Flashcards in MSK Deck (129)
rare form of localised gigantism
painless enlargement of the 2nd or 3rd digit of the hand or foot. It is usually unilateral but may involve adjacent digits in the distribution of the median or plantar nerves
What other injury is associated with perilunate dislocation?
What ages do you see physiologic periostial reaction?
Infant has more than usual physiologic periosteal reaction, diffusely - what is it from?
prostaglandin treatment to keep ductus arteriosis patent
Ddx of periosteal rxn in an infant:
Prostaglandin therapy, Caffey's disease, congenital syphilis, hypervit. A, multifocal osteomyelitis, lymphoma/leukemia
What's Caffey's disease?
infantile cortical hyperostosis a largely self-limiting disorder which affects infants. It causes bone changes, soft-tissue swelling, and irritability
The mandible, ulna and clavicle are most common sites
Radiation therapy, what do you worry about 10-40 years out?
Radiation induced sarcoma
Soft tissue calcification ddx:
Dystrophic (amorphous, may ossify)
CPPD (usually in cartilage)
*metastatic Ca2+ (elevated Ca2+ levels)
Tumoral calcinosis (fluffy, periarticular)
primary soft tissue sarcoma
Ddx for dystrophic calcification in soft tissues:
post-traumatic (heterotopic ossification)
cistercercosis (or other parasite)
hyper Vit. D
Causes of elevated serum Ca2+
primary hyperparathyroidism, chronic renal disease, milk-alkali, hyper Vit. D, widespread bone destruction
hip pain in a 12 year old
Slipped Capital Femoral Epiphysis
early - widened epiphysis
late - capital slips posterioinferomedially
Flowing syndesmophytes, no sacral involvement =
DISH (Diffuse Idiopathic Skeletal Hyperostosis)
Severe destruction/derangement of a joint - think... What might be the cause in the upper extremity?
upper extremity: syringomyelia
otherwise, usually diabetes
Name findings of renal osteodystrophy
2ndary hyperpara: subperiosteal bone resorption, soft tissue calcs, brown tumors (eg ribs, hands), sclerosis (rugger jersey spine, salt and pepper skull)
What is cherubism?
progressive fibrooseous lesions of mandible and maxilla in childhood, some think related to fibrous dysplasia
What syndromes are occasionally seen with polyostotic fibrous dysplasia?
McCune-Albright (also has precocious puberty and cutaneous pigmentation)
Mazabraud (soft tissue myxomas, increased risk of malignant transformation)
What's the syndrome of polyostotic fibrous dysplasia and soft tissue lesions? What are the lesions? What's the concern?
Mazabraud. Soft tissue myxomas.
Increased risk of malignant transformation.
Differential for multiple lucent bone lesions:
hyperpara (brown tumors)
What's the order of appearance of ossification centers in the elbow?
Internal (medial) epicondyle
External (lateral) epicondyle
Infant foot deformity - talus looks vertical
Congenital vertical talus
"opposite" of club foot
causes hindfoot valgus and flatfoot
Ddx for multiple wormian bones
kinky hair syndrome
primary acroosteolysis (Hajdu-Cheney syndrome)
Partially absent clavicle - what cause?
hyperparathyroidism : subperiosteal bony resorption
rheumatoid arthritis : bilateral or unilateral changes with soft tissue swelling, erosion of the outer third of the clavicle
features of psoriatic arthropathy
bilateral asymmetric, distal joints
erosions, pencil-in-cup, ankylosis, sausage digit
features of achondroplasia
spine: posterior scalloping, narrow interpedicular distance in lower lumbar (stenosis)
Flat, tombstone iliac wings
short, flared bones, esp femur and humerus (rhizomelic)
skull: frontal bossing
Gibbus deformity of vertebral body
what's the significance of "vacuum vertebral body"?
air means it's a non-neoplastic, non-infectious fracture - nothing there to fill space, so nitrogen gas
Bony features of Marfan syndrome
acetabular protrusion, lumbosacral dural ectasia, pectus excavatum/carinatum
synovial sarcoma features
soft tissue mass near knee or elbow (not in joints, just near them)
can calcify 30%
osteochondral fx of lateral condyle associated with:
features of gout
punched out lytic lesions with overhanging edges, tophi