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Notes Flashcards

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1
Q

Congenital/dysplasia atlantoaxial instability (5)

A 
Occipitalization
Odontoid agenesis
Os odontoideum
Down's
Marfan's
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2
Q

Trauma atlantoaxial instability (2)

A

Type 2 dens fx

Transverse ligament rupture

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3
Q

Arthritis causing atlantoaxial instability (6)

A 
RA
AS
PSA
Reiter's
SLE
Gout
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4
Q

Infection causing atlantoaxial instability

A

Osteomyelitis

Postpharyngeal infection

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5
Q

Air is ___ on an xray

A

Black

Fat = dark gray

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6
Q

Epiphyseal tumors (3)

A

GCT
ABC
Chondroblastoma

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7
Q

Dipahyseal tumors (3)

A

Ewings
Nonhodgkins lymphoma
MM

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8
Q

Meatphyseal tumors

A

Everything else besides GCT/ABC/chondroblastoma (epiphyseal); ewings/nhl/MM (diaphyseal)

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9
Q

Age group of GCT

A

20-40

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10
Q

Prepubertal

A

ABC

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11
Q

Age group of ewings

A

10-25

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12
Q

Cortex

A

Osteoosteoma

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13
Q

MC arthritis of wrist

A

OA
RA
CPPD

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14
Q

Congenital anomalies rule 1

A 
Congenital anomalies in the spine occur MC at transitional areas.
Occipital cervical (occipitalization)
Cervical thoracic (extra rib)
Thoraco lumbar (diastometayelia)
Lumbosacral
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15
Q

Congenital anomalies 2

A

Skeletal/spinal anomalies may be isolated entities but are frequentaly associated with other skeletal/spinal anomalies
Therefore look for other osseous abnormalities on the radiograph

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16
Q

Congenital anomalies rule 3

A 
VATER SYNDROME = 
Vertebral.vascular anomalies
Anal atresia
Tracheo-esophageal fistual
Esophageal atresia
Renal and radial dysplasia
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17
Q

Dark CSF

A

T1

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18
Q

Only reason you’ll have a C2 megaspinous

A

Posterior arch at C1

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19
Q

Anterior arch sclerosis

A

Spina bifida
Os odontoideum
Posterior arch agenesis

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20
Q

Arcuate foramen

A

Posterior ponticle (15% of population)

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21
Q

Unfused secondary growth center after age 12

A

Os terminale

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22
Q

Limbus bones often occur with

A

Large schmorles nodes

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23
Q

Congenital blocks MC at

A

C2-3 and C5-6

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24
Q

Wasp waist
Vestigial disc
Posterior elements

A

Congenital block

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25
Multiple congenital blocks
Klippel file
26
Signs of klippel file (5)
``` Low hairline Short neck Decreased aROM (d/t block vertebrae) GU anomalies (kidney malformation: horseshoe) thus do IVP Occipitalization ```
27
Types of spondy
1. Congenital 2. Isthumus (MC L5) - stress, elongated pars, acute trauma 3. Degenerative 4. Traumatic (Bi pedicle fx) C2 MC (hangman) 5. Pathological 6. Iatrogenic
28
2 MC types of spondy
2 and 3 | Isthumus and degenerative
29
Spondylolysis
Pars interarticularis defect with or without slippage (spondylolisthesis)
30
90% of all spondies involve what segment
L5
31
13x increased incidence of what with spondy spondy
SBO Asymmetric facets. Only 2-3% patients with spondy over 25 show progressive dipalcement
32
Clinical features of spondylolisthesis
Pain maybe Pain is usually present at onset of lysis of pars interarticularis Hyperlordosis and gait changes may be seen Only neuro sign = referred pain to lower extremity Palpable "step-off" defect
33
Management for spondylolisthesis (for type 2-3)
Conservative care initially Asymptomatic - no contraindications for sport etc Spondy spondy at fresh stress fx stage may be treated with boston overlap brace (antilordotic)
34
Progression of spondy between
5-15 years of age
35
Spondy's mc in what gender
2x mc with females
36
Displaced risk increased with associated what
SBO
37
Trapezoidal shaped L5 and dome shaped SI may lead to
Increased slippage
38
SI may what anteriorly to stabilize L5?
Buttress
39
Dysplastic/congenital features
L5 facets/posterior arch/upper sacral malformation | Often accompanying SBO
40
Type 2 mc at what level
L5 Young active individuals (extension activities) 3 subtypes. C = rare; b = giraffe neck
41
Etiology of isthmic
``` Repetitive microtrauma Acute fx Not recorded in infants Congenitally slender pars = predisposes Hyperlordosis. Nonunion d/t lack of immobilization (not diagnosed fast enough) ```
42
Inverted napoleon's hat sign or bowline of brailsford
Seen with significant anterolisthesis (seen in type 3 and above)
43
Napoleon's hat sign
spondy | Achondroplasia
44
This is recommended for patients exhibiting clinical signs of a stress fx but have negative plain films
SPECT bone scan
45
Imaging if pain at 6months and follwed by what
X ray | CT (spect
46
What imaging if trauma?
CT. | Can find out if new or old. Assessing spinal canal. Healing
47
George's line
Posterior body line Or draw ulman's line To determine spondy and grading
48
6 distal radius fx's
``` Colles Smiths Bartons Chauffers Torus Slipped radial epiphysis ```
49
2 distal ulna fx's
Ulnar styloid | Nightstick
50
Fischer's fx
Triquetrum
51
8 hand fx's
``` Boxer's/barroom Metacarpal shaft Metacarpal base Bennet's (thumb) Rolando's (thumb) Transverse (thumb) Gamekeeprs' (thumb) Phalangeal ```
52
Duck head
Colle's fx | Look at angle of articular surface
53
Pie sign
Lunate dislocation
54
MC spinal levels for fx
C1-2 C5-7 T12-L2
55
Measurements of spine
``` ADI ST retropharyngeal/tracheal Anterior body line Posterior body line (george's line) Spinolaminar jx line Spinous processes ```
56
ADI for adults and children
3 mm | 5 mm )children
57
St retropharyngeal
10 mm C1 6 mm at C2 22 mm at c6
58
Offset greater than 7 mm indicates what in jefferson fx
Transverse ligament rupture
59
Posterior arch fracture
Refer
60
MC least stable dens fx
Type 2
61
Tumors of diaphysis
Ewings, lymphoma, mm
62
Metaphyseal tumors
Everything but ewings, lymphoma and mm; gct, chondroblastoma and abc
63
Epiphyseal tumors
Gct (starts in metaphysis but crosses after growth plate closes thus look at 20-40 years of age) Chondroblastoma Abc (only benign tumor that can growh into growth plate at young age)
64
Most grow in ___ part of bone. Why?
Metaphyseal/ d/t metabolic activity
65
These 2 tumors are eccentric
Osteosarcoma and GCT
66
Most malignancies are MC in vertebral body or neural arch?
Vertebral body b/c more vascular
67
MC in spine
Chordoma
68
MC benign in spine
Hemangioma
69
Sclerosis of osteoid osteoma is d/t
Nidus
70
3 patterns of lesions
Moth eaten Geographic Permeative
71
Vertebral neoplasms: body (7)
``` Mets Mm Lymphoma Chordoma Ewings Osteosarcoma Hemangioima ```
72
Vertebral neoplasm: posterior elements(4)
Expansile lytic: ABC, osteoblastoma, GCT | Sclerotic: osteoid osteoma
73
3 common malignant spinal neoplasms
Mets (lytic, blastic, mets) Mm Lymphoma
74
Less common malignant spinal neoplasms (5)
``` Ewings Osteosarcoma Chordoma Chondrosarcoma GCT (quasi) ```
75
3 aggressive lesions: children
Osteosarcoma Ewings Infection
76
4 aggressive lesions: 20-40
Lymphoma Gct Chondrosarcoma Infection
77
3 aggressive lesions: 40-70 years
Mets Mm Infection
78
IHOP
Hodgkins lymphoma (atnerior body scalloping) Osteoblastic mets Pagets
79
Osteoblastic mets common sites
``` Male = prostate Female = breast (although mets = lytic. Rare to have blastic mets) ```
80
WINKING OWL SIGN
Missing pedicle. Opposite pedicle doesn't look sclerotic which would indicate it's been there long. Ifi both pedicles are gone = blind owl
81
MC reason for bony stenosis of IVF
Uncovertebral DJD Super common finding Vip to pick out so don't call fx
82
How much translation is too much in cervical and lumbar spine for instability?
C2 down = 3.5mm in cx; 4mm in lx
83
5 cx'al lines in spinous spaces
``` Spinolaminar jx Georges Anterior body line Ullman's line ... ```
84
MR T1 color; MRI T2
T1 black CSF | T2 white CSF
85
Shepards crook
Pagets
86
Sabers shin
Pagets
87
Tuft resorption. Ddx
Scleroderma Sle Psoriatic Hpt
88
Small lyticnlesions all same size
Mm
89
Ddx for cortical disruption, lytic masses, moth eaten, periosteal response
Ewings Infx Osteosarcoma If infx on ddx mustrefer to ER
90
TERRY thomas sign
Gap tooth...scapholunate dissociation
91
3 consecutive levels Irregular end plates Body wedging
Schermmans
92
The triangle ilia thing
Oci. Mc in females of weight bearing age. | Know female if paraglenoid sulcus
93
Aa greater than what is no good
3.5 cm
94
Transitional tp
Lumarization
95
Dagger sign | Trolley tracks
As
96
Butterfly vertebra often hand in hand with what
Sbo
97
Thoracic ribs go what direction
Up. Cxal ribs go down
98
Pes excavatum associated with
Marfans
99
4 ankle ossicles
Os trigonum, os peroneum, os tibial externum, os supranaviculare. Msk, u/s mri would show st swelling if symptomatic or bone edema
100
Ant limbus bone in cxal
Teardrop. Unstable!
101
Risers sign
Young pt. Ilia growth plates unfused
102
3+ levels of schmorls nodes and nuclear impression
Schermanns. Ask about trauma as a kid
103
Mc plac for tarsal coalition
Calcaneus and navicular
104
Puttis triad
Slanted roof Displacd femur Absent epiphysis
105
Rhomboid fossa
Inferior part of clavicle
106
Supracondylar processes point which way
Towardsj joint. Osteochondroma go away
107
Serbs anomaly
1st and 2nd rib synostosis
108
Management of hyperflexion injury
Neurosurgical consult.
109
What must we rule out with pancake plana?
Mets and MM
110
What are signs of new compression fx
Step defect and zone of condensation
111
Duck poop sign
Triquetrium fx
112
Spotty carpal sign
``` GSRAT Gout Pseudoexatrophy (CRPS) RA TB ```
113
Opposite sided fractures in pelvis; same side
Bucket | Malgaine
114
Obturator internus fat pad
Acetabular head fx | Broken kohler's teardrop
115
Mc type of patellar fx
Horizontal
116
Klein's line
Femur | Surgery

Bone Path 4 (3 decks)

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