Superficial Structures - Part 7

Question 1

What causes Achilles tendonitis? (2)

Answer 1

1. Inflammation

2. Trauma

Question 2

What are the clinical findings of Achilles tendonitis? (3)

Answer 2

1. Pain or tenderness at the site of insertion
2. Palpable mass
3. Decreased range of motion in the foot or ankle joint

Question 3

What is the US appearance of Achilles tendonitis? (6)

Answer 3

1. Thickening of the tendon
2. Tendon thickness exceeding 7mm
3. Prominent hypo echoic areas
   interspersed between the
   fibrous tissues
4. Irregular wall margins
5. Hypervascularity
6. Calcifications in chronic cases

Question 4

What are 3 differential diagnosis of Achilles tendonitis?

Answer 4

1. Partial tear
2. Anisotropy artifact
3. Tendinosis

Question 5

What is the cause of an Achilles tendon tear?

Answer 5

Trauma

Question 6

What are the clinical findings of an Achilles tendon tear? (3)

Answer 6

1. Painful tendon
2. Positive Thompson test
3. Focal cleft at tendon insertion

Question 7

What is the US appearance of a complete Achilles tendon tear? (2)

Answer 7

1. Irregular tendon contour

2. Hematoma surrounding the defect

Question 8

What is the US appearance of a partial Achilles tendon tear? (2)

Answer 8

1. Focal disruption in the tendon

2. Fluid collection within the tendon

Question 9

What are 3 differential diagnosis of an Achilles tendon tear?

Answer 9

1. Anisotropy artifact 2. Tendonitis

3. Tendinosis

Question 10

What is an Achilles tendon tear most commonly located?

Answer 10

Distal portion 2-6cm from the calcaneus

Question 11

What are the causes of a Baker’s cyst? (4)

Answer 11

1. Knee trauma
2. Rheumatoid arthritis
3. Osteoarthritis
4. Chronic knee
   dysfunction

Question 12

What are the clinical findings for a Baker’s cyst? (2)

Answer 12

1. Pain in knee or proximal calf

2. Knee swelling Palpable mass

Question 13

What is the US appearance for a Baker’s cyst? (4)

Answer 13

1. Anechoic mass in the medial and posterior aspect of the knee
2. May contain internal echoes
3. May extend into the calf
   - rarely extends into the thigh
4. Fluid collections dissect inferiorly
   into the muscular fascial planes when ruptured

Question 14

What are 3 differential diagnosis for a Baker’s cyst?

Answer 14

1. Joint effusion
2. Abscess
3. Hematoma

Question 15

What are the risk factors for a development displacement of a hip? (6)

Answer 15

1. Family history of congenital dislocation of the hip
2. Female infant
3. Breech presentation
4. Pregnancies with
   oligohydramnios
5. Foot deformity that requires further treatment
6. Neonatal torticollis

Question 16

What are the clinical findings for development displacement of a hip? (6)

Answer 16

1. Clicky hip on the 2. Barlow or Ortolani maneuvers
2. Limited abduction
3. Thigh asymmetry 5. Limb shortening 6. Abnormal leg posture

Question 17

What is the US appearance for development displacement of a hip? (2)

Answer 17

1. Shallow acetabulum
2. Femoral head not in contact with
   acetabular floor

Question 18

What is the alpha angle for development displacement of a hip?

Answer 18

Less than 60 degrees

Question 19

What is the beta angle for development displacement of a hip?

Answer 19

Greater than 50 degrees

Question 20

What are 2 differential diagnosis for development displacement of a hip?

Answer 20

1. Immature hip

2. Technical error

Question 21

What are causes of a ganglion cyst? (2)

Answer 21

1. Idiopathic

2. Repetitive motion

Question 22

What are the clinical findings for a ganglion cyst? (2)

Answer 22

1. Small bulge found on the wrist
   - but can occur with any tendon
2. Pain

Question 23

What is the US appearance for a ganglion cyst? (3)

Answer 23

1. Anechoic fluid collection at tendon connection to bone

2. Single or multiple 3. Variable size

Question 24

What are 2 differential diagnosis for a ganglion cyst?

Answer 24

1. Tenosynovitis

2. Synovial sarcoma

Question 25

Morton’s neuroma

Answer 25

Benign growth of the plantar nerve tissue

Question 26

What are the clinical findings of Morton’s neuroma? (2)

Answer 26

1. Sharp burning pain radiating from the foot to the toes | 2. Numbness of the ball of the foot

Question 27

What is the US appearance for Morton’s neuroma?

Answer 27

Hypo echoic intermetatarsal mass

Question 28

What are 2 differential diagnosis for Morton’s neuroma?

Answer 28

1. Ganglion cyst | 2. Giant cell tumour

Question 29

What causes a muscle tear? (2)

Answer 29

1. Sprain | 2. Strain

Question 30

What are the risk factors for a muscle tear? (5)

Answer 30

1. Increase in age 2. Lifting above the head 3. Sports strains 4. Cigarette smoking 5. Corticosteroid medications

Question 31

What are the clinical findings for a muscle tear? (3)

Answer 31

1. Pain 2. Swelling 3. Decrease in range of motion

Question 32

What is the US appearance for a muscle tear? (3)

Answer 32

1. Heterogeneous mass 2. Focal disruption of the normal muscle 3. Perifascial fluid

Question 33

What are 2 differential diagnosis for a muscle tear?

Answer 33

1. Giant cell tumour | 2. Neuroma