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(3) Musculoskeletal Imaging > S2_L3 Trauma at the Knee > Flashcards

S2_L3 Trauma at the Knee Flashcards

1
Q

The following are etiologies of genu valgum, except
A. Familial
B. Hip or foot position
C. Trauma to the physeal plate
D. Fractures
E. Neurologic deficits
F. Idiopathic
G. None of the above

A

G. None of the above

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2
Q

The following are etiologies of genu recurvatum, except
A. Familial
B. Idiopathic
C. Neurological deficits
D. Muscular deficits
E. None of the above

A

E. None of the above

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3
Q

The following are etiologies of genu varum, except
A. Renal or dietary rickets
B. Epiphyseal injury
C. Osteogenesis imperfecta
D. Lateral tibial osteochondritis
E. Blount’s disease
F. None of the above

A

D. Lateral tibial osteochondritis

NOTE: Blount’s disease is also known as medial tibial osteochondritis

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4
Q

The following are complications of fractures of the distal femur, except
A. Malunion (rotated or shortened)
B. Joint and soft tissue adhesions
C. Post-traumatic arthritis
D. None

A

D. None

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5
Q

The following are complications of patellar fractures, except
A. Post-traumatic arthritis
B. Chronic loss of knee extension strength with excision of patella due to a decreased moment arm of the patella
C. Malunion
D. None

A

C. Malunion

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6
Q

Schatzker Classification of Tibial Plateau Fractures:

  1. Split and depression of the fracture fragment
  2. Bicondylar fracture

A. Type I
B. Type II
C. Type III
D. Type IV
E. Type V
F. Type VI

A
  1. B
  2. E
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7
Q

Schatzker Classification of Tibial Plateau Fractures:

  1. Split fracture fragment
  2. Dissociation of metaphysis and diaphysis

A. Type I
B. Type II
C. Type III
D. Type IV
E. Type V
F. Type VI

A
  1. A
  2. F
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8
Q

Schatzker Classification of Tibial Plateau Fractures:

  1. Split fracture, involving the medial plateau
  2. Central depression fracture

A. Type I
B. Type II
C. Type III
D. Type IV
E. Type V
F. Type VI

A
  1. D
  2. C
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9
Q

Modified TF
A. Type I to III in the Schatzker Classification of Tibial Plateau Fractures are due to low energy or velocity trauma.
B. Type IV to VI are a result of high energy trauma.

A

TT

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10
Q

Modified TF
A. Genu varum is a physiologic bowing that is symmetrical and will be outgrown as the child ages.
B. Genu varum is also known as knocked knees.

A

TF

B. Genu varum is also known as bow legged.

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11
Q

Modified TF
A. AP radiographs of the entire LE (Scanogram) are used to assess genu recurvatum and genu valgum.
B. Lateral radiographs demonstrate the deformity in genu varum.

A

FF

A. AP radiographs of the entire LE (Scanogram) are used to assess genu varum and genu valgum.
B. Lateral radiographs demonstrate the deformity in genu recurvatum.

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12
Q

Modified TF
A. PCL injury is caused by a valgus force with rotary stress.
B. ACL injury is caused by dashboard Injuries.

A

FF

A. PCL injury is caused by dashboard Injuries.
B. ACL injury is caused by a valgus force with rotary stress.

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13
Q

The following are radiologic findings in knee osteoarthritis, except
A. Decreased knee joint space
B. Sclerosis of subchondral bone
C. Marginal osteophytes
D. Subchondral bone cysts
E. Varus or valgus deformity
F. None

A

F. None

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14
Q

True of the treatment procedures for genu recurvatum, except
A. Conservative treament is usually done
B. Bracing
C. Exercise is used to restore alignment and muscular balance
D. None of the above

A

D. None of the above

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15
Q

Modified TF
A. Knee dislocation causes injury to the cruciate ligaments of the knee.
B. Knee dislocation ruptures at least 3 of the 4 major ligaments (ACL, PCL, LCL, and MCL).

A

TT

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16
Q

TRUE OR FALSE: In the evaluation of collateral ligament injuries, radiographs show excessive narrowing of the joint space on valgus or varus stress views.

A

False

Correct answer: In the evaluation of collateral ligament injuries, radiographs show excessive widening of the joint space on valgus or varus stress views.

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17
Q

TRUE OR FALSE: The bucket-handle meniscal tear automatically warrants a surgical intervention.

A

True

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18
Q

Modified TF
A. MRI is the study of choice for evaluating collateral ligament injuries.
B. The discontinuity of the low signal intensity ligament is seen on the sagittal image.

A

TF

B. The discontinuity of the low signal intensity ligament is seen on the coronal image.

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19
Q

Modified TF
A. Injury to the Lateral Collateral Ligament is due to a valgus force.
B. Injury to the Medial Collateral Ligament is caused by a varus force.

A

FF

A. Injury to the Lateral Collateral Ligament is due to a varus force.
B. Injury to the Medial Collateral Ligament is caused by a valgus force.

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20
Q

Modified TF
A. The MCL is more commonly involved in knee injuries as compared to the LCL.
B. The MCL is associated with tears of capsule and medial meniscus as part of O’ Donoghue’s Terrible (or Unhappy) Triad.

A

TT

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21
Q

Modified TF: Meniscal tears
A. The lateral meniscus is more frequently injured due to more peripheral attachments and decreased mobility.
B. The medial meniscus is more frequently involved if a developmental abnormality (discoid meniscus) is evident.

A

FF

A. The medial meniscus is more frequently injured due to more peripheral attachments and decreased mobility.
B. The lateral meniscus is more frequently involved if a developmental abnormality (discoid meniscus) is evident.

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22
Q

Modified TF
A. Meniscal tears are caused by shear, rotatory, and compression forces.
B. The CT Scan is the standard modality for evaluating the meniscus.

A

TF

B. The MRI is the standard modality for evaluating the meniscus.

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23
Q

Modified TF
A. Patellar fractures are evaluated using tangential, lateral, and oblique views.
B. Patellar fractures are classified based on direction and displacement of the fragment.

A

TT

24
Q

Modified TF
A. The mechanism of injury of patellar fractures include falls or a dashboard impaction injury.
B. Avulsion fractures, specifically due to the forceful contraction of the quadriceps, may also lead to this fracture.

A

TT

25
Q

Modified TF
A. The mechanism of injury of patellofemoral subluxation is a direct blow to an extended knee.
B. A powerful quadriceps contraction with a rotatory or a valgus force (cutting movements) may also result in this injury.

A

FT

A. The mechanism of injury of patellofemoral subluxation is a direct blow to a flexed knee.

26
Q

TRUE OR FALSE: The medial and lateral tibial plateaus are most frequently involved in fractures of the proximal tibia.

A

True

27
Q

TRUE OR FALSE: The most frequent type of patellar fractures is the transverse linear fracture.

A

True

28
Q

Modified TF
A. The coronal MRI best demonstrates cruciate ligaments at the level of the intercondylar notch.
B. Radiographs can also evaluate possible avulsion fractures at the ACL attachments.

A

FT

A. The sagittal MRI best demonstrates cruciate ligaments at the level of the intercondylar notch.

29
Q

Identify the three structures in O’ Donoghue’s Terrible (or unhappy) Triad

A
  1. Anterior cruciate ligament
  2. Medial meniscus
  3. Medial collateral ligament
30
Q

TRUE OR FALSE: The Pellegrini-Stieda Lesion is characterized by a chronic lateral collateral ligament tear with calcification.

A

False

Correct answer: The Pellegrini-Stieda Lesion is characterized by a chronic medial collateral ligament tear with calcification.

31
Q

Modified TF
A. Ambulation with an assistive device can be achieved by 6 weeks after a distal femoral fracture.
B. Normal activity is possible by 3-4 months, provided that the fracture is not severely communited.

A

FT

A. Ambulation with an assistive device can be achieved by 4 weeks after a distal femoral fracture.

32
Q

Modified TF
A. MVA comprises majority of the causes for fractures of the distal femur.
B. Other causes include falls from a height and minor falls or low level forces if the individual is osteoporotic.

A

TT

33
Q

Modified TF
A. Rehabilitation for distal femoral fractures includes early ROM, then ambulation with PWB progresses when the radiographic union is evident.
B. A sign of healing is callus formation or obliteration of the fracture line in 1 of the 4 cortices seen in a view.

A

TF

B. A sign of healing is callus formation or obliteration of the fracture line in 2 of the 4 cortices seen in a view.

34
Q

Modified TF: Cruciate ligament injury
A. Conservative management is preferred for sedentary or elderly patients and surgical intervention is indicated for athletes.
B. Conservative treatment involves controlled motion bracing and strengthening exercises.

A

TT

35
Q

Modified TF
A. Surgical treatment for cruciate ligament injuries include direct primary repair and reconstruction using tendon grafts.
B. After reconstruction, return to normal activity is possible in 6-8 months.

A

TF

B. After reconstruction, return to normal activity is possible in 4-6 months.

36
Q

Modified TF
A. Genu valgum is also known as bow legged.
B. Genu valgum is observable with the knees in contact & ankles spaced widely.

A

FT

A. Genu valgum is also known as knocked knees.

It becomes most obvious when child begins to walk

37
Q

True about the treatment for patellar fractures, except
A. Non-operative treatment involves a long leg cast for 4-6 weeks
B. Cast will then be replaced by a hinged knee brace
C. Non-operative treatment is for non-displaced or minimally displaced fractures
D. None

A

D. None

38
Q

True about the treatment for patellar fractures, except
A. Operative treatment is for significant displacement, articular incongruity, or open fractures
B. Patellectomy is done for comminuted fractures
C. Excision is for severe comminution
D. Tension band wiring and cancellous screws are also done
E. None

A

E. None

39
Q

TRUE OR FALSE: Conservative treatment for collateral ligament injury involves controlled motion bracing and rehabilitation.

A

True

40
Q

True about the non-operative treatment for osteoarthritis, except
A. Lubricating compounds (Hyaluronic acid)
B. NSAIDs
C. Bracing, ambulatory devices
D. Strengthening
E. Total knee replacement and unicompartmental knee replacement
F. None

A

E. Total knee replacement and unicompartmental knee replacement

41
Q

True about the treatment for genu valgum, except
A. Address strength and flexibility deficits
B. Surgical treatment is for severe cases to restore joint articulation
C. Conservative treatment involves orthotic correction of supinated foot
D. None

A

C. Conservative treatment involves orthotic correction of supinated foot

Correct answer: C. Conservative treatment involves orthotic correction of pronated foot

42
Q

TRUE OR FALSE: The Kissing Contusion or Lateral Femoral Notch Sign is an indirect sign of an ACL tear on MRI.

A

True

43
Q

TRUE OR FALSE: Treatment for proximal tibial fractures depend on the amount of tibial depression, comminution and joint stability.

A

True

44
Q

TRUE OR FALSE: The most common radiographs performed for trauma are X-rays.

A

True

45
Q

True about the radiologic evaluation for patellofemoral subluxation, except
A. Evaluation involves multiple tangential and lateral views at varying angles
B. Weight-bearing AP and oblique views are also done
C. CT & MRI are used to assess joint congruity
D. None

A

D. None

46
Q

TRUE OR FALSE: The MOI for proximal tibial fracture is a car-pedestrian accident (the bumper hits knee) and the twisting of knee in elderly osteoporotic individuals.

A

True

car-pedestrian accident (the bumper hits knee) is the most common

47
Q

The ff. scenarios warrant radiographs to be done, except:
A. Twisting injury, able to walk, and no effusion is present
B. Inability to flex the knee to 90º
C. Palpable tenderness over the patella or fibular head
D. Inability to walk without limping
E. Joint effusion after a direct blow or fall

A

A. Twisting injury, able to walk, and no effusion is present

48
Q

TRUE OR FALSE: To evaluate for distal femoral fractures, AP and lateral projections can be done and a CT scan can evaluate the depth and extent of fracture lines.

A

True

49
Q

Surgical reduction with internal fixation for distal femoral fractures are done in the ff. scenarios, except:
A. Open Fractures
B. Fracture with associated neurovascular compromise
C. Pathologic fractures
D. Marked Obesity
E. Ipsilateral leg fractures
F. None

A

F. None

50
Q

Modified TF
A. Surgical treatment for meniscal tears includes partial meniscectomy and the repair of the meniscus for peripheral tears. B. Partial meniscectomy is often the preferred intervention of the two.

A

TT

51
Q

TRUE OR FALSE: The non-operative treatment for distal femoral fractures is skeletal traction then casting for 3-6 weeks.

A

True

52
Q

TRUE OR FALSE: Surgical treatment for a proximal tibial fracture is ORIF with plates and screws to elevate the depressed plateau, then perform bone grafting for the defect.

A

True

NOTE: This is done in any type II or III fracture

53
Q

Modified TF
A. Operative treatment for patellofemoral subluxation involves the surgical release of lateral patellar retinaculum that tends to be tight in patellar subluxation.
B. Distal repositioning of patellar ligament is also done for extensor mechanism malalignment or an excessive Q angle.

A

TT

54
Q

Modified TF
A. The non-operative route for proximal tibial fractures is for minimally displaced fractures and elderly with osteoporosis.
B. Treatment involves NWB for 4-6 weeks.

A

TT

55
Q

True of the radiologic evaluation for proximal tibial fractures, except
A. AP, lateral, and both oblique views can be done
B. 3D Recon CT is used to check extent of fracture line and it influences length of plate used upon management
C. Lipohemathrosis (mixed blood, fat and synovial fluid into the knee joint) can occur
D. The Parfait or FBI sign – Fat-Blood-Interface can be observed
E. None

A

E. None

Lipohemathrosis is also the Parfait or FBI sign – Fat-Blood-Interface

56
Q

Rehabilitation for Meniscal Tears

  1. Progressive isotonic and isokinetic exercises
  2. 4-5 months
  3. Protected ROM

A. Early phase
B. Intermediate phase
C. Return to function phase

A
  1. B
  2. C
  3. A
57
Q

Rehabilitation for Meniscal Tears

  1. Full restoration of normal ROM and plyometrics for joint loading situations
  2. Progressive ambulation
  3. Isometric Exercises and PWB

A. Early phase
B. Intermediate phase
C. Return to function phase

A
  1. C
  2. B
  3. A

(3) Musculoskeletal Imaging (25 decks)

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