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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
Chordoma AKA : Type : Age : Symptom : Detail : Management : Labs: Location : Name Sign :
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 :
26
Ivory white vertebra
Hodgkin lymphoma- anterior scalloping - 20-40 blastic met - no change on vertebra - over 40 pagets - widening of vertebra - over 50
27
Decreased alkaline phosphatase
zinc, malnutrition, pernicious anemia, thyroid disease, Wilson disease hypophosphatasia,
28
Increased Alkaline phosphatase
Pagets Osteosacroma Lytic and blastic met fibrosarcoma & chondrosacroma Hyperparathyroidism Calcified prostate
29
Reed sternberge cells
Hodgkin lymphoma
30
Saber shin & shepperd crook
Paget Fibrous Dysplasia
31
Bone scan : cold
MM
32
Over 50 yo
MM Pagets
33
Over 40
Metastasis Chordoma Chondrosacroma & Fibrosarcoma
34
Malignant 9
MM Lytic mets Blastic mets pagets osteosacroma Fibrosacroma & Chondrosacroma Chordoma Ewing sacroma hodgkin lymphoma
35
Types of scoliosis
Rotatory = spinous is going on concavity Simple = spinous is going to convexity
36
Lines of mensuration for scoliosis
Cobb's = best method risser furgeson
37
Test for scoliosis
Adam test
38
Scoliosis measurement for 25 yo and younger
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
39
scoilios for over 25 yo
adjust only after growth plates closed = no need for referral
40
Monitor scoliosis progression
1.) left wrist X-ray = best 2.) riser sign = 2nd best 3.) tanner staging = least * the younger the father degree can go
41
Inflammatory Seropositives artritis
RA Systemic lupus Schleroderma
42
Inflammatory Seronegative artitis
psoriatic arthritis Enteropathic arthropathy AS Reiter's
43
Non inflammatory arthritis AKA degenerative
DJD = OA DISH Neurogenic arthropathy AKA Charcot joint synoviochondrometaplacia
44
Metabolic artritis
Gout CPPD HAAD
45
other artritis
septic
46
+FANA
RA Lupus
47
Rheumatoid Arthritis AKA : Type : Age : Symptom : Management : Labs: Location : Name Sign : 11
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
48
Ankylosing Spondylitis AKA : Type : Age : Symptom : where it starts? Detail : associated with what Ortho : Management : Labs: Location : Name Sign : 9
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
49
+HLA B27
Seronegative Psiruativ arthritis Enteropathic arthritis AS Reiter
50
Enteropathic Arthropathy AKA : Type : Age : Symptom : Detail : Ortho : Management : Labs: Location : Name Sign :
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 :
51
Psoriatic Arthritis Type : Age : Symptom : Management : Labs: Location : Name Sign :
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
52
Reiter's Disease AKA : Type : Age : Symptom : Detail : Ortho : Management : Labs: Location : Name Sign :
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
53
Systemic Lupus Erthematosus AKA : Type : Age : Symptom : Detail : Ortho : Management : Labs: Location : Name Sign :
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
54
Scleroderma AKA : Type : Age : Symptom : Detail : Ortho : Management : Labs: Location : Name Sign :
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)
55
Osteotitis condensing Ilia AKA : Type : Age : Symptom : Detail : Ortho : Management : Labs: Location : Name Sign :
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
56
degenerative joint disease AKA : Type : Age : Symptom : Detail : Ortho : Management : Labs: Location : Name Sign :
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 )
57
Diffuse Idiopathic Skeletal Hyperostosis AKA : Type : Age : Symptom : Detail : related to what Ortho : Management : Labs: Location : Name Sign :
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
58
Neurogenic arthropathy AKA : Type : Symptom : Detail : seen with what? Management : Location : Name Sign :
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
59
Synoviochondrometaplasia AKA : Type : Age : Symptom : Detail : Ortho : Management : Labs: Location : Name Sign :
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
60
Gout AKA : Type : Age : Symptom : Detail : Ortho : Management : Labs: Location : Name Sign :
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
61
Calcium pyrophosphate dihydrate crystal deposition disease AKA : Type : Detail : Management : Location : Name Sign :
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
62
Hdroxyapatite deposition disease AKA : Type : Management : Location : Name Sign :
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
63
Septic Arthritis Symptom : Detail : Management : Labs:
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 :
64
Avascular necrosis
AKA: osteonecrosis, osteochondrosis
65
Major cause of AVN
trauma
66
Labs for AVN?
none
67
What can AVN lead to ?
DJD
68
Special test for AVN?
Bone scan MRI ( BEST) manage w/ ortho
69
are AVN self resolving? if so, how long?
8 months to 2 years
70
preiser's
carpal scaphoid
71
scheurmann's
vertebral end plate epiphysis
72
legg calve perthes
femoral epiphysis
73
kohler's
tarsal navicular
74
keinboch's
carpal lunate
75
sever's
calcaneus
76
blount's
medial tibial condyle
77
freigberg's
head of 2nd and 3rd and 4th metatarsal
78
osteochondritis dessicans
articular surface of the medial femoral condyle
79
panner's
capitellum
80
Osteochondritis dessicans Type : Age : Symptom : Ortho : Management : Location : Name Sign :
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
Scheurmann's disease AKA : Type : Age : Symptom : Detail : Ortho : Management : Location : Name Sign :
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
Legg calve perthe's Type : Age : Symptom : Management : Location : Name Sign :
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
Slipped capital femoral epiphysis AKA : Type : Age : Symptom : Detail : femoral head and neck movement Ortho : Management : Location : Name Sign :
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
Congenital hip dysplasia Type : Detail : Ortho : Name Sign :
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
Protrusion acetabula AKA : Type : Age : Symptom : Detail : Ortho : Management : Location : Name Sign :
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
Protrusion acetabula AKA : Type : Detail : associated with what Ortho : Location : Name Sign :
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
Fracture management
: Orthopedist : RIICE : Rest, Ice, immobilization, compression, elevation
88
Avulsion
: portion of bone torn away by muscle or ligament tractional force
89
comminuted fracture
: with more than 2 fragments
90
diastasis
: displacement or separationn of a slightly movable joint
91
compound
: AKA: open fracture : skin ruptured and bone exposed
92
Greenstick
: AKA : hickory stick : incomplete fracture in children
93
impaction
: bone fragments driven into one another : bone goes in bone
94
torus
: AKA : buckling : incomplete fracture : one side of the cortex is affected : bowing of bone
95
Occult
: clinically evident but not seen on x-ray : may become evident a week on 10 days later
96
Stress
: AKA : fatigue : insufficiency of repetitive stress causing a fracture
97
Bennett's
fracture of 1st metacarpal
98
Boxer's
fracture of 2nd or 3rd metacarpal
99
Bar Room
fracture of 4th or 5th metacarpal
100
Scaphoid
most common fractured carpal bone
101
Night stick
fracture of the proximal ulna
102
Montegia ( una si montegia)
Fractured Ulna with radial head displacement : Una si montegia
103
Galeazzi
fracture of Distal 1/3 of the radius with dislocation of the distal radio-ulnar joint
104
C[o]lles
fracture of distal radius with posterior displacement of the distal fragment
105
Smith's
fracture of the distal radius with anterior displacement of the distal fragment
106
March
Stress fracture of the 2nd, 3rd ,or 4th metatarsal
107
Jones
transverse fracture at the proximal 5th metatarasal
108
clay shoveler's
: Avulsion fracture of the spinous process : MC: @ C6-T1 : Hyperflexion injury
109
Hangman's
: bilateral medical fractures of C2 : due to her-extension injury
110
Jefferson's bursting
: fractures through the anterior and posterior arches of atlas : due to axial compression
111
Ondontoid fracture
fracture of dens
112
Type 1 Ondontoid fracture
avulsion of the tip of dens
113
Type 2 Ondontoid fracture
fracture through the base of dens
114
Type 3 Ondontoid fracture
fracture through body of C2
115
Tear drop Associated w what
: 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
Salter Harris types
fracture through any growth plate
117
Salter Harris types type 1
: horizontal fracture through the growth plate : SCFE
118
Salter Harris types Type 2
: Growth plate and metaphysis ( Most common) (child abuse)
119
Salter Harris types Type 3
Growth plate and epiphysis
120
Salter Harris types Type 4
growth plate, metaphysis and epiphysis
121
Salter Harris types Type 5
compression deformity of the growth plate ( most severe)
122
Osgood schlatter's
: Tibilial apophysitis : 10-16 yo :pinpoint pain and swelling : Use Cho-pat brace : Lateral x-ray
123
Rider's bone
: Avulsion of the ischial tuberosity : hamstring pull
124
Chance Aka Detail Mc loc?
: AKA : seatbelt : horizontal fracture through a single body and posterior arch : MC @ L1-L3
125
Spondylolysis
fracture through the pars interarticularis without slippage
126
spondylolisthesis
slippage of the vertebral body with or without fracture
127
spondylolisthesis Type 1
: Displastic : Congenital defect
128
spondylolisthesis Type 2
: Isthmic : fracture through pars
129
spondylolisthesis Type 3
: Degenerative : DJD of the facet joint
130
spondylolisthesis Type 4
: traumatic : fracture through pedicle
131
spondylolisthesis Type 5
: pathological : pathology on that segment
132
What is used to grade spondy?
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
Dislocations
134
Lunate
: Most commonly dislocated carpal bone : associated with pie sign
135
Scaphoid
: Associated with the Terry Thomas sign : signet ring sign : Most common fx bone in the hand
136
Shoulder dislocation
Most common is anterior inferior and medial
137
Hill sachs
: AKA hachet : posteriolateral fracture of humeral head
138
Bankart lesion
: Fracture inferior glenoid labrum
139
Slap lesion
: Soft lesion of the labrum the superior aspect is torn from anterior to posterior : diagnosed with MRI
140
Posterior ponticle : AKA : : Detail : : Location :
: 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
Down's syndrome : : Detail : : Location :
: : 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
Os odontoideum
: 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
Congenital block Detail Associated Management
: adjacent vertebra osseously fused from birth : associated with wasp waist and hypo plastic disc : Adjust above or below segment
144
Klippel-feil syndrome
: patient presents with a short webbed neck, low hairline, and decreased ROM : multiple congenital blocks : associated with sprengle's deformity and omovertebral bone
145
Pedicle agenesis Name sign How to ddx ?
: 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
Butterfly vertebra
failure of the center of the vertebral body to ossify properly
147
Hemivertebra
: failure of development of a lateral ossification center : Isolated wedged vertebra causes scoliosis : associated with gibbous deformity
148
spinal bifida
: no symptoms : failure of the laminate fuse : elevated alpha fetoprotein : folic acid deficiency
149
transitional vertebra
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
Facet tropism
: asymmetric articular planes : MC at L5/S1 : best on side posture
151
knife clasp syndrome
: spina bifida of S1 : L5 spinous enlargement : Pain on extension : avoid extension because SP of L5 will hit the caudal equana
152
Coxa Vara
: End up knock knee : less than 120*
153
Coxa Valga
: End up bow legged : created than 130*
154
Coxa-femroal angle normal
120-130*
155
What to measure coxa-femoral angle?
Mikulicz's line of mensuration
156
Madelung's deformity
Bowing of radial shaft w/ increased interosseous membrane
157
Negative ulnar variance
: ulna is unusually shorter than the radius : seen with schapho-lunate dislocation : Lunate dislocation is worse
158
Pelligrini steida
calcification of the medial collateral ligament
159
myositis ossificans
: calcification of the muscle belly : most commonly seen in the biceps and in the quadriceps : refer to ortho
160
abdominal aortic aneurysm Location Measurement? Name sign Test Management
: 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
Cholelithiasis 9f Pain referral where? Test?
: 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
Uterine fibroids
: Fibroid cyst/ leiomyoma ( tumor of smooth muscle) : MC benign tumor in females
163
Calcified prostate Age Labs Metastasis to where
: over 50 yo : urinary problems : Labs: PSA, aci phosphatase : Metastasis ( MC limbar spine) : Alkaline phosphatase :
164
Phleboliths
: calcification within veins : Asymptomatic
165
Fat pads
Location: elbow : indicates a radial head fracture : seen on the lateral view
166
sickle cell anemia
: hair on end appearance on skull : H shaped vertebra on spine : collapsed vasculature
167
thalasemia
: 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
Hyperparathyroidism
: 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
Osteopetrosis Cause Detail Early Late
: hereditary : absense of marrow : Marble bone disease : Anemia : hepatosplenomegaly : Early is Bone within a bone " Erlenmeyer flash deformity" : Late is sandwich vertebra "
170
Rickets
: 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
How much better is CT than plain film?
10X
172
What is best seen when using CT? 11
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
How is CT measured?
house field units
174
What is best seen on MRI
Meniscus ligament tendon IVD Spinal cord meninges bone Multiple sclerosis BEST FOR ALL AVN
175
How much better is MRI compare to CT
100x
176
What color is water on T1 weighted T2 weighted
T1 = grey T2 = white t2h20
177
what color is cortical bone
always black > sigmoid bone
178
DEXA
Dual emission x-ray absorpmetry Measures bone density for osteoporosis
179
Bone scan
: 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
PET SCAN
: 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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