150 Shades of Radiology

Question 1

Draw and label the anatomy of paediatric elbow XR

Answer 1

Question 2

Describe the salter harris classification of fractures

Answer 2

S - Slipped Epiphysis

A - Above - Fracture above growth plate

L - Lower - Fracture below growth plate

T - Through - Fracture across growth plate

R - Rammed together - Compression

Question 3

When do the ossification centres appear in a child’s elbow?

Answer 3

Capitellum: 2-24 months (1)

Radial head: 3-6 years (3)

Internal (medial) epicondyle: 4-7 years (5)

Trochlea: 8-10 years (7)

Olecranon 8-10 years (9)

External (lateral) epicondyle: 10-13 years (11)

CRITOE: 1, 3, 5, 7, 9, 11

** IF YOU CAN SEE THE TROCHLEA THE INTERNAL EPICONDYLE MUST BE PRESENT - is the most likely # and displaced **

Question 4

Define a Monteggia #

Answer 4

A combination fracture of ulna & dislocation of radial head

Question 5

What is the Radial Neck Alignment Line?

Answer 5

The centre line of the radial neck extrapolated proximally should pass through the centre of the capitellum

If this line is displaced then dislocation of the radius should be suspected

Question 6

What is the difference between a sigmoid and caecal volvulus

Answer 6

Sigmoid volvulus

• arises LLQ, extends towards RUQ
• nil haustra evident
• causes obstruction of distal large bowel hence ascending, transverse and descending colon may be dilated

Cecal volvulus

• arises in the RLQ, extends to LUQ or epigastrium
• will still see haustral
• distal colon usually collapsed and small bowel is distended

Question 7

Describe the classical triad for a bronchial foreign body.

Answer 7

Cough, unilateral wheeze, reduce breath sounds

Question 8

What is the humero-capitellar alignment line?

Answer 8

The line through the anterio humeral cortex and the middle or posterior segment of the capitellum. If line runs anteriorly through the capitellum need to look for a supracondylar #.

Question 9

Extracapsular vs intracapsular NOF

Answer 9

Extracapsular = intertrochanteric

Intracapsular = femoral neck

Question 10

Which type of renal calculi are caused by infection?

Answer 10

Struvite - these are more common in women. (Triple Phosphate Stones)

Question 11

Name 4 features on this XR of cervical spondylosis

Answer 11

Cervical spondylosis is due to degeneration of the discs

As they age, disc fragmentation, desiccation and collapse occurs beginning in the nucleus pulposus

This process results in buckling and bulging of the central annular lamellae and annulus fibrosis with increased mechanical stress at the cartilaginous vertebral margins

Subperiosteal bone formation occurs on the disc margins forming osteophytes on the ventral aspect of the spinal canal

These contribute to stabilising adjacent hyper-mobile vertebral bodies caused by loss of disc material

These bars may be large enough to encroach on neural tissue causing cord compression

Question 12

Differentials for solitary pulmonary nodule.

Answer 12

Question 13

Describe paraneoplastic syndrome.

Answer 13

Question 14

Monteggia vs Galeazzi #

Answer 14

Monteggia - ractured ulna, dislocated proximal radius

Galeazzi - fractured radius dislocated proximal ulna