Musculoskeletal curriculum

The musculoskeletal curriculum is one of our curriculum articles and aims to be a collection of articles that represent the core of musculoskeletal knowledge.

Definition

Topics pertaining to bones, joints, muscles, tendons and ligaments, but excluding the skeletal structures of the head.

Anatomy

Core anatomical topics include:

Upper limb

• bones and muscles:  rotator cuff
• joints:
  • shoulder joint
  • elbow joint
  • wrist joint
• regions and spaces: carpal tunnel

Lower limb and pelvis

• bones and muscles
• joints:
  • hip
  • knee
  • ankle
• regions and spaces: popliteal fossa

Spine and chest wall

Radiological examinations

Plain radiography is the baseline imaging modality in most musculoskeletal problems. Other common musculoskeletal imaging modalities and imaging-guided procedures include:

• CT
• ultrasound: rotator cuff ultrasound
• MRI
• arthrography

Pathology

Trauma

Upper limb

• shoulder injury
  • acromioclavicular dislocation
  • glenohumeral dislocation
  • Hill-Sachs and bony Bankart lesions
  • glenoid labrum injuries:
    • SLAP lesions
  • glenohumeral ligament injuries
  • rotator cuff tear grading
  • subcoracoid impingement

• arm injury
  • proximal humeral fracture
  • distal humeral fracture
  • radial head fracture
  • ulnar fracture
  • elbow dislocation
  • fracture-dislocations of the radius and ulnar:
    • Monteggia fracture-dislocation
    • Galeazzi fracture-dislocation
    • Essex-Lopresti fracture-dislocation
  • Colles fracture
  • other distal radial fractures
    • Barton fracture
    • Smith fracture
    • chauffeur fracture
• wrist injury
  • scaphoid fracture
  • carpal instability
    • scapholunate dissociation
      • scapholunate advanced collapse
    • DISI
    • VISI
• hand injury
  • gamekeeper thumb
  • mallet finger
  • volar plate avulsion injury

Lower limb

• pelvic and hip injury
  • pelvic avulsion injuries
  • pelvic fractures
  • femoral neck fractures
    • Garden classification
  • dislocation of the hip
    • anterior dislocation
    • posterior dislocation
• knee injury
  • avulsion fractures of the knee
  • patella fractures
• ankle injury
  • Weber ankle fracture classification
  • triplanar fracture
  • pilon fracture
  • tillaux fracture
  • Maisonneuve fracture
• foot injury
  • avulsion of the 5th metatarsal
  • calcaneal fracture
  • Jones fracture
  • Lisfranc injury

Spine

• cervical spine fractures
  • Jefferson fracture
  • odontoid process fracture
  • hangman fracture
  • clay-shoveler fracture
  • flexion teardrop fracture
  • extension teardrop fracture
  • hyperflexion fracture-dislocation
  • burst fracture
  • wedge fracture
  • facet dislocation
  • anterior subluxation
  • atlantooccipital dissociation
• thoracolumbar spine fractures
  • compression fracture
  • burst fracture
  • Chance fracture

Bone tumours

There are a bewildering number of bone tumours. Below are listed those considered important either because they are common, or because they are important or because they have specific imaging findings. For a more complete list, please refer to: bone tumours.

• bone-forming tumours
  • osteoid osteoma
  • osteoblastoma
  • bone island (enostosis)
  • osteoma
  • osteosarcoma
• cartilage-forming tumours
  • enchondroma
  • osteochondroma
    • hereditary multiple exostoses
  • chondrosarcoma
• fibrous bone lesions
  • fibrous dysplasia
  • ossifying fibroma
  • malignant fibrous histiocytoma (MFH)
• bone marrow tumours
  • Langerhans cell histiocytosis
  • multiple myeloma
  • Ewing sarcoma
  • primary bone lymphoma
• bony metastases
• other bone tumours or tumour-like lesions:
  • simple bone cyst
  • aneurysmal bone cyst
  • giant cell tumour of bone
  • chordoma

Soft tissue tumours

• malignant fibrous histiocytoma
• liposarcoma
• synovial cell sarcoma
• rhabdomyosarcoma
• pigmented villonodular synovitis
• lipoma arborescens

Arthritides

• general
• degenerative
  • osteoarthritis
• inflammatory
  • erosive osteoarthritis
  • autoimmune arthritis
    • rheumatoid arthritis
    • SLE
    • scleroderma
    • dermatomyositis
  • seronegative arthritis:
    • ankylosing spondylitis
    • psoriatic arthritis
    • reactive arthritis

• metabolic and endocrine
  • gout
  • CPPD
  • haemochromatosis
  • Wilson's disease
  • ochronosis
  • amyloid deposition
  • acromegaly

Infections

• septic arthritis
• osteomyelitis
  • pyogenic
    • Brodie abscess
  • tuberculous
    • Pott Disease
  • fungal
  • syphilitic

Congenital and developmental

• upper limb
  • Madelung deformity
• lower limb
  • tarsal coalition
• spine and chest wall
  • pectus carinatum and excavatum
  • rib anomalies
  • scoliosis
• general
  • melorheostosis
  • osteopetrosis
  • osteopoikilosis

Sports medicine

Sports medicine encompasses more than just musculoskeletal disease but in radiology, this is the main interaction with this speciality. The following topics concentrate on overuse injuries but bearing in mind that sports medicine encompasses some of the above topics but especially trauma. It should also be noted that many of these conditions can occur outside the sports medicine setting.

Upper limb

• shoulder girdle
  • tendinopathy - biceps brachii long head, rotator cuff
  • calcific tendinitis
  • tendinopathy/tear
• long head of biceps tendinopathy/tear
• glenoid labral tear
  • SLAP tear
• adhesive capsulitis
• pectoralis major tear
• osteolysis of the distal clavicle
• quadrilateral space syndrome
• stress fracture/reaction of the proximal humerus

Thorax

• costochondritis
• sternoclavicular joint injury
• rib stress fracture
• rib tip syndrome

Pelvis and lower limb

• pelvis and hip
  • bursitis - trochanteric bursitis
  • , ischial bursitis, iliopsoas
  • tendinopathy/enthesopathy
    • gluteal injuries
    • - gluteus minimus/medius, tensor fascia latae enthesopthy
    lata
  • piriformis syndrome
  • sciatic nerve compression
  • hip labral injury
  • femoro-acetebular impingement
  • anterior hip impingement
  • transient osteoporosis of the hip
  • adductor injury
  • iliopsoas injury
  • sportsman's hernia
  • osteitis pubis
  • snapping hip
  • stress fracture - femoral neck, pubic rami
• thigh
  • hamstring injury
  • quadriceps injury
  • meralgia parasthetica
• knee
  • ligament tear - anterior cruciate ligament tear
  • , posterior cruciate ligament tear
  • , medial collateral ligament tear
  • , lateral collateral ligament tear
  • posterolateral corner injury
  • posteromedial corner injury
  • meniscal tear
  • patellar maltracking
  • patellar dislocation
  • osteochondritis dissecans
  • chondromalacia patellae
  • patella tendinopathy
  • tendinopathy - quadriceps tendinopathy, patellar, popliteus
  • medial plica syndrome
  • iliotibial band friction syndrome
  • pasbursitis - pas anserinus bursitis
  • , prepatellar bursitis
  • , suprapatellar bursitis
  • popliteus strain/tendinopathy
• leg
  • medial tibial stress syndrome
  • stress fracture - tibia and fibula
  • gastrocnemius/soleus strain
  • popliteal artery entrapment
• ankle
  • ligament injury - lateral collateral ligament injury, medial collateral, syndesmosis
  • medial collateral ligament injury
  • syndemosis injury
  • anterior ankle impingement
  • - anterior, posterior ankle impingement
  • Achilles tendon rupture
  • tendinopathy - Achilles tendinopathy
  • calcaneal bursitis
  • tibilas, tibialis posterior tendinopathy
  • , flexor hallucis longus tendinopathy, peroneal
  • peroneal tendinopathybursitis - calcaneal, adventitial​
  • stress fracture - calcaneal, distal fibular, medial malleolar, talar
  • sinus tarsi syndrome
• foot
  • stress fracture - navicular, cuboid, cuneiform, metatarsal, sesamoid
  • accessory navicular syndrome
  • plantar fasciitis
  • cuboid syndrome
  • sesamoiditis
  • Haglund syndrome