ABD board: MSK, Breast, Superficial Structures

the ducts of the breast used to transport milk to the nipple

lactiferous ducts

inflammation of the breast that is related to pregnancy

puerperal mastitis

inflammation of the tendon and synovial tendon sheath

tendosynovitis

a technique used to measure the relationship of the femoral head and acetabulum by evaluating the alpha and beta angles created by the relationships of these structures

Graf technique

1. Which of the following techniques is used to measure the relationship of the femoral head and acetabulum by evaluating the alpha and beta angles? a. Graf b. Ortolani c. Barlow d. Thompson

a. Graf

27. A complicated Baker cyst may contain a thin flap of tissue referred to as: a. Pannus b. Plicae c. Septation d. lipoma

a. Pannus

31. All of the following are true of ganglion cysts except: a. a ganglion cyst is a common mass found along the superior aspect of the hand and wrist, between the tarsals b. ganglion cysts typically appear sonographically as an incompressible, anechoic mass with acoustic enhancement c. clinically, ganglion cysts may be hard to touch and painful d. ganglion cysts are often treated with an injection of corticosteroids

a. a ganglion cyst is a common mass found along the superior aspect of the hand and wrist, between the tarsals

21. The accumulation of synovial fluid from a weakening in the joint capsule of the knee, as seen in conditions such as rheumatoid arthritis can result in a: a. hemangioma b. lipoma c. Baker cyst d. Ganglion cyst

c. Baker cyst

8. A common mass found along the dorsal aspect of the hand and wrist is the: a. Baker cyst b. Thompson cyst c. Ganglion cyst d. lipoma

c. Ganglion cyst

5. What test can be performed to determine a torn achilles tendon? a. McBurney test b. McDonald test c. Thompson test d. Baker test

c. Thompson test

2. Inflammation and infection of the skin and subcutaneous tissue is termed: a. ascites b. retroperitoneal fibrosis c. cellulitis d. subcutaneous edema

c. cellulitis

9. The achilles tendon connects the: a. ankle to the knee b. heel to the ankle c. heel to the calf muscle d. knee to the calf muscle

c. heel to the calf muscle

30. Sonographically, normal muscle appears as: a. hyperechoic tissue that contains linear echogenic strands b. complex tissue that contains linear, hypoechoic strands c. hypoechoic tissue that contains linear, echogenic strands d. echogenic tissue that contains linear, hypoechoic strands

c. hypoechoic tissue that contains linear, echogenic strands

35. Hyperemic flow within or around a structure is often indicative of: a. malignancy b. benignancy c. inflammation d. rupture

c. inflammation

A synovial cyst located within the popliteal fossa; may also be referred to as a popliteal cyst

Baker cyst

the bowl-shaped surface of the pelvis where the head of the femur normally rests

acetabulum

a milk-filled breast cyst

galactocele

clinical test for developmental hip dysplasia that is used to evaluate the hip for dislocation

Barlow test

tendon located along the posterior ankle that connects the calf muscle to the posterior surface of the heel

Achilles tendon

clinical test for developmental hip dysplasia that is used to evaluate the hip for the reduction or relocation of a dislocated hip

Ortolani test

clinical test used to evaluate for a complete tear of the achilles tendon

Thompson test

6. A cystic mass located within the popliteal fossa is most likely a: a. Baker cyst b. Thompson cyst c. Ganglion cyst d. Lipoma

a. Baker cyst

33. Tendons sonographically appear as: a. echogenic, fibrous structures connecting muscles to bone b. echogenic, fibrous structures connecting bone to bone c. hypoechoic, linear arrangements within hyperechoic tissue d. hyperechoic tissue that contains linear, echogenic strands

a. echogenic, fibrous structures connecting muscles to bone

32. A partial tear of a tendon typically appears as: a. focal hypoechoic areas within the tendon b. a focal echogenic area within the tendon c. a diffusely heterogenous area within the tendon d. edema and refractive shadowing in the area of the divided tendon

a. focal hypoechoic areas within the tendon

28. Which of the following is also referred to as a Bible bump? a. ganglion cyst b. superficial endodermal cyst c. superficial epidermal cyst d. epidermoid

a. ganglion cyst

19. Which of the following would be best described as a benign tumor comprised of blood vessels? a. hemangioma b. lipoma c. hamartoma d. oncocytoma

a. hemangioma

20. Which of the following transducers would be best suited to sonographically assess for a splinter in a patient's hand? a. high frequency linear array transducer b. low frequency curved array transducer c. high frequency sector transducer d. low frequency linear array transducer

a. high frequency linear array transducer

23. Which of the following best describes the most common sonographic appearance of gynecomastia? a. hypoechoic, retroareolar mass b. hyperechoic, exophytic mass c. anechoic, retroareolar mass d. hyperechoic, areolar mass

a. hypoechoic, retroareolar mass

3. Clinical findings of tendonitis include all of the following except: a. itching in the area of the tendon b. pain c. edema d. the area is warm to touch

a. itching in the area of the tendon

15. All of the following are keys to identifying foreign bodies with sonography except: a. most foreign bodies appear hypoechoic b. a linear array transducer should be used c. most foreign bodies are better visualized using a standoff pad d. comet-tail artifact may be seen posterior to metallic objects

a. most foreign bodies appear hypoechoic

10. In what position should the patient be placed to better evaluate the Achilles tendon? a. prone b. supine c. right lateral decubitus d. left lateral decubitus

a. prone

11. Inflammation of the breast that is related to pregnancy is referred to as: a. puerperal mastitis b. retromammary mastitis c. chronic mastitis d. emphysematous mastitis

a. puerperal mastitis

25. inflammation of the tendon and synovial tendon sheath is referred to as: a. tendosynovitis b. tendonitis c. cellulitis d. pannus

a. tendosynovitis

37. Which of the following best describes the Thompson test? a. the calf is squeezed and the foot should plantarflex in a patient who does not have a complete tear of the achilles tendon b. the calf is squeezed and the foot should not plantarflex in a patient who does not have a complete tear of the Achilles tendon c. the Achilles tendon is squeezed and the foot should plantarflex in a patient who does not have a complete tear of the Achilles tendon d. the Achilles tendon is squeezed and the foot should not plantarflex in a patient who does not have a complete tear of the Achilles tendon

a. the calf is squeezed and the foot should plantarflex in a patient who does not have a complete tear of the achilles tendon

a congenital disorder associated with severe joint contractures

arthrogryposis

29. Clinical findings of a Baker cyst may mimic those of a(n): a. Arteriovenous malformation b. Deep venous thrombosis c. knee fracture d. ganglion cyst

b. Deep venous thrombosis

4. Which of the following is a clinical test for developmental hip dysplasia that is used to evaluate the hip for the reduction or relocation of a dislocated hip? a. Graf b. Ortolani c. Barlow d. Thompson

b. Ortolani

39. Bullets, shrapnel, and other metallic objects may cause: a. acoustic enhancement b. comet-tail artifact c. edge enhancement d. mirror image artifact

b. comet-tail artifact

17. Which of the following would be best described as a benign tumor comprised of fat? a. hemangioma b. lipoma c. hamartoma d. oncocytoma

b. lipoma

14. Subluxation denotes: a. synovial joint obstruction b. partial hip dislocation c. rupture of the bursa d. inflammation of the acetabulum

b. partial hip dislocation

22. Fluid within the synovial sheath is indicative of: a. hyperemic flow b. tendosynovitis c. cartilaginous inflammation d. cartilaginous extension

b. tendosynovitis

12. Which of the following best describes the Thompson test? a. the patient lies prone and performs plantarflexion b. the patient lies prone while the symptomatic calf is squeezed c. the patient lies supine and performs plantarflexion d. the patient lies prone and performs dorsiflexion

b. the patient lies prone while the symptomatic calf is squeezed

16. A 6-year old female patient presents to the sonography department for a hip sonogram with irritability, unwillingness to walk, and low-grade fever. Sonographically, you visualize a hypoechoic fluid collection that elevates the joint capsule. What is the most likely diagnosis? a. developmental hip dysplasia b. subluxation c. joint effusion d. hip dislocation

c. joint effusion

inflammation and infection of the skin and subcutaneous tissues

cellulitis

40. Which of the following at the site of a foreign body may produce bright echoes and therefore cause some ambiguity about the correct orientation of the object? a. fluid b. enhancement c. dust d. air

d. air

38. Superficial lipomas may appear as all of the following except: a. hypoechoic to the surrounding tissue b. isoechoic to the surrounding tissue c. hyperechoic to the surrounding tissue d. anechoic to the surrounding tissue

d. anechoic to the surrounding tissue

7. A patient presents with a palpable, oozing mass at the level of the natal cleft. What is the most likely etiology of this mass? a. Pannus cyst b. epidermoid c. hemangioma d. lipoma

d. lipoma

24. Acoustic shadowing caused by bending of a sound beam at the edge of a curved reflector is referred to as: a. mirror image artifact b. indirect artifact c. reflective shadowing d. refractive shadowing

d. refractive shadowing

26. A patient presents to the sonography department with a history of cellulitis on his abdomen. The patient has fever, edema, and complains of focal tenderness in a specific region affected by the cellulitis. Sonographically, you identify a localized complex collection of fluid. What is the most likely diagnosis? a. superficial hemangioma b. subcutaneous carcinoma c. mastitis d. superficial abscess

d. superficial abscess

34. A standoff pad is most useful in imaging: a. deep structures that produce acoustic enhancement b. deep structures that produce acoustic shadowing c. structures that produce refractive shadowing d. superficial structures

d. superficial structures

36. All of the following will aid in the sonographic assessment of an Achilles tendon except: a. the patient lies prone, with his or her feet hanging off the end of the bed b. Both the symptomatic and asymptomatic Achilles tendon should be scanned for comparison c. the entire tendon should be evaluated in sagittal and transverse scan planes d. the patient is scanned standing, with a small amount of pressure placed on the symptomatic side

d. the patient is scanned standing, with a small amount of pressure placed on the symptomatic side

13. Which of the following is true about patients with a lipoma? a. they often complain of pain in the area of the mass b. they are often obese c. they are only slightly tender in the area of the mass d. they feel no pain in the area of the mass

d. they feel no pain in the area of the mass

18. What is the most likely cause of a hip joint effusion in infants? a. tendonitis b. bursitis c. developmental hip dysplasia d. transient synovitis

d. transient synovitis

a congenital anomaly in which the ball of the hip is prohibited from resting appropriately in the natural socket provided for it on the pelvis

developmental dysplasia of the hip

a common cyst found adjacent to a joint or tendon; most often found along the dorsal aspect of the hand, wrist, ankle, or foot

ganglion cyst

the benign enlargement of the male breast; typically located posterior to the areola

gynecomastia

a benign tumor composed of blood vessels

hemangioma

buildup of fluid within the hip secondary to inflammation

hip joint effusion

the largest and most superiorly located pelvic bone

ilium (pelvis)

a benign, fatty tumor

lipoma

inflammation of the breast

mastitis

area located between the groove of the buttocks

natal cleft

a hanging flap of tissue

pannus

cyst located along the natal cleft that is comprised of loose hairs and skin debris

pilonidal cyst

acoustic shadowing caused by bending of a sound beam at the edge of a curved reflector; may be referred to as edge artifact or edge shadowing

refractive shadowing

partial dislocation of the hip

subluxation

cysts commonly found in the scalp, face, neck, trunk, or back; they can be congenital, the result of trauma, or the result of an obstructed hair follicle

superficial epidermal cyst