Revise Radiology MSK Flashcards by Sami Al-Balasmeh

T1 dark line in vertebral body with normal signal elsewhere

Osteoporotic compression fracture

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Sequestrum

Piece of necrotic bone surrounded by granulation tissue.
Sign of active osteomyelitis

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Thickening of flexor tendon sheath with locking sensation

Trigger finger

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Associated with aneurysmal bone cyst

Chondroblastoma,
Osteoblastoma,
Giant cell tumour,
Fibroxanthoma,

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Smoldering infection in hands without periosteal reaction in children

Tuberculous dactylitis

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Achondroplasia spinal appearances

Posterior vertebral scalloping,
Gibbus deformity,
short pedicle canal stenosis
Decreasing interpedicular distance
Widening of intervertebral discs

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Chronic kidney disease causes (endocrine)

Hyperparathyroidism

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Tibial stress fracture risk of malunion

Anterior = high risk
Posteriomedial = low risk

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Wrist deformities and relevant angles

Normal SL = 30-60. Normal CL < 30
SLAC: SL > 60, CL < 30
DISI: SL > 60, CL > 30
VISI: SL <30, CL >30

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Pedunculated bone tumour arising from metaphysis of long bones with cartilaginous cap

Osteochondroma

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Marrow darker than muscle on T1, Lucent metaphyseal bands on X-ray, child

Leukaemia

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Lodwick classification of lytic lesions

1a: geographic with thin, sclerotic margin
1b: well defined border without sclerosis
1c: ill defined border
2: moth eaten
3: permeative

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DIP and PIP joint involvement with central erosions

Erosive osteoarthritis

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Bulky mass, posterior distal femoral metaphysis, string sign

Parosteal osteosarcoma

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Parosteal vs periosteal sarcoma

Metaphysis vs diaphysis
50% vs no marrow extension
Outer vs inner layer of periosteum

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Maffucci vs Ollier

Ollier: multiple enchondromas, slight increase in chondrosarcoma risk
Maffucci: multiple enchondromas, haemangiomas, higher sarcoma risk

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Normal atlanto-occipital distance

<5mm

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elastofibroma dorsi

Benign soft tissue lesion, usually infrascapular. Can show PET uptake. Similar density to muscle with fat component

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Well defined lucent lesion in proximal humerus with intact trabeculae

Pseudocyst of humerus. Get CT

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Well defined lytic lesion with non-sclerotic margin

Giant cell tumour

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Spotty osteoporosis following recent ORIF

RSD

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Geographic lytic lesion with sclerotic margin in intertrochanteric NOF

Liposclerosing myxofibroma (10% risk of malignant degeneration)

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Osteochondromas pointing towards the joint, originating from the epiphysis

Trevor disease

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Scaphoid fracture mechanism of injury

Hyperextension

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Fibrous lesion between planter portions of metatarsal heads

Morton's neuroma

Eccentric lytic lesion in knee with thin sclerotic border

Fibrous cortical defect (<3cm) Non-ossifying fibroma (>3cm)

Linear or triangular T1/T2 bright structure projecting from centre of posterior vertebral bodies

Basivertebral veins

Anserine bursa of the knee

Consists of Sartorius, Gracilis and Semitendinosus tendons, can become inflamed leading to pes anserine bursitis, characterised by medial knee pain

Chronic wrist pain, positive ulnar variance, cystic changes in lunate bone

Ulnar impaction syndrome

Multiple loose bodies with varying calcification in the knee with joint effusion

Synovial chondromatosis

Most common pulley injury in competitive sports

Types of SLAP tear

Type 1: Superior labrum frayed but still attached Type 2: Superior labrum and biceps anchor detached from glenoid rim Type 3: bucket handle tear Type 4: Bucket handle tear extending into biceps tendon

Anterior tibial lesion in child with anterior tibial bowing

Osseofibrous dysplasia

Mild fever, chronic pain, well defined lytic lesion with sclerotic rim

Brodie's abscess

Infant, symmetrical metaphyseal fractures with diaphyseal diffuse periosteal reaction

Congenital syphilis

Bilateral periostitis of distal long bones

Hypertrophic osteoarthropathy

Vertebral body squaring with Romanus lesions

Seen in early ank spond

Klippel-Feil syndrome associated with

Unilateral renal agenesis

Epidural collection along the ALL

TB spondylitis (Pott's disease)

Primary hyperparathyroidism features

Subperiosteal resorption of bone

Osteopenia with reduced joint space and cartilage calcification in hands

Haemochromotosis

Commonest soft tissue injury associated with avulsion of medial proximal tibia

MCL tear

DDH causes increased risk of

Labral tears

Retro-achilles bursitis, thickening of achilles tendon, calcaneal bony prominence

Mullholland deformity/Haglund's disease

Avulsion fracture at base of proximal first phalanx with UCL disruption

Gamekeeper's thumb

Longitudinal temporal bone fractures

Associated with inco-stapedal joint dislocation

Hypoechoic swelling of the median nerve with increased cross sectional area

Carpal tunnel syndrome

Best sequence to assess Triangular fibrocartilage complex tear

T2 coronal

washed out hand with proximal distribution, premature fusion of growth plates

Juvenile idiopathic arthritis

Double density sign on bone scintigraphy

Osteoid osteoma

Gorlin Goltz associated with

Increased risk of medulloblastomas

Best modality to assess pathological fractures

Femoral fracture with long periosteal reaction and underlying pagets

Atypical fracture, due to bisphosphonate

Fragment near the medial process of calcaneal tuberosity, often associated with plantar spur

Plantar Fascia rupture

Kaposi sarcoma (MRI)

Intermediate T2, high T2 signal in lower extremeties with variable gadolinium enhancement

Melorhheostosis management

Conservative

AVN grading

Ficat and Arlet classification: Grade 2: Osteopenia, sclerosis and cysts with no crescent sign. Grade 3: crescent sign

Hill sachs vs bankart

Hill sacs are more common and affect posteriosuperior humeral head Bankart affects anterior inferior glenoid

Syrinx associated with

Neuropathic arthropathy

Most sensitive test for HOA

MRI

Marfans vs homocysteinuria

Upward vs downward lens dislocation

Subligamentous collection along the anterior spine

Lesion arising from muscle causing cortical bone erosion

Malignant Fibrous Histiocytoma

Talocalcaneal coalition associated with

Pes planus

Fibrous dysplasia PET

hot

Long fibula associated with

Achondroplasia

Erosive arthritis

Central erosions, gullwing appearance

incomplete femoral neck fractures associated with

Pagets

Loss of lamina dura

Scleroderma

Bennett vs Rolando

Both fractures through base of thumb metacarpal. Rolando is comminuted

Heterogenous lesion in distal diaphysis with sclerotic margins

Medullary infarct

High T2 loose bodies in the knee

Primary synovial chondromatosis

Fever, irritability, coarse & irregular periosteal reaction with soft tissue swelling

Caffey disease - Infantile cortical hyperostosis

FAST scan can reliably detect how much free fluid

>200ml

ECU tendon moved from original position

Tendon sheath synovitis

Best position for supraspinatus imaging

ADduction and Internal rotation (back pocket)

Best position for biceps tendon visualisation

Arm ADducted, internally rotated (slight) and palm facing up

Subscapularis best position

Arm ABducted, externally rotated

Infraspinatus best position

Arm flexed, placed across chest

Bilateral cortical thickening and sclerosis, with patchy marrow changes

Erdheim Chester disease

Geographic bone destruction with wide zone of transition, fluid levels and aneurysmal dilatation

Telangiectatic osteosarcoma

Ix to further investigate wrist fractures/dislocations

Jefferson fracture

Fracture of the ring of the atlas due to axial loading

VACTERL spinal anomalies

Spina bifida occulta

Complex presacral mass in baby

Sacrococcygeal teratoma

diffuse osteosclerosis with splenomegaly

Myelofibrosis

Flexion teardrop fractures associated with

Anterior cervical cord syndrome

Expansile, lytic lesion with sclerotic rim in metaphysis, with internal septations and calcifications

Chondromyxoid fibroma

Phemister Triad

Peri-articular osteoporosis peripherally located osseous erosion, gradual joint space narrowing Suggests TB arthropathy

Thin sclerotic rim, extension across physeal plate, occurs in epiphyses or equivalents

Chondroblastoma

Large, lobular or cystic calcium deposits near joints

Tumoural calcinosis

Communication between ankle joint and common peroneal tendon sheath

Calcaneofibular ligament rupture

Posterior superior shoulder impingement

Involves infraspinatus and posterior fibres of supraspinatus. Seen in throwers

Causes of sclerotic bone mets

Prostate, breast, lung

Revise Radiology MSK Flashcards

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