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CORE: MSK > Knee > Flashcards

Knee Flashcards

1
Q

most common direction of dislocation?

A

anteriorly

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2
Q

vascular injury with knee dislocation?

A

commonly popliteal injury

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3
Q

imaging recommendation for knee dislocation?

A

CT angiography

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4
Q

anatomic patellar variants

A

bipartite/multipartite patella and dorsal defect

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5
Q

patellar fracture mechanism?

A

direct blow; extreme sudden tension of the extensor mechanism

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6
Q

classification system for tibial plateau fractures

A

Schatzker classification

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7
Q

which fractures are more stable? lateral or medial tibial plateau?

A

lateral plateau fractures are more stable

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8
Q

which horn is bigger in the medial meniscus? which horn is bigger in lateral meniscus

A

medial meniscus: posterior

lateral meniscus: same size bilaterally

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9
Q

attachment of meniscus?

A

anterior/posterior meniscal root; injury causes extrusion

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10
Q

name the meniscofemoral ligaments and the landmark?

A

ligament of Humphry (anterior to PCL)

Ligament of Wrisberg (posterior to PCL)

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11
Q

what is the red zone of menisci?

A

outer zone; more likely to heal bc more vascular

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12
Q

how to differentiate between myxoid degeneration vs tear?

A

tear extends to articular surface ; myxoid degeneration doesn’t

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13
Q

most common type of meniscal tear? location? cause?

A

horizontal/oblique tear most commonly occurs in posterior horn of medial meniscus

most commonly due to degenerative changes

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14
Q

best view to see longitudinal/vertical tears?

A

sagittal views; fixed distance from edge of meniscus

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15
Q

cause of bucket handle tear?

A

extension of vertical tear with a free inner edge of meniscus

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16
Q

most common location for bucket handle tear? where does displaced fragment commonly go?

A

medial meniscus; displaced fragment ends up in intercondylar notch most commonly (but can also go anterior/posteriorly)

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17
Q

“absent bowtie” sign
“double delta” sign
“double PCL” sign

A 
absent bowtie: fewer than 2 bowties on adjacent slices
double delta sign: anterior displacement (sagittal)
posterior displacement (sagittal; medial meniscus)
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18
Q

vertically oriented tear perpendicular to meniscus arc

A

radial or transverse tear

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19
Q

marching cleft sign

A

radial tear changes position relative to edge of meniscus

may look identical to a longitudinal tear/vertical tear on a single sagittal image.

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20
Q

ghost meniscus sign

A

no meniscal tissue seen when plane of imagine is directly through the radial tear

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21
Q

high rate of meniscal extrusion associated with what type of tear?

A

radial tear –> osteoarthritis

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22
Q

cause of meniscal cyst?

A

extension of joint fluid through meniscal tear

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23
Q

meniscal cyst associated with what type of tear?

A

horizontal cleavage

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24
Q

what is a discoid meniscus?

A

congenital malformation; increase thickness of meniscus, extends into central tibial plateau

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25
problem with discoid meniscus?
increase risk of joint line pain, clicking, locking in kids/adolescents; prone to cystic degeneration/tear
26
most common location for discoid meniscus
lateral meniscus
27
MRI diagnosis of discoid meniscus
3 contiguous sagittal slices of oval/bow-tie shaped menisci (4 mm thick, so 12 mm) ; loss of central tapering/bowtie
28
attachments of ACL?
femoral intercondylar notch and attaches to the anterior tibial plateau, lateral to the spine
29
number of fiber bundles in ACL
anteromedial band and larger posterolateral band
30
MRI findings ACL tear
frank discontinuity of fibers or abnormal course/signal; may also see secondary buckling of PCL due to anterior displacement of tibia (positive drawer sign) bone contusion in the lateral femoral condyle and the posterolateral tibial plateau
31
O Donoghue's Triad
ACL, meniscal, MCL tear; posterolateral corner knee injury
32
XR findings ACL tear
Segond fracture; lateral tibial plateau (ACL and IT band injury) avulsion fracture detachment of lateral capsular ligament
33
Where does IT band insert?
Gerdy's tubercle of tibia
34
Blumensaat's line?
drawn along intercondylar roof
35
ACL graft course?
behidn blumensaat's line parallel to intercondylar notch
36
ACL graft too steep? ACL graft too lax?
graft impinged with leg extension by femur graft not enough stability
37
cyclops lesion? postop ACL?
nodular scarring of Hoffa's fat pad; nodular soft tissue
38
which is thicker? ACL vs PCL?
PCL
39
insertion sites of PCL
femoral intercondylar notch more anteriorly than ACL and inserts on posterior tibial plateau
40
MR of PCL injury
laxity of PCL; ? abnormal high T2 signal
41
MCL ligament attachments
posterior aspect of medial femoral condyle; medial tibial metaphysis, deep to pes anserinus MCL is extrasynovial (not seen on arthroscopy); intlaced with medial meniscus
42
MCL injury grading
Grade I: sprain | Grade 2: severe sprain/tear; Grade 3: complete tear
43
What is a pellegrini stieda lesion?
post traumatic calcification medial to medial femoral condyle
44
composition of LCL
biceps femoris, LCL, IT band
45
posterolateral corner components
LCL complex: BFT, LCL, IT band Arcuate ligament (Y shaped), connecting fibula to lateral femur Popliteofibular ligaments Popliteus tendon (lateral femur insertion)
46
IT band syndrome
friction between anterolateral femur/tendon of IT band; anterolatearl knee pain common in runners
47
insall salvati ratio?
patellar tendon length to patelar length
48
patella alta ratio? baja?
alta >1.2, baja < 0.8
49
extensor mechanism of quadriceps?
quadriceps tendon, patella, patellar tendon quad muscles: vastus intermedius, medialis, lateralis (from femur) rectus femoris arises from AIIS
50
clinical presentation of quadriceps tendon tear?
loss of extension
51
common site of quadriceps tear?
within 2 cm of patella; results in patella baja
52
cause of patella alta?
tear of patellar tendon, superior displacement of atella
53
jumper's knee?
patellar tendinosis; thickening of tendon
54
where are bone marrow contusions from patellar dislocation? what happens to medial retinaculum
lateral femoral condyle and medial patellar facet; tearing of medial retinaculum
55
osteochondrosis of tibial tuercle?
osgood schlatter disease; repetitive microtrauma?
56
Imaging findings of osgood sclatter XR, MR
XR: tibial tuberosity fragmentation/edema MR: increased distal patellar tendon signal, bone marrow edema, edema within hoffa's fat pad
57
divide compartments of knee
patellofemoral (medial, -median ridge -lateral, odd facets) trochlear cartilage: medial, central, lateral medial tibiofemoral lateral tibiofemoral
58
types cartilage injuries to the knee
thinning surface irregularity, fissuring, delamination (dissecting detachment)
59
etiology of osteochondrosis disseicans (OCD)
repetitive trauma in adolescents....cartilage dehydration and subsequent stiffening transmitting greater force to subchondral bone during loading
60
common locations for OCD
knee (lateral medial femoral condyle); ankle (posteromedial/anterolateral talar dome), elbow (gymnasts; anterolateral capitellum)
61
unstable OCD?
fragment unattached to bone --> secondary OA
62
PVNS? most common location?
benign; hyperplastic proliferation of synovium within the joint; outside joint --> giant cell tumor knee
63
PVNs presentation
knee swelling, recurrent dark brown effusions from hemorrhage --> hemosiderin deposits and cause blooming artifact
64
lipoma arborescens?
overgrowth of intracapsular synovial fatty tissue --> fatt masses --> premature OA
65
treatment for lipoma arborescens
synovectomy
66
common location for baker's cyst? ddx?
semimembranous tendon and medial head of gastrocnemius muscle ddx: popliteal aneurysm
67
tennis leg?
tear of plantaris tendon or medial head of gastrocnemius

CORE: MSK (13 decks)

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