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CORE MSK > MSK CORE 2 - Sheet1 > Flashcards

MSK CORE 2 - Sheet1 Flashcards

(114 cards)

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1
Q

2 fractures of the base of the first metacarpal?

A

Bennett and Rolando (comminuted)

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2
Q

gamekeeper’s thumb

A

avulsion fracture of the base of the proximal phalax (+ UCL disruption)

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3
Q

what ligament in disrupted with gamekeeper’s thumb?

A

ulnar collateral ligament

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4
Q

Stener lesion is associated with what named fracture?

A

gamekeeper’s thumb - the Adductor tendon gets caught in the torn edges of the UCL.

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5
Q

median nerve distribution

A

thumb to radial aspect of 4th digit

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6
Q

accessory muscle associated with cubital tunnel syndrome

A

anconeus epitrochlearis

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7
Q

the site where the ulnar nerve passes beneath the cubital tunnel retinaculum is aka

A

the epicondylo-olecranon ligament or Osborne band

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8
Q

Hill-Sachs is best seen on which view?

A

internal rotation view

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9
Q

which nerve is injured in 60% of inferior shoulder dislocations?

A

axillary

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10
Q

bisphosphate fracture is typically on which side of the femur?

A

lateral

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11
Q

stress fracture is typically on which side of femur?

A

medial

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12
Q

SONK is not actually osteonecrosis, but is

A

an insufficiency fracture that favors the medial femoral condyle of old ladies

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13
Q

what do Looser Zones look like?

A

wide lucent bands that transverse bone at right angles to the cortex

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14
Q

ligament torn in “Terry Thomas” sign?

A

scapholunate ligament

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15
Q

tendons involved in De Quervains tenosynovitis?

A

first dorsal (extensor) compartment (extensor pollicis brevis and abductor pollicis longus).

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16
Q

Dupuytren Contracture:

A

nodular mass on the palmar aspect of the aponeurosis that progresses to cord-like thickening and eventual contracture (usually involving the 4th finger).

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17
Q

T-sign (MRI elbow)

A

UCL partial tear

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18
Q

which elbow part is most commonly involved in Panner and OCD?

A

capitellum

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19
Q

Panner vs. OCD: age

A

Panner: 5-10 OCD: teenager

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20
Q

tendon/ligament involved with lateral epicondylitis (tennis)

A

Extensory tendon injury (classically extensor carpi radialis brevis) and Radial Collateral Ligament Complex - Tears due to varus stress

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21
Q

tendon/nerve involved in Medial Epicondylitis (golfers)

A

Common flexor tendon and ulnar nerve may enlarge from chronic injury

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22
Q

most common form of shoulder impingement

A

subacromial - attrition of coracoacromial arch

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23
Q

which tendon is damanged in subacromial impingement?

A

supraspinatus

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24
Q

mechanism of subcoracoid impingement?

A

lesser tuberosity and coracoid do the pinching

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25
which tendon is damanged in subcoracoid impingement?
subscapularis
26
who gets posterior superior internal impingement?
Athletes who make overhead movements.Greater tuberosity and posterior inferior labrum do the pinching.
27
which tendon is damanged in posterior superior impingement?
lnfraspinatus (and posterior fibers of the supraspinatus).
28
SLAP acronym
"superior labral tear from anterior to posterior"
29
SLAP under 40yo
bankart lesion
30
SLAP over 40yo
rotator cuff tear
31
Spectrum of Bankart Lesions (least to most severe)
GLAD --> Perthes --> ALPSA --> True Bankart
32
definition: GLAD lesion
Glenolabral Articular Disruption. No instability (aren't you GLAD there is no instability)
33
definition: Perthes
Detachment of the anteroir lnferior labrum (3-6 o'clock) with medially stripped but intact periosteum.
34
definition: ALPSA
Anterior Labral Periosteal Sleeve Avulsion. Medially displaced labroligamentous complex with absence of the labrum on the glenoid rim.
35
HAGL
humeral avulsion (of the inferior) glenohumeral ligament
36
spinoglenoid notch
infraspinatus atrophy
37
suprascapular notch
supraspinatus
38
quadrilateral space syndrome
axillary nerve - atrophy of teres minor
39
what if you see atrophy of muscles in 2+ nerve distributions?
parsonage-turner - idiopathic involvement of the brachial plexus
40
other injury commonly associated with subscapularis tear?
medial dislocation of the long head of the biceps tendon
41
"double PCL" can only occur in the setting of an intact...
ACL - bucket handle tear of usually the medial meniscus
42
meniscal ossicle
focal ossification of the posterior horn or the lateral meniscus,
43
O'Donoghue's Unhappy Triad:
ACL Tear, MCL Tear, Medial Meniscal
44
When I say "kissing contusion", you say
ACL tear
45
What's the Master Knot of Henry?
It's a "Harry Dick" (where Dick (FDL) crosses Harry (FHL) at the medial ankle)
46
I Say PTT (posterior tibial tendon) is out, You Say
Spring Ligament is Thickened, and Hindfoot Valgus
47
MRI finding in sinus tarsi syndrome
MRI finding is obliteration of fat in the sinus tarsi space and replacement with scar.
48
Tarsal Tunnel Syndrome:
Pain in the distribution of the tibial nerve (first 3 toes), from compression as it passes through the tarsal tunnel (behind the medial malleolus).
49
how do you maintain the ability to plantar flex in the setting of Achilles tendon rupture?
if your plantaris muscle is intact
50
plantar fasciitis is worse at what time of day?
morning
51
definition: sequestrum
a segment of necrotic bone that is separated from living bone by granulation tissue
52
definition: involucrum
a layer of living bone that has formed about dead bone; it can become perforated by tracts
53
definition: cloaca
An opening in the involucrum
54
osteomyelitis <1 month
multicentric involvement with joint involvement (bone scan often neg)
55
osteomyelitis <18 month
spread to epiphysis through blood
56
osteomyelitis 2-16 years
transphyseal vessels are closed (primary focus is metaphysis)
57
what primary bone tumor can cause occult pneumothorax
osteosarcoma met to the lung
58
most common primary malignancy of the sacrum?
chordoma
59
when involving the spine (instead of the sacrum), chordoma is most common at what level?
C2 (and very T2 bright!)
60
treatment for osteosarcoma
Chemo tirst (to kill micro mcts) , followed by wide excision
61
treatment for Ewings
Both Chemo and Radiation, followed by wide excision.
62
treatment for chondrosarcoma
usually just wide excision
63
treatment for giant cell tumor
Because it extends to the articular surface usually requires arthroplasty.
64
classic location of cortical desmoid
radiolucent cortical irregularity involving posteromedial aspect of the distal femoral metaphysis at the attachment of the adductor magnus tendon
65
epiphyseal equivalents you should remember
carpals, patella, greater trochanter, calcaneous - epiphyseal lesions can happen here too
66
Shepard Crook deformity
fibrous dysplasia in the femur
67
Mazabraud = polyostotic fibrous dysplasia + what other soft tissue finding
soft tissue myxomas - also increased risk of osseous malignant transformation
68
McCune Albright
polyostotic fibrous dysplasia + girl + cafe au lait + precocious puberty
69
3 classic appearances of EG
1. vertebra plana in a kid 2. skull with lucent "beveled edge" lesions 3. "floating tooth" with lytic lesion in alveolar ridge
70
what age gets EG?
less than 30
71
class ddx for vertebra plana (MELT)
mets/myeloma, EG, lymphoma, trauma/tb
72
most common age for giant cell tumor?
20-30 (physis must be closed)
73
Jaffe-Campanacci Syndrome:
Syndrome of multiple NOFs, cafe-au-lait spots, mental retardation, hypogonadism, and cardiac malformations.
74
'Pain at night, relieved by aspirin. "
osteoid osteoma
75
osteoblastoma vs. osteoid osteoma
osteoblastoma = osteoid osteoma > 2cm, patients <30yo, posterior elements
76
3 classic blastic mets
prostate, carcinoid, medulloblastoma
77
2 classic lytic mets
renal and thyroid
78
uncommon/classic presentation of MM
diffuse osteopenia
79
classic ddx for lucent lesion in posterior elements (3)
osteoblastoma, ABC, TB
80
age for ABC
<30 yo
81
age for chondroblastoma
kids 2-25
82
3 classic lesions of the intertrochanteric region
lipoma, solitary bone cyts, monostotic fibrous dysplasia
83
classic location of liposclerosing myxofibroma
intertrochanteric region of the femur (geographic lytic lesion w/sclerotic margin)
84
what's the other name for osteochondroma?
exostosis
85
what's another name for Trevor disease?
(Dysplasia Epiphysealis Hemimelica - DEH): osteochondromas in the ankle/knee epiphyses with joint deformity in young kids
86
which way does avian spur point?
toward the joint (exostosis is away)
87
when I say avian spur, you say
ligament of struthers (smashes the median nerve if symptomatic)
88
when is tibial bowing normal?
18 months - 2 years
89
When I say Ankylosis in the Hand, You Say
Erosive OA or Psoriatic
90
Reiter's is rare in the
hands (Just remember Reiters below the waist.)
91
ARRS Hooray!
Gout mimickers: Amyloid, RA, Reticular histiocytosis, Sarcoid, Hyperlipidemia
92
2 things that give you hooked MCP osteophytes
Hemochromatosis or CPPD (with chondrocalcinosis in the TFCC)
93
milwaukee shoulder
almost-neuropathic looking shoulder 2/2 hydroxyapatite
94
5 Classic ways of showing hyperparathyroidism (renal osteodystrophy)
1. rib notching 2. resorption along radial aspect of fingers AND brown tumors 3. tuft resorption 4. rugger jersey spine 5. pelvis with "constricting" femoral necks + wide SI joints
95
cervical spine fusion (2)
Congenital (Klippel-Feil) or JIA
96
erosion of the dens (2)
CPPD or RA
97
bad kyphosis of the c-spine
NF1
98
big bridging lateral osteophytes (spine)
psoriatic arthritis
99
"flowing syndesmophytes"
ank spond
100
reversible ulnar deviation without erosions
SLE
101
non-erosive ulnar deviation s/p rheumatic fever
Jacoud's arthropathy
102
ossification of the ALL with sparing of disc spaces
DISH (T-spine most common)
103
yellow marrow increases with
age
104
normal pattern of bone marrow conversion
The epiphyses convert to fatty marrow almost immediately after ossification. Distal then proceeds medial (diaphysis first, then metaphysis).
105
normal pattern of bone marrow reconversion?
reverse order of normal marrow conversion, beginning in the axial skeleton and heading peripheral.
106
What areas are spared/normal variants in bone marrow conversion?
proximal femoral metaphysis of teenagers.The distal femoral sparing is especially true in teenagers and menstruating women.
107
what does bone marrow look like in leukemia?
darker than muscle (and normal discs) on T1
108
most frequent tendon involved in hydroxyapatite deposition?
supraspinatus (near the greater tuberosity); also like to test longus coli
109
transmission method of osteopoikilosis
AD
110
Engelmann's disease
progressive diaphyseal dysplasia - fusiform bony enlargement with sclerosis of the long bones (starts in kids)
111
"widening of the joint space in an adult hip"
Pituitary Gigantism
112
most common complication of Paget's
deafness
113
abnormal lab in mixed phase of Paget's
elevated alkaline phosphate
114
abnormal lab in sclerotic phase of Paget's
elevated hydroxyproline

CORE MSK (2 decks)

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