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MSK Flashcards

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1
Q

Crescent sign

A

Osteonecrosis

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2
Q

FICAT staging of AVN

A

I - normal XR, abnormal line of demarcation on MRI
II - trabecular changes, patchy sclerosis and lucency
III - segmental flattening
IV - secondary OA

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3
Q

SLAP lesion

Dx criteria

A

labral tear
superior labrum anterior - posterior to biceps anchor

High SI perpendicular to biceps tendon ( normal sublabral sulcus is parallel to biceps anchor)

Linear high signal which extends posterior to labrum.

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4
Q

ABCDES approach to joints

A 
Alignment
Bone density
Cartilage/joint space
Distribution
Erosion
Soft tissues
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5
Q

Psoriatic arthritis

RF

A 
Pencil in cup / IP jt erosions (fuzzy)
Periostitis/new bone form
Distal predominance
Telescoping
Ivory phalanx
Soft tissue swelling- sausage digit
Sacroiliitis/ankylosis
Asymmetrical paravertebral ossification, bulky, non marginal
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6
Q

Arthritis with preserved joint space 3

A

Synovial osteochondromatosis
PVNS
TB - Phemisters triad

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7
Q

Phemister triad in TB joint involvement

A

PEriarticular osteopenia
Marginal erosions
Gradual narrowing of jt space

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8
Q

Ossification of the PLL

A 
Idiopathic
Men
C -S
Myolpathy
DISH
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9
Q

DISH

A

flowing ossification > 4 levels
normal disc height
SI joints normal
….Extensive osteophytosis without disc narrowing or sclerosis

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10
Q

Pagets disease
3 Phases
Buzzwords
Complications

A

Lytic - flame/lytic with non sclerotic/ blade of grass

Mixed - trabecular coarsening, osseous expansion, cortical thickening

Sclerotic - ivory vert.

Picture frame
Oste. circumscripta
Cotton wool skull

Complications:
Bowing
Fractures
Neurologic compromise
Sarcomatous transformation
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11
Q

SLE arthritis
RF
6

A 
non sp ST swelling
Non erosive
Reducible subluxation (3-8%) - ulnar dev
Calcification
Osteoporosis
Acrosclerosis/osteolysis
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12
Q

Arthritis with normal joint space

A

Gout
PVNS
Primary synovial osteochondromatosis
SLE

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13
Q

Arthritis with uniform jt space narrowing

A

Inflammatory

Infection

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14
Q

Arthritis with non uniform narrowing

A

OA
Neuropathic
CPPD

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15
Q

SLAC Wrist

A 
Scapholunate advanced collapse
Widening of scapholunate articulation ( Terry Thomas)
Capitate migration down
SL tears
Common with CPPD, RA, drilling
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16
Q

Lytic lesions in posterior elements of spine

GO APE

A 
GCT
OSteoblastoma
ABC
Plasmacytoma
EG
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17
Q

Radiographic changes of acute pyogenic osteomyelitis

Acute
7-10d
2-4w
6-8w

A

Acute (24-48hrs) : ST swelling, loss of fat plane

7-10 days : intramedullary destruction

2-4 weeks : cortical destruction, endosteal scalloping, periosteal reaction

6-8 weeks : sequestrum, involucrum (reactive new bone beneath elevated periosteum)

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18
Q

Sclerosing osteomyelitis

A

Osteomyelitis of Garre
Subacute form
Extensive diaphyseal sclerotic lesions

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19
Q

Septic arthritis
MRI findings
6

A 
Joint effusion
Soft tissue oedema
Synovial CE
Uniform jt space narrowing
Erosions
Bone marrow oedema
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20
Q

Sickle cell osteomyelitis

A

Salmonella, staph
Diaphyseal
Frequent in areas of infarction

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21
Q

Syphilis

Wimberger’s sign

Study These Flashcards
A

Symmetric lytic lesions medial metaphyses of proximal tibia

Periostitis

Saber shin deformity ( anterior bowing)

Gummas ( sterile bone abscesses; mixed skull lesions)

22
Q

Rubella

XR findings

Study These Flashcards
A

Medial metaphyseal beaking
Irregular metaphyses with celery stalking
DDx : toxo,CMV

23
Q

Hypoparathyroidism

RF

Study These Flashcards
A

OSteosclerosis

Soft tissue Ca : subcut, BG

24
Q

Hypothyroidism

RF

Study These Flashcards
A

Delayed skeletal maturation
Wormian bones
Epiphyseal dysgenesis : stippled, coned, fragmented

25
RF thyroid acropachy | usually post Rx
fluffy symm periostitis | Soft tissue swelling
26
Scurvy signs
Wimbergers ring at epiphyses White line of Frankel of metaphysis Metaphyseal corner # or spur ( Pelkens spur)
27
Arthropathy affecting hands/wrists DISTAL 3
Psoriasis Reiters OA
28
Arthropathy affecting hands/wrists Proximal 2
RA | CPPD
29
Diseases that cause subchondral cysts GEODES | 4
RA DJD CPPD AVN
30
Causes of high riding shoulder | 3
CPPD RA Rotator cuff tear
31
Asymmetric non marginal syndesmophytes | 2
Psoriasis | Reiters
32
Erosions with sclerotic margins | 1
Gout
33
Gout
``` punched out Erosions Mouse bite erosions juxta articular Sharply marginated overhanging edge Preserved joint space Asymm polyart distri normal mineralisation ST masses ```
34
Cause of pseudo charcot joint | 1
CPPD
35
Associations of CPPD | 3
Primary HPT Gout Haemachromatosis
36
Scleroderma/dermatomyo RF 4
Soft tissue calcification Soft tissue wasting Osteoporosis Acro osteolysis
37
CPPD | RF
Chondrocalcinosis Patellofemoral comp Pseudogout arthropathy : medial jt sp narrowing, subchond sclerosis , osteophyte formation.
38
Haemachromatosis RF Assoc
Severe jt space narrowing mainly MCP Sclerosis minimal chondrocal Assoc with CPPD 50%
39
Charcot | 6D
``` Density ( sclero/paenia) Destruction Debris Distension Disorganisation Dislocation (heterotopic new bone) ```
40
JIA | 2
overgrowth epiphyses | Gracile diaphyses
41
Apple core appearance of femoral neck | 2
Synovial (osteo)chondromatosis | PVNS
42
Friebergs infraction
AVN of second MT head flattening, collapse, sclerosis can also involve 3/4th MT heads compensatory hypertrophy of cortex
43
Keinbochs
lunatomalacia | AVN of lunate
44
Kohlers
tarsonavicular AVN
45
Haglunds Xd
retrocalcaneal bursitis -- > extensive erosive changes posterosup aspect of calcaneus new bone, soft tissue mass
46
Ankylosing spondylitis HIP/pelvis 5
``` concentric jt space narrowing articular erosions fluffy enthesopathy fused SIJ protrusio acetabuli ```
47
Haemachromatosis Demo RF
``` 30-50 yr, rare, delayed dx Arthritis/joint pain presenting Early OA without trauma : MCP, ankle, wrist FHx positive Do Serum Fe/transferin sat ratio >45% ```
48
Milwaukee shoulder
``` Older women Huge effusion Arthritis Crystal ( HADD) rotator cuff tear ```
49
fluid vs synovitis
Anechoic fluid compressible fluid no hyperaemia fluid Synovitis - non compressible, hyperaemia.
50
Intra articular Gout USS monosodium urate neg birefringence
``` joint effusion - tiny hyperechoic foci cartilage icing - double contour sign ( cf CPPD mid cartilage) Synovitis Erosions ```
51
Tophi appearance USS MRI
USS: hyperechoic, heterogeneous with hypoecho rim, wet clump of sugar variable shadowing MRI T 1 low /iso T2 hetero CE hetero

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