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131 Cards in this Set
- Front
- Back
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What is the name of the tendons that run behind the fibular
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the peroneal tendons
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What is a common injury that occurs to the peroneus brevis tendon
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a perneus brevis tendon tear
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What is the cause of a peroneus brevis tear
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dorsiflexion/inversion
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What direction does the peroneus brevis tendon tear
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it is usually a longitudinal tear
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Tom Dick And Harry
Toms Harry Dick |
posterior compartment tendons
posterior tibialis flexor digitorum artery flexor hallisus |
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What is the tarsal tunnel of the ankle
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this is where tom dick and harry are located
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When moving through the coronal images of the knee what is a clue you are looking at the posterior horn
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the fibula is located more posterior and so is the PCL
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What is a radial tear of the meniscus
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Radial tears are perpendicular to the long axis of the meniscus. They start at the inner margin and go either partial or all the way through the meniscus dividing the meniscus into a front and a back piece (if they occur in the body...side)
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What is a longitudinal tear of the meniscus
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Longitudinal tears parallel the long axis of the meniscus dividing the meniscus in an inner and outer part.
So the distance between the tear and the outer margin of the meniscus is always the same (figure). The tear never touches the inner margin. |
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What is a bucket handle tear of the meniscus
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a type of longitudinal tear where the tear is displaced toward the center of the knee like a bucket handle
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Named 3 types of displaced tears of the menisci
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Bucket-handle tear = displaced longitudinal tear.
Flap tear = displaced horizontal tear. Parrot beak = displaced radial tear. |
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What is a flipped meniscus
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Flipped meniscus is a form of bucket handle tear.
There is a capsular detachment or peripheral tear of the meniscus, usually the posterior horn. The posterior horn flippes over onto the anterior horn. |
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What is a complex tear of the meniscus
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Complex tears are a combination of these basic shapes.(radial, horizontal, longitudinal)
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What is a horizontal tear of the meniscus
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Horizontal tears divide the meniscus in a top and bottom part (pitta bread).
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What happens if a horizontal tear goes all the way through the
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If horizontal tears go all the way from the apex to the outer margin of the meniscus they may result in the formation of a meniscal cyst.
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What is a meniscal root tear
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A meniscal root tear is a radial tear located at the meniscal root.
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How do you diagnose a meniscal root tear
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Normally when you image the posterior cruciate ligament on sagittal images you should see a considerable posterior horn of the meniscus on that image or the image adjacent to it.
If this is not the case it is an absent or empty meniscus-sign indicating a radial tear. |
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How do you detemine if you are looking at the medial meniscus on sagital views
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The posterior horn is always larger than the anterior horn
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Where is the posterior horn of the medial meniscus
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The posterior root is immediately anterior to the posterior cruciate ligament.
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Describe the insertion points of the anterior horn of the medial mensicus
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The anterior horn has an insertion on the tibia and a second portion that travels from medial to lateral to connect to the anterior horn of the lateral meniscus
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On sagital views what horn is higher (lateral meniscus)
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On sagittal images the posterior horn is higher in position than the anterior horn.
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What is the criteria for a meniscal tear
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The two most important criteria for meniscal tears are an abnormal shape of the meniscus and high signal intensityon PD-images unequivocally contacting the surface
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What plane is best for visualization of the radial tears of the anterior and posterior horns
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coronal views
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What plane is best for visualization of radial tears of the body
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sagital
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What is the classic sign for a radial tear of the body on sagital imaging
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interuption of the bow tie
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Where is the most common location of a radial tear
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the body
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What is a complication of a meniscal tear
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2ndary osteoarthritis
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What changes are seen on T2W images in myoid degeneration of the ACL
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bright signal
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What is a complication of myxoid degeneration of the ligaments
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cyst developing behind the knee
cyst with in the bone from mucin |
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If you see a mass in the ACL what is it most likely going to be
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a ganglion cyst
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What is a discoid meniscus
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A discoid meniscus is thought to be more prone to tear than a normal
meniscus, and it can be symptomatic even without being torn. |
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How often do mensical cyst occur
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5% of cases
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Can meniscal cyst cause pain without an associated pain
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yes
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Are meniscal cyst associated with discoid menisci
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yes
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What does a discoid mensicus look like on coronal and sagital images
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meniscus with meniscal tissue extending into the intercondylar notch medially
more than 2 images with a bowtie |
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What may cause a pseudotear of the anterior horn of the meniscus
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transverse ligament of the anterior horns (connects the anterior horns of the medial and lateral menisci)
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What ligament normaly has lower signal; PCL or ACL
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PCL
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What is the ligament that travels behind the posterior collateral ligament
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ligament of wrisberg
ligament of humphrey is anterior |
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What is an intercondylar notch cyst
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Cyst within or extending from the intercondylar notch
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What are the findings of a intercondylar notch cyst
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Increased signal intensity (T2WI) mass expanding and/or extending from a cruciate ligament
Size: Mild expansion of cruciate ligament to cyst, several centimeters in size |
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What is the cause of an intercondylar notch cyst
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Related to trauma followed by tissue breakdown of cruciate ligament or adjacent tissue (mucoid degeneration)
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What is the ddx of a t2 bright cyst posterior to the knee
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intercondylar notch cyst
meniscal cyst popliteal cyst |
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What is popliteal cyst
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Fluid distension of gastrocnemius/semimembranosus bursa which is usually in communication with the knee joint
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What are the findings of jumpers knee
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thickened high signal patella tendon, particularly of the deep and proximal fibers.
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What is jumpers knee
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is a chronic insertional injury of the posterior and proximal fibres of the patella tendon, where they insert into the inferior pole of the patella.
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Where i s the avulsion fracture of in segunds injury
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avulsion of the lateral tibial plateau
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What percent of people with a segund fx have a ACL tear
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95%
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What is the mechanism of a segund fx
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internal rotation and varus stress
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What injury commonly occurs to the ITB in a pt with a segund fx
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avulsion of the posterior ITB/lateral capsule
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What percent of pt with a segund fx have a meniscal tear
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40-66% (lateral>Medial)
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What has occure if fluid is seen between the medial meniscus and the MCL
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a meniscocapsular tear
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What are the findings of lipoma arborescens
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Increased (fat) signal thickening of the synovium
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What happens to the synovium in lipoma arborescens
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fatty infiltration of the joint capsule resulting in distension of the joint capsule
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What do you see in the knee joint in a pt with lipoma arborescens
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fat globules in a effusion . see fat on T1 and then the globules will sat out on PD FS
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What 2 other conditions involve the synovium
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PVNS and osteochondromatosis
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Do patients with lipoma arborescens have a big effusion
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yes
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how do you tell if the meniscus is extruded
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if it is beyond the outer margin of the tibia by 2-3 mm
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What is the cause of SONC
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stress reaction of weight bearing surface
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What is SONC associated with
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low bone mineral and meniscal tear
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What is a clinical sign of SONC
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acute onset of pain
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What is the ddx of SONC
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OCD
Infarct |
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Where does OCD occur
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lateral aspect medial epicondyle
LAME |
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What is the radiographic finding of OCD
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Radiograph shows rounded lucency in subarticular region, usually at convex surface of bone
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What is the main goal of MR in OCD
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Main goal for MR is to determine stability of lesion; T2 FS is most important sequence
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What is the appearnace of bone infarcts
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serpintine
T2-bright T1-dark |
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How is a bone infarct differentiated from SONC and OCD
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it is usually multifocal but if it isfocal an infarct can look like SONC
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What is the bone marrow edema pattern of the femoral head
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T1-low
T2-bright |
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What is the bone marrow edema ddx
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transient osteoporosis
transient bone marrow edema syndrome AVN Stress fx trauma Osteiod osteoma infection infiltrative neoplasm |
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Do transient osteoporosis and transient bone marrow edema syndrome go away after a few months
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yes
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If you are under the age of 30 with edema pattern in the femoral neck and head what should come to mind
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osteoid osteoma
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What do you expect to see in AVN and stress fx
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a line
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Do osteoid osteomas have a nidus
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yes
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What are the findings of transient osteoporosis
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osteopenia
normal joint space effusion and edema on MRI |
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What do you find on bone scan in transient osteoporosis of the hip
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hot on bone scan
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What is the prognosis of transient osteopenia of the hip
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self limited without joint space narrowing (2-9 months)
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Does transient osteoporosis of the hip occur more often in males or females
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males
if it occurs in females it will be during the 3rd trimester of pregnancy |
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Where is a classic location for a labral tear of the hip
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anterior
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What are the SS of a labral tear of the hip
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hip pain, clicking, locking
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What are presdisposing factors to a labral tear of the hip
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FAI
DDH Legg Calve Perthes Trauma Osteoarthritis Idiopathic |
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What is the problem in the CAM type FAI syndrome
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femoral side
aspherical femoral head neck junction |
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Who tends to get CAM type FAI
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younger males
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What basic dysfunction in FAI
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abnormal contact between the proximal femur and the acetabular rim with repetitive motion
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What is the issue in Pincer type FAI
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acetabular side
acetabular overcoverge |
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What type of FAI syndrome has retroversion
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pincer
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What do you look for on plain radiograph in CAM type FAI
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bumps of the head neck junction (pistol grip deformity)
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What tendons attach to the greater trochanter
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gluteus medius
gluteus minimus |
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What r the 2 ligments of the proximal carpal row
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scapholunate
lunotriquetral |
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What are the 3 ligaments of the distal carpal row
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trapezium trapezoid
trapezoid-capitate Capitate-hamate |
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What cartilage goes across from the ulnar to the carpal bones
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triangular fibrocartilage
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What is the cause of ulnar carpal impaction syndrome
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Hyperextension of wrist + rotational load
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What is the best diagnostic clue of ulnar carpal impaction syndrome
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Eccentric sclerosis proximal ulnar lunate
positive ulnar variance is associated Area of subchondral sclerosis in lunate > triquetrum Hyperintense central perforation TFC (FS PD FSE) |
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What is the cause of ulnar carpal impaction syndrome
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Degenerative condition caused by excessive load-bearing across the ulnar aspect of the wrist
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Where is the pain located in ulnocarpal impaction syndrome
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DRUJ
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Is ulnocarpal impaction associated with positive ulnar variance
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yes
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What is positive ulnar variance
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ulnar is 1mm or more longer than the radius
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What is the presumed cause of ulnocarpal impaction syndrome
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ulnar bone hitting the carpal bones (bc ulnar variance)
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Is the marrow sometimes abnormal in the corner of the lunate, triquetrum and the distal ulnar in ulnocarpal impaction syndrome
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yes
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Is the TFC damaged in ulnocarpal impaction syndrome
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yes
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Is lunotriquetral tears associated with ulnocarpal impaction syndrome
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yes
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What tendons are on the lateral side of the elbow
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extensors
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What tendons are on the medial side of the elbow
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flexors
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What does a high riding humeral head usually indicate
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a rotator cuff tear
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What should you loook at on the sagital view if there is a supraspinaatus tear
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muscle atrophy (line through the top of the acromion and coracoid the muscle should go above this)
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How do rotator cuff tears generally progress
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articular to the bursal side
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Where do you see fluid in the shoulder joint if the pt has a full thickness tear
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Subacromial
Subdeltoid |
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What 3 things will happen to the muscle following a full thickeness tear
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retraction
atrophy fatty infiltration |
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What is a dislocated bicep tendon associated with
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subscapularis tendon tear
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What is a (non-bony) bankart lesion
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on axial the anterior labrum tip is broke off
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What is a hills sachs lesion
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impaction fx after dislocation
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Where does the hill sachs lesion occur
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the top 2 cm of the humeral head posteriorly
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Do you quantify a hills sachs defect
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yes
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Is the periosteal attachment torn in a bankart lesion
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yes
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What part of the labrum is torn iin a bankart
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anteroinfero
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Are ALPSA lesions still attached to the glenoid via the periosteum
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yes
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What is a ALPSA lesion
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antero labral ligamentous sleeve avulstion
intact scapular periosteum |
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Where is the detatched labraum in an ALPSA lesion
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balled up labrum infero medial to glenoid
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What is a perthes lesions
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similar to an ALPSA but it is not balled up (also has a periosteal attachement)
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Where is the avulsion of a perthes lesion
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inferior to the labrum
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What is the best position to see a perthes lesion
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ABER positons
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If you see a cyst around the glenohumeral joint what should you suspect
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a labral tear
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Where is the detatched labraum in an ALPSA lesion
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balled up labrum infero medial to glenoid
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What is a perthes lesions
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similar to an ALPSA but it is not balled up (also has a periosteal attachement)
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Where is the avulsion of a perthes lesion
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inferior to the labrum
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What is the best position to see a perthes lesion
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ABER positons
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If you see a cyst around the glenohumeral joint what should you suspect
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a labral tear
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What happens to the muscle on MR when there is nerve impingement or damage
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increased signal on fluid sensitive images
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What is a common cause of impingement of a nerve in the shoulder
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cyst from labral tears
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What causes a cyst in the suprascapular notch
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a slap tear
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Why is it bad to have a cyst in the suprascapular notch
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impingement syndrome of the suprascapular nerve with branches to the supraspinatus
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What are the findings of a suprascapular nerve entrapment
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mixed motor and sensory issues
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What if you have a cyst impinging upon the spinoglenoid notch
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the suprascapular nerve is also involved but lower and the branches to the infraspinatus are effected (add to prior that the suprascapularis notch cyst will also effect the infraspinatus bc it is more proximal)
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