Chapter 14: Musculoskeletal Imaging and Superficial Structures

19. clinical findings of a bakers cyst may mimic those of a/an: a. arteriovenous malformation b. deep vein thrombosis c. knee fracture d. ganglion cyst

B

____ is infection and subsequent inflammation of the skin and subcutaneous tissue.

cellulitis

______, which connect bones to other bones, appear echogenic as well.

ligaments

12. which of the following would be best described as a benign tumor compromised of blood vessels? a. hemangioma b. lipoma c. hamartoma d. oncocytoma

A

pannus

a hanging flap of tissu

Baker cyst

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

_____ around the foreign body will appear as a hypoechoic area adjacent to the structure,it is important to note that air at the site of a foreign body may produce bright echoes and therefore cause some ambiguity about the correct orientation of the object.

inflammation

what is the clinical findings of cellulitis

tender and warm to the touch

13. which of the following transducers would be best suited to sonographically assess for a splinter in a patients hand? a. high frequency linear array transducer b. low frequency curved array transducer c. high frequency linear array transducer d. low frequency linear array transducer

A

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

A

hemangioma

a benign tumor composed of blood vessels

what are the clinical findings of tendonitis

pain painful region may be swollen painful region may be warm to the touch

what are the clinical findings of a tendon rupture

pain swelling edema

what is cellulitis most oftenly caused by

staphylococcus aureus and strephtococcus pyogenes

what is the sonographic appearance of a lipoma

superficial lipomas may appear hypoechoic, isoechoic, or hyperechoic compared to surrounding tissue

_____ appears as a thickened and hypoechoic tendon,while ____ will appear as localized,enlarged hypoechoic area within the tendon. _____flow may be noted within the tendon as well.

diffuse focal hyperemic

what are the sonographic findings of tendonitis

diffuse: enlarged, hypoechoic tendon focal: localized, enlarged hypoechoic area within the tendon fluid may be noted hyperemic flow may be noted

a _____ may also be referred to as a tear. Can be complete or partial.

tendon rupture

11. which of the following would be best described as a benign tumor compromised of fat? a. hemangioma b. lipoma c. hamartoma d. oncocytoma

B

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

B

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

B

16. 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

24. 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

26. all of the following will aid 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 in the erect position, with a small amount of pressure placed on the symptomatic side

D

2. 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 the touch

A

what are the sonographic findings of a tendon rupture

Partial tears: appear as focal hypoechoic areas within the tendon Complete: seen as anechoic or heterogenous area within the tendon, often indicative of a hematoma; may also be sonographically identified as refractive shadowing in the area of the separated tendon, with fat, a hematoma, or granulomatous material filling in the gap created by the tear

____ can have a wide range of sonographic features. They are often complex and have a peripheral rim of hyperima that can be detected with color Doppler

abscesses

refractive shadowing

acoustic shadowing caused by bending of a sound beam at the edge of a curved reflector

a ____ is a common mass found along the dorsal aspect of the hand and wrist.

ganglion cyst

27. which of the following best describes a negative thompson test? a. the calf is squeezed and the foot should plantarlfex in a patient who does not have a complete tear in 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 in 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 in the achilles tendon

A

4. a cystic mass located within the popliteal fossa is most likely a: a. baker cyst b. thompson cyst c. ganglion cyst d. lipoma

A

7. to better evaluate the achilles tendon, the patient should be placed in what positon? a. prone b. supine c. right lateral decubitis d. left lateral decubitis

A

20. 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

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

C

3. what test can be performed to determine a torn achilles tendon a. mcburnery test b. mcdonald test c. thompson test d. baker test

C

5. 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

6. 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

lipoma

a benign fatty tumot

inflammation of a tendon, tendonitis, can be diffuse or focal. It may be caused by _____ or _____

overuse strain

10. 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

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

A

18. a complicated baker cyst may contain a thin flap of tissue referred to as: a. pannus b. plicae c. septation d. lipoma

A

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

D

30. 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

9. which of the following is true concerning 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 tendon in the area of the mass d. they feel no pain in the area of the mass

D

the ____ is the most commonly injured ankle tendon. It is located posterior to and connects the calf muscle to the posterior surface of the heel, or calcaneus. Both tendons should be scanned for comparison

achilles tendon

how is a ganglion cyst treated

an injection of cortcosteroids

what are the sonographic findings of a bakers cyst

anechoic mass with posterior enhancement complicated baker cysts may contain echogenic fluid, pannus, debris, or septations

what is the sonographic appearance of a ganglion cyst

appears as an incompressible, anechoic mass with acoustic enhancement.

what are the clinical findings of a bakers cyst

asymptomatic focal tenderness in the popliteal fossa

a ____ is a benign fatty tumor

lipoma

____ appear sonographically a hypoechoic tissue that contains linear, echogenic stands.

muscles

Achilles tendon

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

patients will present with posterior ankle pain. The ____ can be performed to see if there is a complete tear of the tendon

thompson test

____ is a benign mass that is compromised of vascular channels. Blood flow will be detectable with color Doppler, and are typically heterogenous in appearance

hemangioma

cellulitis

inflammation and infection of the skin and subcutaneous tissues

tendosynovitis

inflammation of the tendon and synovial tendon sheath

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

C

fluid within the synovial sheath is often indicative of ____.

tendosynovitis

what are the clinical findings of a ganglion cyst

it may be hard to the touch and painful.

what is the sonographic findings of cellultitis

hypoechoic, edematous strands within the soft tissue

8. 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 plantatflexion d. the patient lies prone and performs dorsiflexion

B

a _____ or popliteal cyst is located in the popliteal fossa behind the knee. these result from the accumulation of synovial fluid from a weakening in the joint capsule of the seen as seen in conditions such as rheumatoid arthritis. A channel may be seen connecting the cyst to the joint space

baker cyst

14. 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. bakers cyst d. ganglion cyst

C

Thompson test

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

Most foreign bodies appear as hyperechoic structure with some degree of posterior shadowing. Bullets, shrapnel, and other metallic objects may be cause a _______ as well.

comet tail artifact

how is the thompson test performed

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

___ may be noted as echogenic, fibrous structure connecting muscle to bone. The transducer must be parallel to correctly image

tendon

22. 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

23. tendons sonographically appear as: a. echogenic, fibrous structures connecting muscle to bone b. echogenic, fibrous structures connecting bone to bone c. hypoechoic, linear arrangements with hyperechoic tissue d. hyperechoic linear tissue that contains linear, echogenic strands

A