs: +RA latex
: +FANA
: +ESR
: +CRP
: normocytic normochromic anemia ( same as MM)
Location : Hands, pelvis
Name Sign : Rat bite erosion
: symmetrical distribution
: bilateral uniform loss of joint space
: pannus formation
: localized periarticular osteoperosis
: DIP are spared
: affects the MCP ( Haygarth’s nodes)
: Swan neck and boutonniere deformity
: Ulnar deviation or fibular deviation( lanes
deformity)
: Atlanta-axial instability (C1 C2 )
: Baker’s cyst = benign swelling of the semi
membranous bursa

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48
Q

Ankylosing Spondylitis

AKA :
Type :
Age :
Symptom : where it starts?
Detail : associated with what
Ortho :
Management :
Labs:
Location :
Name Sign : 9

A

AKA : Marie Stumpell , Bilateral sacroilitis
Type : Seronegative Arthritis
Age : Male 15-35
Symptom : Low back pain with morning stiffness
: starts in the lower 1/3 of SI joint
Detail : Associated with iritis
Ortho : Chest expansion, Forester’s bowstrings, Lewin’s
supine
Management : Co- treat with rheumatologist
: Back extension exercise
: Deep breathing, swimming
: Chiropractic care of unaffected area
Labs: +HLA B27
: ESR
: CRP
Location : Spine, SI joint,
Name Sign : Ghost sign = Bilateral SI join fusion
: Star sign = blastic looking at the tip of the
SI joint
: Shiny Corner sign = hard to find
: Bilateral MARGINAL syndesmophytes =
spine
: squaring of vertebral bodies
: Bamboo spine = eggshell
: Dagger sign = interspinous supra spinous
: Trolley track sign = Capsular log, facet
: Poker spine

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49
Q

+HLA B27

A

Seronegative

Psiruativ arthritis
Enteropathic arthritis
AS
Reiter

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50
Q

Enteropathic Arthropathy

AKA :
Type :
Age :
Symptom :
Detail :
Ortho :
Management :
Labs:
Location :
Name Sign :

A

AKA :
Type : Seronegative Arthritis
Age : Same as AS
Symptom : Same as AS +
: GI dysfunction
: Chrohn’s dx = mucus
: Ulcertitive colitis = bloody
: IBS = diarrhea + constipation
Detail : most commonly found in females
Ortho :
Management : adjust to tolerance, co-manage with
rheumatologist, check for instability upper
cervical
Labs: HLA 27+
: ESR
: CRP
Location : pelvis
Name Sign :

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51
Q

Psoriatic Arthritis

Type :
Age :
Symptom :
Management :
Labs:
Location :
Name Sign :

A

AKA :
Type : seronegative arthritis
Age : 20-50
Symptom : silver scaly lesion on extensors
: and on surface of elbow, knees and back
: pitted nails
: cocktail sausage digits = brown swollen
fingers
:
Detail :
Ortho :
Management : Adjust to tolerance, Co-manage with rheumatologist, Check for instability
Labs: +HLA B27
: ESR
: CRP
Location : DIP, spine
Name Sign : Increased joint space
: mouse ear deformity
: pencil in cup deformity
: Ray sign
: atlanto-axial instability
: non-marginal syndesmophytes in the spine

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52
Q

Reiter’s Disease

AKA :
Type :
Age :
Symptom :
Detail :
Ortho :
Management :
Labs:
Location :
Name Sign :

A

AKA : Reactive arthritis
Type : Seronegative Arthritis
Age : 20-50
Symptom : Urethritis = can’t pee
: Conjunctivitis = can’t see
: arthritis = can’t dance
Detail : Caused by Chlamydia
Ortho :
Management :
Labs: +HLA B27, ESR, CRP
Location : spine, feet
Name Sign : Calcaneal spur = spur
: fluffy periostosis = looks like a line @
calcaneus
: non- marginal syndesmophytes

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53
Q

Systemic Lupus Erthematosus

AKA :
Type :
Age :
Symptom :
Detail :
Ortho :
Management :
Labs:
Location :
Name Sign :

A

AKA :
Type : Seropositive Arthritis
Age : 20-40
Symptom : Malar / Butterfly rash = from sunlight
: Oral ulcers
: Discoid lesions = scan in skin
: alopecia = hair less
: affect kidney
: Raynaud phenomenon = Pale, blue, red
hands
Detail : Autoimmune dx
: Immune system attacks collagen in ligament,
tendon and skin
Ortho : positive rebound effect
Management : Co manage - rheumatologist
: adjust uninvolved area
: x-ray check instability Atlanta axial
Labs: +LE prep
: +FANA
: +RA Latex
: +ESR
: CRP
: leukopenia
: Thrombocytopenia
: Anti-DNA
Location : hands
Name Sign : Ulnar deviation with no joint destruction

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54
Q

Scleroderma

AKA :
Type :
Age :
Symptom :
Detail :
Ortho :
Management :
Labs:
Location :
Name Sign :

A

AKA : Progressive systemic sclerosis
Type : seropositive arthritis
Age : 30-40
Symptom :
Detail : Erosion of the distal tuffs of phalanges
: Associated with CREST
: Calcium deposits in hand
: Raynaud’s hand turn white, blue then red
: Esophageal dysfunction = weak
: Sclerodactyly = thickening and tightness on
fingers and toes
: Telangiectasias = dilated cappiliares
= tiny red areas on face,
hands and in mouth
Ortho :
Management : adjust to tolerance, check for instability,
co-manage with rheumatologist
Labs: +Fana , CRP, ESR
Location :
Name Sign : missing distal tuffs on
: looks like lots of white stuffs all around
hands ( Calcium deposits)

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55
Q

Osteotitis condensing Ilia

AKA :
Type :
Age :
Symptom :
Detail :
Ortho :
Management :
Labs:
Location :
Name Sign :

A

AKA : Osteitis triangularis
Type :
Age : 20-40
Symptom : no symptom
Detail : Multiparous = previously pregnant
: SI joint not involved
: incidental finding, self resolving
Ortho :
Management : trochanteric belt for stability , adjust to
tolerance, check instability Atlanta axial

Labs: no labs
Location : pelvis
Name Sign : Bilateral whitening ( blastic looking) on the
side of the ilium of the SI joint BUT NOT
THE sacrum

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56
Q

degenerative joint disease

AKA :
Type :
Age :
Symptom :
Detail :
Ortho :
Management :
Labs:
Location :
Name Sign :

A

AKA : Osteoarthritis
Type : Degenerative arhritis
Age :
Symptom : Non- inflammatory
: stiffen on rest and improve with activity
:
Detail : most common on weight bearing joints
Ortho :
Management : adjust to tolerance, educate pt,
glucosamine and chondroitin
Labs: non
Location : weight bearing joints , hands, hip, knee, spine
Name Sign : Spine = IVD narrowing, osteophytes,
endplate sclerosis
= most common c5-c6 on spine
= spinal stenosis
= IVF encroachment
= spurring
Knee = medial joint space decreased with
lateral space preserved
Hip = Decreased super-lateral joint space
with sclerosis
Hand = decreased joint space with
sclerosis, asymmetrical
distribution, non uniform loss of
space
= Heberden’s nodes ( DIP )

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57
Q

Diffuse Idiopathic Skeletal Hyperostosis

AKA :
Type :
Age :
Symptom :
Detail : related to what
Ortho :
Management :
Labs:
Location :
Name Sign :

A

AKA : Forestier’s dx, Ankylosing hyperostosis
Type : Non-inflamatory arthritis
Age : Over 40
Symptom : spinal pain and stiffness
:
Detail : High correlation with Diabetes Mellitus
Ortho :
Management : adjust, no inflammation and
: educate pt, glucosamine, chondroitin
Labs: fasting blood glucose, AIC glucose
Location :
Name Sign : DISC SPACE MUST be preserved
: Facets never involved
: Candle wax drippings Hyperostosis of 4 or
more continuous segments
: Hyperostosis = too much growth of bone
tissue
= may fuse together making
anterior bridging
: can cause calcification of PLL

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58
Q

Neurogenic arthropathy

AKA :
Type :
Symptom :
Detail : seen with what?
Management :
Location :
Name Sign :

A

AKA : Charcot’s joint
Type : non-inflammatory arthritis
Age :
Symptom : impaired sensory function on joints
Detail : Seen with diabetes, syphillis, syringomyelia,
tabes dorsals
: 6 D’s = Density, Debris, destruction, distension,
dislocation, disorganization
Ortho :
Management : orthopedist,
Labs:
Location : feet, femur etc
Name Sign : Looks like a bomb exploded on it
: everything is messed up

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59
Q

Synoviochondrometaplasia

AKA :
Type :
Age :
Symptom :
Detail :
Ortho :
Management :
Labs:
Location :
Name Sign :

A

AKA :
Type : non inflammatory arthritis
Age : Over 40
Symptom :
Detail : related with OA
:
Ortho :
Management : refer to ortho
Labs:
Location : most common joint affected is knee
Name Sign : looks like popcorn around the joint
: multiple loose bodies in the joint
: round and Ovoid blastic looking in the joint

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60
Q

Gout

AKA :
Type :
Age :
Symptom :
Detail :
Ortho :
Management :
Labs:
Location :
Name Sign :

A

AKA :
Type : metabolic arthritis
Age : Over 40
Symptom : extremely painful
Detail : NOT in the spine
: Uric acid
: history of high in red meat, red wine, beer , aged
cheese
: goes to the cold areas = toe( podagra ) 70%
ear ( tophi crystals)
: when 1 joint only 70% @ podegra
Ortho :
Management : diet changes, send treatment to
rheumatologist,
: Drugs = acute = colchicine
= chronic = allopurinol
Labs: ESR & uric acid test
: joint aspiration
Location :
Name Sign : Overhanging edge sign = only arthritis to
start from outside and work to get in
: Juxta-articulation erosions = destroy the
bone above and below then destroy the
joint space

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61
Q

Calcium pyrophosphate dihydrate crystal deposition disease

AKA :
Type :
Detail :
Management :
Location :
Name Sign :

A

AKA : CPPD , pseudogout
Type : Metabolic arthritis
Detail : Chondrocalcinosis = when cartilage affected
Management : rheumatologist, joint aspiration
Location : most common seen in knees
Name Sign : Thin linear calcification parallel to the articular cortex within the joint space

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62
Q

Hdroxyapatite deposition disease

AKA :
Type :
Management :
Location :
Name Sign :

A

AKA : HADD
Type : metabolic arthritis
Management : co manage rheumatologist, joint aspiration
Location : shoulder joint
Name Sign : Round oval calcification near the insertion
of bursa or tendon

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63
Q

Septic Arthritis

Symptom :
Detail :
Management :
Labs:

A

Symptom : Fever, chills ,
Detail : history of trauma, surgery w/ warm tender
swollen joint
: staph aureus,
Ortho :
Management : send to ER / infectious dx specialist
Labs: WBC count , culture and sensitivity testing ,
Location :
Name Sign :

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64
Q

Avascular necrosis

A

AKA: osteonecrosis, osteochondrosis

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65
Q

Major cause of AVN

A

trauma

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66
Q

Labs for AVN?

A

none

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67
Q

What can AVN lead to ?

A

DJD

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68
Q

Special test for AVN?

A

Bone scan
MRI ( BEST)
manage w/ ortho

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69
Q

are AVN self resolving? if so, how long?

A

8 months to 2 years

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70
Q

preiser’s

A

carpal scaphoid

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71
Q

scheurmann’s

A

vertebral end plate epiphysis

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72
Q

legg calve perthes

A

femoral epiphysis

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73
Q

kohler’s

A

tarsal navicular

74
Q

keinboch’s

A

carpal lunate

75
Q

sever’s

A

calcaneus

76
Q

blount’s

A

medial tibial condyle

77
Q

freigberg’s

A

head of 2nd and 3rd and 4th metatarsal

78
Q

osteochondritis dessicans

A

articular surface of the medial femoral condyle

79
Q

panner’s

A

capitellum

80
Q

Osteochondritis dessicans

Type :
Age :
Symptom :
Ortho :
Management :
Location :
Name Sign :

A

Type : AVn of femoral condyle
Age : 16-25
Symptom : knee locks out on extension
Ortho : Wilson’s sign
Management : co-manage orthopedist
Location : Knee joint
Name Sign : best seen on tunnel view
radiograph
: Looks like a little fracture on the side of the
knee

81
Q

Scheurmann’s disease

AKA :
Type :
Age :
Symptom :
Detail :
Ortho :
Management :
Location :
Name Sign :

A

AKA :
Type : AVN
Age : 10-16
Symptom : Rounded shoulder
: Back pain after lifting
Detail : AVN of the secondary growth center of the
vertebral bodies ( under the endplates)
Ortho :
Management : Stop all physical activity
: thoracic lumbar brace
: adjust
: can lead to early DJD and permanent
postural deformity
Location : spine
Name Sign : must have all 3 below to be considered
: Loss of anterior body height by 10-15%
: multiple endplate irregularities on 3 or
more continuous segments
: Increased kyphosis

82
Q

Legg calve perthe’s

Type :
Age :
Symptom :
Management :
Location :
Name Sign :

A

AKA :
Type : AVN for femoral head
Age : 4-9
Symptom : Painless limp , decrease internal rotation
Detail :
Ortho :
Management : Refer to orthopedist for “A” brace
Location : hip, femur head
Name Sign : Crescent sign = fragmentation of femoral
head
: Flattening of femoral head
: Snow capped appearance= increased
white density of the femoral head
: Increased joint space
: Healed = Mushroom capped

83
Q

Slipped capital femoral epiphysis

AKA :
Type :
Age :
Symptom :
Detail : femoral head and neck movement
Ortho :
Management :
Location :
Name Sign :

A

AKA : salter Harris type 1 fracture
Type : AVN of hip
Age : 10-16
Symptom : decrease internal rotation, painless limp
Detail : Femoral head slides inferior and medial
: femoral neck slides superior and lateral
Ortho : Klein’s
: shenton’s
: skinner’s
Management : refer to orthopedist
Location : femoral head
Name Sign : Femoral head slides inferior and medial
: femoral neck slides superior and lateral

84
Q

Congenital hip dysplasia

Type :
Detail :
Ortho :
Name Sign :

A

Type : AVN of hip
Detail : Putti’s triad
: hypoplastic femoral head
: shallow acetabular shelf
: femoral head outside of acetabulum
Ortho : telecosping
: ortolani’s
: barlow’s
: alli’s
Name Sign

85
Q

Protrusion acetabula

AKA :
Type :
Age :
Symptom :
Detail :
Ortho :
Management :
Location :
Name Sign :

A

AKA : Otto if bilateral
Type : AVN of hip
Age :
Symptom :
Detail : axial migration of femoral head with uniform loss
of joint space
: Most often occurs w/ RA
: seen w/ osteoporosis, osteomalacia, Paget’s,
trauma, idiopathic
: obliteration of Kohler’s tear drop
Ortho : Line of mens = Kohler’s
Management :
Location :
Name Sign :

86
Q

Protrusion acetabula

AKA :
Type :
Detail : associated with what
Ortho :
Location :
Name Sign :

A

AKA : Otto if bilateral
Type : AVN of hip
Detail : axial migration of femoral head with uniform loss
of joint space
: Most often occurs w/ RA
: seen w/ osteoporosis, osteomalacia, Paget’s,
trauma, idiopathic
: obliteration of Kohler’s tear drop
Ortho : Line of mens = Kohler’s
Location : hip
Name Sign : looks like femur went through the pelvis and went in

87
Q

Fracture management

A

: Orthopedist
: RIICE
: Rest, Ice, immobilization, compression, elevation

88
Q

Avulsion

A

: portion of bone torn away by muscle or ligament tractional force

89
Q

comminuted fracture

A

: with more than 2 fragments

90
Q

diastasis

A

: displacement or separationn of a slightly movable joint

91
Q

compound

A

: AKA: open fracture
: skin ruptured and bone exposed

92
Q

Greenstick

A

: AKA : hickory stick
: incomplete fracture in children

93
Q

impaction

A

: bone fragments driven into one another
: bone goes in bone

94
Q

torus

A

: AKA : buckling
: incomplete fracture
: one side of the cortex is affected
: bowing of bone

95
Q

Occult

A

: clinically evident but not seen on x-ray
: may become evident a week on 10 days later

96
Q

Stress

A

: AKA : fatigue
: insufficiency of repetitive stress causing a fracture

97
Q

Bennett’s

A

fracture of 1st metacarpal

98
Q

Boxer’s

A

fracture of 2nd or 3rd metacarpal

99
Q

Bar Room

A

fracture of 4th or 5th metacarpal

100
Q

Scaphoid

A

most common fractured carpal bone

101
Q

Night stick

A

fracture of the proximal ulna

102
Q

Montegia ( una si montegia)

A

Fractured Ulna with radial head displacement

: Una si montegia

103
Q

Galeazzi

A

fracture of Distal 1/3 of the radius with dislocation of the distal radio-ulnar joint

104
Q

C[o]lles

A

fracture of distal radius with posterior displacement of the distal fragment

105
Q

Smith’s

A

fracture of the distal radius with anterior displacement of the distal fragment

106
Q

March

A

Stress fracture of the 2nd, 3rd ,or 4th metatarsal

107
Q

Jones

A

transverse fracture at the proximal 5th metatarasal

108
Q

clay shoveler’s

A

: Avulsion fracture of the spinous process
: MC: @ C6-T1
: Hyperflexion injury

109
Q

Hangman’s

A

: bilateral medical fractures of C2
: due to her-extension injury

110
Q

Jefferson’s bursting

A

: fractures through the anterior and posterior arches of atlas
: due to axial compression

111
Q

Ondontoid fracture

A

fracture of dens

112
Q

Type 1 Ondontoid fracture

A

avulsion of the tip of dens

113
Q

Type 2 Ondontoid fracture

A

fracture through the base of dens

114
Q

Type 3 Ondontoid fracture

A

fracture through body of C2

115
Q

Tear drop

Associated w what

A

: avulsion fracture of the anterior inferior aspect of the vertebral body from a hyperextension trauma
: MC @ C2
: associated with acute anterior cervical cord syndrome
: Hyperextension = C2, C3
: Hyperflexion = C4 and down

116
Q

Salter Harris types

A

fracture through any growth plate

117
Q

Salter Harris types type 1

A

: horizontal fracture through the growth plate
: SCFE

118
Q

Salter Harris types Type 2

A

: Growth plate and metaphysis ( Most common) (child abuse)

119
Q

Salter Harris types Type 3

A

Growth plate and epiphysis

120
Q

Salter Harris types Type 4

A

growth plate, metaphysis and epiphysis

121
Q

Salter Harris types Type 5

A

compression deformity of the growth plate ( most severe)

122
Q

Osgood schlatter’s

A

: Tibilial apophysitis
: 10-16 yo
:pinpoint pain and swelling
: Use Cho-pat brace
: Lateral x-ray

123
Q

Rider’s bone

A

: Avulsion of the ischial tuberosity
: hamstring pull

124
Q

Chance

Aka
Detail
Mc loc?

A

: AKA : seatbelt
: horizontal fracture through a single body and posterior arch
: MC @ L1-L3

125
Q

Spondylolysis

A

fracture through the pars interarticularis without slippage

126
Q

spondylolisthesis

A

slippage of the vertebral body with or without fracture

127
Q

spondylolisthesis Type 1

A

: Displastic
: Congenital defect

128
Q

spondylolisthesis Type 2

A

: Isthmic
: fracture through pars

129
Q

spondylolisthesis Type 3

A

: Degenerative
: DJD of the facet joint

130
Q

spondylolisthesis Type 4

A

: traumatic
: fracture through pedicle

131
Q

spondylolisthesis Type 5

A

: pathological
: pathology on that segment

132
Q

What is used to grade spondy?

A

meyerding’s

1 = up to 25%
2 = 26-50%
3 = 51-75% ( inverted Napoleon hat sign grade 3 or more)
4 = 76-100%

Flexion extension radiographs for stability, special test SPECT

133
Q

Dislocations

A
134
Q

Lunate

A

: Most commonly dislocated carpal bone
: associated with pie sign

135
Q

Scaphoid

A

: Associated with the Terry Thomas sign
: signet ring sign
: Most common fx bone in the hand

136
Q

Shoulder dislocation

A

Most common is anterior inferior and medial

137
Q

Hill sachs

A

: AKA hachet
: posteriolateral fracture of humeral head

138
Q

Bankart lesion

A

: Fracture inferior glenoid labrum

139
Q

Slap lesion

A

: Soft lesion of the labrum the superior aspect is torn from anterior to posterior
: diagnosed with MRI

140
Q

Posterior ponticle

: AKA :
: Detail :
: Location :

A

: AKA : posticus ponticus
: Detail : Arcuate foramen forms when atlanto-occipital
ligament calcifies
: Transmits the sub-occipital nerve and the
Vertebral artery
: Location : Antlano occipital

141
Q

Down’s syndrome

:
: Detail :
: Location :

A

:
: Detail : 20% are born without the transverse ligament.
: increased ADI indicates atlanto axial instability
: must perform stress firms before treatment is
commenced
: Location : Atlanto-axial

142
Q

Os odontoideum

A

: AKA :
: Detail : Normally developed cephalic part of the dens
is not fused with the C2 body
: Smooth, wide Lucent defect between the body
of C2 body and dense
: Location : C2

143
Q

Congenital block

Detail
Associated
Management

A

: adjacent vertebra osseously fused from birth
: associated with wasp waist and hypo plastic disc
: Adjust above or below segment

144
Q

Klippel-feil syndrome

A

: patient presents with a short webbed neck, low hairline, and decreased ROM
: multiple congenital blocks
: associated with sprengle’s deformity and omovertebral bone

145
Q

Pedicle agenesis

Name sign
How to ddx ?

A

: Winking owl sign
: Always assume this is lytic met first
: check age if under 40 it is not lytic mets
: check sclerotic change of one above or below
: if non = not lytic mets
: contra lateral pedicle hypertrophy and sclerosis

146
Q

Butterfly vertebra

A

failure of the center of the vertebral body to ossify properly

147
Q

Hemivertebra

A

: failure of development of a lateral ossification center
: Isolated wedged vertebra causes scoliosis
: associated with gibbous deformity

148
Q

spinal bifida

A

: no symptoms
: failure of the laminate fuse
: elevated alpha fetoprotein
: folic acid deficiency

149
Q

transitional vertebra

A

Sacralization : L5 TPs may fuse or form joints with
sacrum
: patient will have 4 lumbar
Lumbarization : patient have 6 lumbars
: 1st sacral segment appears like a
lumbar segment

150
Q

Facet tropism

A

: asymmetric articular planes
: MC at L5/S1
: best on side posture

151
Q

knife clasp syndrome

A

: spina bifida of S1
: L5 spinous enlargement
: Pain on extension
: avoid extension because SP of L5 will hit the caudal equana

152
Q

Coxa Vara

A

: End up knock knee
: less than 120*

153
Q

Coxa Valga

A

: End up bow legged
: created than 130*

154
Q

Coxa-femroal angle normal

A

120-130*

155
Q

What to measure coxa-femoral angle?

A

Mikulicz’s line of mensuration

156
Q

Madelung’s deformity

A

Bowing of radial shaft w/ increased interosseous membrane

157
Q

Negative ulnar variance

A

: ulna is unusually shorter than the radius
: seen with schapho-lunate dislocation
: Lunate dislocation is worse

158
Q

Pelligrini steida

A

calcification of the medial collateral ligament

159
Q

myositis ossificans

A

: calcification of the muscle belly
: most commonly seen in the biceps and in the quadriceps
: refer to ortho

160
Q

abdominal aortic aneurysm

Location
Measurement?
Name sign
Test
Management

A

: Most common location for an aortic aneurysm
: distal to renal artery
: normal abdominal aorta can measure up to 3.8 CM
: more than 3.8 = AAA
: radiographic signs
: aortic dilation
: curvilinear calcification
: fusiform appearance
: Special test: doppler, diagnostic ultrasound,
ultrasonography, CT
: refer to vascular specialist

161
Q

Cholelithiasis

9f
Pain referral where?
Test?

A

: Affiliated with the 9 F’s
: Fair, fat, female, fertile, forty, flatulents, fatty stool, fast food
: pain referral to the inferior border of the right scapula ( ciscerosomatic)
: Murphy’s inspiratory arrest
: special test: ultrasound and cholecystogram

162
Q

Uterine fibroids

A

: Fibroid cyst/ leiomyoma ( tumor of smooth muscle)
: MC benign tumor in females

163
Q

Calcified prostate

Age
Labs
Metastasis to where

A

: over 50 yo
: urinary problems
: Labs: PSA, aci phosphatase
: Metastasis ( MC limbar spine)
: Alkaline phosphatase
:

164
Q

Phleboliths

A

: calcification within veins
: Asymptomatic

165
Q

Fat pads

A

Location: elbow
: indicates a radial head fracture
: seen on the lateral view

166
Q

sickle cell anemia

A

: hair on end appearance on skull
: H shaped vertebra on spine
: collapsed vasculature

167
Q

thalasemia

A

: Cooly’s anemia
: mediteranian anemia
: hereditary disorder of hemoglobin synthesis
: microcytic hypochromic anemia
: “Erlenmeyer flash deformity = widened epiphysis
= the femur looks like a erlenmeyer flash
: Hair on end appearance on skull
:

168
Q

Hyperparathyroidism

A

: AKA :
: Age : 30-50 yo
: Detail : Over activity of the parathyroid gland
: Calcium Up in blood
: Phosphorus down in blood
: Location : Skull, spine
: name sign : Rugger Jersey spine = looks like a striped
shirt
: Renal Calculi “Brown’s tumor”
: Salt and pepper skull = looks blastic in the
skull
: Labs : Increased alkaline phosphatase

169
Q

Osteopetrosis

Cause
Detail
Early
Late

A

: hereditary
: absense of marrow
: Marble bone disease
: Anemia
: hepatosplenomegaly
: Early is Bone within a bone “ Erlenmeyer flash
deformity”
: Late is sandwich vertebra “

170
Q

Rickets

A

: Detail : Deficiency of vitamin D, Calcium , or
phosphorus
: Muscle tetany and weakness
: Location : Growth plates in long bones
: Name sign : Bone deformity & lucency
: Paintbrush metaphysis
=absent zone of provisional
calcification

171
Q

How much better is CT than plain film?

A

10X

172
Q

What is best seen when using CT? 11

A

Fractures
Calficifed soft tissue
Traumatic lesion
pathology
Degenerative changes
anomalies ( Spinal bifida)
Lungs, Abdominal organs, brain
Aneurysms
Brodie’s abscess
Spinal stenosis
lateral recess stenosis

173
Q

How is CT measured?

A

house field units

174
Q

What is best seen on MRI

A

Meniscus
ligament
tendon
IVD
Spinal cord
meninges
bone
Multiple sclerosis
BEST FOR ALL AVN

175
Q

How much better is MRI compare to CT

A

100x

176
Q

What color is water on

T1 weighted
T2 weighted

A

T1 = grey
T2 = white t2h20

177
Q

what color is cortical bone

A

always black > sigmoid bone

178
Q

DEXA

A

Dual emission x-ray absorpmetry

Measures bone density for osteoporosis

179
Q

Bone scan

A

: AKA scintigraphy
: injects technetium to measure body’s attempt to make new bone (osteoblastic)
: Hot : AVN
: Blastic
: Lytic
: pagets
: hodgkin
: fractures
: Cold: MM
: Normal is where uptake is usually hot
: Not normal is where increased uptake that is not normally hot

180
Q

PET SCAN

A

: AKA : positron emission tomography scan
: Uses a tracer ( Glucose) to find tumor.
: Tumor uses a lot of energy to grow so it will bring all tracer in area of tumor.
: Also shows how effective organs are using the glucose.

part 2 / 3 boards (7 decks)

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