medmaestro's version from 2015-11-28 03:08

Characteristic features of BONE TUMOURS

Question Answer
1. Neoplastic new bone/ OSTEOID formation in sarcomatous stromaOsteosarcoma
2. NOCTURNAL PAIN RELIEVED BY SALICYLATES,Double density sign ,Lucent nidus of osteoblastic tissue surrounded by reactive sclerosisosteoid osteoma
3. Small blue round cells with PAS positive diastase,Bone destructionEwing’s sarcoma(1)
4. Physaliferous cellschordoma
5. HOMER WRIGHT PSEUDOROSETTES,Onion skin lesions,Bone tumour resembling OSTEOMYELITISEwing’s sarcoma(2)
6. Ballooned appearance ,Fallen fragment signunicameral bone cyst
7. Finger in balloon , pencil in cup appearanceaneurismal bone cyst
8. Herring bone arrangement of fibroblastsfibrosarcoma
9. Benign bone condition with cellular atypiachondromyxoid fibroma
10. Honeycomb appearanceadamantinoma
11. Pinwheel pattern /Storiform/whorled/radiating bundlesnon-ossifying fibroma,fibrous cortical defect
12. Shepherd crook’s deformity of femur,Ring of Orange , Smoky matrix ,Leontiosis osseafibrous dysplasia
13. COAST OF MAINE appearance polyostotic fibrous dysplasia , Mc Cune Albright syndrome
14. Driven snow appearancePindborgs tumour


Question Answer
15. String signparosteal osteosarcoma
16. Target calcificationosseous lipoma
17. Polka dot sign,Corduroy/Accordion signvertebral hemangioma
18. Nocturnal pain NOT RELIEVED BY SALICYLATESOsteoblastoma
19. Trumpet shaped metaphysic ,Coat hanger appearanceDiaphyseal aclasis
20. O ring sign,Punctate/stippled calcification /Flicks/Wisp of calcifications in lucent area,Celery stick appearance,Associated with Wolliers disease & MAFFUCCI SyndromeEnchondroma
21. Eccentric geographic lytic lesion,Dense punctuate mottled calcification,CHICKEN WIRE mineralization /calcification /CODMANS TUMOURchondroblastoma
22. CODMANS TRIANGLE,Sunray appearance,bone tumour with calcified secondariesosteosarcoma
23. Endosteal scalloping,Most common malignant tumour to appear benign radiologically,Dense popcorn / comma calcificationchondrosarcoma
24. Eccentric epiphyseal lytic lesion with Soap Bubble appearance,Multinucleate giant cellsGiant cell tumour(Osteoclastoma)
25. Wormian bonesosteogenesis
26. Risser’s signepiphysis of long bones
27. Aneurysmal signTB Spine (ANTERIOR type)
28. Tonguing of vertebraMorquio-Brails disease
29. Trethowan’s signSlipped Capital Femoral Epiphysis
30. Sagging rope signPerthe’s disease
31. Patchy calcificationChondrosarcoma (Malignant tumour appearing benign on X Ray )
32. FabellaSesamoid bone in the LATERAL head of Gastrocnemius
33. Spondylosisdegenerative spine disease
34. Spondylolysisbreak in Posterior elements (At pars interarticularis)
35. Spondylolisthesisslip of one vertebra over the other



Question Answer
1. Staphylococcus aureusM/C organism in OSTEOMYELITIS,Acute hematogenous osteomyelitis (90%) & infected metal implants
2. Group B StreptococciInfants < 1 yr old
3. Hemophilus influenzachildren 1-16 yrs old
4. Pseudomonas aeruginosanosocomial ,puncture wound through shoe
5. Pasteurella multocidaAnimal bite
6. Eikenella corrodensHuman bite
7. Salmonellasickle cell disease
8. AnaerobesDiabetic ulcers, fight bites
9. Candida albicans , Aspergillus , Atypical mycobacteriaImmunocompromised
10. Escherichia coliNeonatal
11. Neisseria gonorrhoeaSeptic arthritis in young sexually active adult


Location of Annular Pulleys:

Question Answer
A1over the metacarpophalangeal joint
A2middle portion of the proximal phalanges
A3over the proximal inter phalangeal joint
A4middle portion of the middle phalanges
A5over the distal inter phalangeal joint
Critical PulleysA2 & A4-Essential in maintaining the Mechanical advantage of the Flexor Tendons.


Question Answer
Flexor Zone IExtends from insertion of the Profundus on the distal phalanx to insertion of the Flexor digitorum superficialis on the middle phalanx
Flexor Zone IIExtends from the proximal portion of the A1 Pulley to insertion of the Superficialis tendon.SIGNIFICANCEMost problematic region of injury because it contains both the Profundus & Superficialis tendons in a relatively AVASCULAR Region.[NO MAN’S ZONE]
Flexor Zone IIIFrom proximal edge of the A1 pulley to the distal edge of the transverse carpal ligament
Flexor Zone IVLies beneath the Transverse Carpal Ligament
Flexor Zone VProximal to the Transverse carpal ligament & includes the Forearm


Question Answer
Extensor Zone IExtends from distal insertion of the Extensor tendon to the attachment of the central slip at the proximal end of the middle phalanx.
Extensor Zone IIExtends from the metacarpal neck to the proximal inter phalangeal joint
Extensor Zone IIIFrom the metacarpal neck to the distal border of the dorsal carpal ligament
Extensor Zone IVArea under the Dorsal Carpal Ligament (EXTENSOR RETINACULUM )
Extensor Zone VProximal to the proximal margin of Dorsal Carpal Ligament


Question Answer
IExtensor pollicis brevis , Abductor pollicis longus (EPB,AbPL)
IIExtensor carpi radialis brevis, Extensor carpi radialis longus (ECRB,ECRL)
IIIExtensor pollicis longus(EPL)
IV4 Tendons of Extensor Digitorum Communis & Extensor Indicis Proprius (EDC,EIP)
VExtensor digiti quinti (EDQ)
VIExtensor carpi ulnaris (ECU)


Question Answer
1. Aviator’s# of neck of Talus
2. Baby car# of distal end of humerus with proximal radius / ulna
3. Barton’s /Marginal ## dislocation of Radiocarpal joint-Intraarticular # of distal articular surface of radius
4. Bennett’s dislocationoblique intra articular # of Base of First 1st metacarpal with subluxation of trapezio-metacarpal joint dislocation
5. Boxer’sventrally displaced # through Neck of Fifth 5th metacarpal.
6. Bumpercomminuted depressed # of lateral tibial condyle
7. Buttonhole# with loss of bone as in gunshot injury.
8. Chauffer’sRadial styloid #
9. ChanceHorizontal # through vertebra (Body,Pedicles , Laminae) due to sudden deceleration with lap-only seatbelt ; usually L1 or L2
10. Clay shoveller’sa # of spinous process of T1 vertebra


Question Answer
11. Colles’# occurring in adults at the corticocalcaneal junction of the distal radio ulnar joint .
12. Cough# Rib (5th or 7th ) caused by coughing
13. Cotton’sTrimalleolar ankle #
14. Galeazzi# of distal third of Radius with dislocation of distal radioulnar joint (Synonyms:-Reverse Monteggia #, Piedmont # ,# of Necessity)
15. Monteggia# of proximal third of Ulna with anterior dislocation of proximal Radioulnar joint .
16. Night stickIsolated # shaft of ulna
17. Gosselin’s #V shaped # of distal end of tibia
18. Green stick / Hickory stick # or Willow #bending of a bone with incomplete #
19. Jefferson’s #burst # of C1 vertebra –ATLAS
20. Jone’s #avulsion # of base of 5th metatarsal
21. Hangman’s #traumatic spondylolisthesis of C2
22. March #stress # of shaft of 2nd or 3rd metatarsal
23. Pond #depressed skull # in infants
24. Pott’s #bimalleolar ankle #


Question Answer
25. Rolando’s #complete extraarticular # across the base of the 1st metacarpal
26. Smith’s #reverse of Colle’s #; # distal end of radius with volar or ventral tilt and angulation
27. Tripod #trimalar # involving the inferior orbital rim,lateral orbital wall ,and #-dislocation of zygomatic arch
28. Essex kiorestu #radial head # with DRUJ(Distal RadioUlnar Junction) disruption
29. Laugier’s #Trochlear fractures
30. Leforte – Wagstaff #anterior fibular tubercle avulsion # by the anterior tibiofibular ligament ,usually associated with Lauge Hansen SER type # patterns
31. Malgaigne’s #Sacroiliac disruption with pubic rami #
32. Maisonneuve ## of the proximal 3rd of fibula with an external rotation type injury.
33. Pilon ## distal end of tibia
34. Pseudo Jone’s #farctures involve # of styloid process
35. Seymour #distal phalangeal growth plate #
36. Segond #seen on AP Xray (lateral capsular sign ) is a capsular avulsion from the lateral tibial metaphysic that is highly associated with ACL disruption.
37. Tillaux Chaput #avulsion of anterior tibial margin by the anterior tibiofibular ligament ;it is the tibial counterpart of Leforte-Wagstaff #


Question Answer
Cortical bone graftsused primarily for structural support(fibula,tibia)-STAB GRAFT
Cancellous bone graftprovides osteogenesis for healing – SILVER/ STRIP GRAFT
Autogenous grafttaken from tibia,fibula or ilium
CHIP Grafts are obtained fromcancellous bones
Most common site for taking/harvesting bone graftiliac crest
Common source for cortical bone graftingfibula
Graft primarily provides SCAFFOLDDING upon which new bone is laid downOSTEOCONDUCTION
Muscle pedicle bone graftingNon-union # Neck of Femur –BAKSHI OPERATION OR MEYER’S OPERATION
Most common type of graft used in INDIAautograft/autogenous graft
Allograft bone is preserved byby deep freezing (-70oC),By decalcifying and by formalin preservation
Best donor for allograftidentical twin
BMP-2 is used asBone healing stimulator
Some mcq
Question Answer
Cubitus varus (gun stock deformity)# supracondylar humerus
Cubitus valgus deformity,Tardy ulnar nerve palsy ,Salter Harris type II & IV injury,usually require operative trt-OR & IF# lateral condyle of humerus
Dinner fork deformityColle’s #(lower end of radius)


Question Answer
Cramer wire splintemergency immobilization of #
Thomas / Bohler Braun splint# femur
Aluminium splintimmobilization of fingers
Cock up splintradial nerve palsy
Knuckle bender splintulnar nerve palsy
Toe raising splintfoot drop
Four post collarneck immobilisation
Mermaid splinttreatment of Rickets
Aeroplane splintbrachial plexus palsy
SOMI Bracecervical spine injury
ASHE(anterior spinal hyper extension) bracedorso lumbar spinal injury
Taylor’s bracedorso lumbar immobilization
Milwaukee / Boston braceScoliosis
Lumbar corsetback ache
Volkmann’s splintVolkmann’s ischemic contraction
Von Rosen splint,Iifeld –Craig splint ,Frejka pillowCongenital dislocation of hip
Underarm brace / LumboSacral Orthosis(LSO)treatment of Lumbar Scoliosis
Charleston night bending brace worn only during night ,in treatment of idiopathic scoliosis

Braces for scoliosis

Question Answer
Underarm brace / LumboSacral Orthosis(LSO)treatment of Lumbar Scoliosis
Charleston night bending brace worn only during night ,in treatment of idiopathic scoliosis
Boston barcefor scoliosis,cosmetically more acceptable
Milwaukee brace/cervico thoraco lumbosacral orthosisfor scoliosis -used for nearly all curvatures
OperationUsed for
Bankart’s procedurerecurrent shoulder dislocation
Bristlow procedurerecurrent shoulder dislocation
Dilwyn Ewan procedureCTEV
Girdlestone arthroplastyTB Hip
Grice Green operationSubtalar arthrodoesis
Hauser’s operationRecurrent dislocation of patella
Jone’s operationfoot deformity in polio
Keller’s operationHallux valgus correction
Lambrinudi operationCorrection of equinus deformity of foot
Meyer’s operationfracture neck of femur
Putti Plat operationRecurrent dislocation of shoulder
Soutter’s releaseFlexion deformity of hip in polio
Steindler’s releaseCavus deformity of foot
Tension band wiringFracture patella,Fracture olecranon
Turco’s procedureCTEV
Wilson’s releaseFlexion deformity of knee
Yount’s releaseFlexion deformity of knee in polio


Osteotomyused for
Derotation osteotomyCDH
Dimon – Houston osteotomyInter trochanteric #
Dwyer osteotomyCTEV
French osteotomyCubitus varus deformity
High tibial osteotomyOA of knee with varus deformity
McMurray’s osteotomy# neck of femur
Pauwel’s osteotomy# neck of femur
Pemperton’s #CDH
Salter’s/Chiari-Digas osteotomyCDH
Sandwich osteotomySlipped epiphysis
Spinal/Smith Peterson osteotomyAnkylosing spondylosis
Wilson’s osteotomycongenital coxa vara