Msk Radiology

Front 1

What kind of arthritis is degenerative?

Back 1

Osteoarthritis

Front 2

What kind of arthritis is inflammatory? Which of these is seropositive?

Back 2

RA: seropositive

Psoriatic: seronegative

Front 3

What are some kinds of crystal deposition disease/

Back 3

CPPD

Gout

Front 4

What are some of the radiological signs of OA?

Back 4

Joint space narrowing
Osteophyte
Subchondral sclerosis
Subchondral cyst

Front 5

What are some of the radiological signs of inflammatory arthritis?

Back 5

Juxta articular osteopenia
Joint space narrowing
Erosions
Alignment abnormalities

Front 6

What is the common pathway for conditions causing inflammatory arthritis?

Back 6

Synovitis
Marrow edema
Erosion
Deformities

Front 7

What is osteopenia?

Back 7

Loss of bone density

In normal bone xray, you can see the cortex on either side. In osteopenia, you see a blurring of the layers

Front 8

What are the ABCS or arthritis?

Back 8

A: alignment
B: bone
C: cartilage
S: soft tissues

Front 9

What does a film of reactive arthritis look like?

Back 9

"Sausage digit"

Fusiform swelling of an entire digit

Front 10

What does a film of gout look like?

Back 10

Non-marginal erosions

Asymmetrical soft tissue swelling (tophi) which is just a collection of urate crystals

Front 11

What is a heberden's node? Where is it found?

Back 11

It's a narrowing of the DIP

OA

Front 12

What are the features of RA on plainfilms?

Back 12

Bare areas, erosions
Uniform joint space narrowing
Absence of osteophytes
Symmetric
Periarticular, diffuse osteopenia
Periarticular swelling
Subluxations

Front 13

What is a condition that can cause abnormal alignment of the hands without erosions?

Back 13

SLE

Front 14

Where does psoriatic arthritis target?

Back 14

DIP symmetrically

Asymmetrical pauciarticular

Several joints in one digit

SI joints

Front 15

What are the features of psoriatic arthritis?

Back 15

Marginal erosions
Fluffy periositis near involved joints
Fusiform soft tissue swelling (sausage digit)
PRESERVED MINERALIZATION

Sometimes, pencil in a cup!

Front 16

Where does reactive arthritis target?

Back 16

Pauciarticular joints in feet more commonly than hands

SI joints

Front 17

What are the features of reactive arthritis?

Back 17

Similar to psoriatic, but more commonly attacks the feet

Fluffy periositis

SI joins

Front 18

What are the signs of ankylosing spondylitis on plainfilms?

Back 18

Sacroilitis and Syndesmophytes

Front 19

Where does ankylosing spondylitis attack?

Back 19

SI joints
Spine
Large joints

Front 20

What are the features of ankylosing spondylitis?

Back 20

Symmetrical SI joint erosions, fusion
Spine erosions, syndesmophytes, fusion
Fluffy periositis
Late development of spine pseudoarthroses and fractures

Front 21

What crystals are deposited in gout? CPPD? HADD?

Back 21

Gout: monosodium urate

CPPD: clcium pyrophosphate dihydrate

HADD: calcium hydroxyapatite

Front 22

Where are the target sites for gout?

Back 22

Great toe MCP
Other asymmetric, pauciartiular sites

Front 23

What are the features of gout on plainfilms?

Back 23

Bone changes late in course
Bizarre, non-marginal erosions
TOPHI
Bone mineralization is preserved

Front 24

What are some of the malignant tumors of the musculoskeletal system?

Back 24

Malignant: osteosarcoma, chondrosarcoma, Ewing's ssarcoma

Benign: simple cyst, fibrous dysplasia, nonossifying fibroma, Paget's disease, osteoid osteoma

Front 25

What are characteristics of nonaggresive MSK tumors?

Back 25

Well defined margins with native bone

No (or mature) periosteal reactions

Front 26

What are characteristics of nonaggresive MSK lesions?

Back 26

Poorly defined margins

Periosteal reaction

Front 27

What are the characteristics of an osteosarcoma?

Back 27

Calcified soft tissue mass

Front 28

What are the features of a chondrosarcoma?

Back 28

Calcified matrix of cartilage

Front 29

What are the features of Ewing's Sarcoma?

Back 29

Ill-defined margins, permeating bone
Hair on end, sunburst periosteal reaction
Large soft tissue expasion

Front 30

Who gets a simple bone cyst?

Back 30

Kids

Front 31

What is the most common location for a simple bone cyst?

Back 31

Proximal humerus

Front 32

What are the features of a simple bone cyst?

Back 32

Central lesion
Mildy expansile
Sharp margins
No periosteal reaction

Blue arrow is a fallen fragment, which is a fracture htat has happened through a cyst (pathognomonic)

Front 33

What are the features of a nonossifying fibroma?

Back 33

Eccentrically located
Well defined sclerotic margins with ridges

Front 34

What are the features of fibrous dysplasia?

Back 34

Greyish, homogenous (ground glass) appearance

Front 35

Where is fibrous dysplasia commonly found?

Back 35

Proximal femur, pelvis

Front 36

What are the feagures of Paget's disease?

Back 36

A triad!
-Bone expansion
-Trabecular thickening
-Cortical thickening

Front 37

What are the features of an osteoid osteoma?

Back 37

Small, benign
Sclerotic reactive bone

Front 38

What kind of a person gets an osteoid osteoma?

Back 38

Kids, young adults

M>F

Front 39

What kinds of medications does an osteoid osteoma respond to? Why?

Back 39

NSAIDS (asprin)

It produces prostaglandins

Front 40

If someone comes in with a cervical spine fracture, what views should you order?

Back 40

Lateral (most important)
AP
Obliques (bilateral)
Odontoid

Front 41

What is a hangman's fracture?

Back 41

A fracture of the posterior process of C2

Front 42

What is a Jefferson fracture? What causes this?

Back 42

C1 ring fracture with lateral displacement of fragments

Caused by diving into shallow water

Front 43

What kind of fracture is caused by hyperextension? Why is it so crucial?

Back 43

Odontoid

YOU CAN'T MISS THIS. THEY WILL BE PARALYZED IF YOU LET THEM LEAVE!

Front 44

What is the most common kind of shoulder dislocation?

Back 44

Anterior

Front 45

What has happened here?

Back 45

Anterior shoulder dislocation

Front 46

What direction to hips dislocate?

Back 46

Posterior

Front 47

What kinds of joints can you see effusions with on plainfilms?

Back 47

Elbows
Knees
Ankles

Front 48

What is a common location for a fracture on the radius?

Back 48

Head

Front 49

What is the characteristic sign of a radial head fracture?

Back 49

The fat pad sign!

Front 50

If you see this in the knee, what should you think? What is it?

Back 50

It's lipohemarthrosis: fat from the marrow getting into the joint space

You should always think fracture here

Front 51

What are signs of child abuse on films?

Back 51

Posterior rib fractures

Multiple fractures of different ages

Subdural hematoma, subarachnoid hemorrhage

Front 52

What kind of imaging is best for the soft structures of the knee?

Back 52

MRI

Front 53

Generally, what is the source for osteomyelitis in adults? Kids?

Back 53

Adults: contiguous

Kids: hematogenous

Front 54

What are the features of renal osteodystrophy?

Back 54

Hyperparathyroidism --> bone resorption

Osteoporosis
Osteosclerosis

Fuzzy margins of bone

Front 55

What's the best imaging modality for osteonecrosis?

Back 55

MRI

This may be the most disturbing MRI I've ever seen.

Front 56

What are features of sickle cell disease in the MSK?

Back 56

Osteonecrosis

H-shaped depressionin the vertebral bodies