MS I

Question 1

When examining xrays remember to think what ?

Answer 1

Think 3-dimensionally

but reminder everything is flat though in a 2 dimensional pancake

Question 2

Most series of skeletal system come with an ?

Answer 2

AP and lateral view

direction of the beam that is going through an object

Question 3

Particular views may be added to look at a specific _________ or for a specific __________

Answer 3

structure

pathology

**wrist pain, pain in anatomic snuff box = scaffold fracture - not a hard bone to look at it is is a funny place. Might want to get a PA lateral wrist or even an additional scaffold view **

Question 4

transverse fracture ?

Answer 4

straight across

Question 5

oblique fracture ?

Answer 5

diagonal

Question 6

comminuted fracture ?

Answer 6

in pieces

Question 7

avulsion fracture ?

Answer 7

“pull away” - tendons connect muscle to bone - when a tendon pulls away from bone and a piece of bone fragment will come with it

avulsion- “pull away” - tendons connect muscle to bone - when a tendon pulls away from bone and a piece of bone fragment will come with it

Question 8

impacted fractures ?

Answer 8

jumping from a height - crush injury in the middle of the bone

Question 9

greenstick fracture ?

Answer 9

little kid bones - force injury it will break on one side but the other just bows

Question 10

Pathologic fracture ?

Answer 10

associated with disease - fracture would not happen if disease wasn’t there - this is probably CA, distal humeral head transverse fracture

Question 11

Angulation ?

Answer 11

extent to which fracture fragments are not anatomically aligned

in a angular fashion

Question 12

Convention ?

Answer 12

describe angulation as the direction the apex is pointing relative to anatomical long axis of the bone (e.g. apex medial, apex valgus) or direction of distal fragment

Question 13

Fatigue fracture ?

Answer 13

happen with normal bone, a NL bone under a lot of stress, foot of a marathon runner, boot camp

Question 14

Insufficiency fracture ?

Answer 14

happen in abnormal bone that would not happen in normal bone - osteoporosis of the spine having a compression fracture

Question 15

Recognizing a fracture by what findings?

Answer 15

Break in the continuity of cortex

Radiolucent fracture lines

Overlap of cortical and spongy bone (more white)

Unexplained fragments of bone

Denser area of impaction - looks like a fuzzy halo

Callus of a healing fracture

Question 16

Fracture healing stages?

Answer 16

Inflammatory phase

Reparative phase

Remodelling phase

Question 17

Inflammatory phase appears ?

Answer 17

Hours to days

Question 18

Reparative phase appears when ?

Answer 18

Days to weeks

Question 19

Remodelling phase appears when ?

Answer 19

Months to years

Question 20

Inflammation phase ?

Answer 20

soon after a fracture occurs a hematoma forms at the injury site. Marcophages and inflammatory leukocytes move into the dmaaged area to scavenge debris and begin producing the pro-inflammatory agent that initiate healing

Question 21

Soft Callus ?

Answer 21

inflammatory triggers call divison and the growth of new blood vessels. Among the new cells, chondrocytes secrete proteoglycans, creating fibrocartilage that forms the soft callus

**inflammation starts to trigger some bone repair

Question 22

Hard Callus ?

Answer 22

Through endochondral ossification and direct bone formation, woven bone replaces the soft callus to create a hard callus around the broken fragments of bone

**and a hard callus and remodeling can last months to years **

Question 23

Remodeling ?

Answer 23

Overtime, mechanically strong, highly organized cortical bone replaces the weaker disorganized woven bone. Because it is continually remodeled, bone is the only tissue to heal w/o a scar

**and a hard callus and remodeling can last months to years **

Question 24

________ have a remarkable remodeling capability

Answer 24

children

Question 25

Dislocation ?

Answer 25

Dislocated from correct position no communication with the joint surface

Question 26

Subluxation ?

Answer 26

Partially dislocated

Question 27

Osteomyelitis - Bony destruction: Lytic lesion ?

Answer 27

lysed - cut away ( radiolucent area on an xray)

Question 28

Osteomyelitis - Bony destruction: +/- expansile ?

Answer 28

it look slike some remodeling or callus formation - it is just inflammation from the body response

Question 29

Osteomyelitis - Bony destruction: +/- sclerotic margin ?

Answer 29

body is trying to defend against infection

Question 30

Osteomyelitis - Bony destruction: +/- periosteal reaction ?

Answer 30

inflammation of the periosteum as well

Question 31

if you suspected infection in bone it it is important to get an X ray to document the status of the bone ( in a few weeks they come back in then have a comparison to see, it takes about ?

Answer 31

2 weeks for it to show if the bone had been infected )

Question 32

CRP , ESR ?

Answer 32

sed rates - inflammatory markers are good for osteomyelitis

Question 33

With Osteomyelitis, bony destruction appears ?

Answer 33

2 weeks after infection

Question 34

Osteoarthritis ?

Answer 34

NOSS Narrowing of joint space no more cartilage layer Sclerosis of the joint Osteophyte formation - spurring of bone off the side of the joints Small cysts in the bone near the joint - little tiny and more radiolucent areas **just from wear and tear**

Question 35

Rheumatoid Arthritis ?

Answer 35

Soft tissue swelling Osteoporosis Narrowing of the joint space Marginal erosions Wrists can be fused in advanced cases **AI process - own body creatingABS TOWARD JOIT SPACE , a lot of displacement as well - look at thumb and then we can get certain deformities ** **RA - follow specific patterns **

Question 36

Gout ?

Answer 36

Large erosions of bone Sclerotic margins Halo of Tophi adjoining erosions Random joints **GOUT has no symmetry here - it can be one wrist but not the other ** **tophi - uric acid crystal deposits **

Question 37

Osteonecrosis aka ?

Answer 37

avascular necrosis aseptic necrosis

Question 38

Osteonecrosis ?

Answer 38

Early appearance is normal (MRI better in early disease) Patchy radiolucencies Areas of sclerosis and bone collapse Common in the epiphyseal marrow cavities of long bones **patches of radiolucencies near the end of the bone - look like bony cysts - avascular necrosis - bone is thinning away and dying **