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MSK IMAGING
Chapter 1 and 2
| Term | Definition |
|---|---|
| 3 primary forces of trauma | compression, tension, shear |
| Compression | push together |
| tension | pull apart |
| shear | force that slides two portions of a bone past one another |
| Periosteum | thin, tough tissue that contributes to bone production and remodeling, especially during growth and fracture healing |
| Wolffs Law | increase in bone stress shifts the balance towards greater bone production |
| Tension example | transverse fracture of the patella |
| Compression fracture | Usually produces an oblique fracture |
| Closed fracture | osseous fragments do not break the skin surface |
| open fracture | associates with skin disruption and exposure of a bone fragment |
| complete fracture | results in two or more separate bone fragments - transverse, oblique, or spiral |
| Incomplete fracture | cortex is only partially interrupted- most often occur in children |
| 3 major types of displaced incomplete fractures in children | buckle, greenstick, plastic bowing deformity |
| Buckle fracture | focal compression of cortex caused by an axial load |
| Torus Fracture | complete type of buckle fracture |
| Greenstick Fracture | results from bending force with distraction of cortex fragments on the convex side of the bone |
| Pure plastic bowing deformity (plastic deformation) | bending of a bone without discrete fracture line |
| COMMUNITION | indicates that the bone is fractured into more than two fragments |
| segmental comminuted fracture | one in which the same bone is fractured in separate sites with an intact segment of bone between the fracture sites |
| Butterfyl comminuted fracture | one in which a wedge shaped butterfly fragment of intervening bone is present |
| Always describe | fracture location, position, alignment |
| alignment | displacement, angulation, distraction, fragment overlap, rotation |
| angular deformity | refer to a directional change of the fracture fragments relative to the long axis of the fractured bone |
| Intraarticular fracture | an articular fracture, extends through an articular surface |
| fat fluid level | caused by escape of marrow far into a joint space and is much more specific for an intraarticular fracture but less commonly seen |
| Die punch fragment | articular surface fragment that is driven into the epiphysis or metaphysis |
| Post-traumatic osteoarthritis | one of the most important complications of an intraarticular fracture |
| Fatigue (stress) fracture | occurs when abnormal stresses are placed on normal bone, usually in the form of multiple and frequent repetition of otherwise normal stress. |
| Classic locations for stress fractures | femoral neck, tibial shaft in runners, and metatarsals of new military recruits, calcaneus, femoral and fibular diaphyses |
| insufficiency fracture | occurs when normal stresses are placed on bone that is weakened by a generalized process such as osteoporosis. |
| fracture reduction | restoration of normal alignment |
| Closed reduction | manipulation of the fractured extremity and casting it |
| pathologic fracture | refers to a fracture caused by normal stresses to an abnormal bone. |
| Internal fixation | placement of a cortical plate fixed with transverse screws on the surface of the bone, pin, or screw placement across the fracture, rod or nail within the medullary space along the long axis of the bone. |
| External fixation | pins placed through the skin into the bone remote from fracture site |
| dynamic fixation | fragment motion is allowed in one direction but constrained in all others. |
| Fracture Healing | affected by patient age, degree of local bone and soft tissue devtalization, fracture location, degree of immobilization apposition of bone fragments after reduction, complicating factors such as infection, tumor at fracture site, systemic complications. |
| malunion | fracture healing with angular or positional deformity. can result in a limb-length discrepancy or limb deformity that may limit function or cause pain |
| avascular necrosis | occasionally occurs after a fracture and is more common in bones or portions of bones or portions of bones in which there is tenuous blood supply. |
| Osteomyelitis | potential complication of an open fracture or orthopedic hardware placement |
| Stress riser | can significantly lower the fracture threshold of a long bone shaft and many fractures begin at a stress riser |
| Valgus | distal bone is oriented more lateral than normal |
| Varus | Distal bone is oriented more medial than normal |
| Subluxation | Partial loss of contact between joint surfaces |
| Dislocation | complete loss of contact between joint surfaces |
| Diastasis | Separation of a normally minimally mobile joint |
| Ligaments | strong, flexible bands or cords of fibrous tissue composed of highly ordered collagen fibers- provide joint stability |
| Sprain | ligamentous injury less severe than a complete disruption |
| Impingement | abnormal tissue compression - common reason for a patient to present to a sports medicine clinic |
| Bursa | synovium-lined potential space that allows reduced friction so that adjacent extraarticular tissues such as ligaments or tendons can slide easily past one another or an adjacent bone. |
| Subluxation | partial loss of contact between the articular surfaces |
| Grade 1 - Ligament grading system | Injury without macroscopic tear |
| Grade 2 - | partial tear |
| Grade 3 - | complete ligament interruption |
| Tendon | Connects a muscle to a bone |
| anisotrpoic | not the same in every direction |
| Tenosynovitis | inflammation of a tendon sheath |
| Stenosing tentosynovitis | scarring of the tendon with adhesion to the tendon sheath |
| Axial T1 | used to assess for fatty infiltration |
| Axial fluid filled sensitive sequence | used to assess for edema |
| Gadolinium | used if necrosis or an abscess is suspected |
| Heterotopic ossification | bone formation in soft tissue- commonly found in hip joint |
| Chondromolacia | soft cartilage |
| Fracture | disruption in the continuity of all or part of the cortex of abone |
| Sesamoid Bones | bones that form in a tendon as it passes over a joint (patella) |
| Accessory Ossicles | accessory epiphyseal or apophyseal ossification centers that do not fuse with the parent bone |
| Spiral fracture | twisting force or torque produces a fracture similar to those that might be caused by planting the foot in a hole while running |
| Four parameters to describe fractures | Displacement Angulation Shortening Rotation |
| Angulation | describes the angle between the distal and proximal fragments |
| Shortening | Describes how much, if any overlap there is of the ends of the fracture fragments |
| Colles Fracture | Fracture of the distal radius with dorsal angulation |
| Smith Fracture | fracture of the distal radius with plantar angulation of the distal radial fracture fragment |
| Jones Fracture | transverse fracture of the 5th metatarsal about 1 to 2 cm from its base caused by plantar flexion of the foot and inversion of the ankle |
| Boxer's Fracture | Fracture of the neck of the 5th metacarpal with palmar angulation of the distal fracture fragment |
| March Fracture | type of stress fracture caused by repeated microfractures to the foot from trauma and most often affects the shafts of the 2nd and 3rd metatarsals |
| Supracondylar fracture | most common fracture of the elbow in children |
| WBC | 4000-11000 cells/mm3 |
| Creat | 0.6-1.2 (males) 0.5-1.1mg/dl(females) |
| platelet count | >50,000 for angiography |
| Prothrobin Time PT | <15 seconds |
| INR | < or equal to 1.5 for safe femoral artery access |
| Proximal Humerus | features greater/lesser tubercles, intertubercular groove, and muscle attachments |
| Rotator Cuff Muscles | supraspinatus, subscapularis, infraspinatus, teres minor |
| Biceps Brachii | Long head and short head origins, inserting into radial tuberosity |
| Bursa and Shoulder | Synovial-filled sacs reduce friction. Key structures include acromion, deltoid, subcoracoid and subacromial bursae, rotator cuff, biceps, and glenohumeral joint capsule |
| Humerus Landmakrs | Anatomical/surgical necks, tubercles, intertubercular groove, deltoid tuberosity, epicondyles, capitulum, trochlea |
| Salter-Harris Classification | Describes 5 types of growth plate fractures |
| Coulomb /kilogram | Quantifies electrostatic charge |
| Roentgen | Measures radiation exposure by quantifying the number of ion pairs formed in a given volume of air when exposed to radiation. |
| Absorbed Dose | The amount of energy imparted to matter by ionizing radiation per unit mass of the irradiated material |
| Gray (GY) 1 GY | 100 Rad |
| Dose equivalent | measurement that reflects the biological damage caused by absorbed radiation dose. |
| Sievert (Sv) 1 Sv | 100 Rem |
| Effective Dose | doe measurement that accounts for the varying radiosensitivity of different cell types and the size of tissues or organs exposed |
Created by:
kristen.carmon43