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289 Cards in this Set
- Front
- Back
- 3rd side (hint)
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stage 1 avn radiographic findings
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normal
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stage 2 avn radiographic findings
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osteopenia/sclerosis, round head
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stage 3 avn radiographic findings
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flattening of head/crescent sign
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stage 4 avn radiographic findings
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secondary degeneration
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DDX: hemosiderin in joint (3)
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hemophilia; PVNS; old trauma
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DDX: diffuse periostitis (4)
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chronic venous stasis; HPOA; caffey disease; thyroid acropachy
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caffey disease AKA
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Infantile cortical hyperostosis
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DDX: arthritis with subluxation (3)
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RA; SLE; neuropathic
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DDX: arthritis with osteoporosis (4)
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RA; JRA; disuse/steroids; septic arthritis
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DDX: arthritis without osteoporosis (4)
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seronegative (psoriatic); gout; synovial osteochondromatosis; PVNS
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DDX: arthritis with preservation of joint space (3)
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PVNS; synovial osteochondromatosis; TB (Phemister's triad)
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DDX: hook osteophytes (3)
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Hemochromatosis; CPPD; acromegaly
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target joints of CPPD (3)
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MCPs, radiocarpal, patellofemoral
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target joints of RA (3)
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MCP, PIP, pan-knee
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target joints of OA (3)
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DIP, PIP, Medial > lateral in knee
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ABCDE of arthritis
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alignment; bone mineralization; cartilage; distribution; erosions
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"juxtaarticular erosion with overhanging edge"
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gout
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DDX: soft tissue calcification (3)
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HPT; connective tissue diseases: (scleroderma, SLE, dermatomyositis, polymyositis); trauma
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DDX: IP-predominant arthitis (3)
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OA; psoriatic; EOA;
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sausage digit =
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psoriatic arthritis
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subchondral cysts, periarticular erosion and preserved joint space--affects one joint
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PVNS
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reducible subluxations, no erosions or joint space loss
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SLE arthropathy
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In osteomyelitis, a sequestrum is...
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the dead bone
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involucrum is...
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the surrounding reactive bone in osteomyelitis
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SAPHO is...
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synovitis, acne, pustulosis, hyperostosis, osteitis
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wimberger sign
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syphlitic osteochondritis along the medial/proximal tibia in congenital syphilis
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celery stalking...
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congenital rubella (metaphyseal irregularity)
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DX?
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Bankart (Labrum and periosteum are torn)
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DX?
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GLAD (Glenolabral Articular Disruption)
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DX?
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ALPSA (Anterior Labroligamentous Periosteal Sleeve Avulsion)
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DX? (does not extend posterior to biceps anchor)
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Sublabral foramen
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DX?
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Mucopolysaccharidoses (fan-shaped metacarpals)
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DDX: generalized osteopenia (4)
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osteoporosis, osteomalacia, HPT, neoplasm
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DX?
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Rickets
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DX?
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Melorheostosis
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DX?
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Ewing Sarcoma
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DDX: metaphyseal lesion (3)
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NOF, osteochondroma, sarcoma
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DDX: epiphyseal lesion (4)
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subchondral cyst, GCT, chondroblastoma [low T2], Brodie's Abscess
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DDX? DX?
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enostosis (bone island); blastic met
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bone island cold on bone scan
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DDX? DX?
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Osteoid Osteoma (oval lucency); Brodie Abscess
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DX? Anatomy?
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DeQuervain's Tenosynovitis; Abductor Pollicus Longus, Extensor Pollicus Brevis
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DX?
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TFCC tear
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Components of Essex-Lopresti Fracture (3)
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Radial head fracture, interosseous membrane injury, DRUJ disruption
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DX? explanation?
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Gamekeeper's thumb with Stener lesion (balled up ulnar collateral ligament superficial to the adductor aponeurosis)
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DX?
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Extensor Carpi Ulnaris Tendonitis and subluxation
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Extensor tendons of the wrist--I
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APL and EPB
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Extensor tendons of the wrist--II
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Extensor Carpi Radialis Brevis/Longus
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Extensor tendons of the wrist--III
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Extensor Pollicus Longus
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Extensor tendons of the wrist--IV
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Extensor Digitorum/Indices
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Extensor tendons of the wrist--V
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Extensor Digiti Minimi
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Extensor tendons of the wrist--VI
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Extensor Carpi Ulnaris
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Median nerve is closest to which extensor tendon group: I or VI?
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I
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Lister's Tubercle is between which Extensor Tendon Groups?
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II and III
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Expansile, circumscribed lytic lesion involving extremities and posterior elements of spine
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osteoblastoma
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DX? DDX?
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Osteoblastoma (calcified matrix clinches);
ABC |
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DX?
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Osteosarcoma
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Common location for osteosarcoma (part of body, part of bone, extension, location in >50 year old)
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around knee, metaphysis, extension into epiphysis, axial skeleton/flat bones
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DX?
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Parosteal Osteosarcoma
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Aggressive Osteosarcoma variant and main features?
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Telangiectatic Osteosarcoma; minimal osteoid matrix formation, fluid-fluid levels/hemorrhage
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Osteosarcoma with good prognosis?
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Parosteal Osteosarcoma
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risk factors for secondary osteosarcoma (4)
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Paget’s, XRT, chronic bone infarct, chronic osteomyelitis
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DX?
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Enchondroma (no chondroid matrix in hand is okay)
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DX?
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Mafucci Syndrome (multiple enchondromas, hemangiomas, high risk of sarcoma)
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Well-defined lytic lesion centered in epiphyses of a skeletally immature patient
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chondroblastoma
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DX?
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Chondroblastoma
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DX?
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Osteochondroma
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Complications of osteochondroma (4)
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neurovascular impingement, fracture, bursitis, malignant degeneration
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Signs of malignant degeneration of an osteochondroma (3)
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pain, growth after skeletal maturity, cartilage cap > 1.5cm,
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DX?
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Malignant degeneration of an enchondroma (note cortical destruction)
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DX?
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Path Fx through a chondrosarcoma
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DX?
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Fibrous Dysplasia (Shepherd's Crook Deformity)
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DX?
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Polyostotic fibrous dysplasia
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DX?
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Fibroxanthoma (NOF)
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size difference between fibrous cortical defect and non-ossifying fibroma
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>2 cm = NOF
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DX?
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Fibrosarcoma (note permeative cortical destruction and wide zone of transition)
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DX?
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Malignant Fibrous Histiocytoma (fibrosarcoma could look like this, too)
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DX?
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Soft tissue hemangioma
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MR appearance of glomus tumor (nailbed)
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T2/STIR bright, intense enhancement, distal erosion
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DDX: fluid-fluid level in a bone lesion (2)
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Telangiectatic osteosarcoma; ABC (secondary to GCT, CB, or OB)
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DX?
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Multiple Myeloma
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DX? DDX?
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Plasmacytoma; Multiple myeloma, Metastasis, Benign (osteoporotic) compression fracture, Vertebral hemangioma (VH)
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DX?
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Aneurysmal Bone Cyst
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Etiology of Primary ABC
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Trauma
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Etiology of secondary ABC
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Tumor (GCT, OB, CB)
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DX?
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Solitary bone cyst with pathologic fracture and fallen fragment
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Solitary bone cyst etiology and description
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growth plate defect; central lucent lesion abutting growth plate while active
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Finding? DDX (5)?
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Vertebra Plana; (EG (#1 in kids), myeloma, mets, osteoporosis, Ewing sarcoma)
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DX? DDX (3 yo F)?
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EG vs Ewing Sarcoma
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DX?
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Giant Cell Tumor
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Lytic epiphyseal lesion extending to subchondral bone without surrounding sclerosis--Occurs typically in skeletally mature patients
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Giant Cell Tumor
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DX? (Name the sign)
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Giant Cell Tumor (doughnut sign)
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DDX for something that looks like a Giant Cell Tumor (5)
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chondroblastoma, chondrosarcoma, mets, MM, post traumatic cyst, geode
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Ewing Sarcoma: Peak age, most common location (2)
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10-15yo; diaphysis and flat bones
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DX? (low on T2)
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Ewing Sarcoma (high nucleus/cytoplasm ratio)
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Large, lobulated, expansile lytic lesion in distal tibial meta-diaphysis
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adamantinoma
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DX?
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Adamantinoma
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common lytic mets (3)
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lung, renal, breast
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common blastic mets (3)
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prostate, breast, bladder
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DX? Name the sign
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Benign Peripheral Nerve Sheath Tumor (schwannoma); target sign is typically seen in neurofibroma
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Findings favoring a malignant myxoma (3)
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large >5cm, deep, increased heterogeneity
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DX?
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Primary bone lymphoma
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DDX? (4)
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Lymphoma, Paget, blastic metastases, low grade osteomyelitis
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lesion at spinoglenoid notch results in:
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pressure on the suprascaular nerve and denervation of the infraspinatus muscle
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lesion at suprascapular notch results in:
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pressure on the suprascaular nerve and denervation of the supra- and infraspinatus muscles
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DX?
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Capitellar Osteochondritis Dissecans
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Osteochondrosis of the entire capitellum in a 5-11 yo child =
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Panner's disease
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mnemonic for elbow ossification
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CITE (capitellum 1-2, internal/medial epicondyle 4, trochlea 8, external/lateral epicondyle 10)
Radial head 3-6 Olecranon 6-12 |
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DX?
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Medial epicondylitis
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DX?
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Lateral Epicondylitis
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DX? (Name the sign)
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Posterior glenohumeral dislocation (Trough sign)
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Finding? Significance?
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Hill-Sachs Fracture; indicates prior anterior dislocation
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Name the attachment site: A (Posterolateral intercondylar notch)
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ACL origin
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B: Medial tibial spine
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ACL Insertion
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C: Lateral proximal tibia @ joint line
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Lateral capsular ligament
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D: Intercondylar notch at anterior-mid aspect medial femoral condyle
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PCL origin
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E: Posterior mid tibial plateau, extraarticular
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PCL insertion
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F: Medial femoral condyle, immediately distal to adductor tubercle
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MCL origin
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G: Medial proximal tibia, adjacent to joint line
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MCL insertion, deep meniscofemoral ligament (coronary ligament)
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H: Anteromedial proximal tibia, approximately 5 cm distal to joint line
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MCL insertion, superficial fibers
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I: Lateral femoral condyle
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LCL origin
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J: Fibular styloid
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Arcuate ligament (and popliteofibular, fabellofibular) insertion
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K: Anterolateral tibial plateau, adjacent to joint line
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ITB insertion (Gerdy tubercle)
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L: Fibular head & anterolateral tibia
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Conjoint tendon (LCL & biceps femoris) insertion
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Findings? DX?
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Sausage finger (Dactylitis) in Psoriatic arthritis
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Findings? DDX (5)?
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Arthritis Mutilans; RA, Psoriatic, Charcot, Juvenile Idiopathic Arthritis, Gout
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Finding? DDX (5)?
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Arthritis Mutilans; RA, Psoriatic, JIA, Charcot, Gout
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DX?
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Erosive Osteoarthritis
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DX?
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Septic arthritis
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DDX?
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Epidermal Inclusion Cyst
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DX?
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Tuberculous Arthritis
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DDX: Atrophic joint destruction (5)
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RA, Charcot, Septic, TB, Fungal
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Findings in MSK Sarcoid: (3)
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STS, lace-like bone, punched-out erosions
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DX?
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Sarcoidosis
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DX?
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Leprosy (calcified digital nerve and acroosteolysis)
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DDX (5), DX?
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Acroosteolysis DDX: HPT, Thermal injury, Progressive systemic sclerosis, Traumatic amputation, Lesch-Nyhan
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DX?
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Progressive Systemic Sclerosis
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DX?
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enchondroma
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Dark on T1, no enhancement. DX? (Clue?)
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Ganglion cyst. Look for tail pointing to origin)
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DX? (Classic findings?)
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Multicentric reticulohistiocytosis; red bumps in the skin (lipid-containing macrophages deposited in skin and around joints)
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DX?
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SLE arthiritis; Non-erosive severe deformity
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Five forms of Juvenile Idiopathic Arthritis by prevalence:
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Oligoarticular JRA (40%); Seronegative polyarticular JRA (25%); Still's disease (20%); juvenile-onset AS (10%); juvenile onset RA (5%)
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Still's disease features: age, clinical (3), RF
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<5yo, fever, anemia, hepatosplenomegaly; negative
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oligoarticular JRA features: distribution, RF,
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1-several large joints, RF negative
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polyarticular JRA: distribution, RF
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symmetric polyarticular, RF negative
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coned epiphyses =
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embolic disease (such as in meningococcemia)
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DX? distance for abnormality? accentuated with ulnar or radial deviation?
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Scapholunate ligament injury (4mm); radial deviation
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DX?
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Thyroid Acropachy
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DX?
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Scapholunate ligament tear
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DX?
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Scapholunate ligament tear
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DX?
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Scapholunate advanced collapse
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DX?
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Calcium Hydroxyapatite deposition disease at gluteus maximus insertion
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DX?
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Rotary subluxation of the scaphoid
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DX?
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Lunate dislocation
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Stage, DX?
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Perilunate dislocation (stage 2)
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stage, DX?
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Midcarpal dissociation (stage 3)
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DX? Stage?
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Lunate dislocation (stage 4)
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DX?
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triquetral fracture
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DX?
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osteonecrosis of the proximal pole of a non-union scaphoid fracture
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DDX?
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heavy metal ingestion, physiologic lines
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DX, classic features (4)
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chondroblastoma; teenager, arises in epiphyses, +/- extends into metaphyses, sclerotic rim,
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DX?
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Sail sign
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DX?
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Anterior humeral line intersect anterior 1/3 of capitellum...supracondylar fracture
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DX? Name the tendon group which is injured.
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Lateral epicondylitis, common extensor tendons.
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DX? (two separate patients)
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Radial head subluxation (nursemaid's elbow)
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DX?
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Nail Patella Disease
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DX?
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Hypertrophic Pulmonary Osteoarthropathy
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DX?
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Galeazzi fracture-dislocation
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Common site of tendon injury in general
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musculotendinous junction
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DX?
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Triceps Tendon Tear
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Parsonage-Turner Syndrome AKA...
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Acute brachial neuritis
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Increased signal in supraspinatus, infraspinatus, and deltoid muscles =
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Parsonage-Turner Syndrome
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DX?
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Parsonage-Turner Syndrome
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Focal painful denervation of the teres minor muscle
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Quadrilateral space syndrome
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DDX for distal clavicular resorption (6)
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chronic rotator cuff tear, post-operative, RA, HPT, AC separation (mimic), post-traumatic osteolysis
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Benign DDX for parosteal osteosarcoma (1)
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Juxtacortical Chondroma
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DX?
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Juxtacortical Chondroma
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DX?
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Distal biceps tendon rupture
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DX?
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Subscapularis rupture
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DX?
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Synovial osteochondromatosis
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elevated humeral head which articulates more with the acromion/clavicle than glenoid =
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Rheumatoid Arthritis
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DX?
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RA with rotator cuff tear
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Isolated glenohumeral degenerative changes DDX (3)
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pyrophosphate arthropathy, neuropathic arthropathy, posttraumatic arthropathy
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DX?
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Calcific tendinitis
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DX?
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Tumoral Calcinosis
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DX?
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sternoclavicular dislocation
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DX?
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elastofibroma dorsi (benign fibroblastic proliferation)
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DX? DDX? (5)
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sacral chordoma; chondrosarcoma, giant cell tumor, plasmacytoma, metastasis
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DX? (Finding)
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Developmental dysplasia of the hip; (coxa magna)
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DDX: Prostrusio acetabuli (5)
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trauma, arthritis (RA, OA, AS, JIA), Paget's, renal osteodystrophy, fibrous dysplasia
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DX?
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Fibrodysplasia ossificans progressiva
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hip dislocations: % anterior/posterior
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85-90% posterior
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Mazabraud's Syndrome =
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fibrous dysplasia + intramuscular myxomas
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ligamentous calcification in fluorosis (2)
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sacrospinous and sacrotuberous
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DX?
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gluteus medius tendon tear
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DDX unilateral sacroiliitis
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reactive arthritis, psoriatic arthritis
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bowel disease associated with AS (3)
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Crohn, UC, whipple's
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DX?
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Extraskeletal osteosarcoma
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DX?
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Nail-Patella Syndrome
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Nail-Patella Syndrome AKA (2)
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Fong's syndrome, osteoonychodysostosis
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DDX?
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Paget's, lymphoma, leukemia, metastases, MYELOFIBROSIS, mastocytosis
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DX?
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Hemangiomatosis
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DX?
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Multiple hereditary exostosis
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Multiple Hereditary Exostosis: gender, genetics
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males > females; autosomal dominant
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DX? Finding?
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Sickle Cell Disease, bone within a bone
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DX?
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Proximal Focal Femoral Deficiency
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Transient BM edema vs. occult fracture (2 features)
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no inciting event, resolves within weeks
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DX?
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Multiple epiphyseal dysplasia
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Spectrum of osteopetrosis (3 clinical groups), eponym for one; pathophysiology involves what cell type?
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autosomal recessive/infantile fatal; intermediate (early detection, benign course); Autosomal dominant (adult detection) AKA Albers-Schoenberg; osteoclast dysfxn
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Definition of Legg-Calve-Perthes disease
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idiopathic osteonecrosis of the capital femoral epiphysis in a skeletally immature patient
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DX?
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Legg-Calve-Perthes Disease
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DX?
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osteopoikilosis
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DX? Name the line.
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slipped capital femoral epiphysis. Klein's Line
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DX? (Classification scheme)
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Intertrochanteric fracture (Evans-Jensen, based on number of fragments and displacement)
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DX? (high T2 signal intensity within the lesion)
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liposclerosing myxofibrous tumor of bone
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Most likely DX?
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Malignant fibrous histiocytoma
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DX? DDX? (3)
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myositis ossificans; sarcoma, surface osteosarcoma, osteochondroma
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myoblastoma AKA; common locations; course
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granular cell tumor; breast, chest wall, skin, subcutaneous tissues; benign
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glomus tumor arises from
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neuromyoarterial glomus
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18 yo male with knee pain. DDX? Next step? DX?
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Give contrast to prove cyst vs. mass lesion. Solid enhancement in this synovial sarcoma
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DX?
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Engelmann's Disease (progressive diaphyseal dysplasia)
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Description? DX?
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Cortical and medullary sclerosis. Erdheim-Chester disease.
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Erdheim-Chester disease AKA
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lipid granulomatosis
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DX? (AKA)?
|
Trevor disease AKA articular chondroma AKA dysplasia epiphysealis hemimelica
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DX?
|
Hemophilia
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DX?
|
Marrow infiltrative diseases (gaucher's)
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DX?
|
Discoid lateral meniscus
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DX?
|
Chondromalacia patella
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DX?
|
Pigmented villonodular synovitis
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DX?
|
CPPD
|
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DX? Name the sign...
|
Empty notch sign = ACL tear (complete)
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DX? sign?
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empty lateral notch sign, complete acl tear
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DX? Association?
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Segond fracture (lateral capsular avulsion), associated with ACL tear.
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Salter Harris type?
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I
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Salter-Harris type?
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II
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Salter-Harris type?
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III
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Salter-Harris type?
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IV
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Salter-Harris type?
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V
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Baker's cyst protrudes through...
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semimembranosus and medial gastrocnemius tendons
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Two signs? DX?
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Double PCL, double delta; bucket-handle meniscal tear with flipped fragment
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Components of O'Donaghue's terrible triad...mechanism...
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ACL, MCL, Medial meniscus; valgus stress in flexion
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repetitive traction injury at in the inferior pole of the patella in an adolescent
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Sindig-Larsen-Johanssen syndrome
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DX?
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Transient lateral dislocation of the patella with medial patellar retinaculum tear
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DX?
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Lipoma Arborescens
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DX?
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Corner (metaphyseal) fracture, non-accidental trauma
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|
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SONK is now called...
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Insufficiency fracture of the knee
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DX?
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Insufficiency fracture of the knee (AKA SONK)
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DX?
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Metallosis
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Normal at rest, this appearance during forced flexion. DX?
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Popliteal entrapment
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|
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popliteal entrapment caused by?
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medial head of gastrocnemius
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DX? Most common locations (2)?
|
Meniscal cyst. AHLM, PHMM
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DX?
|
Pseudoarthrosis in NF1
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Direction of tibial bowing in NF1?
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anterolateral
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DX? Description?
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Small, beaked medial tibial metaphysis in Blount's disease
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DX?
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Maisonneuve fracture
|
|
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DX?
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Juvenile Tillaux
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DX?
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Triplane fracture
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DX?
|
Achilles tendinopathy
|
|
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DX?
|
tibialis posterior tendon tear
|
|
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DX?
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Homolateral Lisfranc injury
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|
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Dx?
|
Divergent Lisfranc injury
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Dx?
|
Medial swivel subtalar dislocation
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|
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DX?
|
Plantar Fasciitis
|
|
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Normal thickness of plantar fascia?
|
3-4 mm upper limits
|
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DX?
|
Plantar fibromatosis
|
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DX?
|
Sinus tarsi syndrome
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DX? sign?
|
Anteater sign in calcaneonavicular coalition
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Three types of connection in coalition:
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Synostosis (bone-bone); synchondrosis (cartilagenous); syndesmosis (fibrous)
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|
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Most common locations of tarsal coalition (2)
|
talocalcaneal, calcaneonavicular
|
|
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DX? Name the finding.
|
Talar beak, talocalcaneal coalition
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|
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DX?
|
talipes equinovarus
|
|
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DX?
|
metatarsus adductus
|
|
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DX?
|
intraosseous lipoma
|
|
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DX?
|
intraosseous lipoma
|
|
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DX?
|
JIA
|
|
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DX?
|
DISH
|
|
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DX?
|
Giant cell tumor of tendon sheath
|
|
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DX?
|
Freiberg Infraction
|
|
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DX? Location of object pointed to by arrow?
|
Synovial osteochondromatosis, distended subcapsularis bursa
|
|
|
|
deep sulcus sign, which side, what cut-off for depth, associated meniscal tear?
|
lateral, 1.5mm, lateral
|
|
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DX?
|
dermatomyositis
|
|
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DX?
|
Rheumatoid arthritis with rice bodies
|
|
|
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fracture associated with posterior glenohumeral dislocation
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lesser tuberosity
|
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|
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dense joint effusion
|
hemophilia
|
|
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DX?
|
Talocalcaneal coalition
|
|
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name of bone in sprengel deformity
|
omovertebral
|
|
|
|
volar plate injury happens where
|
PIP joint in finger
|
|
|
|
dense end of a bone in a teenager
|
think osteosarcoma (osteoblastic)
|
|
|
|
thick ilioischial/iliopectineal lines
|
paget's
|
|
|
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sternal lesion (3)
|
chondrosarcoma (100% calcify), mets, myeloma
|
|
