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MSK > 32. Imaging of the Lower Limb > Flashcards

32. Imaging of the Lower Limb Flashcards

1
Q

Which is the best way to position the feet for a AP hip xray?

A

Feet turned in - shows the femoral neck well this way

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2
Q

What’s is the best position to get a lateral view x-ray of the hip?

A

To raise the leg up or turn it out to get a good view of the femoral neck.

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3
Q

Name the places on this AP paediatric hip x-ray (2 years old)

A
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4
Q

What is the Y shaped epiphyseal plate that occurs at the junction of the ischium, ilium and pubis in a skeletally immature patient called?

A

Triradiate cartilage

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5
Q
A
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6
Q

What does the AABCSS search strategy stand for?

A

Adequacy (is everything included)
Alignment (check alignment lines)
Bones - check for lytic lines (darker) or sclerotic (lighter),
Cartilage - check for symmetry, no signs of dislocation or subluxation
Soft tissues - bladder stones, calcification of prostate
Satisfaction of search - double check

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7
Q

What is the line between the medial aspect of the femoral neck and the inferior aspect of the pubic ramus called?

A

Shenton’s line

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8
Q
A
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9
Q

How do traumatic avulsion fractures occur?

A

When the tendon is stronger than the developing apophyses - pulls off a piece of bone with it.

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10
Q

Which muscles attach to these parts of the pelvis?

A
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10
Q

Which muscles attach to these parts of the pelvis?

A
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11
Q

Normal or abnormal?

A

Abnormal

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12
Q

What is seen a P who has osteoarthritic changes on an X-ray?

A

Reduced joint space
Osteophtes
Subchondral sclerosis

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13
Q

Which is the best investigation of choice in major trauma? Why?

A

CT - can quickly diagnose active bleeding, whole body CT can detect injuries and complex fractures - can be 3D reconstructed.

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14
Q

Which is the best investigation for evaluation of avascular necrosis?

A

MRI

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15
Q
A
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16
Q
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17
Q

What is it called when contrast is injected into the joint under MRI?

A

MRI arthrography

18
Q

Which investigation is best for detecting hip effusions, synovitis, adductor tendon pathology and greater trochanteric pain?

A

US

19
Q

What is a tripartite patella?
How do you know it isn’t pathologic?

A

A normal variant of a patella - can have 2 or more bones in the patella sometimes = multipartite.

Can tell its not pathology by the fact that it has rounded edges

20
Q

What is found underneath the patella tendon?

A

Hoffa’s fat pad

21
Q
A
22
Q

What do you need to be aware of in X-rays of children and their knees?

A

The tibial tubercle can appear fragmented - this is normal.

23
Q

What is it called when fat is released from the bone marrow in a fracture, which then mixes with blood in the joint capsule of the knee?
How can you identify this on X-Ray?

A

Lipohaemarthrosis

On Xray - is a darker area above because the fluid/blood floats on top of the fat.

24
Q

When is a CT of the knee done?

A

Usually for evaluation of complex fractures - specialist referral.
Also done when P cannot have MRI

25
Q

On T1 MRI - is fat bright or dark?

A

Bright

26
Q
A
27
Q

What is common pathology of the menisci of the knee?

A

Tears and degeneration

28
Q

What are signs of ACL tear?

A

Disruption to some or all of the ACL fibres
Bucking of the ACL
May see avulsion of tibial spines
May see anterior tibial translation relative to the femur

29
Q
A
30
Q
A
31
Q

Which ligaments of the ankle protect against eversion?

A

Syndesmotic ligaments - Anterior inferior tibiofibular, posterior inferior tibiofibular, interosseous ligaments.

32
Q

Which ligaments of the ankle stabilise and protect against inversion?

A

The lateral ligaments -

ATFL (Anterior tibiofibular ligament)
PTFL
Calcaneofibular ligaments

33
Q
A
34
Q

What on these X-Rays looks abnormal?

A

Lateral talar shift (=deltoid ligament rupture)
Oblique fracture of the fibula
Posterior malleolus fracture
Subluxation

35
Q

What pathology of the achilles can be seen in each of these photos?

A
36
Q

When is the foot likely to be X-rayed?

A

Examining for trauma or arthritic changes

37
Q
A
38
Q
A

R Hand image - 5th metatarsal inferiorly - break (transverse line bad, longitudinal line not necessarily pathology)

39
Q

What are the symptoms of Charcot foot?

A

Lack of pain sensation
Dislocations / subluxations due to ligament laxity
Joint space is increased
Metatarsal joints are disrupted
Dislocated tarsal bones can be seen

40
Q

Which pathologies can be seen in the following X-rays?

A
41
Q

When is a CT of the foot done?

A

To assess complex fractures - such as calcaneal fractures

Enables surgical planning

42
Q

What soft tissue tumour can be found in the foot?

A

Morton’s neuroma

43
Q
A

MSK (21 decks)

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