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RMSK overall > Elbow RMSK > Flashcards

Elbow RMSK Flashcards

(80 cards)

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1
Q

Prominent recess/FOSA of elbow

A

coronoid and radial fossa anteriorly and olecranon fossa posteriorly

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2
Q

Where are the fat pads located

A

in each joint recess. it is intracapsular but extrasynovial

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3
Q

Medial elbow joint stabilizers

A

UCL- 3 components anterior , posterior and oblique

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4
Q

Which is the most important medial stabilizer

A

anterior bundle

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5
Q

Lateral elbow stabilizer

A

LCL complex

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6
Q

what are the components of the lateral elbow stabilizer

A

radial collateral ligament, annular ligament, small accessory radial collateral ligament and LUCL

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7
Q

Brachialis inserts to

A

Ulna BRU!!!

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8
Q

Biceps brachii inserts where?

A

radial tuberosity

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9
Q

what kind of insertion is biceps brachii

A

dual insertion… short head is more superficial and inserts distally on radial tuberosity

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10
Q

triceps inserts to

A

olecranon process

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11
Q

which muscles compose the superficial layers of the distal triceps?

A

lateral and long head

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12
Q

shorter head of triceps and deeper

A

medial head

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13
Q

Where can you find the anconeus

A

between olecranon process and lat epicondyle

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14
Q

Medial compartment of elbow

A

common flexor tendon ( FCR, PL, FCU, FDS) all originating from medial epicondyle

FDP- NOT INCLUDED

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15
Q

Lateral compartment of elbow structures?

A

ECRB, ED, EDM, ECU all from lateral epicondycle

Not including ECRL- since it is more proximal

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16
Q

Where is origin of ECRL

A

proximal to lateral epicondyle

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17
Q

Space between olecranon process of ulna and Medial epicondyle is bridged by what ligament

A

bridged by the cubital tunnel retinaculum ( osborne ligament)

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18
Q

True cubital tunnel

A

between two heads of flexor carpi ulnaris and deep to arcuate ligament

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19
Q

WHere does median nerve course through sa elbow muscular landmark?

A

between ulnar and radial headfs of pronator teres

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20
Q

Radial nerve course from humerus .. which muscles does it pass from elbow to forearm

A

posterior aspect of humeral shaft then distally and laterally beneath the brachioradialis.. deep branch courses under supinator and superficial branch beneath BR into forearm

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21
Q

Commonly missed in elbow scan

A

anterior joint recess. ulnar collateral ligament, LCL complex, radial head and annula recess, capitellum, posterior joint recess, olecranon bursa

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22
Q

vascular Landmark of biceps brachii tendon

A

lateral to brachial artery

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23
Q

Two different superficial nerves of anterior elbow and landmarks

A

lateral antebrachial cutaneous nerve- lateral and superficial ..( continuation of musculocutaneous nerve) to BT, radial nerve- superficiial and deep

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24
Q

Lacertus fibrosus location

A

superficial to biceps tendon

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25
Views for distsal biceps tendon 
usual anterior aproach.. lateral to brachial artery
26
Other views for distal biceps tendon
Medial approach v1 ( move medial until brachial artery seen then angle lateral toward center of elbow. + heel toe maneuver + slight flexion )
27
Another medial approach v2
SAX then LAX once footprint is seen
28
3rd method for distal biceps
Pronator window approach- elbow flexed... transducer over medial epicondcle and elbow flexed... viewing at coronal plane , move towards wrist and slightly anterior to visualize radial tuberosity
29
structures to evaluate on posterior elbow
joint recess, triceps, soft tissues over olecranon, trochlea, capitellum, olecranon fossa, cartilage 
30
superficial layer of triceps brachii posteriorly comprised of which heads
long and lateral heads
31
deeper layer of triceps represent
medial head of triceps 
32
lateral structures ( tendon, ligament, bony landmarks)
common extensor tendon, LCL complex, raidal head, annula recess, capitellum, radial collateral ligament
33
foorptint origin of common extensor tendon
proximal 46% of bone surface.. a bony ridge may be seen at the ending. 
34
structure to remember near the radiocapitellar joint
meniscus like synovial fold called the POSTEROLATERAL PLICA
35
differentiate the radial collateral and the lateral ulnar collateral ligament 
RCL adjacent to CET... LUCL.. oblique and inserts to crista supinator of ulna
36
Which recess in elbow most sensitive for joint fluid accumulation
posterior olecranon recess
37
Complex fluid in elbow appearance
hypoechoic to hyperechoic
38
heterogeneous fluid indicates?
hemorrhage or infection
39
findings that suggest complex fluid
compressibility, redistribution or motion of contents, lack of internal flow on color doppler
40
findings suggestive of synovial hypertrophy
non compressibility | flow on color doppler
41
What causes synovial hypertrophy
infection, RA, inflammatory arthritis, intra-articular osteoid osteoma
42
synovial pathology with calcified hyperechoic foci
pigmented villonodular synovitis... if synovial chondromatosis there will be hyperechoic foci
43
Common sites for intra-articular bodies
olecranon, coronoid, annula recess
44
synovial fold syndrome 
adjacent to radial head it is heterogeneous thickener or elongated
45
Evaluate for articular hyaline cartilage where
over capitellum and look for osteochondral abnormaloty
46
olecranon bursa location
superficial to olecranon process of ulna, must FLOAT
47
findings suggestive of gout
hyperechoic synovial hypertrophy with internal hyperechoic foci
48
findings suggestive of a full thickness tear
anechoic or hypoechoic tendon fiber disruption, tendon retraction with refraction shadowing
49
distal biceps tendon tear of only one head will be classified as
partial thickness tear
50
dynamic evaluation of full tear
proximal segment will show little or no movement with pronation to neutral
51
dynamic evaluation of partial tear
somve movement is seen equal to amount of rotation
52
appearance of DOMS
focal or diffuse hyperechoic area of the involved muscle with possible enlargement ( triceps, biceps, brachiorad)
53
partial thickness tear triceps 4 considerations
Observe superficial layer of tendon, Usually combined lateral and long head attachments, May have fractured displaced osteophyte 2-4cm retraaction of avlused bone 
54
Lateral epicondylitis most common tendon
most common carpi radialis brevis ( most anterior and most common) 
55
findings of lat epic
tendinosis >4.2mm if common extensor tendon with possible hyperechoic calcification and adjacent bone irregularity
56
Poor prognosis for lat epicondylitis
size of intasubstance common extensor tendon tear and radial collateral ligament inclusion- poor outcome 
57
what stabilizes the medial elbow joint?
Ulnar collateral ligament ( APO) anterior posterior and oblique 
58
Insertion of the anterior bundle
sublime tubercle 
59
full thickness tear appears
complete fiber discontinuity, variable anechoic, hypo echoic isoechoic fluid and hemorrhage.. difficult to distinguish from partial 
60
dynamic evaluation of elbow for ulnar collateral ligament tear criteria for joint gapping and requirements for surgery?
during valgus stress joint gapping >1mm difference- UCL tear req. surgery... if 2.5mm full thickness tear
61
Are all calcifications pathologic in UCL?
can be asymptomatic with baseball players
62
Lateral elbow stabilizers and ligaments?
radial collateral ligament , annular ligament, LUCL.
63
Criteria for cubital tunnel syndrome
>9mm2 or ratio of >2.8
64
Where does the ulnar nerve dislocate
medially and anteriorly over the medial epicondyle and reloates with extension 
65
snapping triceps syndrome 
includes medial head of triceps and also ulnar nerve.. so 2 snaps.
66
anconeus epitrochlearis muscle incidence? and possible pathology
normal variant in 23% can cause ulnar nerve compression.. diagnosed in extension 
67
Median entrapment sites
distal humerus- ligament of Struthers (supracondylar process). antecubital region- pronator syndrome, distally AIN from fibrous bannds of anomalous muscles 
68
Radial nerve pathologies
spiral groove syndrome - wrist drop and sensory but spared triceps function 
69
Humeral shaft injury
can injure radial nerve from enlargement to transection 
70
Spiral groove compression
Saturday night palsy 
71
Radial tunnel syndrome location and distribution and manifestation?
between two heads of supinator.. | Proximal lateral forearm pain in present without motor abnormalities
72
Posterior interosseous nerve syndrome clinical manifestation
painless lack of finger and thumb extension without wrist drop. imaging is enlargement of radial nerve deep branch just proximal to entrance between two heads of supinator
73
causes of PIN syndrome
Arcade of Froshe, fibrouse bands, leash of henry.
74
The deep branch of radial nerve normally flattens as it enters supinator meaning
not nerve compression
75
Peripheral nerve sheath tumors echo characteristics?
schwanoma and neurifibroma appear as defined hypoechoic mass with low-level internal echoes. may havei ncreased through transmission 
76
Inflammatory epitrochlear lymph node
enlarged, oval shape, normal echogenic hilum and hilar vascular pattern.. 
77
Malignant epitrochlear lymph node
round with absence of echogenic hilum, thickening of hypoechoic cortex and peripheral or mixed vascularity 
78
Lateral flexion approach- can view full thickness tear of BT
elbow 90 degress, transducer is placed transverse to radius and at the beginning of radial head.. go distally till you see the supinator at level of radial tuberosity
79
Dorsal flexed pronation view good for what ?
can see distal biceps and good position for injection 
80
Medial flexion view can view what structure?
can see BT more proximally can see bicipitoradial bursa if enlarged 

RMSK overall (4 decks)

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