Saturday, August 31, 2019
October Reading
October Reading MSK Requisites Chapters 9 (Spine Trauma), 10 (Pelvis), and 11 (Hip and Femur)
Thursday, August 8, 2019
August Quiz Answers
1. This structure covers the bone surface except at joints and contributes to bone production and remodeling:
a. Apophysis
b. Trabecula
c. Periosteum (1 pt)
d. Metaphysis
2. The patient has a fracture of the base of the 5th metatarsal with a small fragment retracted from the base. This would represent what type of force of trauma?
a. Shear
b. Distraction
c. Compression
d. Tension (1 pt)
3. What is a Die-Punch fragment? Articular surface fragment that is driven into the epiphysis or metahysis. Where does it most commonly occur? Tibial plateau fx (2 pts)
4. What is an osteochondral fracture? Compression or shear fracture of subchondral bone and overlying cartilage that is confined to the peripheral portion of the epiphysis (1 pt)
5. What is an insufficiency fracture? Fracture caused by normal stresses are placed on bone that is weakened by a generalized process such as osteoporosis (1 pt)
6. What is a pathologic fracture? Fracture caused normal stresses to an abnormal bone - like a benign or malignant tumor (1 pt)
7. An intraarticular fracture that has significantly increased risk of developing post traumatic osteoarthritis? fx with step-off or diastasis of greater than 2 mm (1 Pt)
8. What are the 2 types of nonunion? Hypertrophic (sclerotic and associated with excess bone deposition) and atrophic (associated with demineralization) (2 pt)
9. What are 3 common types of causes of orthopedic hardware failure? Inadequate reduction, inadequate hardware, noncompliant patients (3 pt)
10. What is impingement? Abnormal tissue compression (1 pt)
11. What is anisotropic? Not the same in every direction (1 pt)
12. What is the magic angle? Normal ligament or tendon will have intermediate or bright signal when oriented 55 degrees relative to the bore of the magnet on short TE sequences such as GRE, T1 (1pt)
13. How to avoid magic angle? use longer TE such as T2 (1 pt)
14. What are tendons most prone to subluxation? Extensor carpi ulnaris, peroneus brevis and longus, tibialis posterior (3 pt)
15. If you think there is fatty infiltration of a muscle, which sequence will you look at?
a. T2FS
b. T1 (1 pt)
c. STIR
d. GRE
16. What are the 3 grades of muscle strain? Grade 1 - edema between muscle fibers usually along myotendinous junction; 2 - extensive edema and fluid collections; 3 - disruption of the musculotendinous junction with loss of function (3 pt)
17. What is the finding at about 4 weeks after denervation on MRI? Edema in the muscle (high signal on STIR and T2) What about after several months? muscle wasting with fatty infiltration best seen on T1 (2 pt with 1 for each answer)
18. What is an osteochonral defect? A cartilage defect that involves both cartilage and subchondral bone (1 pt)
19. What is the feared complication of physeal injury? growth arrest (1 pt)
20. What is the 1st finding in osteochondritis dissecans on MRI? Subchondral marrow edema (1 pt)
21. Anatomic neck fracture of the humerus is worrisome, why? Blood supply to head is disrupted causing poor healing, avn, and secondary osteoarthritis. (1 pt)
22. Fractures of what parts of the scapula are treated with surgical reduction and fixation? Glenoid, scapular neck, and coracoid (3 pts)
23. Other than AC separation, what are other causes of widened AC joint? Erosion of distal clavicle in RA, hyperparathyroidism, infection, traumatic osteolysis (weightlifters) (4 pt)
24. AC joint is normally how wide with what difference between sides? 5 mm (I don't call widened until 7-8 mm) with no more than 2-3 mm difference between sides (2 pt)
25. Coracoclavicular distance is usually what with what difference between sides? no wider than 11-13 mm with no more than 5 mm difference (2 pt)
26. Which rotator cuff tendon attaches to the lesser tuberosity? Subscapularis (1 pt)
27. If the biceps tendon is dislocated - you should assume there is a tear in what tendon? Subscapularis (1 pt)
28. Denervation of the posterior deltoid and teres minor is associated with fibrous bands in what space? Quadrilateral space with impingement on the axillary nerve (1 pt)
29. Acromioplasty is performed for what? Surgical decompression of the subacromial space in the setting of rotator cuff impingement (this is currently an issue of debate) (1 pt)
30. If you see fluid filled cysts within a muscle belly, you should look for what? Tendon delamination (intrasubstance tears) (1 pt)
31. Where is the critical zone in the rotator cuff and what is it? 1 cm proximal to the distal insertion of the rotator cuff. It is the watershed area between humeral head and muscular blood supply (2 pt)
32. Where does one find a Hill-Sachs lesion on the humerus? Wedge shaped defect in the lateral posterosuperior aspect of the humeral head at or above the coracoid process. (1 pt)
49 points total
a. Apophysis
b. Trabecula
c. Periosteum (1 pt)
d. Metaphysis
2. The patient has a fracture of the base of the 5th metatarsal with a small fragment retracted from the base. This would represent what type of force of trauma?
a. Shear
b. Distraction
c. Compression
d. Tension (1 pt)
3. What is a Die-Punch fragment? Articular surface fragment that is driven into the epiphysis or metahysis. Where does it most commonly occur? Tibial plateau fx (2 pts)
4. What is an osteochondral fracture? Compression or shear fracture of subchondral bone and overlying cartilage that is confined to the peripheral portion of the epiphysis (1 pt)
5. What is an insufficiency fracture? Fracture caused by normal stresses are placed on bone that is weakened by a generalized process such as osteoporosis (1 pt)
6. What is a pathologic fracture? Fracture caused normal stresses to an abnormal bone - like a benign or malignant tumor (1 pt)
7. An intraarticular fracture that has significantly increased risk of developing post traumatic osteoarthritis? fx with step-off or diastasis of greater than 2 mm (1 Pt)
8. What are the 2 types of nonunion? Hypertrophic (sclerotic and associated with excess bone deposition) and atrophic (associated with demineralization) (2 pt)
9. What are 3 common types of causes of orthopedic hardware failure? Inadequate reduction, inadequate hardware, noncompliant patients (3 pt)
10. What is impingement? Abnormal tissue compression (1 pt)
11. What is anisotropic? Not the same in every direction (1 pt)
12. What is the magic angle? Normal ligament or tendon will have intermediate or bright signal when oriented 55 degrees relative to the bore of the magnet on short TE sequences such as GRE, T1 (1pt)
13. How to avoid magic angle? use longer TE such as T2 (1 pt)
14. What are tendons most prone to subluxation? Extensor carpi ulnaris, peroneus brevis and longus, tibialis posterior (3 pt)
15. If you think there is fatty infiltration of a muscle, which sequence will you look at?
a. T2FS
b. T1 (1 pt)
c. STIR
d. GRE
16. What are the 3 grades of muscle strain? Grade 1 - edema between muscle fibers usually along myotendinous junction; 2 - extensive edema and fluid collections; 3 - disruption of the musculotendinous junction with loss of function (3 pt)
17. What is the finding at about 4 weeks after denervation on MRI? Edema in the muscle (high signal on STIR and T2) What about after several months? muscle wasting with fatty infiltration best seen on T1 (2 pt with 1 for each answer)
18. What is an osteochonral defect? A cartilage defect that involves both cartilage and subchondral bone (1 pt)
19. What is the feared complication of physeal injury? growth arrest (1 pt)
20. What is the 1st finding in osteochondritis dissecans on MRI? Subchondral marrow edema (1 pt)
21. Anatomic neck fracture of the humerus is worrisome, why? Blood supply to head is disrupted causing poor healing, avn, and secondary osteoarthritis. (1 pt)
22. Fractures of what parts of the scapula are treated with surgical reduction and fixation? Glenoid, scapular neck, and coracoid (3 pts)
23. Other than AC separation, what are other causes of widened AC joint? Erosion of distal clavicle in RA, hyperparathyroidism, infection, traumatic osteolysis (weightlifters) (4 pt)
24. AC joint is normally how wide with what difference between sides? 5 mm (I don't call widened until 7-8 mm) with no more than 2-3 mm difference between sides (2 pt)
25. Coracoclavicular distance is usually what with what difference between sides? no wider than 11-13 mm with no more than 5 mm difference (2 pt)
26. Which rotator cuff tendon attaches to the lesser tuberosity? Subscapularis (1 pt)
27. If the biceps tendon is dislocated - you should assume there is a tear in what tendon? Subscapularis (1 pt)
28. Denervation of the posterior deltoid and teres minor is associated with fibrous bands in what space? Quadrilateral space with impingement on the axillary nerve (1 pt)
29. Acromioplasty is performed for what? Surgical decompression of the subacromial space in the setting of rotator cuff impingement (this is currently an issue of debate) (1 pt)
30. If you see fluid filled cysts within a muscle belly, you should look for what? Tendon delamination (intrasubstance tears) (1 pt)
31. Where is the critical zone in the rotator cuff and what is it? 1 cm proximal to the distal insertion of the rotator cuff. It is the watershed area between humeral head and muscular blood supply (2 pt)
32. Where does one find a Hill-Sachs lesion on the humerus? Wedge shaped defect in the lateral posterosuperior aspect of the humeral head at or above the coracoid process. (1 pt)
49 points total
Sunday, August 4, 2019
September Quiz Reading
Reading for the September Quiz will be Chapters 6 through 8 of Musculoskeletal Requisites!
Elbow, wrist, and hand!
Elbow, wrist, and hand!
August Quiz
EVMS Reading Quiz for August 2019
1. This structure covers the bone surface except at joints and contributes to bone production and remodeling:
a. Apophysis
b. Trabecula
c. Periosteum
d. Metaphysis
2. The patient has a fracture of the base of the 5th metatarsal with a small fragment retracted from the base. This would represent what type of force of trauma?
a. Shear
b. Distraction
c. Compression
d. Tension
3. What is a Die-Punch fragment? Where does it most commonly occur?
4. What is an osteochondral fracture?
5. What is an insufficiency fracture?
6. What is a pathologic fracture?
7. An intraarticular fracture that has significantly increased risk of developing post traumatic osteoarthritis?
8. What are the 2 types of nonunion?
9. What are 3 common types of causes of orthopedic hardware failure?
10. What is impingement?
11. What is anisotropic?
12. What is the magic angle?
13. How to avoid magic angle?
14. What are tendons most prone to subluxation?
15. If you think there is fatty infiltration of a muscle, which sequence will you look at?
a. T2FS
b. T1
c. STIR
d. GRE
16. What are the 3 grades of muscle strain?
17. What is the finding at about 4 weeks after denervation on MRI? What about after several months?
18. What is an osteochonral defect?
19. What is the feared complication of physeal injury?
20. What is the 1st finding in osteochondritis dissecans on MRI?
21. Anatomic neck fracture of the humerus is worrisome, why?
22. Fractures of what parts of the scapula are treated with surgical reduction and fixation?
23. Other than AC separation, what are other causes of widened AC joint?
24. AC joint is normally how wide with what difference between sides?
25. Coracoclavicular distance is usually what with what difference between sides?
26. Which rotator cuff tendon attaches to the lesser tuberosity?
27. If the biceps tendon is dislocated - you should assume there is a tear in what tendon?
28. Denervation of the posterior deltoid and teres minor is associated with fibrous bands in what space?
29. Acromioplasty is performed for what?
30. If you see fluid filled cysts within a muscle belly, you should look for what?
31. Where is the critical zone in the rotator cuff and what is it?
32. Where does one find a Hill-Sachs lesion on the humerus?
1. This structure covers the bone surface except at joints and contributes to bone production and remodeling:
a. Apophysis
b. Trabecula
c. Periosteum
d. Metaphysis
2. The patient has a fracture of the base of the 5th metatarsal with a small fragment retracted from the base. This would represent what type of force of trauma?
a. Shear
b. Distraction
c. Compression
d. Tension
3. What is a Die-Punch fragment? Where does it most commonly occur?
4. What is an osteochondral fracture?
5. What is an insufficiency fracture?
6. What is a pathologic fracture?
7. An intraarticular fracture that has significantly increased risk of developing post traumatic osteoarthritis?
8. What are the 2 types of nonunion?
9. What are 3 common types of causes of orthopedic hardware failure?
10. What is impingement?
11. What is anisotropic?
12. What is the magic angle?
13. How to avoid magic angle?
14. What are tendons most prone to subluxation?
15. If you think there is fatty infiltration of a muscle, which sequence will you look at?
a. T2FS
b. T1
c. STIR
d. GRE
16. What are the 3 grades of muscle strain?
17. What is the finding at about 4 weeks after denervation on MRI? What about after several months?
18. What is an osteochonral defect?
19. What is the feared complication of physeal injury?
20. What is the 1st finding in osteochondritis dissecans on MRI?
21. Anatomic neck fracture of the humerus is worrisome, why?
22. Fractures of what parts of the scapula are treated with surgical reduction and fixation?
23. Other than AC separation, what are other causes of widened AC joint?
24. AC joint is normally how wide with what difference between sides?
25. Coracoclavicular distance is usually what with what difference between sides?
26. Which rotator cuff tendon attaches to the lesser tuberosity?
27. If the biceps tendon is dislocated - you should assume there is a tear in what tendon?
28. Denervation of the posterior deltoid and teres minor is associated with fibrous bands in what space?
29. Acromioplasty is performed for what?
30. If you see fluid filled cysts within a muscle belly, you should look for what?
31. Where is the critical zone in the rotator cuff and what is it?
32. Where does one find a Hill-Sachs lesion on the humerus?
Thursday, July 25, 2019
August Reading
EVMS 2019-2020 Reading For August Quiz
Welcome back to the EVMS Unofficial Quiz
Reading for the August Quiz - Musculoskeletal Imaging The Requisites 4th Edition - Ch. 1-5
The quiz will be up on August 4th
Answers due by midnight on August 7th.
Welcome back to the EVMS Unofficial Quiz
Reading for the August Quiz - Musculoskeletal Imaging The Requisites 4th Edition - Ch. 1-5
The quiz will be up on August 4th
Answers due by midnight on August 7th.
Monday, April 15, 2019
April Quiz Answers
Hey the answers are Here - It has been a fun year! Hope everyone enjoyed it.
Dr. Dey is the grand winner with Dr. Bonney as the runner up and Dr. Trace coming in 3rd. For everyone who participated - thanks and here is to a hopefully successful one next year!
1. C
2. Associated with ureteroilial stricture
3. Through natural urethra or through straight cath of a stoma or urethra
4. Reabsorption of ammonium and chloride may lead to worsening hepatic impairment
5. Renal artery PSV > 200 cm/s; Renal artery PSV to abominal aorta PSV ratio of > 3.5:1; lack of Doppler US in cases of occlusion; Aliasing
6. Every 1-2 years; >1.5 cm
7. Crossing renal vessel
8. Nutcracker phenomenon - left renal vein compressed between aorta and SMA; Syndrome - clinical signs and symptoms from phenomenon - hematuria, left flank pain; pelvic congestion syndrome, lower limb varices and varicoceles
9. T1
10. at least T3a
11. When mass is suspected of being hematologic, metastatic, infectious or inflammatory
12. cT1a lesions; anatomic or functionally 1 kidney; bilateral tumors; multiple masses; familial syndromes; preexisting CKD, proteinuria; young, multiple masses, comorbidities
Bonus - D
Dr. Dey is the grand winner with Dr. Bonney as the runner up and Dr. Trace coming in 3rd. For everyone who participated - thanks and here is to a hopefully successful one next year!
1. C
2. Associated with ureteroilial stricture
3. Through natural urethra or through straight cath of a stoma or urethra
4. Reabsorption of ammonium and chloride may lead to worsening hepatic impairment
5. Renal artery PSV > 200 cm/s; Renal artery PSV to abominal aorta PSV ratio of > 3.5:1; lack of Doppler US in cases of occlusion; Aliasing
6. Every 1-2 years; >1.5 cm
7. Crossing renal vessel
8. Nutcracker phenomenon - left renal vein compressed between aorta and SMA; Syndrome - clinical signs and symptoms from phenomenon - hematuria, left flank pain; pelvic congestion syndrome, lower limb varices and varicoceles
9. T1
10. at least T3a
11. When mass is suspected of being hematologic, metastatic, infectious or inflammatory
12. cT1a lesions; anatomic or functionally 1 kidney; bilateral tumors; multiple masses; familial syndromes; preexisting CKD, proteinuria; young, multiple masses, comorbidities
Bonus - D
Sunday, April 7, 2019
April Quiz
April 2019 EVMS Unofficial Radiology Quiz
The Last for the 2018-2019 season!
The Final Countdown!
Man I wish I could still grow my hair that long
1. The typical diversion usually has the ostomy?
a. Just below the umbilicus so they can use the urachal remnant
b. In the left lower quadrant as it is easier for right handed people to handle the bag
c. In the right lower quadrant similar to an ileostomy.
2. In incontinent diversions, why do they usually not implement antireflux anastomosis?
3. Continent diversion - How does one void?
4. Why does one need to have adequate liver function for a continent diversion?
5. What are the direct signs of renal artery stenosis
6. Patient has a 1.2 cm renal artery aneurysm. How often should she be reevaluated? When should she have definitive intervention?
7. UPJ obstruction is caused in 29-46% of the time by what?
8. What is nutcracker phenomenon and what is the distinction between this an nutcracker syndrome?
9. Renal mass that is 3 cm in longest dimension with intact capsule and no involvement of the renal sinus fat would be considered what T stage?
10. Same mass but invades the renal pelvis would be at least what T stage?
11. When should renal mass biopsy be considered?
12. Who should get partial nephrectomy?
Bonus:
Controversial, but what band may or may not have been partially responsible for the invention of CT?
a. The Who
c. New Order
d. The Beatles
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