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Part 4 Boards X-ray > AP Lumbopelvic > Flashcards

AP Lumbopelvic Flashcards

1
Q

Check the lower 1/3 of the SI joints

A

AS
Osteitis condensans ilia
DJD

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2
Q

AS

A

Bilateral fusion of the SI joints
Bilateral sacroilitis
Enteropathic arthritis
Gost joints (SI joint fused) and star sign (calcif sup SI joint)

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3
Q

Osteitis Condensans Ilia aka

A

Hyperostosis triangularis

Osteitis Triangularis

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4
Q

Osteitis condensans ilia

A

Multiparous females

20-40

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5
Q

Bilateral symmetrical trianglular sclerotic areas on the lower half of the ilium

A

Osteitis condensans ilia

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6
Q

Osteitis condensans ilia

A

Joint space is spared
Self-resolving
No labs

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7
Q

Case management osteitis condensans ilia

A

Trochanteric belt for stability

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8
Q

DJD lower SI joint

A

Sclerosis ilium side
>40
Bilateral whitening on ilia and sacral sides of SI joint

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9
Q

3 other possiblities aside from DJD

A

Early AS
PA
Reactive arthritis

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10
Q

Compare one ilium to the other for alterations in color or shape

A

Color - whiter = blastic mets, pagets
Darker - lytic mets, mm, benign bone tumors
Shape - PFF - paget’s, fractures, fibrous dysplasia

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11
Q

Find L4 and T12 - check for

A

Lumbarization or sacralization

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12
Q

L5 TPs may fuse or form joints with the sacrum

A

Sacralization

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13
Q

6 lumbars (1st sacral segment appears like a lumbar segment)

A

Lumbarization

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14
Q

Check the sacrum for alterations of color, shape, spina bifida, and knife clasp deformity

A

Color whiter - blastic mets or pagets
Color darker - lytic mets, mm, benign bone tumors (GCT)
Shape - PFCF - paget’s fractures congenital anomalies, fibrous dysplasia
Spina bifida - vertical radiolucency
Knife clasp - elongated L5 SP going into spina bifida of sacrum

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15
Q

Check the square block head system from bottom up

A 
Pedicles = eyes
SP = nose
TP = ears
Body = head
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16
Q

Check L5/S1 facets for

A

Tropism/asymmetrical facets

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17
Q

Check the body (head)

A

Hemivertebrae

Butterfly vertebra

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18
Q

Hemivertebrae

A

Half a VB
Failure of development of a lateral ossification center
Isolated wedged vertebra causes a congenital or structural scoliosis
Associated with scrambled spine appearance - multiple curvatures

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19
Q

Butterfly vertebra

A

Failure of the center of teh VB to ossify properly

NEVER creates a scoliosis

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20
Q

Butterfly vertebra aka

A

Receded cortical margins
Indented cortical endplates
Sagittal cleft defect
Increased intrapedicular distance

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21
Q

A crushed/smooshed head

A

Malignancy - mm/fx

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22
Q

A darker head

A

Mm or lytic mets

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23
Q

A brighter head

A

Pagets or blastic mets

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24
Q

Check the pedicles (eyes)

A

Pedicle agenesis - contralateral pedicle hypertrophy and sclerosis (superpedicle) - other pedicle obviously whiter
Lytic mets of pedicle

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25
Q

Lytic mets of pedicle

A

Missing pedicle with contralateral side of no color change

Associated with winking owl sign

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26
Q

Check the spinouses (nose)

A

Spina bifida
Fractures
Missing

27
Q

Spina bifida

A

Vertical radiolucency with smooth cortical margins around un-united pieces

28
Q

Fractures

A

Double spinous sign

29
Q

Missing

A

Agenesis
Malignancy
Surgery

30
Q

Check the TP (ears)

A

Fracture
Non-union
Scoliosis

31
Q

Fracture TP

A 
Bone displaced from itself
Fulcrum fracture
Psoas and quad lumborum attachment
Jagged radiolucency
No cortical margins
Displacement
32
Q

Non-union TP

A 
In place
No symptoms
Smooth
Cortical margins present
No displacement
33
Q

Scoliosis named for

A

Largest or major curve

Named on side of convexity

34
Q

Rotatory scoliosis

A

Spinouses deviate away from convexity

35
Q

Simple scoliosis

A

Spinouses deviate towards convexity

36
Q

M/c scoliosis

A

Adolescent idiopathic simple scoliosis - adams ortho test

37
Q

X-ray lines scoliosis

A

Cobb’s

Risser ferguson’s

38
Q

Case management 25 and younger scoliosis

A

<20 - adjust and monitor. With fisser’s sign and wrist films
21-40 refer to orthopedist - don’t adjust - milwaukee brace
>40 surgical consultation

39
Q

Scoliosis can lead to

A

DJD
Cardiopulmonary compromise
Postural fatigue

40
Q

Check the ribs - m/c benign tumor

A

Fibrous dysplasia

41
Q

Check the ribs

A

Fractures

Lytic mets

42
Q

Fractures ribs

A

Most common condition

Bone displaced from itself

43
Q

Check the ribs lytic mets

A

Most common malignancy

Look for teeth marks in the bone

44
Q

Check the soft tissue from the ribs down to the iliac crest

A 
AAA
Renal artery
Gallstones
Kidney stones
Staghorn calculi
Pancreatic calcification
Calcified spleen
Splenic artery calcification
Congenital anomaly
45
Q

AAA on AP view appears like a

A

Half moon shape from the sides of L2-4

Curvilinear

46
Q

Radiographic signs AAA

A

Aortic dilation
Curvilinear calcification
Fusiform appearance

47
Q

Special test AAA

A

Doppler ultrasound
Diagnostic US
Ultrasonography
CT

48
Q

AAA refer to

A

Cardiovascular specialist

49
Q

Renal artery

A

Calcification - smaller cheerio

Aneurysm - larger cheerio

50
Q

Gallstones

A 
90% can’t be seen (cholesterol)
Bag of marbles right upper side
R upper quadrant pain
Steatorrhea
Inc after fatty meal
Long hx poor diet
51
Q

Location at L1-2
Start at iliac crest and work your way up the film
Black center outlined in white
Affiliated with 9 F’s

A

Gallstones

52
Q

Gallstones referral pain

A

To inferior border of the right scapula (viscerosomatic)

53
Q

Murphy’s inspiratory arrest

A

Gallstones

54
Q

Case management gallstones

A

Gastroenterologist
Small - let pass or lithotripsy
Large or blocking biled duct = surgery (take out Gb)

55
Q

Special test

A

Ultrasound and cholecystogram

56
Q

Kidney stones

A 
90% show up
Laying down pisses it off
Tx same as gallstones
Refer nephrologist
Pyelogram ureters
57
Q

Location L1-2, start at the SI joint and work your way up the film
Solid white in color

A

Kidney stones

58
Q

M/c caslicum oxalate
Murphy’s punch
Bloo in urine, change in urinary frequency

A

Kidney stones

59
Q 
Calcification of the renal calyces
Solid white in color
Larger than stone
Does not affect ureters
Surgery
A

Staghorn calculi

60
Q

Spotty white calcification that crosses the midline at L1-2 area

A

Pancreatic calcification

61
Q

Upper left quadrant T12-L2 area

Does not cross the midline

A

Calcified spleen

62
Q

Splenic artery calcification

A

Worm

63
Q

Congenital anomaly order affection L5/S1 from most significant to least

A 
Knife clasp
Lumbosacral transitional segment
Facet tropism
Spina bifida L5/S1
Enlarged TP of L5

Part 4 Boards X-ray (22 decks)

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