Hip and Legs Flashcards

1
Q

Why is it important to not externally rotate the hip on X-ray?

A

Shortens the neck of the femur

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2
Q

What is the most common type of hip dislocation?

A

Posterior (85-90%)

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3
Q

How is the leg positioned after a posterior hip dislocation?

A

Internally rotated and adducted (across midline) and leg is superior to acetabulum

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4
Q

If the femur is seen superior on X-ray following a dislocation, what type probably occurred?

A

Posterior

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5
Q

Where does the leg lie after an anterior hip dislocation?

A

Externally rotated, abducted, and flexed

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6
Q

Anterior hip dislocations may be associated with what other condition?

A

Femoral neck fracture

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7
Q

If the femur is seen inferior on X-ray following a dislocation, what type probably occurred?

A

Anterior

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8
Q

Where would the femur end up after a central hip dislocation?

A

Into pelvic outlet

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9
Q

What is the most serious complication of fractures of the proximal femur?

A

AVN

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10
Q

What gender is more likely to be affected by fractures of the proximal femur? Age population?

A

Females; elderly

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11
Q

What is the most common location for a fracture of the proximal femur?

A

Subcapital

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12
Q

What two kinds of stress can cause a fracture of the proximal femur?

A

Overuse or insufficiency

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13
Q

What is the most common fracture seen due to insufficiency?

A

Hip (proximal femur)

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14
Q

What imaging procedure should be used following hip trauma?

A

MRI to check for marrow edema

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15
Q

How long does it take for a stress fracture to appear as a transverse radiolucency or fluffy periosteal reaction?

A

7-10 days

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16
Q

Why do stress fractures usually appear radiographically normal?

A

Less than 30% bone destruction, so unable to be seen

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17
Q

What is most likely the cause of a femoral shaft fracture in children under 5?

A

Abuse (usually transverse or comminuted)

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18
Q

What is the best recommendation for an athlete with a stress fracture?

A

REST for 6 months to allow healing

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19
Q

The FBI sign is more important in what area?

A

Knee

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20
Q

What is the most common area to be affected of the proximal tibia?

A

Lateral tibial plateau

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21
Q

An avulsion of the anterior tibial spine is more common in what population?

A

Children

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22
Q

An avulsion of the anterior tibial spine results from what mechanism?

A

Hyperextension (usually fall of bicycle)

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23
Q

What soft tissue injury is likely to occur with an avulsion of the anterior tibial spine?

A

ACL (more common in adults)

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24
Q

What is the most common patella fracture type?

A

Transverse/horizontal

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25
Q

What is an important differential diagnosis when assessing patellar fractures?

A

Bipartite patella (look to history)

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26
Q

What is the usual location for a bipartite patella?

A

Superlateral margin

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27
Q

What is the most common knee ligament to be damaged?

A

MCL

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28
Q

What is the second most common knee ligament to be damaged?

A

ACL

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29
Q

What is the most common forced directed to the knee for injury?

A

Lateral to medial

30
Q

What makes up the Odonohue’s triad?

A

MCL tear, ACL tear, lateral meniscus compression (MAYBE medial meniscal damage, too)

31
Q

How do tendons and ligaments appear on MRI?

A

Black (signal hypointense) when normal

32
Q

What is the term for a longitudinal vertical tear of the meniscus?

A

Bucket handle tear

33
Q

What is the term for a fraying of free edge of one of the menisci?

A

Parrot beak tear

34
Q

The increased density (white) of a tendon/ligament tendon must extend where to be classified as a tear?

A

To articular surface

35
Q

What shape are the menisci on sagittal MRI?

A

Triangles

36
Q

If a meniscoidal tear does not contact the articular edge, what is it then called?

A

Meniscoidal degeneration

37
Q

Which area of the meniscus is likely to have the tear visible on MRI?

A

Posterior horn

38
Q

How does marrow convert in children: red to yellow marrow or yellow to red?

A

Red to yellow as we mature

39
Q

What is the most common fracture of the lower leg?

A

Both tibia and fibula together

40
Q

How long does it take for tibial fractures to heal in adults?

A

16 weeks (decreased vascularity of tibias)

41
Q

When a fracture of the lower leg is isolated, which bone is it likely to involve?

A

Fibula alone

42
Q

Stress fractures of the lower leg occur mostly in what part?

A

Proximal third

43
Q

Fractures of the lower leg occur mostly in what parts?

A

Middle or distal third

44
Q

What fracture of the lower leg is a type of avulsion fracture of the lateral tibial condyle of the femur?

A

Segond fracture

45
Q

What other injuries are likely to be associated with a segond fracture?

A

ACL tear or medical meniscus compression

46
Q

Which fracture of the lower leg is a spiral fracture of the proximal third of the fibula associated with a tear of the distal tibiofibular syndesmosis and the interosseous membrane?

A

Maisonneuve fracture

47
Q

What other injuries are seen to accompany a Maisonneuve fracture?

A

Medial malleolus or rupture of the deep deltoid ligament

48
Q

What is the most common type of ankle fracture?

A

Bimalleolar

49
Q

What kind of mechanism can result in a trimalleolar fracture?

A

Usually severe rotation (to get the posterior malleolus involved)

50
Q

What is the “3rd” malleolus?

A

Posterior aspect of distal tibia

51
Q

What makes up Neer’s ring?

A

Tibia, fibula, talus

52
Q

What is the most common combination for a break of Neer’s ring?

A

Bimalleolar fracture

53
Q

When the talar dome angulation is greater than 16 degrees, what does that indicate?

A

Soft tissue injury

54
Q

What is the most commonly fractured tarsal bone?

A

Calcaneus

55
Q

What is usually the mechanism of injury for a calcaneal fracture?

A

Fall from height

56
Q

What angle of measurement is used to assess for a calcaneal fracture?

A

Boehler’s angle

57
Q

What fracture of the axial skeleton is likely to be accompanied with a calcaneal fracture?

A

Thoracolumbar junction compression fracture

58
Q

Boehner’s angle should be no less than how many degrees?

A

28 degrees (less would indicate fracture)

59
Q

What two bones are the slowest to heal?

A

Scaphoid and tibia (decreased vascularity)

60
Q

What is the second most common fractures tarsal?

A

Talus

61
Q

What type of fracture is a transverse fracture at the base of the fifth metatarsal?

A

Jones/Dancer’s fracture

62
Q

What motion/positions cause a Dancer’s fracture?

A

Plantar flexion and inversion of foot

63
Q

What tendon is involved with the avulsion associated with a Dancer’s fracture?

A

Peroneus (fibularis) brevis tendon

64
Q

Where is the pain referred with a Jones/Dancer’s fracture?

A

Lateral malleolus (because fibularis brevis tendon wraps around it)

65
Q

How can a Dancer’s fracture be differentiated from a growth center of the 5th metatarsal?

A

Growth centers will be vertical, fractures will be transverse

66
Q

What is sometimes referred to as a “bedroom” fracture?

A

Oblique fracture to proximal portion of distal metatarsal

67
Q

What is another name for stress fractures of the feet?

A

March fractures

68
Q

Stress fractures of the feet most commonly involve which digits?

A

2nd and 3rd metatarsal shafts

69
Q

A Lisfranc dislocation is usually in which direction?

A

Dorsal

70
Q

What mechanism usually causes a Lisfranc dislocation?

A

Fall from height

71
Q

What is the rare mid tarsal dislocation where the foot is displaced medially?

A

Chopart’s dislocation